Diagnosis

[petemcarthur]

I'm interested in how people were diagnosed, most people seem to have had sleep studies done with lots of fancy gadgets. All they did with me was send me home with an auto machine, the next day I was given the manual version and that was it. Is this standard practise in other clinics?

[James @ Intus]

Most people nowadays get diagnosed with finger pulse oximetry or a respiratory study, both mostly in-home. A small group still with a polysomnogram at the clinic.

Very few are done your way. The Auto-CPAP will be able to record apnoea's and hypopnoea's but not how badly they affect you so it's somewhat uncommon for that reason. I guess they'd only do it if they were 99% sure beforehand it would be 'simply OSA'. Just one night is also a bit uncommon as most get to use the APAP for a week or so.

Either way, if the end result is you got CPAP quickly and you now benefit from it, I can't see why it would be bad, other than the fact it is very minimal in terms of baseline information. It's not according to the UK guidelines, that I can tell you.

[acebass]

I had a full overnight study with oximeter, infra red camera and sound recording, then a few weeks later an overnight stay with an Apap. The morning after, a nurse explained the results to me and I was sent home with a machine with the pressure fixed and told to return in a month to see how I was complying with treatment..

[shuckie]

I had the polysomnography at home which was an awful experience. I don't know how they managed to diagnose me as I felt as though I'd hardly slept all night. Having the tubes poking into the sides of my nostrils, the oximeter cable wrapping around my arm and waking up a few times to find an electrode had disconnected didn't exactly make for a restful night lol!

When I first went to the clinic I was given an APAP to find out how much pressure was needed to keep my airway open. I only had it for one night as I needed to take it back the following afternoon so the technician could analyse the data on the memory card. Again, I didn't sleep very well but apparently there was enough information for the technician to decide that I needed a pressure of 10.

I don't know how severe my apnoea is as I haven't been told yet. I'm hoping that my consultant will tell me at my appointment tomorrow.


shuckie

[acebass]

I don't know how severe my apnoea is as I haven't been told yet.

Mine was an average 70 apnoeas an hour...(560 apnoeas recorded during an 8 hour period).

[Poppy56]

I was diagnosed after a night at my clinic. I was called in a few days later to discuss the findings and to arrange another night at the clinic to try out my CPAP. Went home with it the following night. A lovely clinic too - it's a small house a few miles from the hospital and you get your own bedroom.

[pavarottiman]

Diagnosis.

After 2 years of feeling rubbish and exhaustive tests for my diabetes my GP told me he had no idea why I was feeling this way, then I went on a flight to Aberdeen and dozed off during the flight, a little old lady sat next to me was concerned I appeared to stop breathing and told the stewardess who woke me up to ask if I was ok? and did I have sleep apnea?, her brother had it, I knew of the condition but didn't think I had it. Anyway came home told the GP, and oh!, that could be the cause of feeling rubbish, sleep study, CPAP, eight years on and feeling fine.

[Berneta]

Sleep Study

I was sent to have my sleep study done at my local Hospital. They had a new section away from the rest of the hosptial. Very quiet, and It was a lovely room much like a Private Hotel Room--complete with unobtrusive cameras and sound, Fan, TV, etc. I had wires attached all over me, Slept restlessly--in spite of being tired. The CRT (Certified Respiratory Therapist) who monitored me was in a different room with a baby monitor in both rooms, so that I could speak to her, And she could watch me on camera and watch the computer without disturbing me. The next morning after I was awakened and dressed--she told me that she was certain that I had Mild Sleep Apnea and was glad that it had been caught before it got much worse. She that I had not been in REM sleep for more that minutes as every time I went into REM-- I stopped breathing and woke up. She said the results of my test showed that my oxygen level was at its lowest point during Rem, and was at 79 and that was when I woke up. She said I stopped breathing 55 times in less than an hour during REM. I was not able to dream for more than seconds. She said all the information would be sent to a Specialist-- and his results would be sent to my DR, Then a week later another Sleep Study was done at the same place with a CPAP+ Humidifier and Nose Pillows. I absolutly refused to use a full face mask because of claustrophobia. She told me that I would learn to breathe through my nose all the time. That first night with the CPAP was blissful--a full 7 hours of sleep and I woke up feeling like a million dollars had been dropped in my lap. I remembered Vividly Colored Dreams. Something not experienced in years. The CRT was friendly, informed, kind, and intelligent. She said the results of the second test would again be sent to the Specialist-- who whould determine if the settings she had made for me that night were correct, and then he would send that info to my Dr who made out the prescription for me-- and I had all my Gear in another week, It took me three weeks start to finish--and was a good experience. The medical supply company I went to for the CPAP was very informed and ready to answer any questions, I was given a huge packet of information, and told that I could call my Therapist any time tole free, And also that any extra or replacement supplies, would be delivered to my home free, and my Therapist would do a home visit free once every 6 months, or more often if needed. I have no compaints and am sleeping 8--9 hours a night without waking-- except for a few nights to check my blood sugar ( as I am a Diabetic) and it is inclined to drop too low sometimes at night and it wakes me when it does. I take a glucose tablet if needed, and go right back to sleep. The nightmare of 5 trips to the loo every night is over! All in all--it was not an unpleasant experience, and I am glad I had no problems, Other than the usual ones getting the adjustment just right-- which only took a night or two. After hearing all the problems that some of you have had--I feel very lucky. Berneta

[shuckie]

I don't know how severe my apnoea is as I haven't been told yet. I'm hoping that my consultant will tell me at my appointment tomorrow.

