I went in today and the RT was great.
Maybe not as great as you thought... read on.
She listened to my concerns, and I now have a Remstar Plus [...] This machine has a smart card in it, so we can assess.
Apparently she either didn't listen too well to those concerns, or she's extremely ignorant of the basics of her own job. The Remstar Plus can be configured with a smartcard, yes, but it ONLY records "compliance" info on that card... basically, ONLY the number of hours you used the machine each night. Only the higher CPAP models like the "Remstar Pro2" or the more recent "Remstar Pro M" (or the "Remstar Auto" for APAP) record the detailed data that's necessary to evaluate how you're doing, like apneas, hypopneas, leak rates, etc. on a minute-by-minute basis.
All your smartcard from that Plus is going to contain is "she used the machine 7 hours last night, and 6 the night before, and 6.5 the night before that..." which is useless for figuring out how well the therapy is working.
Furthermore, a Plus is a CPAP machine! If you've not been titrated, you need an Auto (APAP) machine! A CPAP only blows one set pressure at you (the RT's worthless guess pressure) whereas an APAP will intelligently watch you and your respiratory events in realtime and will adjust its pressure adaptively to try to clear them... and the *detailed* data (not just compliance data) on its smartcard will reveal what your ideal CPAP pressure would be. Then, often you can switch to a CPAP at that pressure (or just keep the APAP, running in either APAP or CPAP mode).
Why the heck is this person a professional RT when most of us here know volumes more than she does, and we're just amateurs! That's pathetic.
As for a sleep study, it would seem that in BC most places use oximetry.
Which, again, is useful for helping to screen for sleep apnea (not a real, full diagnosis mind you, just one metric), but is USELESS for determining what fixed pressure to use to TREAT it!
Apparently the wait for a sleep study is 1-2 years and I am not sure if you can get them privately.
Ah, that explains it. You're in Canada. Witness the joys of state-provided, socialist, "free" healthcare. Free, very slow (even with life-threatening issues like sleep apnea!), and often terrible quality services (an RT who's completely clueless, for instance).
I'm in the US, with private health insurance co-funded by me and my employer (the typical arrangement down here). No government involved. Sleep study night #1 was less than a week after my doctor ordered it. Night #2 was the two days later. I had a formal diagnosis, titrated pressure, mask and "Pro M" CPAP machine (with detailed data recording) the day after that.
One of my dearest friends had her sister die while waiting for cancer treatment over in Britain... again, slow, terrible but "free" socialist state-provided healthcare. If she'd had fast private insurance, she almost certainly would've lived.
The good news is that I *think* you *can* seek out a privately-funded sleep study in Canada. In England I'm pretty sure that going outside the government system using your own money is actually a crime (isn't the nanny state WONDERFUL?), but I think it's okay in Canada. Even if not, fly to the US and pay for one here. If you have sleep apnea, especially moderate or severe, it's worth it rather than letting your body be harmed every night for an extra 1-2 years.
At the very least, go have a chat with the so-called "RT" and request an APAP (a good one being the Respironics Remstar Auto or the more recent Remstar Auto M-Series). Auto-titrating with detailed data recording to assess the effectiveness of your therapy and gives an idea of what your ideal CPAP pressure would be.
Good luck!