[Diagnosis] Please help me interpret sleep study results

[lukazi]

Hi All,

I'm very excited to come across this forum. Firstly I would like to greet you all and thank you for the amazing support you have been providing to each other!

I'm a 40 year old male, 180cm tall, 88kg. I am regularly exercising and I'm not overweight. I have been chronically tired since I was 20 years old. Over the years I've seen a number of doctors and all of them said there was nothing wrong with me. A couple of weeks ago I decided to do a home sleep study as my own initiative. Please see the attached results. 

Could you kindly help with the following questions:

1. I am especially interested if these results (which seem to show a moderate OSA) could be the cause of my fatigue?
2. Is it possible that I have had OSA since I was 20 years old?
3. Should I treat this OSA?
4. What would be the best option to treat it?
5. Is what I have called positional OSA?
6. I spoke to a lady from the pharmacy and she suggested I use a vibrating device called NightShift. It is worn around a neck and it slightly vibrates when a person sleeps on their back hence reminding them to sleep on their side. Do you have any experience with this device?
7. Would it be sufficient if I just try forcing myself to sleep on my side?


Your help would be so much appreciated ?

Thanks!
   
   
   

[lukazi]

Any thoughts on this guys?

[Melman]

1. I am especially interested if these results (which seem to show a moderate OSA) could be the cause of my fatigue?
   Yes, moderate OSA may be the cause of your fatigue but there may be other contributing factors such as not practicing good sleep hygiene.
2. Is it possible that I have had OSA since I was 20 years old?
  Yes
3. Should I treat this OSA?
   Yes
4. What would be the best option to treat it?
   An auto adjusting APAP machine, preferably a Remed Airsense 1 or 11 Autoset
5. Is what I have called positional OSA?
   Although your OSA is worst when sleeping on your back, if I understand correctly, you also have significant OSA when not on your back so it's not just  positional.
6. I spoke to a lady from the pharmacy and she suggested I use a vibrating device called NightShift. It is worn around a neck and it slightly vibrates when a person sleeps on their back hence reminding them to sleep on their side. Do you have any experience with this device?
   I've never heard of this but suspect arousals caused by the vibrating device would be detrimental to your sleep.
7. Would it be sufficient if I just try forcing myself to sleep on my side?
  I don't believe there is sufficient data to make a conclusion. In my opinion it would not be sufficient.

Your help would be so much appreciated ?

Thanks!

[Dormeo]

Your non-supine AHI was 3.53, which would not warrant a diagnosis of sleep apnea if it were for the whole night.

It's cheap and easy to try staying off your back as an experiment. If you start feeling well-rested during the day, great. If you don't, your next step would be to use PAP therapy.

People use all kind of methods for training themselves to side-sleep. You can use pillows to prop yourself in a side-sleep position or sew a tennis ball into the pocket of a t-shirt and wear the t-shirt backwards. Search Amazon using "side sleeping" and you'll see a number of ideas. With luck, you will be able to stay on your sides without aids after a while.

While you're at it, you might use a low and firm pillow for your head if you don't already.

There's a typo in Melman's excellent post: the first ResMed machine should be "10," not "1." You might also consider the ResMed Aircurve 10 VAuto, which has a feature that might make it an especially good bet for treating hypopneas.

And to follow up on his comment about sleep hygiene, here are the recommendations made for better sleep. They can really help!

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

[pholynyk]

My first sleep test was in 2003, and was like yours: If I slept on my side, my apneas were 'acceptable' By 2010 I was falling asleep at work, so I retired. It took another five years for a doc to suggest a sleep test, at which point I had moderate to severe apnea.

Sleep apnea is progressive, and the damage it does to your body is progressive.

I can only wonder what shape I would be in if I had been able to get an AS10 AutoSet back in 2003.

You can get an AS10 AutoSet now and save yourself some trouble down the road.

[Gideon]

IMHO, get a PAP machine.
A doctor would prescribe an APAP such as the ResMed AirSense 10 or 11 AutoSet described above. The Resmed AirCurve (a BiPap/BiLevel) VAuto would be my first choice as it is more flexible mostly because it can provide much more Pressure Support than the APAPs can provide (they can provide 3cm max and call it EPR). Vauto also has several settings that can be used to shape the waveform, though these are not used by most users.

[lukazi]

Hi guys,

Thanks very much for your replies! I tried sleeping on my back and was able to stay on my back for most of the night. I did this maybe for a week, however I was still waking up very tired, with brain fog. That's why I decided to rent Resmed Airsense 10 Auto set for a month.

First night - sleep was very interrupted and I struggled to fall asleep. Only got maybe 5hrs of sleep. However I wasn't super tired during the day.
Second night - I had 8 hours of sleep only 2 toilet trips (as opposed to 4-5). Slept pretty firmly however felt terrible the whole day (brain fog, tiredness, couldn't concentrate). I'm thinking this could be a coincidence, maybe just too tired and worn out from gym.
Third night - last night it took me almost 3 hrs to fall asleep. The other 5.5hrs I slept were interrupted with me tossing and turning and 4 toilet trips. However I felt more rested and less brain fog than the night before when I had 8hrs of sleep.

Can anyone please help me interpret these weird results?

Also, I know you guys suggested that I should be using CPAP with the AHI of 16. However are there any studies showing that this level of OSA would cause damage if left untreated?

Lastly, any chance my sleep study results (level 2 home study) are incorrect? A level 2 home study I did a year ago showed AHI of 1.1 (with ApneaLink Air).

Thanks so much!

[Dormeo]

Here is some information about the health risks of untreated apnea:

https://www.mayoclinic.org/diseases-cond...c-20377631

It's possible that either or both of the two tests you had is not representative of your sleep. But now that you've rented a machine, you have a source of information for each night you sleep with it. You'll need an SD card in the slot (32GB or less) and you'll need to download Oscar to a laptop or desktop, with a way to read the card (plug-in card reader if needed). Take a screenshot of a daily chart and post it in this thread so we can take a look.

This will be much, much better than trying to interpret your experiences, though those are important too. But getting used to using the machine is rarely easy, and so how well you're sleeping with it at this stage of things isn't going to tell us much.

[lukazi]

IMHO, get a PAP machine.
A doctor would prescribe an APAP such as the ResMed AirSense 10 or 11 AutoSet described above.  The Resmed AirCurve (a BiPap/BiLevel) VAuto would be my first choice as it is more flexible mostly because it can provide much more Pressure Support than the APAPs can provide (they can provide 3cm max and call it EPR). Vauto also has several settings that can be used to shape the waveform, though these are not used by most users.

Hi mate, I already ordered resmed 10 autoset. However there is a 30 day return policy. Do you think I should get Aircurve or would autoset provide sufficient treatment?

Aircurve is twice as expensive but I can afford it if I'm going to have better results with it.

[Gideon]

The VAuto is a device of choice for patients who are not compliant (cannot use) CPAP or APAP.  I have no way of knowing if your therapy will be better with the VAUTO, only confident that it would not be worse.