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How To Fail A Sleep Apnea Study

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Diagnosis And Treatment Of Obstructive Sleep Apnea In Adults

Preventing Stroke: OBSTRUCTIVE SLEEP APNEA & FAILED ABLATION

MICHAEL SEMELKA, DO JONATHAN WILSON, MD and RYAN FLOYD, MD, Excela Health Latrobe Hospital, Latrobe, Pennsylvania

Am Fam Physician. 2016 Sep 1 94:355-360.

Patient information: See related handout on obstructive sleep apnea, written by the authors of this article.

Obstructive sleep apnea is a common, chronic disorder that disrupts breathing during sleep. It affects persons of all ages but especially those middle-aged and older.1 Patients with OSA temporarily stop or decrease their breathing repeatedly during sleep.25 This cessation or decrease in breathing is the result of repetitive partial or complete obstruction of the airway caused by narrowing of the respiratory passages.4,68 These breathing disruptions can awaken a person or prevent deep, restful sleep. The effects of fragmented sleep on daytime fatigue and sleepiness are widely recognized.3,6

WHAT IS NEW ON THIS TOPIC: OBSTRUCTIVE SLEEP APNEA

In patients with obstructive sleep apnea, continuous positive airway pressure lowers blood pressure and rates of arrhythmia and stroke, improves left ventricular ejection fraction in patients with heart failure, and reduces fatal and nonfatal cardiovascular events.

A recent meta-analysis demonstrated similar rates of blood pressure lowering between continuous positive airway pressure and mandibular advancement devices.

BEST PRACTICES IN SLEEP MEDICINE: RECOMMENDATIONS FROM THE CHOOSING WISELY CAMPAIGN

SORT: KEY RECOMMENDATIONS FOR PRACTICE

What Is A Sleep Study

A sleep study involves the simultaneous collecting of many physiological signals while you sleep. When looked at as a whole, this data offers insight into different aspects of your sleep health.

Data collection occurs via multiple small electrodes attached to wires, which are placed strategically around the head and body. The application is painless, and the study is noninvasive. However, the adhesive backing that holds the electrodes in place may cause some discomfort or pull your hair slightly when they are removed.

Some of the sensors that may be a part of a sleep study include:

  • Electroencephalograph: This sensor monitors changes in brain wave activity, which helps to determine the stages of sleep.
  • Electromyograph : An EMG tracks changes in skeletal muscle activity. This can help identify when REM sleep is happening, as well as specific disorders such as periodic limb movement disorder.
  • Electrooculogram : This sensor detects muscle movement around the eye. This helps corroborate the data collected from the EEG and EMG to pinpoint REM sleep.
  • Electrocardiograph : An ECG monitors heart rate and rhythm.
  • Oximeter: This device gauges oxygen saturation in the blood, which helps identify disorders such as sleep apnea.
  • Respirometry Device: This is used to measure airflow and help technicians determine if respiratory help is needed.
  • Thoracoabdominal Belt: This device can be used to assess breathing effort.

How To Fake An Apnea Test By Remaining Asleep In Bed

How to fake an apnea test by remaining awake in bed during the night is easy. This method of testing has been around for a very long time, and its fairly certain that at one time, acne was being tested on people who were not healthy or were mentally unstable.

In other words, if you are suffering from sleep apnea, you might be a little drowsy during the day, and if you are asked to go into a quiet room to take a test, you may be too tired to really comprehend what is happening. Sleep doctors used to test people for acne by keeping them asleep in an assured air environment, where no one else was around, and slowly increasing the patients airway pressure so they could record their breathing patterns.

They would then chart their progress and keep records of their findings. The idea was to discover whether or not the patients symptoms were caused by the apnea, or were the symptoms themselves a sign that the area had caused some damage to the patients brain.

The idea of how to fake an apnea test by remaining awake in bed throughout the night is not really all that far fetched.

There are actually ways of doing this procedure that doesnt require you to go into a medically supervised room, and that dont require you to do anything more than remain asleep.

The idea of how to fake an apnea test by remaining awake in bed throughout the night is nothing new. Its just that in the past, people needed to wear these devices while they slept.

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What To Expect During A Sleep Apnea Test

Patients who are suspected to have sleep apnea are typically instructed by a doctor to take a polysomnogram . This is a sleep apnea test that can be done in a supervised sleep clinic or in the patients home.

During the test, your bodys movements are monitored to be reviewed by a sleep specialist. The results are then used to determine whether or have sleep apnea or another sleep disorder like narcolepsy or even anxiety.

If you are diagnosed with sleep apnea, you may be asked to complete additional testing as a way to determine the best course of treatment for your needs.

1. Before your sleep study, you will be given a list of instructions from your sleep doctor. You will be instructed to shower and wash your hair before your arrival and will be told not to use spray and oils on your hair and scalp. Makeup typically isnt allowed either. Such products interfere with the adhesive used to attach sensors and monitors to your skin.

2. Depending on the severity of your condition, your sleep study may be done using portable equipment in your home or in a private bedroom of a hospital or sleep clinic .

