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Re: Sleep Study failure

Posted by Chele on August 05, 2001 at 11:48:24:

In Reply to: Sleep Study failure posted by Robert on August 04, 2001 at 13:20:16:

Robert,
You are far from being the only person to get inadequate results from your first study. What worries me, is the impression I got that a significant number of people are sent away being told they have "no apneas," when they actually did. To make sure you can get a second one, it's important to muster all your ammo before you meet with the doctor (if you do get to meet with him - you said you are dependent on the county hospital, so it may be difficult to get the individual follow-up attention you need).

One-and-a-half hours of data is pretty scant. The doctor who "read" my first study had 3 and a half hours, yet he claimed that this was insufficient. He also stated that I had no apneas, no hypopneas, and probably suffered from "insomnia." (The difficulty in falling asleep had mostly to do with the conditions at the lab, and nervousness.) He didn't even bother to mention my blood-oxygen desaturation, although it had dropped to 84. Because of his incompetent findings, I had to fight tooth and nail to get my insurance even to allow me to try CPAP - and that was with a sleep specialist doctor pulling for me! If you don't have insurance, I guess you would have to wage that same fight with the County doctors? ... When I got my second study, six months later, it was at a highly-rated Sleep Center with more advanced technology (as opposed to a lab), and it showed mild-to-moderate OSA with an RDI (apneas + hypopneas per hour) of 26. So, the "negative" finding on the first test may not be conclusive. In fact, one of the doctors at the Sleep Center told me that a significant portion of the studies they do, are re-takes on people whose first study at a lab was inadequate.

You can have apneas and hypopneas without entering the REM stage, but the techs and doctors want to see what happens in REM because your muscles relax the most then and the frequency of disordered breathing incidents can be higher. Reduced REM is typical of OSA. Also, so-called "REM latency", which is the time before REM starts, can be all sorts of lengths of time. On my "good" study, it was 143 minutes, which is over 2 hours - so if I had slept as little as you did, I wouldn't have had REM either.

Fight for another study! Even if it has to be with the Country Hospital again, maybe being more psychologically and otherwise prepared - knowing what to expect - will enable you to sleep more the second time around. I hope so.



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