08-30-2015, 09:18 AM
Sleep Study for night time workers
I finally went through exposure therapy for fear of masks and was ready to get set up on on a cpap/bipap machine. I went to the sleep study cpap titration and he never put the dang thing on because I only slept 2-hours. I work the night shift, and as much as I tried, I couldn't get to sleep. The night before the study, I got 4-hours of sleep, and when I went in, I was dog tired. But after 2-hours of sleep, I was wide awake. I've been trying to get my central sleep apnea dealt with almost a year and now. I'm out of ideas. My insurance won't pay for another study, so I'm stuck on oxygen, which hasn't helped with the insomnia, and daytime tiredness. I don't understand why this is so hard, my husband had his cpap titration the first night in a split study and a week later had the machine. I'm about to throw my hands up and quit. I was thinking about auto titration cpap/bipap machines but do you need a titration study before hand? Any ideas? 
RE: Sleep Study for night time workers
Have you talked to the sleep center to see if you can do another study since the first one had issues? There are home studies. Which are less expensive but not as comprehensive as a lab study.
If you understand the basics you can buy a previously owned machine and adjust it yourself. In a nutshell, a titration study is used to see what CPAP pressure alleviates apnea. You can eventually narrow down what you need on your own. In fact, it is what most of us are doing now.
RE: Sleep Study for night time workers
The downside of an incomplete sleep study is that your insurance may not pay for a PAP machine without the study.
Also, not having a split night study does not determine the nature of the apnea -- Obstructive, Central, Mixed...
You might end up with a Auto PAP machine that is not right for you if it turns out you have central or mixed apnea that requires an ASV PAP machine to treat it.
Why is it difficult in your case -- fairly obvious that your work schedule interfered.
RE: Sleep Study for night time workers
julrez9,
Some sleep centers have provisions for people that work shifts. If you are used to sleeping during the day, then ask for a daytime sleep study.
I also would check with insurance again and explain the situation as to why you were unable to sleep. I do know that they require you to sleep for a minimum of 2 hours, or you would have to have the test repeated.
If your looking for insurance to pay for your pap machine, you will most likely need that sleep study done. If you slept for at least 2 hours, they should have enough data. Ask your doctor about it, maybe he will write a script based on the 2 hours. It's worth a try.
RE: Sleep Study for night time workers
(08-30-2015, 09:18 AM)julrez9 Wrote: I finally went through exposure therapy for fear of masks and was ready to get set up on on a cpap/bipap machine. I went to the sleep study cpap titration and he never put the dang thing on because I only slept 2-hours. I work the night shift, and as much as I tried, I couldn't get to sleep. The night before the study, I got 4-hours of sleep, and when I went in, I was dog tired. But after 2-hours of sleep, I was wide awake. I've been trying to get my central sleep apnea dealt with almost a year and now. I'm out of ideas. My insurance won't pay for another study, so I'm stuck on oxygen, which hasn't helped with the insomnia, and daytime tiredness. I don't understand why this is so hard, my husband had his cpap titration the first night in a split study and a week later had the machine. I'm about to throw my hands up and quit. I was thinking about auto titration cpap/bipap machines but do you need a titration study before hand? Any ideas?
I re-read your original post.
Question: How do you know you have central apnea?
If you do have central apnea, then an auto pap or bilevel machine will not help; and may even make CSA worse. And auto PAP does not increase pressure if it detects a central event.
Question: Who prescribed oxygen for you? Why are they not seeking an alternative approach such as an ASV machine?
08-30-2015, 09:11 PM
(This post was last modified: 08-30-2015, 09:17 PM by TyroneShoes.)
RE: Sleep Study for night time workers
(08-30-2015, 11:04 AM)justMongo Wrote: The downside of an incomplete sleep study is that your insurance may not pay for a PAP machine without the study.
Also, not having a split night study does not determine the nature of the apnea -- Obstructive, Central, Mixed...