If your testing is done outside of your home, your room wont look like a typical hospital room. To increase comfort and decrease nervousness, the rooms a typically set up like cozy hotels.

3. There will be a group of technicians watching you sleep throughout the night. You wont feel like a fish in an aquarium though. You wont see the technicians unless you buzz them for help.

Can You Fake Sleep Apnea Test And Fool The Doctor

Sleep apnea treatment reduces readmission of heart failure ...

If you are wondering can you fake sleep apnea test and fool the doctor, then you must know that it is not impossible. The reason for this is that many people do experience occasional episodes of apnea. What if you could recognize these episodes and know how to anticipate them so they dont happen as frequently. Wouldnt that be great? In order to determine whether or not you can be able to fool the doctor during a sleep apnea test, we need to understand what goes on during this process.

During a sleep apnea test, a doctor will place some pressure on your airway using either his or her finger or some other object. While this occurs, a computerised machine will simultaneously take readings and show you what the airway tissues are doing during this time. This information can then be compared with the data, the doctor has just taken from the actual apnea episode.

Although this sounds like a fairly simple question, the fact is that when dealing with such a delicate procedure as a sleep apnea test, it is important to get as accurate a result as possible. The problem is that the test can fail to pick up significant changes in the soft tissues of the airways if they are simply left undiagnosed. This means that you could unknowingly push air into your lungs during the test without meaning to. This is why it is important to get as accurate a result as possible when asking can you fake sleep apnea test and fool the doctor.

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What To Do If A Test Fails

How much data are needed with a sleep study? Surprisingly, a successful study can be completed with only a few hours of sleep. Prolonged wakefulness with home testing may lead to a false negative study, meaning that the test does not demonstrate sleep apnea because too much time is spent lying awake with normal breathing. This may prompt an in-center polysomnogram to be performed.

If signals are lost, the duration of this interruption may determine whether a test may have to be repeated. The in-center PSG may be more technically successful, as the sleep technologist can come in to fix a wire that goes astray.

In some cases, a failed test must be repeated in order to reach a diagnosis. Insurance will cover this repeat testing. This is an uncommon need.

What Are The Symptoms Of Sleep Apnea

Symptoms medical examiners can take as suggestive of sleep apnea include:

  • Daytime sleepiness
  • Neck size greater than or equal to 17 in males
  • Neck size greater than or equal to 15 in females
  • The medical expert panel for the FMCSA states that drivers with a BMI greater than or equal to 33 may be conditionally certified to drive depending on a sleep study.

    If you have diabetes, high blood pressure or previously suffered a stroke You should consider talking with your doctor about a sleep study before your DOT physical exam. By being proactive, youll eliminate any unnecessary delays in your certification.

    If you have a BMI of 35 or higher, it may be time to consider bringing up sleep apnea with your doctor.

    If you have a BMI of 35 or greater, you should be proactive and get yourself tested.

    Not sure what your BMI is? Find out with the National Heart, Lung, and Blood Institutes free BMI calculator.

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    What If I Cant Sleep During A Sleep Study

    Sleep studies can be unnerving, even if you are taking one in your own bed. One thing that people worry about is, what if I cant sleep during a sleep study? After all the time and preparation, the last thing you want is to have a bought of insomnia. Next are some tips to help you prepare and relieve your anxiety.

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    Tips To Ensure A Success And Accurate Home Sleep Test

    SLEEP STUDY FOR SLEEP APNEA!!! ((FAILED))
    • Be honest about other medical conditions with your sleep medicine provider. If you have other medical conditions that impact your breathing a home sleep test might not be right for you.

    • Talk to your sleep partner about your sleep behaviors before scheduling a home sleep test. Discuss all those behaviors with your sleep medicine provider. You might have duel sleep disorders or might not have sleep apnea. If there is enough concern for a duel or an alternative diagnosis, you should not have a home sleep test.

    • Follow the instructions provided to you for using the equipment for the HST.

    • Have your sleep partner be a part of your HST. A sleep partner can help place the sensors correctly, be a second set of ears to ensure success with instructions, and even turn the device on once you have fallen asleep.

    • Avoid body sprays, gels, or hairsprays the day before your HST. These items can erode the gel on the sensors.

    • Do not drink alcohol or caffeine close to bedtime. Alcohol and caffeine cause interrupts in sleep patterns.

    • Stick to your regular sleep routine. Do not plan your HST on a night that you have late night evening plans or major events. Plan your HST on a night that is typical without abnormal interrupts.

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    What Is A Home Sleep Test

    Sleep studies allow your doctor to diagnose sleep disorders such as OSA, narcolepsy, restless legs syndrome, insomnia, sleepwalking, and REM sleep behavior disorder. These sleep disorders cannot be diagnosed during a typical office visit and need conclusive data collected during a sleep study.

    The home sleep study occurs at home with equipment provided to you. The equipment includes sensors that register the apnea events. A doctor will review the data before a diagnosis is given.

