[Diagnosis] Got sleep study results and I am quite fustrated

[ewarner64]

Hello!!

So I have been struggling with sleep my whole life, and being only 20, it has affected so many things in my life. I've always been a snorer, being extremely sleepy during the day, sweating during my sleep, not being able to wake up, and not feeling rested.

I moved and my new PCP recommended a sleep study to be done (he literally looked in my mouth and could tell I snore from my very small airway) and I was sent home with a kit a month later. 

I just got the results back and I have 0 events of apnea? My partner has said I have had times in the past where I stopped breathing during my sleep and even sounded like I was choking so I am surprised. I don't know if I got "better" looking results as I couldn't sleep fully with it on. Like, I never actually fell completely asleep. I had to rip off all the wires at like 4 AM because I was so uncomfortable. What do I do?

I am also frustrated because of the last page attached to my results. It may just be a copy and paste response, but it just irked me. "Sleep hygiene" is something I have been making important. I have a whole routine before bed to make sure I can fall asleep. I don't drink except on occasion. And then to not sleep in the supine position... which I only did because I had a thing strapped to my chest. Normally I am a stomach or side sleeper. And I understand the weight thing, but I feel it would mean more if this was a recent development. I have been snoring since before school age.

I apologize for this sounding rant-y, I am just frustrated that I can't get good sleep.

I will attach my results here:

[HalfAsleep]

You might want to blur out your personal info on your sleep test. Just sayin'.

In lab sleep studies are much more accurate than home studies.

You can get help without involving your sleep doctor.

Look at how many minutes you had with snoring episodes: confirms your experience. 200+.

Someone will be along who knows more about this than I do.

[ewarner64]

You might want to blur out your personal info on your sleep test. Just sayin'.

I fixed this, thank you! I didn't even realize.

Also a lab study will be nice. I just am so new to all of this since I was never taken seriously, so still learning haha.

[HalfAsleep]

The notes point you in the direction of a lab study (PSG). I would push for it. The notes are indeed taking you seriously, and it's pretty clear you have disrupted sleep.

[staceyburke]

Apnea is any closing of the airway.  To be counted as an O or H event it has to last at least 10 seconds.  Flow limits are also apnea but they are less than 10 Seconds in duration.  I have in my signature how the events are determined.   So you can still have sleep apnea without the large events.  Flow limits can and do cause sleep interruption and stop people from getting into deep sleep.  Only problem is most sleep studies need to have the O and H events to qualify for you to get a cpap with insurance.  Soring shows the airway is obstructed to some degree.

[SarcasticDave94]

Welcome to the Circus,

Get with your PCP, if they would listen, then request the overnight in-lab PSG sleep study. A sleep or pulmonary specialist is not a requirement in this at all, saving some money. There may be some events that it will pick up that the home edition did not.

There’s two areas for suggesting anything about Apnea diagnosis, equipment choices, and therapy, and these are Subjective - feelings and self observation, then Objective - the testing data. You can complain enough to make the doctor’s ears bleed if that is what is necessary to get the testing and therapy you seek. Simply put, accept no resolution that you don’t agree with.

[Sleeprider]

The Philips Alice home sleep test is a joke. Very hard to determine important things like upper respiratory resistance (flow limitation) which is disruptive to sleep, the system is based entirely on AHI using. As a young person in good health, it's not surprising to see it did not return a result that would recommend CPAP therapy. The tests are designed by insurance to minimize their exposure to costs for mild and moderate sleep disordered breathing. Based on the snore data, you could benefit from therapy, especially if it has the bilevel capabilities of the Resmed CPAP EPR. I don't think it should be too difficult to get a prescription from your PCP or an online supplier, but the initial cost of equipment will be out-of-pocket. You would resolve snoring and flow limitation with fairly low pressures and using an exhale pressure lower than inhale pressure. There are lots of options if you want to pursue this. It's probably worth a try. New full-capability machines are under $459 and used can be obtained without prescription for much less. It helps to have the Rx for supplies, but most suppliers sell mask parts, tubes and other supplies if you know how to avoid prescription requirement. Your choice. Do you want to try?

[BoxcarPete]

Alternatively, the younger and healthier you are, the more likely it is that your problem stems from something "solid" (think surgery correctable) rather than "flabby" (think air pressure pushable). The sleep test results should be good for at least a referral to an ENT for airway evaluation. Many otolaryngologists sub-specialize, so you want to find a good one with a specialty in sleep medicine to get the best options for managing your airway.

Whichever path you choose, keep walking it. As someone who has had quite a bit of work done on my airway (two extensive surgeries, at 8 years old and again this year at 33), I know I'll end up hooked to a machine eventually. I'm just trying to keep that day at bay a little longer...

[ewarner64]

Thank you for your response.

I was thinking about the ENT route as I have not had my tonsils or adenoids removed. I will try my best to advocate at my follow-up (of course, it is not until June...). I understand the need for machines too, however I want to explore literally anything else before I chose that. I have to be absolutely comfortable to sleep and I know the machine would be a harsh transition LOL

---

Thank you for your response.

I'm glad to know that my feelings are validated. Also it is good to know the cost of everything if I end up using a CPAP machine. I will wait to see what my doctor says at my follow-up and go from there. Luckily, I am double insured so I anticipate it wont be too costly!

[ewarner64]

Thank you everyone for your responses!!

I mentioned this in another reply, but my follow-up is scheduled in June so I have some time to think of what I wanna say. Everything said has been more than helpful and I am glad that a Google search led me to this community.

My plan is to explore alternative options. Things such as corrective surgery as I have not had my tonsils or adenoids removed. Maybe even open my airway (UPPP) as my Mallampati Score is around a III. I will be pushing very hard for this as I believe that if I can breathe through my nose, I can sleep better. Hopefully, I won't have to be a Karen (although I am fully justified). If not this, I will push for a lab study to further push my case.

I know I am a pretty healthy individual as I follow a diet and work out somewhat regularly. I don't have many health issues, just really this haha. I will be updating when I get more info, but as for now, I am playing the waiting game.

Thank you guys again!! <3