My home study specifically listed Obstructive, Central, Mixed..., and hypops. I have it all in B&W on the report. Not sure how just a nasal canula, chest strap, and finger sensor can do that, but it did. An xPAP has none of those sensors, and relies on measuring the dynamics of the back pressure only. Different data points that reveal the same issues, I guess, and both seem to be capable of flagging SA events pretty accurately.
But a home study was enough for my insurance to prescribe an APAP.
I later had a full PSG, but I don't think insurance required it, since this was two months after they had paid for my APAP, but, insurance also paid for both studies. I am out of pocket only for copays on my visits.
Bottom line, you won't know what insurance will pay for unless you ask questions, an hour or two on a PSG, home study, or even an xPAP can be revealing regarding whether you have SA events and what kind they are (and how serious it is and whether you need xPAP), and a home study is on YOUR sleep schedule. There are options.
08-31-2015, 10:52 AM
(This post was last modified: 08-31-2015, 10:59 AM by julrez9.)
RE: Sleep Study for night time workers
I've never been put on any device. I was just put on oxygen. I went and got my 1st study before gastric bypass surgery. I'm a big girl so they thought I might have obstructive apnea, well guess what I have central. I have next to no obstructive events but I averaged 17 central events in an hour. I have no idea why they want me to try CPAP first, even my primary doc said I should start on BiPAP. Must be an insurance thing.
Well because of my past, I had a fear of things covering my mouth and nose. I went through therapy while on oxygen and after getting over my fears, made the appointment for a CPAP titration. I went through a lot to get on CPAP and I feel it's a bust. I'm seeing my pulmonologist tomorrow, so I'll find out if I can get on CPAP. The catch is my last sleep study was better than my first. My oxygen only dropped to 88 instead of 79 like the 1st study. So I have no idea what's going on.
RE: Sleep Study for night time workers
I think it is an insurance thing. Fail CPAP first, then be put on the machine you really need. Makes no sense to me. Mabye your doc will write a script for the proper machine.
Let us know how your doctor visit goes.
Good luck,
08-31-2015, 04:05 PM
(This post was last modified: 08-31-2015, 04:21 PM by quiescence at last.)
RE: Sleep Study for night time workers
trouble is, really, that the type of machine (or the need for any machine) has not been established. A total average of 17 per hour is just above the category of "Mild" apnea and studies do not show that this level of apnea result in shortening of life due to onset of other issues like stroke or congestive heart failure. The O2 level in your blood also does not droop into the danger zone, though really close.
home studies cost a lot less and can detect central and obstructive based on whether your body belt (diaphragm) moves while you are not breathing (indicating you were trying to take a breath). I was prescribed for an auto-titrating PAP machine after the test results, and the insurance I carry paid for it (minus co-pay).
other approaches may be sought that could help with quality of sleep, such as mental training and visualization. central events could be during transition from awake to sleep and back. this may be one reason for doing the study in the lab, because they would need to monitor the brain waves (EEG) to ascertain if your were awake or asleep during the central events.
good luck.
QAL
ps. I sent you a PM as well.
Dedicated to QALity sleep.
RE: Sleep Study for night time workers
Well went to the appointment with my doctor, and he didn't have the results to the last sleep study. He said sense I slept on 2-hours there's a good chance that I'll need to redo the test. I also found out that the hospitals here in town do not do sleep tests during the day, only at night. So I'm going to run into the same problem. With my first test, I have to take a sleeping pill with one of my anti-anxiety medications. I had to drug myself to sleep. The reason I didn't take anything this time is because I just had gastric bypass and I can't take time release meds anymore, and I don't know how the other pill will effect me now. The downside, if the last test is accepted and it's better than the first, I may not get treatment for my central sleep apnea. While I was in the hospital, I had to be moved to the ICU because I stopped breathing and my oxygen would crash pretty low, even on 3 litters of oxygen. I had to be put on a mask and given 8 litters. So I got something wrong with me. I just hope this sleep study is rejected but I'll still have to figure out a way to sleep.
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