    Complex Sleep Apnea Syndrome Is A Combination Of Osa And Central Sleep Apnea

    Doctors have recently identified a third type of sleep apnea called complex sleep apnea, which is a combination of obstructive sleep apnea and central sleep apnea. Patients with this type of sleep apnea may at first seem to have obstructive sleep apnea, but unlike typical patients with obstructive sleep apnea, these patients symptoms are not fully addressed with the use of CPAP.

    In patients with complex sleep apnea syndrome, breathing problems persist even after the airway obstruction is addressed and treated, which means something besides the collapsing throat muscles are also contributing to the apnea.

    The problem is that there is still a lot of debate among sleep medicine specialists about whatexactly is going on in complex sleep apnea, or what the key characteristics that define it are.

    In a study published in March 2014 in the journal Sleep Medicine Clinics, doctors conducted a review of 223 patients referred to the Mayo Clinic Sleep Disorders Center over one month, as well as 20 patients diagnosed with central sleep apnea. 00122-7/abstract rel=nofollow> 11) They found that 15 percent of all sleep apnea patients had complex sleep apnea. As many as 84 percent were found to have obstructive sleep apnea, and 0.4 percent had central sleep apnea.

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    Why Do I Need A Sleep Study

    Taking a sleep study in an accredited sleep center or lab is the best way to find out if you have a sleep disorder. It is the “gold standard” of sleep disorders diagnosis. Sleep is not a simple process. Many parts of the brain control your sleep in various stages. These stages of sleep include drowsiness, light sleep, deep sleep, and dream sleep. An overnight sleep study is the best way to analyze your sleep in all of its complexity. This kind of study is called a polysomnogram. It measures your brain waves, heart beat, and breathing. It also records movements of your eyes and legs. It shows your doctor the “big picture” of your sleep pattern. At the same time, it provides precise facts on what your body is doing at every moment of sleep. It combines a panoramic view with microscopic details. It is the most complete and scientific way to evaluate your sleep and discover any problems.

    What Is The Home Sleep Apnea Testing Process

    Failure to Thrive No More

    A home sleep apnea test is designed to be a convenient way to collect information about your sleep. On the day of your test:

    • Follow your regular routine as much as possible
    • Avoid napping
    • Eliminate the use of alcohol and/or caffeine after lunch.

    If you are on a regular medication, tell your doctor. She may recommend that you temporarily stop taking the medication.

    Before your home sleep apnea test, you may have to go to the doctors office to pick up the equipment. Alternatively, someone may deliver the home sleep apnea test to your home.

    A member of the sleep team will give you instructions on how to use the device. Ask questions if there is anything you do not understand.

    You can go to sleep at your regular bedtime. When you are ready to sleep, you will attach the sensors to your body as instructed. You may be asked to keep a sleep log or to press a button on the machine when you get into bed. When you wake up in the morning, you can remove the sensors. You may have to take the device back to the sleep center, return it by mail, and some are disposable. Your sleep center will let you know what to do with your equipment after your test.

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    Crash Risk Soars Among Truck Drivers Who Fail To Adhere To Sleep Apnea Treatment

    DARIEN, IL Truck drivers who fail to adhere to treatment for obstructive sleep apnea are a public safety threat on U.S. roadways, according to results from the largest study of sleep apnea and crash risk among commercial motor vehicle drivers.

    The study, which has been accepted for publication in the journal Sleep, involved 1,613 truck drivers with obstructive sleep apnea and an equal number of control drivers who were matched by job experience and tenure with the trucking firm. Drivers who were diagnosed with sleep apnea were prescribed positive airway pressure therapy and were given an auto-adjusting machine that could be used both at home and in the truck sleeper berth while on the road. Objective treatment adherence data were downloaded from the PAP machines internal memory chip.

    Results show that the rate of serious, preventable crashes was 5 times higher among truck drivers with sleep apnea who failed to adhere to PAP therapy, compared with matched controls. In contrast, the crash rate of drivers with sleep apnea who were fully or partially adherent with treatment was statistically similar to controls.

    The accepted manuscript was posted on the website of the journal Sleep on March 21.

    Do You Need A Sleep Study

    Not everyone with poor quality sleep needs a sleep study done. Many times, a doctor will first use other measures such as a sleep diary to track sleeping patterns, a physical exam and/or review of medical records to determine the cause of the sleep problem. Based on this evaluation, the doctor will recommend a sleep study if they feel its necessary. So, if youre experiencing poor quality sleep, the first step is see a sleep specialist who can help you begin to investigate whats really going on.

    The key to getting a correct diagnosis is finding a specialist to evaluate you. If you dont have one already, read my tips of how to find a really good doctor

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    What Happens After A Sleep Study

    After you complete a sleep study, the collected data is reviewed and scored by the sleep technicians and sleep physician. Once your referring doctor receives these results, they will explain what they have learned from the study. From this point, your medical team can make recommendations and write prescriptions to help remedy any problematic findings.

    If you have been prescribed a Continuous Positive Airway Pressure machine a common occurrence after the diagnosis of sleep apnea a second sleep study may be required to determine the correct airway pressure setting.

    While an overnight sleep study may feel strange at the time, it is worth doing. Once a sleep disorder is diagnosed, your doctor can take steps to correct it, leading to better sleep in the future.

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