Tell Me About Your Sleep Study (for sleep apnea)

In My Humble Opinion
21

I was diagnosed about 5 years ago. Went into the hospital one night, got wired up and spent the night sleeping while they logged me. Went in a second night, got wired up plus got a face mask and spent the night sleeping while they logged me.

The difference was incredible. I was basically choking to death at night. I woke up the morning after the second study and felt like a new human being - it was the best night’s sleep I had had in many years.

I now sleep with a CPAP using a nasal pillow instead of a full face mask. SWMBO claims it’s like sleeping with Darth Vader, but she likes it because I’m not keeping her awake at night by making noises like a warthog in heat.

ETA: the room they had me in for the sleep study was more comfortable than the vast majority of hotel rooms that I’ve stayed in.

22

I’ll be disvoice of disent here.

I had a sleep study and it was the worst night of sleep (if you can call it that) of my life. Time just seemed to drag on and on as I laid there awake with all kinds of shit strapped to my body. They came in and slapped the CPAP on me about halfway through and I found it impossible to sleep with it on because the positive pressure into my nose would blow my mouth open as soon as I would doze off, resulting in a sound that sounded like I was farting from my face. Over and over. Kind of like when you’re a kid and you put the discharge end of a vaccuum cleaner to your face and it flops all over the place.

Then they started the “sleep clock” based on my brainwaves and some other voodoo bullshit. The results claimed I fell asleep about an hour after the lights went out (9pm) when I know for a fact I was wide awake and totally miserable until atleast 2:30-3:00 AM. This screwed up my results because they divide the number of apnea events by the amount of time you slept, so I had like 45 apnea events or something like that divided over like 8 hours or supposed sleep when I was actually only asleep from around 2:30-5. They claimed I have mild apnea and wanted me to do another test and try a home machine but I decided I would just stay on ambien because it lets me sleep and sometimes makes late night TV more entertaining.

23

I’ve had 4 sleep studies, two pairs of them as part of my diagnosis of Obstructive Severe Apnea (OSA). I think others have covered it fairly well what you can expect. Obviously the details will vary dependent upon the clinic. Like others, my first night was being wired up and the staff monitoring me through the night gathering data. Based upon the data, a diagnosis of OSA was made. The 2nd night of the sleep study was for titration, determining the appropriate level of pressure to mitigate the apnea events to a reasonable level. This involved being wired up again but the addition of a CPAP machine.

Of greater concern in your OP and other comments is the mental side of this whole thing. If you are diagnosed with sleep apnea, 99% of what happens next will be mental for you. You’re going to have to adjust some of your sleep habits. Breaking established behavior is not easy and will require you to discipline yourself and gut through it. You’re also going to have to adjust your mental attitude towards apnea and CPAP. Yes, it sucks to have apnea. Yes, the idea of having to use a CPAP machine every night sucks. Overcoming those things is mostly mental and failure means you’ll continue to slowly die every night and increase your risk of stroke, heart failure, etc. The non-compliance rate for CPAP is sadly very high. When I originally went on CPAP, I failed miserably and quit. It wasn’t until a few years later that I reached that point where I knew I had to do something that I tried again and was successful. You can be too but it takes being educated, proactive in your treatment, and most of all having the right mental attitude. I’ll paste below “my story” from another thread we had on CPAP from awhile back, might give you some insight in the event you do get diagnosed with OSA.

I’ve been compliant with treatment via CPAP now for over 2 years and it changed my life. I was originally diagnosed in 2005 with severe OSA. To say I had a negative attitude about it was an understatement. I hated that I had it, I hated even the idea of having to wear a damn mask and being hooked up to a machine at night for the rest of my life. I mean c’mon! I was a good looking dude, in my mid-30’s. Fuck this shit, right? I tried to look into any possible alternative to CPAP, even went to an ENT for surgical options. I was willing to go through maxillomandibular advancement surgery over wearing a damn mask. Unfortunately, for the severity of my apnea oral appliances were not an option and I was not a candidate for surgical treatments (UPPP) and my HMO had protocols and you couldn’t just go get massive facial reconstructive surgery (maxillomandibular advancement). For me, looking for alternatives was really about denial of my problem and grasping for anything at all that was not wearing a damn mask. So relucatantly I visited the DME and took the CPAP they gave me. I could not adjust to the CPAP and the mask (full-face) but then again I honestly cannot say I gave it a real effort either. Like I said, mentally I was not accepting the situation and committing to treatment. It was total bullshit and I was pissed about it, right? Eventually I stopped using it all together and eventually turned the CPAP back in to the DME with a hearty “fuck it” to severe OSA.

