Sandii,
I'm in the US so I can't begin to explain why the rules are so harsh in Australia. You do have my sympathy however.
I'd like to answer some questions that you've asked that are not directly tied to the question of the driver's license mess. But having these answers may help you start putting together what to do next.
(04-02-2016, 04:53 PM)Sandii Wrote: Thanks for your reply. I live in a small regional town in Queensland Australia. I contacted our local place that deals with CPAP machines to get a price on them. The prices, even on his second hand machines are way more than I can afford and I don't have anywhere I can even borrow the money needed from. He also informed me that to buy one of his 'cheaper second hand' ones I would need a prescription from my dr as they need to 'regulate the airflow?'
A plain old CPAP only blows air at one fixed pressure. And the person who sets the machine up has to set it up with the pressure setting ordered by the doctor in the prescription. Only you haven't had a titration study and the doc hasn't any more idea than you do about what the correct pressure to prescribe would be.
The usual way of avoiding an expensive in-lab titration study is to set the new patient up with what's called an APAP or AutoCPAP. Those are the "automatic" machines the guy at the CPAP store said he could sell you without a prescription. In Australia, those machines can be sold without a script because they can be set to adjust the pressure all night long based on what's happening. Here in the states some insurance companies are now setting new OSA patients up with a APAP loaner for a week or two to do the titration at home. The proper pressure setting can be determined from the APAP's data.
So---if it were possible to buy an APAP that would be the way to go. And it sounds like that's what Australian law expects you to do: Just buy the APAP, use it for 4 weeks, and use the APAP data to get your license back. But you are slipping through the cracks because you can't afford the APAP and you can't afford to lose the license while you try to straighten out how to get the APAP for a price you can afford.
Quote:Dr has not given me any 'prescription'.
She has also now gone on leave until 20 April.
As others have pointed out, if it is possible to fire this doc, you should do that. If nothing else, is there a governmental agency or medical board that you can report the doctor to?
Quote:From what I can ascertain the law here regarding trying to get my licence reinstated is that I have to 'trial' a machine for 4 weeks and my 'levels' have to 'significantly' lower & dr has to approve this before the transport dept even considers reinstating my licence.
The "trial" of a machine means that you are supposed to get your hands on a CPAP or APAP machine and use it for 4 weeks. The question, of course, is how can you get your hands on a CPAP or APAP when you can't afford to buy one. The question is whether anybody can
lend or
rent you a machine at modest cost for 4 weeks.
The "levels" that have to be "significantly lower" to get your license back are the treated AHI. The AHI is the "apnea-hypopnea index." It is the average number of events that occur in one hour of sleep. Here in the states, an untreated AHI > 5 is considered mild apnea and an AHI > 30 is considered severe. CPAP/APAP therapy is considered effective if the treated AHI is less than 5. There is a thread somewhere on the board that seems to indicate that Australia is changing it's standards for "effective" treatment. You might want to look for that thread. But loosely you can assume right now that your untreated AHI is most likely well above 10---as in your upper airway collapses and you stop breathing or almost stop breathing at least 10 times every hour you are asleep. The CPAP/APAP should reduce your AHI to less than 5.
So here again, if you can figure out a way of getting a machine, your goal will be to use the machine every night for a trial period of 4 weeks and if the machine's reported AHI for the month is less than 5.0, that will be enough to satisfy the doc and the transportation department and you'd get your license back. Keeping your license may require demonstrating that you continue to use the machine to manage the OSA.
Quote:I do not have private health insurance as am already on a Disability Pension for other medical problems that negate me being able to walk the long distances I would need to to be able to access the grocery store alone let alone anywhere else.
Seems to me that calling the folks at the Disability Pension office is in order. Maybe someone there can help you get your hands on at least a loaner APAP for 4 weeks. Maybe they can help you figure out a way of helping you out in terms of getting to the grocery store and to doctor's appointments and so on.
You also write:
Quote:I'm not that computer 'savvy' so am not sure how that take home test the gp had me do that has resulted in this mess actually works.
There are several types of home sleep tests that can be used to diagnose sleep apnea. Can you remember how many wires and things were involved? Was there a nasal canula of some sort under your nose? Was there a finger clip? Were there any other wires? If you can describe the equipment that was used, I can give you some information about how the home sleep test works.
Quote:I am diagnosed CPTSD (Complex Post Traumatic Stress Disorder) and have been for many years. Part of that disorder is that I never sleep well or for very long, have terrifying nightmares that cause me to thrash about and pushes my heartrate through the roof, night sweats and the nightmares have even caused me to stop breathing and start choking because that's what I'm dreaming of at the time. I know this because I have woken up suddenly with my own hands around my own neck in the past or pillows/blankets over my face. Does anyone know how that test I did can tell the difference between the reactions I have that are related to the CPTSD and actual sleep apnoea?
Here's the thing: Nightmares where you dream about choking and wake up in a night sweat realizing that you have stopped breathing are a pretty common symptom of OSA in people who have no history of CPTSD. In other words, if you had no history suggesting CPTSD, that symptom points quite strongly to OSA as a serious health condition that needs to be treated.
And here's another thing about those dreams: You seem to think that dreaming of choking causes you to stop breathing and then you wake up feeling like you're choking with your hands up around your throat.
But it's just as likely that the obstructive apneas in OSA are causing the dreams: You need to understand that when your upper airway collapses during sleep, your body is indeed experiencing a real (but short lived) suffocation episode. And all the usual fight-or-flight stress hormones are released as the brain arouses enough to force the airway open and end the apnea. And this happens over and over every time you have an apnea or hypopnea. And to be diagnosed with OSA, you probably have at least 10, and probably more like 20, 30, or more apnea/hypopnea events every single hour that you are asleep. And when repeated apneas happen during REM sleep, the brain can and often does turn the sensations from very real suffocations into bizarre disturbing dreams involving choking. When the dreams get sufficiently scary, you wake all the way up to full consciousness and discover you haven't been breathing and because you are suffocating, you're instinctively grabbing at your throat in an effort to clear the blockage.
Quote:Does anyone know how that test I did can tell the difference between the reactions I have that are related to the CPTSD and actual sleep apnoea?
A full-fledged in-lab PSG with all the wires run by a tech who knows the full medical history is the only test I can think of that might be able to definitively figure out whether your dreams are mainly caused by the OSA-triggered suffocations (apneas) or whether they're mainly caused by the CPTSD. It's also possible that the untreated OSA is significantly contributing to your CPTSD symptoms and that properly treating the OSA may help you manage the CPTSD symptoms more effectively.
