Questions

• How should I prepare for my sleep study and what should I bring?
• What happens after the sleep study?
• After the initial evaluation, how often do I need follow-up with my treating physician?
• Why do I need treatment for sleep apnea?
• How long does it take to feel less sleepy after using CPAP?
• Do I need to use CPAP every night?
• What if I travel?
• What problems can I encounter with using CPAP and what should I do?
• What maintenance should I do with my CPAP equipment? Who will issue my subsequent prescriptions for mask, tubing, filters and other supplies?
• How often do I need a sleep study?
• How long will I remain on CPAP? If I lose weight, will this cure my sleep apnea? What other measures do I need to do to improve my sleep apnea?

How should I prepare for my sleep study and what should I bring?

Bring comfortable sleep wear, your favorite pillow, reading material, toiletries, and your usual medications. A TV set is available in the waiting area. The shared bathroom is located in a hall away from the bedroom and shower facilities are available if you need them the next morning.

Children and minors must be accompanied by a responsible adult. Patients with special needs (retarded, demented, or require assistance to the bathroom) must be accompanied by a caretaker. The adult companion is encouraged to bring a sleeping bag; if another sleep room is unoccupied, the companion can sleep in the other bedroom.



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What happens after the sleep study?

It takes 10 days to 2 weeks to process your sleep study-this involves the technician's scoring of your study and the physician's interpretation and preparation of the report.

If you were directly referred to the Sleep Clinic only for testing, the report will be sent directly to your referring physician within 2 weeks after your study. Contact your referring physician for advice. If your diagnostic study was positive, you and your physician will determine what your best treatment option is. If you both decide on CPAP trial, then your physician will refer you to the Sleep Clinic for either a CPAP titration study to be done overnight at the Sleep Clinic or a home CPAP titration study (see description above). It will take 10 days- 2 weeks to process your CPAP study. A prescription for a CPAP device will be faxed to your referring physician and the durable medical equipment (DME) vendor that your insurance company is contracted with. They will obtain authorization from your insurance company to provide you with the equipment. You should hear from your durable medical equipment vendor within 3 weeks of your study. If not, please contact them directly. It is recommended that you follow-up with your treating physician 4-6 weeks after you start CPAP so that he/she can determine how effective it has been for you and to assist you with any problems you are experiencing with CPAP use.

If you were seen by Dr. Abad on consultation, your sleep study documents sleep apnea, and you had previously agreed to undertake CPAP trial, after authorization by your insurance company, a therapeutic study (either CPAP titration in the Sleep Clinic or home CPAP titration) will be arranged. It will take us 10 days - 2 weeks to process your study. We will request authorization from your insurance company for the CPAP device. A prescription for the CPAP device will be faxed both to your durable medical equipment (DME) vendor and the physician who originally referred you to Dr. Abad. You should hear from your DME vendor within 3 weeks of your CPAP study. If not, please contact your DME vendor directly. Also, a follow-up appointment will be scheduled for you to see Dr. Abad within 4-6 weeks after you start CPAP. If you have not been scheduled for this appointment within 3 weeks of your CPAP study, please contact the Sleep Clinic to set it up. At the time of your follow-up appointment, Dr. Abad will go over the results of both sleep studies and also determine how effective CPAP has been for you. She will also address any problems you have regarding use of CPAP. Please bring your machine, mask, and headgear with you to the appointment, in case we need to verify mask fit and other related problems.

Insurance companies usually authorize either rental or purchase of the CPAP machine from your durable medical equipment vendor. It is subject to the same co-pays based on your insurance policy's benefits. You can contact the customer representative of your insurance company to determine your share of cost.



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After the initial evaluation, how often do I need follow-up with my treating physician?

As often as needed if you are experiencing problems with CPAP. Check with your treating physician. In general, assuming you are doing well with your CPAP, we recommend at least an annual check-up after the initial consultation and initial follow-up visit. During your annual follow-up, your treating physician can evaluate efficacy of therapy, address any problems, and renew your prescriptions for your mask, tubing, filters and other supplies.


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Why do I need treatment for sleep apnea?

Untreated sleep apnea has health consequences including the following:

Excessive daytime sleepiness

Unrefreshing sleep

Morning headaches or nausea

Problems with memory

High blood pressure

Heartburn

Heart attack (myocardial infarction)

Strokes

Depression

Loss of interest in sex/impotence


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How long does it take to feel less sleepy after using CPAP?

It varies from person to person but can occur within at least 3-4 weeks after starting CPAP.


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Do I need to use CPAP every night?

Optimal CPAP therapy is every night and you should try to keep it on the entire night. In the research studies that showed benefit of CPAP, patients were using CPAP at least 5 hours/night at least 5 days a week. You will do best if you use it every night.


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What if I travel?

Your CPAP equipment is portable and you should take it with you. Your CPAP machine can be used for either 110 or 220 Volt outlets. If you are camping, special batteries may be used. Consult your DME vendor.




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What problems can I encounter with using CPAP and what should I do?

The following problems can occur:

Nasal stuffiness or congestion or nasal dryness

Dryness of the mouth

Mask air leaks

Noisy machine

Sore, dry, or red eyes

Skin irritation from the mask and/or straps

Sensation of too much air in the chest

Sensation of abdominal bloating, cramping or gas

Persistent sleepiness despite regular use of CPAP

Feeling claustrophobic with the mask

Waking up having taken off the mask during sleep

These problems should be addressed with your treating physician and he/she will make suggestions.


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What maintenance should I do with my CPAP equipment? Who will issue my subsequent prescriptions for mask, tubing, filters and other supplies?

Your DME vendor is supposed to instruct you on care for your machine. General measures are to keep your tubing clean. In the morning, you can use a few drops of Ivory Liquid Soap in the tubing and flush with water until clear and hang up to dry until the evening. You can also use Ivory Liquid Soap on your mask and rinse with water to get rid of the facial oils. Clean your filters at least 1x/week. Let the foam filter dry out and do not put a moist filter back on the machine.

You should have a new mask, tubing, and filters at least yearly. Ask your treating provider for a prescription. If you were seen by Dr. Abad, she will prescribe these during your follow-up visits.



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How often do I need a sleep study?

You need a CPAP titrations study if:

You have recurrence of your sleep apnea symptoms-daytime excessive somnolence, snoring, unrefreshing sleep

Weight gain or weight loss of > 10 pounds may signify the need for new pressure setting

Your machine needs replacement. Most insurance companies require a study within the past year to authorize a new machine.


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How long will I remain on CPAP? If I lose weight, will this cure my sleep apnea? What other measures do I need to do to improve my sleep apnea?

In general, you will remain on CPAP for the rest of your life, unless your sleep apnea resolves due to other treatment modalities, such as sleep apnea surgery, or oral appliance. In general, you need to lose 10% of your body weight to improve your breathing disorder. Weight loss may improve the severity of your sleep apnea but not necessarily cure it. Sustained weight loss is hard to achieve.

Positional therapy (sleeping in a semi-upright position or on your side) usually decreases sleep apnea. However, although it may improve it, by itself, this is insufficient to reverse moderate or severe sleep apnea.



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