[Treatment] Are Sleep Studies Worthless?

[tinytim]

I had an oximetry test 10/2012 & my cardiologist prescribed 2l of oxy while sleeping. I had been diagnosed with Sleep apnea in July 2010 and could not handle the pressure of constant cpap I lost 60ilbs and thought the apnea would be gone well obviously not. I bought an auto bipap s750 respironics to use at home and using sleepyhead my AHI is less than than 0.5 with very few events the auto goes up to a max pressure of 8.5. The software tells me this is effective. I had a titration study done 10/20/12 and informed them I needed proper settings I told them I did not snore as my better half says I don't. The report from the Dr reccomended a pressure of straigh cpap of 12 as higher pressures started to cause central apnea and my oxy was at 90 The (idiots didn't even titrate me at lower pressures and didn't take into consideration my complaints that I could not toleratel straight cpap which was the reason for titration with bipap. I told them I had a bipap machine What a waste of $$. Rather than see a sleep Dr again to hear what I disagree with Isn't lower better if it works? I am going to let the auto do its work & purchased a wrist oximeter to check my oxygen levels as I have an enlarged heart & want my oxygen at optimal levels & will bleed in to achieve oxy levels of 95 or so. I don't get it don't they even listen to the patient or just have the God complex they didn't even listen to me. I have a script that will let me keep getting supplies and when I need one I'll just buy my own auto bipap. Just venting at the waste of time and $$

[tinytim]

to Clarify I didn't even get to talk to a sleep Dr only the sleep lab techs, & read the report My family Dr admits he doesn't have any expertise in this area but will prescribe what I need. I guess it is very difficult to speak with a person who listens thank heaven for this board and all the info that helps us monitor our therapy for better health in my case thank all for the knowledge of an auto machine & how to best utilize it & oximeter results

[trish6hundred]

Hi tinytim,
WELCOME! to the forum.!
It's very frustrating when your Dr. doesn't listen to what you have to say and yes, Some of them do have a god complex, for sure. Maybe you could try to find another one who will listen.
Hang in there for more suggestions and best of luck to you with your CPAP therapy.

[Sleepster]

Hi tinytim,

I recommend you make an appointment with a doctor who has expertise in the area of both sleep apnea therapy and heart disease. That's gonna be hard.

If it weren't for the complication of the heart condition and the needed oxygen, I would agree with your conclusions about the pressure settings. For a patient with simple OSA and no complicating factors I would think that the pressure settings you've got are working just fine for you.

You might want to get a copy of your sleep study results and review them yourself.

[PaulaO2]

I agree with Sleepster. You have too many other things going on. Yes, the auto can work, but with the other stuff, you can't be guessing. There's not much room for error.

[2Tim215]

Hi TinyTim, Welcome to the Forum. You will learn a lot here from lots of people in different but related situations for the most part.
Sleep Studies are not worthless if done correctly by competent specialists in this area and greatly contribute to a lot of information we need to start or continue our journey with Obstructive Sleep Apnea or Central Apnea therapy. I am sorry you didn't get the answers from the Doctor you were seeking. Often, as my case and several others here, we see different specialists to address our needs that extend past Sleep Apnea although in some cases possibly related. The best advice is to keep reading here while seeking a Doctor to address all of your needs starting with the most serious first. Be sure to share with each Doctor your medical history and as advised above get a copy of your Sleep Study which can be useful with each visit and also for members here to try and address any questions. I know this isn't always easy with several appointments, usually meaning several co-pays, and more medications or medical equipment! Believe, I can relate to that! Hope you get in soon to someone who is willing to openly and honestly share their professional findings and give you the comfort of knowing you have a Doctor who is more interested in working with you rather than your insurance company! I wish you well and look forward to a post where this happens!

[twindad]

I can't complain too much about my sleep studies - they were both useful and accurate. The first sleep study they diagnosed me with OSA and billed my insurance $2000, which got cut alot. My wife has been telling me that I quit breathing in my sleep for a long time (same thing as diagnosing me with OSA) for free. My titration study resulted in a pressure of 13 (later raised to 14) and a $2500 bill to my ins, which was cut alot as well. I'm fairly sure I could have arrived at a correct pressure range with an auto cpap myself. I suppose their main value is in ruling out everything else but OSA.

[archangle]

There are just so many answers to that question.

Some sleep labs are worthless. The tests they do may be worthless.

Some sleep doctors are worthless. The sleep test loses a lot of its potential value if the doctor is worthless.

After the first sleep test, if you have a data capable CPAP, if someone monitors your results carefully, further in-lab PSG tests are usually unnecessary unless you have problems with your current therapy.

[tinytim]

My cardiologist says I am not in any heart failure my ejection fraction is almost normal the study had my oxygen over 90 almost all the time. copays are a killer. With the auto my obstructions at a high of 8 are nonexistent much better than the sleep studies, Impossible in this area to find a Dr that addresses both. My concern is treating the Apnea properly which with one month of treatment is under control blood pressure is normal. My only concern is I don't know my oxygen while sleeping I'll monitor it with an oximeter that will record and should be able to easily keep it in a range around 95 I might not have to bleed in oxygen I have a concentrator if necc. The Cardiologist prescribed oxy before I went on Apnea treatment Once the oximeter gets here I'll know what it is. The Auto has no events AHI averages less than 0.5 no snores and at worst 3-4 hypoapneas a night no obstructives Machine is doing it's job. Set at 4- 12 highest it has gotten is 8 inhale pressure. leaks are low Flow is great. Looking at 2 sleep studies they were happy with oxygen levels when the apnea was controlled. I keep copies of all my records. But they never titrated me down went up till I started having central apneas then dropped pressure till that stopped and called it good.In fact the sleep study data is not as good as I get at home with sleepyhead & resperonics data I told them I couldn't tolerate straight cpap but out of 2 they never considered bi-pap even though thats what my primary ordered. I am going to file a complaint with medicare they didn't follow the medical order. As I said there are 3 Drs for sleep in my town and it is impossible to get an appt to talk I've tried for 9 months they just write reports off the sleep lab data even to the point of reccomending a mask I didn't take the study with. I use a full face Quattro plus I don't have the funds to waste on continued appointments. Several highly rated Cardiologists are not worried about my cardiac function. They all tell me my lifespan should be long Holter monitoring has been great I take omly one low dose med. In fact they only want to see me yearly (Heart was damaged by an infection from a tick bite just an enlarged ventricle) My heart has improved over 75% since diagnosed in 2000 Awake all is good I run 2 miles a day have no arrythmias oxygen is always around 97. I just want what is best while asleep and it seems I'm kinda on my own. I will see a pulmanory Dr one time though just to find out what my optimum oxy level should be while asleep. The DME charges 30 copay monthly for a concentrator I bought one new for 300 I run across them all the time. Families seem to get them right before their loved one goes into home and and never use them. I can get the auto bipap from supplier 2 very reasonable. Thanks all will let you know what oxy level is soon

[2Tim215]

Hi tinytim, sounds like you are on top of things. My understanding is oxygen will be lower during sleep. There are mixed studies on what is safe of oxygen levels. I prefer to lean to 93 and above being acceptable, 98-99 normal. From what I have read prolonged 92 and below put people at risk of heart disease, stroke, heart attack, and sudden death. Also affect proper function of other organs. Obviously this is an arguable topic as I read studies with lower thresholds as being "safe". The best advice is to continue therapy and hopefully your oxygen levels will increase to near normal if not normal levels after continued treatment, that is what I am hoping for also! Glad you gave us an update, keep us posted!