Why Are You Back Again?

Once, while I was walking out of the sleep lab with a patient, I joked, “I hope I never run into you in your line of work.”

This gentleman is a residence agent, or as the street name goes, a bounty hunter. Naturally, he probably thought to himself, I hope I never run into you in your line of work...again.

He never did – or at least not yet. But for so many other people with apnea, for various reasons, they have darkened the doors of the sleep lab again.

Do you know what brought you back?

I think several of you readers have been through this experience. Perhaps it was properly explained why you came back, or perhaps you still don’t know. Either way, I hope to explain your past experience and speak to those who will have this futuristic experience.

So, why are you back again? I think this question is linked to 3 primary reasons.

1. Your CPAP is not enough

The first reason might be that your CPAP isn’t sufficient for your apneic events. What am I saying here? Essentially, the continuous positive airway pressure (CPAP) machine isn’t doing enough to treat you efficiently. Most likely, it’s helping in some capacity, but it isn’t fully effective.

A sleep doctor, through modern technology, can read how effective the CPAP is or isn’t. If they believe it isn’t effective, they’ll bring you in for a bilevel positive airway pressure (BIPAP) study. Though the BIPAP has some similar effects to CPAP, it holds more of an ability to treat complex sleep apnea and hypoxemia.

2. You need a new machine

The second reason you might come back for a sleep study is you need a new machine. I hate to say the most Captain Obvious statement...but I will anyway. Just like everything in life, CPAP, BIPAP, and adaptive servo-ventilation (ASV) machines break down and then they aren’t effective anymore.

Before insurance companies just hand you a new machine, they want to make sure you still have sleep apnea. On the surface, this seems like a foolish approach to cost efficiency, but in some instances, the people don’t qualify for a new machine. When I say they “don’t qualify,” what I mean is they don’t have sleep apnea anymore.

Split-night study

If you fall in this category, you’ll receive what is called a split-night study. This just means you’ll start without the CPAP in order to prove you still have sleep apnea. Once it’s been proven, then you’ll go onto CPAP. I bring this up because people who’ve been on CPAP for several years can experience insomnia during the first portion of the split-night study (since their routine is to sleep with it). So in order to prevent sleeplessness, it’s important to go without the CPAP for 3 to 5 days before the sleep study. This is a practice our sleep doctors recommend, but I think you should ask your sleep doctor before doing it.

3. You don't feel rested anymore

The third and final reason you might come back to the sleep lab is: You aren’t feeling rested and revived anymore. Sometimes when you feel this way, the doctor will send you back to a sleep lab. You might just need a higher pressure, a different type of machine, or a different type of mask to help you feel better!

What advice do you have for people going in for a sleep study? Check out the questions and answers in our forums and share your experiences with others.