new sleep study titration??

[restful]

Hi all,

My treatment is going very well.  I have zero issues with my equipment.  I have read numerous threads on here about settings and numbers and I am tuned in very well.

Here is my question.

I had a follow up appointment at my sleep clinic last week.  The doctor barley talked to me and didn't review any of my numbers.  He said I needed a new sleep study titration.  It has only been a year and a half since my last one.  I asked why and he mumbled something about I gained a few pounds (I have gained about 5 pounds).  Is this really necessary?  I don't have full coverage insurance so I will have co-pays for all of this.  Are there any issues if I don't go?

[Melman]

Welcome to the forum. If your apnea is well controlled and you feel well there is, in my opinion, nor reason for a titration study. What model Resmed do you have? If you have an Airsense10 autoset or an S9 auto it can be put in auto mode with a pressure range of 6-20 and you can self titrate with our help. I see you have OSCAR. Before doing anything, I suggest you post a daily chart following the instructions in the links below.

[DeepBreathing]

G'day Restful. Welcome to Apnea Board.

I'm not making any allegations here, but does the doctor get a cut of the lab fees for the test? I think that sometimes (often) there is a financial incentive for doctors to over-service, leaving their patients poorer but with no better treatment. If your AHI is regularly under 5 and you feel well rested and otherwise well, then there is absolutely no apparent reason for another test.

As Melman said, an autoset machine can do a very good job at self-titration. What's more, it will adjust as necessary through the night and over time as your needs change (eg if you gain or lose weight). A titration test in a lab is just a snapshot in time, in an alien environment and wired up to 19 different probes and sensors. How can that possibly provide a sensible result on which to base your settings forever (or at least until the doc's kid needs to see the orthodontist again).

Are there any issues if I don't go?

Do you own your machine, or is it still under some sort of rent-to-buy option? If the latter the insurance company might stick its nose in. The other possible issue is if you need a certificate for commercial driver or aircraft license. If these things don't apply then tell him (in the nicest possible way) where to stick his test.

[WhyMe]

Seems to me that a new titration test would only be needed if you were having problems with your therapy. I can’t imagine what purpose would be served otherwise, but then again, I’m not a doctor, so what do I know about it? ?

[restful]

Welcome to the forum. If your apnea is well controlled and you feel well there is, in my opinion, nor reason for a titration study. What model Resmed do you have? If you have an Airsense10 autoset or an S9 auto it can be put in auto mode with a pressure range of 6-20 and you can self titrate with our help. I see you have OSCAR. Before doing anything, I suggest you post a daily chart following the instructions in the links below.

I have an Airsense10 Autoset.  Will get some charts posted in the near future.  

G'day Restful. Welcome to Apnea Board.

I'm not making any allegations here, but does the doctor get a cut of the lab fees for the test? I think that sometimes (often) there is a financial incentive for doctors to over-service, leaving their patients poorer but with no better treatment. If your AHI is regularly under 5 and you feel well rested and otherwise well, then there is absolutely no apparent reason for another test.

As Melman said, an autoset machine can do a very good job at self-titration. What's more, it will adjust as necessary through the night and over time as your needs change (eg if you gain or lose weight). A titration test in a lab is just a snapshot in time, in an alien environment and wired up to 19 different probes and sensors. How can that possibly provide a sensible result on which to base your settings forever (or at least until the doc's kid needs to see the orthodontist again).

Are there any issues if I don't go?

Do you own your machine, or is it still under some sort of rent-to-buy option? If the latter the insurance company might stick its nose in. The other possible issue is if you need a certificate for commercial driver or aircraft license. If these things don't apply then tell him (in the nicest possible way) where to stick his test.

That was my first thought too, unfortunately.  I am not sure if the doctor gets a cut of the study, but they would get paid for the post study follow-up.  

I own the machine.  Don't need any certificate like that.  My AHI is pretty low.  Normally less than 2.  

Seems to me that a new titration test would only be needed if you were having problems with your therapy.  I can’t imagine what purpose would be served otherwise, but then again, I’m not a doctor, so what do I know about it? ?

I agree.