Can you make anything of my home test results?

[vanillagorilla]

Hi everyone. I've been suffering from poor sleep for about 15 years now. Fatigue, no attention span or ability to concentrate, dissociation, anxiety and IBS have been my symptoms. 10 or so years ago I did a home sleep test which came back negative for sleep apnea. But my sleep became progressively worse over the years so I had another test in 2019, the results of which I have attached. Again it came back negative for sleep apnea but this time they mentioned significant airflow limitation from upper airways resistance.

Unfortunately no doctors will refer me for an in-house sleep study because I do not meet the criteria. So I don't have a way to tell what exactly is causing my terrible sleep. It seems obvious to me, however, that it is probably anatomical as I have a recessed jaw and limited tongue space. I had retractive orthodontics as a teenager with 2 teeth on the top and bottom removed. My nose is also constantly blocked. I tried a CPAP machine in 2019 for a short while but it didn't help and made me feel like I was breathing worse.

I'm posting here because I'm considering trying a CPAP again, plus beginning other treatments. I believe I will likely need maxillofacial surgery to correct the problem, but I really need something to alleviate it in the meantime as I feel I'm going crazy with such a lack of sleep. I'm not sure if anything more can be gleaned from my results, but perhaps someone with a similar issue could tell me what the best next step would be. Thanks.

   
   
   

[Dormeo]

Welcome!

Upper airway resistance can certainly fragment your sleep, leading to the kinds of daytime symptoms you're experiencing.

Whether using CPAP would be of much help to you would depend on what is causing the resistance/limitation. A PAP machine that can deliver a fair amount of pressure support can help overcome flow limitations that are caused by loosened tissues lining the airway in the pharynx, but a PAP machine is not really the first choice for trying to address flow limitations caused by anatomical problems of the kind you describe or by a blocked nose.

I really wish you had some opportunity to try out a bi-level machine (like the one I use) to see whether a little help with those tissues in the pharynx might make some kind of difference, despite the jaw/tongue issues and the blocked nose.

Barring that, a few additional thoughts:

Is the nose problem mostly anatomical? Have you been seen by an allergist or an ENT doctor?

Have other causes for your symptoms been investigated? I'm thinking of tests for thyroid function, iron levels, vitamin B12, vitamin 6, Lyme disease, and connective-tissue or other autoimmune diseases.

Are you being adequately treated for the IBS? Many IBS patients have related sleep problems.

[vanillagorilla]

Hi! Thanks for your thorough and thoughtful response.

I wish I could try a BIPAP machine also. I didn't like the forced air from the CPAP while exhaling and this caused me to wake up a lot. Unfortunately you can only rent CPAPs where I am so I would have to buy one, and it's too much money for me to spend on something I'm not sure will work. But I'll see what the maxillofacial surgeon says.

RE: the nose issue, I had a sinus scan done recently and there is nothing wrong. Apparently I have a slightly deviated septum but my doctor said it shouldn't have much impact on my breathing. My nose has been stuffy for about 12 years at this point. The one time it cleared well was when a doctor put me on the corticosteroid prednisone. So it is due to inflammation but I don't know what's causing it. I haven't been to an allergist or ENT however.

I've had many tests over the years regarding my symptoms. I've even been put on ADHD medication (methylphenidate and dexamphetamine) which did nothing.

As for the IBS, it is mild and I haven't sought treatment. I usually wake up in the morning with some gurgling going on and have to go to the bathroom, but it's not a big problem during the day. But I always have, er, 'loose stools' and have for many years now. I think it might be due to the anxiety I experience during sleep.

I think I will likely just be waiting on my upcoming appt because that should shed some light on any breathing obstructions. Plus I might get a mandibular advancement device to try. I feel like I should use a CPAP again but I really hated the previous experience and it made sleep even more stressful.

Anyway I really appreciate your response, thanks!