For those of you that have had your CPAP prescriptions for a long time, you may be wondering “when should I have a second sleep study performed?” And this is a great question that often goes unanswered by medical professionals.

Currently, there is not set time frame in which your current CPAP prescription expires. Unlike other prescriptions in which annual clinic visits are required to assess any prescription changes, CPAP users are not required to have regular sleep studies to verify any pressure change needs.

We hear about patients all the time that have had their CPAP devices for many years without ever coming in to have a second study performed. And oddly enough, in some cases, this is just fine. Especially when there hasn’t been any major changes or events in the patient’s life that would necessitate a second study. However, there are circumstances that would lead to a patient needing to have a follow-up sleep study, or at least a titration study.

Reasons to have a second sleep study for CPAP users

While there isn’t a required time to have a repeat sleep study performed, many doctors believe that it would be a good idea to talk with your sleep specialist at least every 5 years (some say 2-3 years). At the very least, it is recommended that you discuss any sleep troubles, questions, or concerns with your primary care physician during your annual visits. If they become concerned with your therapy, they may request that you have a second study.

Technology, practices, and standards are always evolving in the medical fields, and to be sure that you are getting the best treatment possible, it’s a good idea to keep in contact with your sleep specialist, or primary care physician, regularly about your sleep health.

If your symptoms return

For the most part, as long as your treatment seems to be going okay, then a follow-up study might not be necessary. However, if your symptoms begin to return, you may want to contact your doctor.

Symptoms to look out for:

• If you start to snore even when wearing your mask at night, it’s often a strong indication that you may need your pressure settings evaluated.
• If you start having pauses in breathing, or experience gasping or choking during sleep.
• If you begin to feel excessively tired during the day again on a regular basis
• If you’re waking with morning headaches
• If you start to have unexplainable mood swings or feel irritated often
• Have trouble with concentration or memory
• Experience bouts of depression.

Basically if any of the symptoms that prevented you from getting quality sleep at night, or gave you troubles during your waking periods resume, it’s a good chance that you may need a new sleep study to trouble shoot your sleep problems.

If your symptoms don’t go away

Sometimes, but not often, when people are screened for sleep apnea, other overlapping sleep disorders go undiscovered. It’s possible that a person may have both sleep apnea and another sleep disorder such as narcolepsy or idiopathic hypersomnia that are causing them to feel tired all the time.

Once they are being treated for sleep apnea, and discover that their symptoms of excessive daytime sleepiness aren’t going away, then it may be necessary to have a follow-up study to reveal any other overlapping disorders.

Depending on the symptoms it may be recommended that you take another polysomnogram, or have a multiple sleep latency test (MSLT), or a maintenance of wakefulness test (MWT) to diagnose or rule out any other disorders.

If you have any major lifestyle changes or changes in health

• If you’ve recently lost or gained a significant amount of weight, it may affect your pressure needs for your CPAP. If you notice that because of your recent weight loss/gain that your pressure settings aren’t quite optimal, you may want to talk with your sleep specialist about having a new titration study performed.
• Many people are asked to have a second  study if they’ve had a stroke, been diagnosed with cardiac disease, had a heart attack since CPAP therapy began, or have recently had surgery requiring a stent.
• You will also need a second titration study if your primary care physician has prescribed you with nocturnal oxygen.

Many newer machines issued contain downloadable data that makes tracking compliance and efficiency of treatment easy. Automatic positive airway pressure (APAP) devices are able to adjust between a low range pressure setting and a high range pressure setting to ensure that each breath a patient takes delivers the best pressure at any give moment.

And while these machines make it easier for doctors and insurance companies to check that therapy is working properly for their patients, even auto-titrating machines may need to be readjusted periodically to ensure full optimization.

People that are not having complaints about their therapy and have downloads proving adequate therapy use and efficacy, often don’t need repeat studies unless drastic changes occur.

However, If you believe that you may be in need of a second sleep study, don’t hesitate to contact The Alaska Sleep Clinic. Just click on the link below and we will have a sleep educator contact you to review your symptoms and determine if another sleep study is necessary.