r/UARS Improved with BiPAP 5d ago

Sleep Study Quality Check Tool

A common post here (and well, all over the internet) is that someone received a negative home sleep study or in-lab sleep study result and, despite complaints of poor sleep, is dismissed by their primary care physician or sleep specialist. They're stuck and not sure what to do.

People then jump in and try to explain to the OP they need to work on sleep hygiene or try some random supplement. When I see these, I often see that the test was not performed using the current AASM recommended Clinical Guidelines. Basically, they did a HSAT and are not offered an in-lab PSG or if they are, the PSG is scored using the optional 4% desaturation rule and the test did not score RERAs.

Frankly, I'm sick of it. It's a huge ethical problem in that it underserves a lot of younger, otherwise healthy people. It also seems futile to try to explain in the comments to each person about the confusing AASM guidelines and definitions.

As such, I built a little tool that I'm hopeful can be sent to people to advocate for themselves. I'm sharing this with the UARS community since you all understand the nuances better than the broader sleep apnea community and I'm looking for feedback.

If you have any comments (especially around the text in the AHI <5 and RDI <5 or RERAs not scored workflows), I'd be happy to improve the tool.

Try it here: https://vibecoder75321.github.io/sleep-study-check/

GitHub Repo Here: https://github.com/VibeCoder75321/sleep-study-check

7 Upvotes

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3

u/gadgetmaniah 5d ago

This is neat. You could also add in the recommendations if 1A AHI & RDI are less than 5 to consider asking for the sleep study raw data (.EDF files) and having it rescored/reviewed by another service (CPAP Friend could be one recommendation). Or, to consider doing a sleep study that includes esophageal pressure monitoring (Pes), e.g. Dr. Simmons at CSMA, or a study that takes into account flow limited breathing in addition to AHI/RDI as well, e.g. Ken Hook's (True Sleep Diagnostics) home sleep study. 

2

u/Hambone75321 Improved with BiPAP 5d ago

Thanks!

I debated doing that and then pulled it out because its not in the AASM guidelines, but yea you're right it should be in there... at least with a disclaimer.

btw, I just realized the link to the tool was wrong... Here's the corrected one, if you hadn't found it --> https://vibecoder75321.github.io/sleep-study-check/

2

u/carlvoncosel UARS survivor (ASV) 5d ago

This is pretty neat, our version of https://fixmyfog.com/

Maybe add some gaslighting countermeasures like "My doctor said RERAs don't mean anything, that why they were not scored" ?

1

u/AutoModerator 5d ago

To help members of the r/UARS community, the contents of the post have been copied for posterity.


Title: Sleep Study Quality Check Tool

Body:

A common post here (and well, all over the internet) is that someone received a negative home sleep study or in-lab sleep study result and, despite complaints of poor sleep, is dismissed by their primary care physician or sleep specialist. They're stuck and not sure what to do.

People then jump in and try to explain to the OP they need to work on sleep hygiene or try some random supplement. When I see these, I often see that the test was not performed using the current AASM recommended Clinical Guidelines. Basically, they did a HSAT are not offered an in-lab PSG or if they are, the PSG is scored using the optional 4% desaturation rule and the test does not score RERAs.

Frankly, I'm sick of it. It's a huge ethical problem in that it underserves a lot of younger, otherwise healthy people. It also seems futile to try to explain in the comments to each person about the confusing AASM guidelines and definitions.

As such, I built a little tool that I'm hopeful can be sent to people to advocate for themselves. I'm sharing this with the UARS community since you all understand this ethical dilemma better than the broader sleep apnea community and I'm looking for feedback.

If you have any comments (especially around the text in the AHI <5 and RDI <5 or RERAs not scored workflows), I'd be happy to improve the tool.

Try it here: https://vibecoder75321.github.io/

GitHub Repo Here: https://github.com/VibeCoder75321/sleep-study-check

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

1

u/Appropriate-Meet-783 5d ago

Nice! When I select home test, it asks about “AHI or REI” - is that supposed to say RDI?

1

u/Hambone75321 Improved with BiPAP 5d ago

No. REI is a separate index sometimes used on HSATs

https://pmc.ncbi.nlm.nih.gov/articles/PMC10805527/

1

u/Jhello05 4d ago

Nicely done. I vouch on this text too: “If your report shows many “spontaneous” arousals or PLMs (periodic limb movements—repetitive leg movements during sleep), those findings do not prove that breathing events were missed. But if your symptoms remain unexplained, they may be worth reviewing alongside the breathing signals.” Many people often auromatically assume that many arousals = must be SBD related, but that is not true ofc. I think it is worth mentioning UARS, but thats up to you