As I've mentioned on another thread I went back to the clinic yesterday for the review appointment with my consultant. For some reason I saw his registrar instead, and in my opinion she didn't come across as being particularly confident about what she was saying. This was disconcerting, and I had to ask two or three times about the results of my PSG before she told me, as it seemed as though she couldn't wait to get me out of the door once she had decided to partially discharge me.

I eventually found out that I had 7.2 apnoeas per hour which didn't sound like a lot, but when I asked whether this meant I had mild or moderate OSA she said that they don't rate it that way, and if she had to rate it she'd have to say it was moderate?

If there's no such thing as mild/moderate/severe sleep aponea, how come it is referred to as such in the articles I've read online? Also, is there any official guidance regarding how sleep apnoea should be classified?

I have no idea what my blood oxygen saturation levels were during the PSG as no-one seems to be in a rush to tell me. Whenever I have asked a sleep technician or the registrar yesterday I'm told that they don't have the results yet. How can I be started on CPAP treatment if they don't know these things?

Sorry for the rant but I felt somewhat deflated after my appointment yesterday and am frustrated that I do not feel fully informed as a patient.


shuckie

[petemcarthur]

Everyone seems to have different experiences. I'm not knocking the NHS here. I really can't complain, from my GP referring me ( or to be precise asking my GP to refer me) to treatment was about 7 weeks. My consultant saw me for about ten minutes, looked at my weight and height, checked my symptoms, explained very concisely what OSA was and why it caused a problem after that it was the auto machine for the night then the manual.

My only gripe is that I would have preferred an auto machine, that's just the engineer in me coming out, it seems a more elegant solution to the problem. The manual seems fine, I'm going to have a fiddle with the Resmed EPR, the clinic disabled it from the patient menu, as if that is going to stop me

I suppose if I was still in a job and could afford it I would have bought my own auto machine but got to be more careful with the pennies nowadays.

[Tigers Fan]

What would you like it to be?

An AHI of 7.2 is 2.2 higher than the maximum for near perfect treatment. 5 and under is the goal.

Do you care what you were before treatment? Does it have any significance now you are being treated?

TF

[Tigers Fan]

Ya gotta admit .......

.....that the NHS has never come close to Bernetta's experience! Could we even get that privately over here? I doubt it, because of the ill-fitting juxtaposition of the NHS and private medicine - and we're British, accepting what we get!

And in America, it seems you can get good service only provided you have the insurance. If you don't have that, the NHS must look fabulous - same as it did to our parents/grandparents pre-1948.

Ohhhhhhhhhh! were did it all go wrong????????????

TF

[Berneta]

American Healt Care

HI TF, You can get good health care over here if you can pay for Heallth Care Insurance-- can make payments on what you owe , or are on a Governmnent Program like Medicaid or Medicare. Or Happen to be rich. Our probem here with Health Care is that some people are too young for Medicare, and can't get on Medicaid because they are young and are partially able to work--or can't find a job at all. Joblessness is a big deal over here. We hope the Presidents New Health Care Program will open new FREE Clinics, and give everyone the chance to get good health care, Even when we have paid for very good insurance, we still have to pay a 10% or more of the costs of things. They call it a CO-PAY. That applies to all medical costs. So everytime I visit my DR--I hand over a $10.00 bill. Then the insurance pays the rest. The more it costs--the more I pay. What really bugs me is that everyone in America could have free health care-- if we were not spending billions of dollars chasing shadows in foreign countries, and going to war with others. WE ought to have learned by now to stay within our own borders, and take care of our own people and their problems. I believe we should NEVER have entered IRAQ. The Billions spent in Iraq could have paid for health care for all Americans, secured our borders, and created jobs--still leaving plenty of money to help people in other countries who have disasters and need help. Just MY opinion! Some Americans agree with me --some would not agree with me, I do not believe in dropping bombs on people who have done nothing to us. Apparently we are all in the same Health Care Boat, and we are not all doing very well. Berneta

[Tigers Fan]

You and us, both, Berneta!

You and us, both!

We have holes in the road and holes in the pavement (sidewalk) so what do they fix? The curb stones!

Can't afford a good health care system but can afford nuclear submarines!