Do I have sleep apnea?

[Maudlin]

Hi all.

I have just registered to this forum. 
I am 39 years old male, normal weight (BMI<25). Whilst in overall good health, I have had sleep problems in the last 3-4 years. Approximately twice a month I wake up choking and gasping for air, in sudden fear and hearth palpitations. At first I didn't put much attention, however, I became pretty worried and started suspecting having a sleep apnea. It is probably important to mention that I don't have daily sleepiness or dizziness or any other typical apnea symptoms. That being said, in my past I used to have some panick attacks and night terrors (that was 10+ years ago) which eventually went away. In January 2020 I went to a doctor and we performed a sleep test. He put gave me a machine (sorry if I don't use the correct terminology), I took it home, slept with it one night and went back at his office for results interpretation. The doctor said he doesn't think I have an apnea (even though he said he can not rule out this possibility 100%) and said I do not fit well the profile of apnea sufferers. Nevertheless, I understand you could have an apnea, without being overweight or obese, it could be due to some anatomical abnormalities like blocked airflow to the lungs, etc. He also checked the saturation levels, mentioned something about hypoapneas but at the end even though he calmed me down I still remained suspicious and with no final answer what is going on with me. I am really concerned I might have health consequences if I continue like that.
So here are some questions worth asking:
1. If I have an apnea, do they happen every night?
2. Is it possible that the machine didn't detect the apneas (since I think I wasn't deeply asleep)?
3. From the symptoms I have described and the results interpretations what is your opinion and what should I do further?

I am very thankful to all willing to help. I attach a file with the results of the test.

[jaswilliams]

Based on the sleep study I would say you do not have sleep apnoea, an AHI of 2 or an RDI of 3.9 is normal.

[Sleeprider]

Your sleep study identifies hypopnea as the major feature of your obstructive sleep disordered breathing. The sleep test did not measure this at a level that would qualify for insurance coverage. Your description of awakening with choking and gasping sounds to me like positional apnea which could have easily been missed in the sleep study, and even your hypopnea may be related. Please read our wiki article and let's discuss http://www.apneaboard.com/wiki/index.php...onal_Apnea

[Maudlin]

Thank you both for your prompt responses.

I have noticed that these apneas with choking and gasping for air occur mostly while sleeping in supine position indeed. The night I did the test I was sleeping on my side (fetal position). After reading the article about the positional sleep apnea it is conceivable for me to think this might be what had happened - perhaps it was just not registered. If I had slept in supine position it would probably have registered it. I never like the supine position and never go to sleep that way, however, it appears since I change sleeping positions at night (not intentionally) I get choked and awake.
Questions:
1. Should I repeat the test by trying intentionally to sleep in supine position?
2. If it turns out I have positional apnea, what are the ways to treat it? Pillows, collars? Could using a CPAP be avoided?

[Illorum]

Based on the sleep study I would say you do not have sleep apnoea, an AHI of 2 or an RDI of 3.9 is normal.

This study did not report RDI. The "RI" is the resmed Risk Indicator that is reported on Resmed Apnealink take home studies. This study was unable to score RERAs or criteria 1b hypopneas, and given nearly a quarter of your breaths were flow limited, I think UARS could be a possibility. Maybe ask for an in lab?

[Sleeprider]

In the wiki we describe an easy self-test sitting comfortable in a chair, and letting your head tilt forward. We can guard our airway when awake, but if you're really relaxed and let the chin tuck you might detect the resistance or obstruction we are talking about. Resistance results in hypopnea, and a blockage results in apnea. Just give it a try.

[Maudlin]

Well, I don't know how reliable this test is but I have tried it and I feel an obstruction when I tilt my chin and head forward.
In the last few days I have been very worried and actually terrified after reading that OSA is the main reason for death in sleep. Of all 10 possible ways to die while sleeping, the OSA was quoted as the riskiest. That scared the sh*t out of me. Having in mind how terrifying my choking and gasping for air awaking are I am now in an absolute horror of the fact I might die while sleeping. If the brain doesn't send a signal and there is oxygene deprivation it could be lead to a cardiac arrest and death. Have you ever experienced anything like that? Has the fear of dying in you sleep been an issue for you?

[Illorum]

Based on the sleep study I would say you do not have sleep apnoea, an AHI of 2 or an RDI of 3.9 is normal

The Resmed Apnitest RI is NOT RDI. This take home test cannot report RDI.


Since this is a home study, it cannot rule out sleep apnea - only confirm it in obvious cases. It is incapable of detecting RERAs  (Respiratory Effort-related Arousals) which you are more likely to have because you are young, not overweight, and predominantly have hypopneas. To make sure you don't, you need an in-lab study that scores RERAs.

Can you elaborate on your sleep problems?

[Maudlin]

Based on the sleep study I would say you do not have sleep apnoea, an AHI of 2 or an RDI of 3.9 is normal

The Resmed Apnitest RI is NOT RDI. This take home test cannot report RDI.


Since this is a home study, it cannot rule out sleep apnea - only confirm it in obvious cases. It is incapable of detecting RERAs  (Respiratory Effort-related Arousals) which you are more likely to have because you are young, not overweight, and predominantly have hypopneas. To make sure you don't, you need an in-lab study that scores RERAs.

Can you elaborate on your sleep problems?

Well, I have elaborated my sleep problems in the beginning of my post in quite many details, as much accurately as I could possibly can. 
Are RERAs as dangerous as the sleep apnea? I understand that RERAs are different form of sleep problems which if untreated could lead to apnea.

[Maudlin]

My main concern still stays the issue with the risk of dying while sleeping.