Question: Do I need a hospital sleep study?

I had an in home sleep study and my AHI was 38, so they put me on an APAP with a nasal mask for a few days and the AHI was down to 19. They told me that was not good enough and needed a formal study done.

I asked why, and they said that I may need a bilevel instead of an APAP. Also it may involve mouth breathing, and a study could determine all that. For me it is cheaper to go ahead and purchase a bilevel than pay the co-pay for a formal study. And I could play aound with a full face mask to see if I am mouth breathing.

So what do you think? Do I really need a formal study?

Doesn't make much sense to ask the advice of patients when professionals give you their opinion. The new machine will need to be set to a doctor's specification by prescription. How will you set the new machine otherwise? Ask for more patient opinions? You really had best listen to the professional advice an in-clinic sleep study done so you can find out specifically what medical needs you have as obviously the in-home study didn't provide enough information for the correct prescription.

Let me clarify. I am trying to convince my dr that it is unnecessary and that he can simply use the data from the in home study. If it just is a way to decide whether to get a bilevel or simple ACAP, I'll go with the bilevel, since the cost will be the same. He will still set the machine.

How detailed was your home study? Did they do video? The hospital study does collect more data than a home study so that could be beneficial to get adequate control.

Hi Cdowis

If your doctor wants you to have another, monitored sleep study then you should probably do just that. It would seem to make sense in this case. CPAP Although reducing your AHI from 38 to 19 is halving it, 19 is still too high. Put simply, it means that you are still stopping breathing every 3 minutes. That's not cool. Now ordinary CPAP is not treating it and they need to know why. It could be that there is something else besides OSA which is creating a false high AHI reading - restless legs for example. The only was to determine this is with a formal sleep study.

When it comes to BiPAP, you cannot just buy one, turn it on and expect it to work. It is a far more complex piece of equipment and needs to be set specifically for every person. It is used for treating more complicated problems that OSA, such as central sleep apnoea, obesity hypoventilation syndrome, type 2 respiratory failure and so on. Where CPAP has just the 1 setting, which is pressure, BiPAP involves many parameters involving not just 2 different pressures but breath timings and other things. It can only be properly set for long term use in a sleep study.

It may be that you just have OSA and something is fooling the APAP, in which case you will need a study to reveal and determine appropriate treatment. It may be that you have central sleep apnoea instead or as well, in which case you will need a sleep study to treat it with BiPAP or ASV. Either way, I don't think you can get out of another study.

Oh, and your doctor cannot use data from a study of your normal sleep to determine the settings for your treatment. He can use it to make a diagnosis but that's all.

I believe the study they want is a titration study. I had one after my home study. This study is used to determine what level of air pressure you need for the obstruction to be opened. This number varies for everyone. Your current setting is not adequate. Sounds like they will also check to see if bipap is better for you.

My understanding is that they can gain more information from an in hospital study than they can from an in home study. I'd be hesitant to just buy a new machine and skip the study.