CPAP is the leading treatment for obstructive sleep apnea. For many years, once diagnosed with this sleep disorder, a titration was performed to determine the optimal pressure setting for your CPAP device. This titration was based on your sleep test results. Over the past several years, due to changes in medical policy from insurance companies in the USA, payors mandate patients bypass the home or lab titration and are instead prescribed Auto CPAP for immediate use.
This Auto CPAP therapy works for 85% of the patients but for those with recurrent central sleep apnea or other concomitant breathing disorder a more sophisticated device is required. The patient must fail using Auto CPAP therapy prior to a titration and new device being prescribed.
Your doctor may suggest tightening the pressure range with your Auto CPAP to increase comfort and prevent events of either apnea or hypopnea. Your doctor may suggest a new sleep test if there are changes to your weight or other symptoms that occur while using Auto CPAP therapy.
However, there are further factors which can determine when you might need another sleep test and adjustment to your Auto CPAP or other therapy.
Returning Sleep Apnea Symptoms
CPAP should ensure your sleep is uninterrupted, so you feel fresher in the morning without the daytime fatigue associated with the sleep disorder. However, if you notice your old symptoms returning, you should talk to your doctor who can arrange a new sleep study.
Symptoms will vary from person to person, but the most common include:
- Excessive daytime fatigue
- Loud snoring
- Frequent breathing pauses while sleeping
- Morning headaches
- Poor concentration
- Increased irritability
- Mood swings
If your symptoms start to return, it could signal that the pressure setting on your Auto CPAP or other device needs adjusting. In this instance, a new sleep study may be required to check your optimal pressure settings and make necessary adjustments to insure normal breathing.
Underlying Health Issues
If you have obstructive sleep apnea along with health issues such as hypertension, then your doctor may recommend a diagnostic sleep study more frequently, possibly once a year. This also applies to people with sleep apnea who have previously suffered a heart attack or stroke.
Untreated sleep apnea increases the risk of heart disease, high blood pressure and stroke. Therefore, your doctor will want to closely monitor your Auto CPAP device to ensure that it continues to address your sleep apnea symptoms. A regular sleep study will ensure your Auto CPAP device remains set to the optimal pressure settings.
Updating a CPAP Device
If you have an older CPAP device, you may want to update it to a newer Auto CPAP device, more technologically advanced model. Most new devices now have a humidifier as standard, as well as having wireless compliance monitoring, which helps you keep track of your progress. Today’s Auto CPAP devices are also smaller and quieter than previous versions.
Many insurance company policies will cover a new Auto CPAP device every three to five years, but they may require you to have a new diagnostic sleep study before providing one. They will want to ensure you still experience sleep apnea, and an at-home test can be sufficient proof. Our company can also perform an at home diagnostic titration to determine the optimal pressure ranges and device to properly treat your apneic events.
A change in weight can prompt the need for a change in pressure Settings on your Auto CPAP device. This applies to weight loss and weight gain.
Weight loss is particularly common once you have been diagnosed with sleep apnea, as excess weight is a risk factor for this disorder. A healthier diet and exercise are recommended to help with weight loss. Another benefit of exercise -- it can help you sleep better generally, which also aids weight loss.
If your weight does change by any significant degree, a sleep study may be required to adjust your Auto CPAP device pressure settings.
Changing To BiPAP or ASV
Not everyone adjusts to using CPAP, roughly 15% of patients find it especially difficult to breathe out if they require a high pressure setting on their device. BiPAP is an alternative device with two air pressure settings compared to Auto CPAP’s or CPAP’s single setting. The pressure setting with a BiPAP device is lower when you exhale compared to when you inhale.
If you are finding CPAP uncomfortable to tolerate, then you can discuss the possibility of a BiPAP device with your doctor. Insurance companies may require you to take a new sleep study to show you have an Auto CPAP intolerance. The key factor is to have the right device for you, one which maximizes compliance, so you retain the benefits of your sleep apnea treatment.
Is It Time for a New Sleep Test?
The success of CPAP depends on several factors -- including the correct pressure settings, ensuring a steady stream of air to keep your airways clear allowing you to experience uninterrupted sleep.
Your initial sleep test at the time of diagnosis acts as a baseline. Your doctor can then advise you how often they feel you should take a new sleep study.
However, over time there are factors that could mean your pressure setting needs adjusting. A simple pressure change can go a long way to preventing the return of your sleep apnea symptoms and the health complications this brings.
Always consult with your doctor if you feel a new sleep study will be beneficial.