Alternatives to sleep study (sleep techs - can you advise?)

March 19, 2018 11:58 AM

Following up on this post. A proper in-lab sleep study will cost thousands. Are there alternatives to rule in or rule out certain conditions? Snowflakes inside...

For example, would using a pulse oximeter for a few nights be helpful? What about simply buying a CPAP machine and using it - could any harm come of it? When I have the $ or proper insurance, I'll happily get whatever a sleep lab suggests. For now, is there something I can try that won't break the bank?

Notes:
* I know - you are not my doctor.
* Symptoms: waking and staying awake for 30-60 mins; not feeling rested on wake (after 7-10 hours in bed), tiredness during day. Easy to nod off for a nap throughout.
* Male, 40s, athletic build, blood pressure on the low side.

posted by falcon42 to Health & Fitness (11 answers total)

I don't think a CPAP could hurt, and from the opinions I understand people who've used them have, you might be able to get one cheap.

Both Android and IOS have sleep-tracker apps that you can run while you sleep, and which helped me figure out if I was snoring or stirring during the night. You run the app and put your phone on your bed next to you so it can detect motion, as well as it recording any snoring (noise above a certain threshold).

Do you have any reason to think your waking periods are anxiety- or stress-related?
posted by rhizome at 12:19 PM on March 19, 2018

Just to answer the technical side, you can buy an adequate recording pulse oximeter fairly cheaply off amazon (easily sub 100$), including the software to download and review the results. There is essentially no risk of harm from wearing a recording fingertip pulse oximeter for a few nights....the problem (and risk of harm), as other eluded to is what to do with any data from that device...if you can find a provider who will look at the data with you, you might be able to make better decisions.

A pulse oximeter recording can suggest apnea as an issue, but is less exact at ruling it out, so dont take it as a magic answer.

Good luck! Sleep issues suck
posted by Northbysomewhatcrazy at 12:26 PM on March 19, 2018

Regardless of any diagnosis you might end up with, you can definitely treat symptoms starting now. If it's apnea (which you don't know but it could be), you'd get something like a CPAP, but for now you can maybe try sleeping on your side rather than your back. Exercise, minimizing carbohydrates in your diet, caffeine, and scheduled 30 min naps are also things that can help. Sleep aids could help with keeping you asleep at night.

Review your sleep hygiene and track your sleep in a sleep diary for a while. Track how you feel and see if there are any patterns.
posted by Stewriffic at 12:27 PM on March 19, 2018

So while it's not impossible to do yourself I guess a CPAP machine has to be calibrated and set to a specific pressure level and if you don't get the right pressure it's not going to help you very much.
posted by GuyZero at 1:50 PM on March 19, 2018

If you DO decide you want to go the DIY CPAP route, what you want to look for is an APAP, which will adjust itself to the pressure needed. Most machines these days also have cards and readers that will tell you what sort of pressures you need and how many apnea events you're having through the night.
posted by elsietheeel at 1:54 PM on March 19, 2018

here's the UptoDate page on sleep apnea

The diagnosis of OSA is best made by a knowledgeable sleep medicine specialist who has an understanding of the individual's health issues. The diagnosis is usually based upon the person's medical history, physical examination, and testing, including:

●A complaint of snoring and ineffective sleep

●Neck size (greater than 17 inches in men or 16 inches in women) is associated with an increased risk of sleep apnea

●A small upper airway: difficulty seeing the throat because of a tongue that is large for the mouth

●High blood pressure, especially if it is resistant to treatment

●If a bed partner has observed the patient during episodes of stopped breathing (apnea), choking, or gasping during sleep, there is a strong possibility of sleep apnea

Testing is usually performed in a sleep laboratory. A full sleep study is called a polysomnogram. The polysomnogram measures the breathing effort and airflow, blood oxygen level, heart rate and rhythm, duration of the various stages of sleep, body position, and movement of the arms/legs.

posted by runt at 1:59 PM on March 19, 2018 [1 favorite]

Reinforcing the apnea/CPAP comments. I had all of your symptoms and was diagnosed with sleep apnea. And my snoring was causing a lot of issues/distress for my partner. Since using a CPAP machine, the quality of my sleep and general health has improved several orders of magnitude. Yes, CPAPs are expensive - well, here in New Zealand they are - but well worth it.

There are of course a number of other anti-snoring devices out there - assuming you do actually snore - which are much cheaper. Might worth having a try perhaps?
posted by vac2003 at 2:57 PM on March 19, 2018

My dad was sent a small device in the mail that he wore to sleep for a week and then he shipped it back? Went in for an office visit? And was prescribed a CPAP. It was my impression that this was both cheaper and allowed him to sleep in his own bed where the results would be more true to life.
posted by I'm Not Even Supposed To Be Here Today! at 3:03 PM on March 19, 2018 [1 favorite]

Best answer: Check out Apnea Board. They're very knowledgable and friendly.

A recording pulse-ox will tell you have sleep apnea (or something otherwise wrong with you) if you have desaturations overnight. You can also have sleep apnea without having desaturations, so it's not perfect.

A data-capable APAP that's supported by SleepyHead (check Apnea Board for details - the exact machine matters) and posting your data there will likely get you pretty far.

Alternately you can search for home sleep studies you can order online. Looks like that would be less than $250 and a better test than trying a CPAP.
posted by unix at 5:50 PM on March 19, 2018 [4 favorites]

Response by poster: Thanks everyone, this is very helpful!
posted by falcon42 at 10:02 AM on March 20, 2018

Response by poster: The folks at Apnea Board are very helpful.
posted by falcon42 at 7:11 PM on March 31, 2018