Flash forward to 2010 and I’m miserable every day. I’m not sleeping well at all. I cannot get through a day without falling asleep. I don’t mean I was a little tired and would go take a cat-nap for 15 minutes. I mean I would fall asleep on and off throughout the day. At work in my office, I’d suddenly startle awake (not breathing when asleep!) not having realized I just crashed out… again! I even fell asleep in my car sitting at stop lights a few times when driving home from work. At night when I did sleep, I was constantly waking up to pee many times a night. Sleep in between those times was brutal. Many times OSA suffers don’t even know they’re not breathing, etc. I was waking up GASPING for air, over and over all night and I knew it. So did my girlfriend (now wife) and she had enough of it and became very insistent that if we were going to be together I had to do something. She wasn’t sleeping at all due to me constantly stopping breathing and then gasping awake. She was also terrified one morning she’d wake up and find me dead. I was scaring the shit out of her every night and believe me - when you have a tall, gorgeous blonde in your bed fellas, you really don’t want to have the lasting feeling she has being one of fear for your life. I agreed to do something about it.

I went back to a new sleep doctor. This time though, I was committed to making this work. When the first sleep doctor I made an appointment with left me feeling like a number and that he wasn’t really listening to me, I walked out of his office and found a different doctor. I did sleep studies again (originally done in 2005) and the new studies confirmed the previous diagnosis and even identified a small amount of central sleep apnea (oh no!). Naturally the new doctor prescribed CPAP for treatment but this time I did research and I took proactive control of my diagnosis, my treatment plan, and my compliance. I identified what some of my biggest problems were before - a full face mask was uncomfortable and I constantly had blow-outs, I had wash-out in my hose, my CPAP machine was noisy, etc. I researched options in the market for machines and masks (there really are hundreds of options) and I put a flag in the ground and told my doctor EXACTLY what I wanted and I would not compromise on the make/model of CPAP, the options (i.e. ClimateLine tubing, quietest motor in the market, specific mask, etc.). To my surprise, I had zero issues with my insurance nor with the DME on asking for specific models of machine and masks instead of just taking the “standard issue” equipment they gave everyone. I sometimes wonder how many people actually just take what they’re given and do not push back via their doctor or DME. I know the first time I got CPAP in 2005 I just took what they gave me. Anyway…

Once I had my equipment it was obviously now up to me to make it work. Having the right CPAP and mask helps but I think for me the biggest factor in my success was my attitude had changed 180-degrees. I was dying every night. I was making life miserable for myself and my girlfriend. If I didn’t make this work, I would probably have a stroke very early in life. Mentally I accepted I had severe OSA and needed CPAP. It took me a surprisingly short amount of time to get used to it this time, I slept like a baby right away but did have challenges with hose management, getting the straps adjusted right (you really don’t want to crank them down as tight as possible. That is not a proper fit for your mask!), etc., for the first few weeks but they were minor inconveniences not giant frustrations. An early poster mentioned routing the hose over your headboard. It took me a month or so to discover this trick. I didn’t even realize my mask had an optional clip that could be used with the head strap to hold the hose above my head for just this type of thing. That definitely made a huge difference as now the hose was always out of my way when sleeping.

Anyway, long story not so short I now cannot sleep without my CPAP and I don’t even want to try. I travel for business a lot and take it with me on business trips. If I plan to spend the night at a family member or friends, the CPAP goes with me. We even hosted an “urban camping” party at my home last year where 20ish friends came and camped out in the back yard - I ran an extension cord to my tent for my CPAP. I think I’m now conditioned that when that mask goes on, I go out like someone flipped a light switch. Do I always sleep 8 hours without waking up? No, of course not. Do I sometimes have to adjust my mask in the middle of the night because I’m a very active sleeper? Sure I do. But I’m routinely 95+% compliance with treatment and almost never feel tired, sluggish, mentally “foggy”, nor fall asleep during the daytime anymore. I love waking up in the morning and feeling RESTED, that I got a great night’s sleep! Jesus, I had no idea this was how the majority of the population slept!

That’s probably more than two cents. If you got questions, I’m happy to share my experience and anything I’ve learned along the way. If you’re struggling with CPAP, keep at it! Research your options. Push back on your doctor and DME for the equipment you need! Get your attitude right - “Suck it up buttercup!” as a dear friend would say.
*

Good luck!

MeanJoe

24

[Quote=cubsfan]
This screwed up my results because they divide the number of apnea events by the amount of time you slept, so I had like 45 apnea events or something like that divided over like 8 hours or supposed sleep when I was actually only asleep from around 2:30-5. They claimed I have mild apnea and wanted me to do another test and try a home machine but I decided I would just stay on ambien because it lets me sleep and sometimes makes late night TV more entertaining.
[/QUOTE]

So wait you’re saying that your apnoea is actually far worse than they diagnosed? And your solution was to take sleep medication? So every might you could have dangerously low blood oxygen levels while sleep medication suppressed your respiration further? You think that’s a wise path to stay on at this point?

