I work 3rd shift so when I'm supposed to have a sleep study I'm wide awake. I had one 6 years ago and fell asleep for the last hour of the test. They said I had mild apnea and told me to lose weight. Since then I have had 2 more sleep studies and couldn't sleep AT ALL. The sleep center told my Dr. that the last 2 tests were "unremarkable". In April I had a TIA (small stroke) and have been hyperventilated ever since, especially upon waking. My Dr. sadi it's just anxiety and prescribed anti-anxiety meds and referred me to a psychiatrist. The psychiatrist said I DO NOT have anxiety, but may be having panic attacks in my sleep due to my sleep apnea worsening. My Dr. won't order another sleep study because the last 2 were "unremarkable". Now what do I do? HELP!!!

You find a different doctor who will take you seriously.  Also, you find a different sleep lab.  Any good sleep lab will schedule sleep studies during the day exactly for people who work 3rd shift as you do.

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

TIAs and panic attacks can be confused, I think you need a strong dose of sleeping pills for your sleep study
overbreathing can become a habit, try to slow down your breathing, take deep slow breaths, hyperventilating can make people feel happy and distracted


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resmed S6 lightweight, respironics comfort gell mask using CPAP since 1995, no humidifier
during my many years of severe fatigue, no doctor ever asked me if I snored

I assume you've told your dr / sleep lab about your work shift....is there no way they will arrange a test during your sleep hours?  I am surprised a dr would put any credit in a sleep study done in your circumstances.

There is a type of apnea that includes hyperventilating.

Ask your dr if he would prescribe and monitor an at-home sleep test....These were approved by Medicare/Medicaid in march of this year.  Then you  could do it during your normal sleep hours.

Thank you so much for the feedback!   My Dr. knows I'm on 3rd shift but the only sleep labs in my area do the test from 7pm to 5am Sun. thru Thurs. nites. Good news & bad news though. My Dr. ordered it but now the insurance says no because of the "unremarkable" tests. My Dr. tried to explain to them that I WAS diagnosed already in 2002 and he just wants an accurate test of severity, but they say it must've gone away because I have tested negative since then. I might just have to do it out-of-pocket. At- home tests aren't available in my podunk area in NE Wisconsin.  But at least the Dr. ordered!

Have your neurologist talk with your psychiatrist and other doctors.  Your small stroke may have affected an area which controls breathing (and perhaps therefore sleep apnea) and/or anxiety.

I have panic attacks similar to yours (trauma related from a robbery/stabbing I experienced).  In your case I wonder in what parts of the brain the TIA occurred.

May you find peace!

Todzo

MrsBaddawg wrote:

Thank you so much for the feedback!   My Dr. knows I'm on 3rd shift but the only sleep labs in my area do the test from 7pm to 5am Sun. thru Thurs. nites. Good news & bad news though. My Dr. ordered it but now the insurance says no because of the "unremarkable" tests. My Dr. tried to explain to them that I WAS diagnosed already in 2002 and he just wants an accurate test of severity, but they say it must've gone away because I have tested negative since then. I might just have to do it out-of-pocket. At- home tests aren't available in my podunk area in NE Wisconsin.  But at least the Dr. ordered!

Can you get an oximetry test ordered (and covered by your insurance)? You can also consider wrist actigraphy (Watch PAT). These things are much much cheaper. Heck, you could probably pay out of pocket, if you really HAD to.

In any event, this could potentially get you a script for an APAP

Todzo, the ER Doc that ordered all the tests after my TIA said it affected my limbic system (??) and I may develop problems but he's not sure what because that sytem encompasses most autonomic responses. **UPDATE** I was told today by the PCP that all his pushing worked and the ins. co. finally approved a split-study. He's also going to give me Ambien for the test so I actually sleep. Unfortunately, the soonest they can fit me in is November and I, as of last nite, have started passing out @ work. So now I'm just praying to get through the next 3 months.

MrsBaddawg, that's great news.

If you have not taken Ambien before, get some samples or small prescription from your doctor and take them NOW.  Not all sleep aids work for all people, and some even increase alertness rather than help you sleep.  For example, Lunesta was the only one that worked for me, Ambien, Ambien/CR and Sonata all increased my alertness and I was wide awake all night (and feeling VERY drugged at the same time).  For some people only Ambien works, not the others.  And some people find out NONE of them are effective (I'm that way now, Lunesta doesn't work any longer.)

Since you have a little time before your next study, please consider using it to trial short courses of sleep aids to see what works best for you.  Start with the zolpidem (generic for Ambien) as recommended, but you might find you need to try others, and sometimes you need to take it for a few nights in a row to get the best effect (so you'd need to do that right before your study, too, if that is what works best for you).  

Also, please call the lab and get on their cancellation list, as you might get into a study a lot sooner.  Just be sure you know how a sleep aid works for you before you accept a new appointment.  You want to be sure you will SLEEP this time

Blessings,
--pseudonym

When I had my first sleep study I worked night shift and slept during the day; the lab accomodated my sleep schedule.  It even allowed them to shoehorn me into the schedule because they could still do their normally scheduled night time studies; the night sleepers were coming into the lab as I was leaving to go to work.

MrsBaddawg wrote:

My Dr. tried to explain to them that I WAS diagnosed already in 2002 and he just wants an accurate test of severity, but they say it must've gone away because I have tested negative since then.

One of my brothers is a doctor and he HATES HMOs for reasons such as this.  They really interfere with his ability to practice medicine.  You don't have Secure Horizons or Liberty Mutual insurance do you?  This sounds like the kind of !@#! LM would pull..

MrsBaddawg wrote:

Unfortunately, the soonest they can fit me in is November and I, as of last nite, have started passing out @ work. So now I'm just praying to get through the next 3 months.

Passing out at work !  Not a good thing!

A post elsewhere on the forum suggested calling the sleep center and getting put on their cancellation list.  That way, if anyone cancels, you can get an earlier slot.

I used Ambien for my sleep study after a previous "sub-optimal" study.  The second study yielded them good results but I was pretty groggy the next day. It was the first time I had ever used Ambien.

I have Network Health and they usually are pretty good but I don't know what their problem was this time. Anyway, I tried to get on the sleep lab's cancellation list but the insurance company scheduled it and will ONLY approve it for Nov. 2. When I called the sleep lab on Fri. to find out if they could get me in any sooner than that, they said they had a cancellation for THAT NITE! I was elated until they said I had to get my PCP to call the ins. for a pre-auth. I called my PCP and his nurse said she went thru too much !*%! to get it approved at all so she is NOT going to call to get it bumped up. She said I'll just have to wait.   The only hosp. approved by the ins. will do sleep studies only at night due to staffing problems. My PCP also says he suspects that my apnea is so severe he's not comfortable with me trying ANY sleep aids until I'm in a hosp. setting. Oh well, I hope Ambien works when the time comes...

Hi MrsBaddawg,

Did you see my post to you, above?  PLEASE don't wait until the study, to find out if ambien works for you.  Please ask your PCP for samples or a short course to try out now, while you have time to find another if it doesn't work.  You have come this far to get another study, and I'd sure hate to see you lie awake through it all because you didn't know how ambien would affect you.

Perhaps ambien will work well for you.  But if not, you have time to try some others and see if there is one that would help you at the study.

Blessings,
--pseudonym

My PCP won't let me try ANYTHING for sleep unless I'm in a hosp. setting in case it works so well I need emrgency attention. So I guess I have to just wait and see...