Preparing for a home sleep study

[WisNaeMe]

I’ve been asked to undertake a home sleep study by my family doctor (as screening prior to possible referral to a sleep clinic).

I undertook an independent home sleep study some six months ago (AHI 37), was diagnosed with sleep apnea and have been self-treating with APAP since then in anticipation of some future referral to a sleep specialist.

Is it advisable to stop this therapy for a period prior to doing a home sleep study, and if so, for how long?

I don’t want my current treatment to color the results of a sleep study, by possibly under-reporting the severity of my sleep apnea in its untreated state due to some residual benefit from my PAP therapy.

I’m happy to play along with my doctor’s plan regards home sleep study, despite already being diagnosed - mainly so I’m pre-wired into the ‘system’ (UK NHS) and so more able to quickly draw down addition medical support should needs must (none of us are getting any younger!).

[PeaceLoveAndPizza]

CPAP does not cure apnoea, it only treats it. I am not qualified to offer a medical opinion, but I would personally use the CPAP up to the home test or stop one or two nights prior.

As we all learn over time, most doctors know the square root of bugger-all about sleep apnoea, but playing along with their recommendations is part of the game.

[Dormeo]

Here's a study of this question:

https://pubmed.ncbi.nlm.nih.gov/25487311/

The conclusion:

There is some evidence that CPAP washout exists in patients with a stable BMI throughout the follow-up period. However, the intensity and duration of this effect remains unclear. Within the limitations of the present study, it seems reasonable to maintain a washout period of 1 week, in case alternative treatments options are considered and especially when a baseline PSG (and subsequent repeat PSG after treatment) is needed in case of clinical trials.

In your place, I'd stop CPAP for one week before the test.

[WisNaeMe]

PeaceLoveAndPizza, Dormeo - thanks for your replies. It confirms what I suspected and that maybe I should hedge my bets and stop PAP therapy a few days before the sleep study - in spite of any inconvenience and possible discomfort!

I think I’d read elsewhere, of someone being called back to a sleep clinic for a further titration/PSG and being advised to stop PAP therapy for three days prior to attending - so I’ll maybe go with that timeframe.

My own remaining problems with my Apnea are around FLs and RERAs, which this test won’t even pick up. So I will continue to self-treat - I’ve just bought a Resmed AirCurve 10 Vauto which will hopefully help me manage these residual issues. I've no real expectations from this engagement with the Health Service, just going through the motions - though they may yet surprise me!

Thanks again.

[Dormeo]

Let us know how it goes, if you have a chance. I'll be curious.

[WisNaeMe]

On chasing up the department organising my home sleep study to find out if and how long I needed to be off PAP therapy prior to it. I inadvertently short-circuited the process and have been referred directly to the sleep clinic for treatment - no study required! (as I'd already had one done and on-file with them). So eventually a bit of common-sense has prevailed ...and it's only take eight months!

Anyway, if anyone fined themselves in this situation of a needing a repeat PSG - the clinic advised that they typically ask patients to come off PAP therapy for 7 to 10 days prior to any repeat PSG. Though I think that would be a bit of a stretch for most of us!

In the meantime, I'll continue to self-treat and won't be holding my breath (so to speak) while waiting on the appointment.

[Deborah K.]

We can help you before, or maybe instead of your second sleep study.  If you download Oscar, a free, really good sleep reporting program, you can see daily reports of your night's sleep and post them here.  With that data folks here can help you dial in better sleep.

[WisNaeMe]

Hi Deborah.
I've been using OSCAR since I started on APAP back October. Been waiting since then for a sleep clinic referral. I was aware of the delays here in UK NHS; the usual, demand for services outstrip supply and respiratory medicine departments still clearing their waiting lists post-covid.

Since I was pretty sure I had Sleep Apnea back then, I decided to get an independent sleep-study and buy a machine to start the ball rolling . Been doing OK on it - AHI <1, but have been having persistent underlying UARS type problems, which were not well-treated with the machine I initially bought (a Lowenstein), as the ResMeds were still in short supply (Covid, 'foamgate', shortage of chips, etc...)

I'd literally just taken delivery of an AirCurve 10 Vauto from the US to deal with the UARS, when I got word that I had been referred to the clinic! My first night on the Vauto, was last night and seemed to go OK (AHI 0.1).

I'm hoping I can get this well managed before I actually see a sleep consultant. I don't want to be left in a position whereby it's one step forward, two steps back - that I end up back on APAP, in order to demonstrate I have UARS and need bi-level (...are the even believers in UARS?). I think there's a reluctance to prescribe bi-level/ASV/etc., within both the US medical model and here the NHS - with cost maybe being too much to the fore...

I'd started another thread a couple of days ago in anticipation of needing help with the Vauto and the move from APAP to Bi-level. (See link)

https://www.apneaboard.com/forums/Thread...d-Bi-Level

Got some good early advice there - shoutout to PeaceLoveAndPizza and staceyburke for responding so quickly.

Feel free to chip in on that thread - all help gratefully received!