25

I haven’t read all of the replies yet, but I had the same concern about being able to fall asleep. I asked the technician how many people say they are never going to fall asleep with all of the wires on. Her reply “all of them”. I then asked, how many people actually do fall asleep. Her reply “all of them”. so don’t worry about being able to fall asleep.

J.

26

I think it’s all a big ripoff. No matter who what, they’re going to tell you you need a cpap. They make a boatload of money off those things, as does the “service” company who delivers your machine. I don’t doubt there are some people who truly need it. But those people already knew they have the problem from spouses. I know several people, including myself, who didn’t really need it. I too was one of the ones who never could fall asleep (I’m a stomach sleeper with a featherbed. Their mattress felt like my kitchen table by comparison!) and I argued with them when they showed me some stats about how often I woke up. Oh, but insurance will pay for it all. Yeah, after deductible & copay. It’s sitting on a shelf in my closet. Good luck!

27

It’s not the sleep technician who decides you need a CPAP. It’s your doctor. And neither of them depend on an apnoea diagnosis in order to get paid.

28

I don’t have concerns that it’s a ripoff. Obviously, I have symptoms, or my doctor wouldn’t even have suggested it, and I am certain that I will be able to look at the data that comes up and see for myself what’s going on.

Wow, thanks, MeanJoe. That was a lot of good information. I’m not looking forward to doing a lot of research into masks and such, but it’s good to know that there are a variety of options. I’m pretty sure that I will be very compliant- it’s my personality to be a rule-folllower, so the guilt of not complying would bother me tremendously. Plus I have developed borderline high blood pressure, after a lifetime of having very low bp, and that bothers me a lot, as does the worry of having a stroke. I’m not happy about it, but I’m confident that I’ll comply if it’s determined to be in my best interest.
Also, if anybody’s still reading- one thing I don’t understand is how, even though I wake up exhausted, I usually think that I’ve slept very well. I rarely remember waking up in the night. Can you have sleep apnea and almost never even remember waking up, and really think that you slept hard all night?

29

Alice, what’s going on is that while you may not be waking completely, you’re not going completely asleep, either. At least, not into deep sleep - the interruptions to your breathing are keeping you, at best, in a light sleep state.
(tavalla’s husband, by the by - I had no doubt that she was experiencing sleep apnea; it’s pretty easy to spot, and to hear.)

30

Yes. Unequivocally, yes.

31

You absolutely can. These aren’t ‘wakings’ in the normal sense of ‘waking up in the morning’ or ‘waking up because a cat decided to use you as a trampoline’. You don’t emerge fully from sleep, it’s just that your sleep is disrupted. Almost all my apneas happened during REM sleep, for instance - but I never remembered waking, just moving from one dream to another.

If your doc decides to try you with a CPAP machine, I can only echo Mean Joe’s comments that it’s all about a) finding the right gear for you, and b) being positive about it. My machine is very quiet - certainly quieter than the box fan you mentioned - and I’m pretty sure it doesn’t keep galen awake at night; it also casts virtually no light, less than an alarm clock. My nose mask is very light and non-restrictive, so it’s comfortable and I don’t unseat it during the night. The clinic I went to offered me a month’s trial - no fee - of one model and a range of masks and headstraps, so I could work out which one worked best before I bought anything.

Wearing one does take some getting used to, but it was worth it to me.

32

Seconded / thirded.

My father-in-law has been a nightmarishly bad snorer for as long as I’ve known him. I have to guess that they never told the doctors about the snoring, as he was NEVER told he should take a sleep test until Typo Knig and I pushed him to bring the subject up recently. In addition to the snoring, the man was like a walking (waddling) advert for apnea: older, male, obese, always drowsy… Not surprisingly, he was diagnosed with apnea.

Of course, to be a contrarian, my problem was the opposite of the “sleep uninterrupted but still have apnea” picture. I’d been aware - for as long as I could remember - of dreams in which I was swimming underwater and needed to breathe, and suddenly found I could breathe underwater. I’m assuming this was my physical sensations impinging on dreams (like those dreams where you GOTTA PEE, and you pee, and you STILL GOTTA PEE).

When Typo and I got hitched, HE noticed the breathing stoppages. In my case there was no snoring (or very rarely), but I often became aware of actually inhaling and holding my breath. Yet 3 separate studies failed to show enough apnea to be worth treating. Sigh. The 4th finally showed enough, but only during a very specific partof my sleep (REM sleep I think).

Alice: something else to think of: Sometimes people have excessive daytime sleepiness despite having adequately treated apnea (or not having apnea at all). In my case, after 4-5 months with the CPAP, I was STILL stumbling into walls.

