Q: Does or did treatment fix my sleep?
Without a standard measurement for sleep quality, a single index answering this question has not been possible using the most widely available resources for sleep measurement. Detailed comparison of serial nights in the sleep lab, often used for research and or clinical care, is labor intensive and yields stages of sleep, and an arousal index that measures sleep fragmentation (largely ignored). Individual trends in actigraphy (movement) or wrist data can be helpful or sometimes conflicting, primarily using estimates of sleep from movement or other peripheral sensors. Direct measurement of sleep at the base of the brain provides accurate information on many aspects of your sleep providing previously unobtainable information for individuals. With multi-night sampling and validated normal values for comparison, CPC provides a picture of your sleep on the nights tested with results for sleep quality, quantity and underlying pathology.
Q: Altitude affects sleep, can CPC coupling capture this change?
Yes. It is possible to record different nights at different altitudes to measure impact on sleep. Altitudes above about 7500 feet become more challenging for sleep. Individual variation and acclimation can occur however is not universal or a ‘given’? Living at altitude often lands one with a recommendation to use oxygen at night over time if symptoms are present. When initially adding oxygen, there is indeed often a remarkable change over a very short time, on breathing events (AHI) and saturations. Often continuous and deep sleep return, sometimes however the arousal index will remain elevated indicating fragmented sleep. How do you know? Re-phrased: does the oxygen I sleep with fix my sleep? Is the benefit sustained? How do I reassess my sleep from a symptom, health or wellness perspective? These real world and logical questions are easily approached by direct measurement of sleep.
Q: Who do the results belong to?
You. These results do not belong to any insurance company. These are yours. No data is shared with anyone. You may share your results and my notes with whomever you wish.
Q: How can I improve my sleep and validate any personal intervention?
As people awaken to the benefits of sleep, an ecosystem of products and promises are available for delivery everywhere, an overwhelming number. Some helpful, some not, and how do we know when we rarely remember how we slept last Tuesday? Validating response to intervention is hard to track using available healthcare resources and intermittent point testing using a direct measure of sleep may be helpful.
Q: Shouldn’t my sleep be measured prior to starting medications for sleep?
An excellent idea! Because there is another dimension to sleep, that of perception, objective evaluation using CPC provides detailed data and graphic information to confirm insomnia. If one has normal sleep, then one is mostly at risk for only the side effects of the medications without opportunity for real improvement. There may be other very good insomnia treatments available and covered by your health insurance for consideration before medications.
Q: Is this evaluation covered under my healthcare insurance?
We make no claims to insurance on your behalf. If you wish to submit the test and consultation to a payor for coverage, this will be your responsibility and no guarantees on payment can be made.
Q: How does CPC work?
CardioPulmonary Coupling using the SleepImage® Software analyses the relationship between cardiovascular heart rate response (CVHR) and breathing measured from autonomic nervous system (ANS) output at the base of the brain (medulla) using only a single 2 patch EEG lead and a small purpose designed M-1 recorder or Vivalink Checkme device. The proprietary cloud-based software analyses offers a wealth of interesting information about sleep, validated in over 80 medical studies.
When the SleepImage software is used with a device/s that records plethysmography (PPG), an sAHI is generated and this equivalent to an AHI from a polysomnogram or PSG. Examples of these devices include pulse oximeters approved for use with SleepImage.
Q: What if I have had a SleepImage CPC test?
Bring the result along to the appointment and we can review the report together, reach understanding and apply the results (billing option#4 below).
Q: Why have I still got symptoms?
About the most common reason for contacting a sleep specialist between visits is for symptoms related to therapy or recurrent / persistent symptoms possible related to sleep quality. CPC answers whether obstructive or central sleep apnea is present, how hard the heart is working at night and how these factors interact to impact sleep quality. Leg movements can also often be seen on the test as an additional finding.
Q: How do I choose between billing options 1, 2 and 3?
Option 1 is for clinical practitioners who would like the SleepImage CPC study to be interpreted by a board certified sleep physician.
Option 2 is for those who dont have a caregiver and wish for SleepExpertise to supply the CPC testing device and to have a tele consultation (30min) regarding the results.
Option 3 is for those who have had a prior CPC evaluation and want a followup CPC study and brief consultation (15min) regarding results.