This led to a repeat study (to confirm that the CPAP was working well enough) including a daytime “sleep latency” test where I was wired up and every couple of hours they would have me lie down for 20 minutes and see if I fell asleep (and how quickly). The end result was that I was diagnosed with EDS, and given medication to help with wakefulness.

Interestingly, while I never felt that the CPAP made me feel much better, now that I’m used to it I definitely feel worse if I skip a night. If I nap w/o the nose-hose, and sleep on my back, the whole nap is a pretty unpleasant cycle of it being hard to inhale, which causes me to wake enough to inhale but not enough to turn onto my side, then falling back asleep, then having trouble inhaling (rinse, repeat).

33

Ha, so I’m not the only one who calls it that! :smiley:

34

I guess I’m a counter example. While they said I have mild sleep apnea, they didn’t recommend a CPAP to me because mine wasn’t severe enough.

J.

35

There are different stages to sleep and different things going on in your brain at each stage. You cycle through these stages throughout the night.
If you have sleep apnea, your brain wakes up just enough to tell you to breathe and unfortunately enough to knock you out of whichever sleep stage you might have been in. So while you may think you never woke up during the night, you never actually reached the stage where truly restorative sleep occurs.
I wish I could be more specific but my disordered sleep training doesn’t happen until next semester so I only know what I learned when my fiance was diagnosed with sleep apnea. I actually started respiratory school to be a sleep specialist but only 2 weeks of the 2 year program focus on sleep studies. I’ll have to earn a separate certification after I receive my RRT. If I ever get to that point, maybe I’ll start an “ask the…” thread.

36

[QUOTE=Alice The Goon]
Wait, wait- second night??
[/QUOTE]

Different sleep labs do it differently. Some do a second night to “titrate” and others do a “split” night where they wake you up midway through the night to titrate.

It sounds like mad scientist chemical laboratory work, but titrating just means they adjust the air pressure to achieve an optimal apnea/hypopnea index, better known as AHI.

Fortunately, the current crop of CPAP machines have automatic modes that perpetually self-adjust, eliminating the need for a titration study. My insurance (BCBS) seems to prefer paying a bit more for auto-set machines as it’s cheaper than a second sleep study, and the results are as good if not better as the automatic mode can cope with allergies, colds, etc. Auto-PAP also leads to better compliance as it’s more comfortable.

Another benefit to CPAP is you’re likely to sleep through the night without potty breaks. I don’t know if that’s because you sleep deeper and don’t receive the “hey, gotta pee!” messages, or if better sleep somehow slows down the kidneys, but it’s rare for me to get up in the middle of the night.

37

When I had my home care rotation this last semester, I asked about this (our version of home care involves working with people’s CPAP issues at home) because I noticed that my fiance does get up to pee much less since he got his machine. They said it was because you don’t notice the signals from your bladder to your brain when you’re sleeping but when your brain wakes you up to breathe, it also wakes you up enough to notice that you have to pee.

Even though I don’t have apnea, I have noticed the same trend with me. If I’m having a bad night sleep I constantly have to get up to pee but if I’m sleeping well all night I don’t have to pee badly enough to intrude on my sleep until it’s nearly time to get up or my alarm is going off.

38

What is involved in the “service” delivery of a CPAP? Does a CPAP typically require extensive on-site assembly or calibration, or is this basically gourmet courier service for people with deep-pocketed insurance policies?

39

When my fiance got his CPAP, and when I did my home care rotation, the clients all came to the office.
The CPAP is programmed by the respiratory therapist using the prescription from the doctor. When the client comes in the therapist teaches them how to use the machine, explains what the settings are and how the insurance company tracks usage (if you don’t use it properly they wont pay for it). Then they take you through finding a mask fit you like. They let you try on multiple masks of different styles (full face, nasal pillows, prongs, etc.).

There’s a trial period so if you find that you really don’t like your mask after using it at night, you can go back to try others.

Generally they go to patient’s houses when they can’t get to the office for various reasons (transportation, disability, etc.)

If you have any questions at all about how or why the CPAP works, the therapist is the one to explain it to you.
Most important, if you’re not happy with your service company, you CAN GET A NEW ONE!!!

40

Actually my diagnosis was not sleep apnea, I have a cow of a different color entirely - I have a variant of segmented sleep made horribly worse by my medications. I annoyed them by being able to fall asleep, not having any breathing disruptions despite snoring like a chainsaw [runs in the family, Dad had it and he didn’t ave apnea either.] I woke up roughly when I said I would, and fell back to sleep when I said I would, and woke up again at roughly 3 minutes to 5 am, with my phone alarm at 5 am as usual.

I was hoping it was something as nice and easy to resolve as sleep apnea, it would have made life a bit easier [though I flop around like a fish out of water, I have serious doubts that I could manage to actually sleep with a mask on without strangling myself with the hose … I tied my IV around my neck once while sleeping :smack:]