Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check

[jgjones1972]

What I'm driving at is; if pressure induced CAs don't cause significant O2 desaturations, then do they even matter?

Just as in an obstructive apnea, you stop breathing, so the possibility of oxygen desaturation is just as likely.

The other negative effect associated with any apnea is arousal. You awaken, or at least partially awaken, and so your quality of sleep is diminished.

As you say, you can measure the desat with an oximeter. The other thing you can do is look at how long the apnea lasts. The longer it lasts the more your oxygen level will drop.

There's really no difference between obstructive and central apneas in this regard.

Exclusively regarding pressure induced CAs, and not regarding CA caused by other factors; my understanding was that the pressure can cause hyperventilation - high O2 saturation; and the central apnea is the way the brain brings O2 levels back into the normal range. I could be completely wrong about this, but that's what makes sense to me. If it is the case, then there shouldn't be significant desaturation (significant meaning below normal levels), just harmless desaturation (from high levels to normal levels). If this is the case (I'm not saying it is, this was just my understanding of it) then there shouldn't be any arousal because O2 levels would not get low enough to cause arousal.

Again, I'm not talking about CAs caused by any of the other numerous factors that can cause CA; just pressure induced CAs. If the pressure isn't causing high O2 saturation and the pressure induced CA isn't simply bringing O2 levels back to normal; then why is the nervous system reacting to positive air pressure by suspending breathing?

[Sleepster]

I understand your point. I don't know of any measurements of oxygen desat levels during CPAP-induced central apneas.

I'd be interested to know, too.

I would suspect that the higher oxygen levels that start the apnea would soon drop off and if the apnea lasts long enough the oxygen level would drop below normal.

[Tom and Ginny]

Hi, Dan. Call your ins. co. and see if they pay for a sleep study. We were surprised to find out that our ins. co. (BCBS) paid for the entire sleep study except $75. We are still waiting for Tom to get his machine and get going on his therapy so he can get some sleep, but we believe this is the best thing we've done for his health in years. After the sleep study and being on the machine for just a few hours, Tom awoke refreshed and feeling better the next day. In fact, Tom still feels better from that one sleep study.

Of course, like all the doctors, they want you to come back every xxx weeks/months, but we intend to check back in with our doctor 30 days after being on the machine, and then we probably won't go back unless something happens and Tom needs the doctor.

As you said, you need your sleep, so this health concern is every bit important as a heart or lung problem. Good luck.

Ginny

[u2canbuild]

I remember the TV show M*A*S*H where they talked someone (the priest?) over the radio through the process of doing a tracheotomy with a pocket knife and a ball point pen.

This just brought back a vivid bad memory.

Unfortunately I saw this done in 1986 while attending a mountian climbing class, in Southern California near Mt Baldy.
A fellow student failed to sell arrest on a steep icy slope, and slid over a projecting rock face down. The damage was so severe, that he could not breathe, the the above technique saved his life.

He recovered; however scarred for life.

[u2canbuild]

Too high of a pressure can induce central apnea.

I agree, My AHI shifted from about 30% central / 70% obstructive to 70% central / 30% obstructive when I cranked up the pressure too far.

Some great members advised me about the issue.

I have sense lowered the pressure part way back and have both lower total AHI and a balanced central / Obstructive.

[danstelter]

So, here's an update. I went to the doc and did a home sleep study. Results came back with around 1 apnea event per hour, and I felt like I slept what is a "normal" night. The doctor and I discussed what could be confounding factors for the test, but we agreed there doesn't seem to be anything that would have confounded the test.

So, basically, in terms of apnea, I'm totally normal. I also get normal oxygen amounts to my brain.

So, my doctor believes I have a restricted airflow because I snore very loudly. Does anyone have experience with a restricted airway like this, causing these or similar symptoms:

Very loud snoring
Seem to sleep fine at night, but the next day experience:
Exhaustion/chronic tiredness all day
Headaches
Difficulty concentrating/dizziness (some days but not all)
Falling asleep earlier than what my normal bedtime would be at night while watching TV
Sometimes needing an hour-long nap just to make it through the day

I think the doctor is right on with this, but I want to hear some of your personal experiences before making a decision to proceed with getting one of those devices the dentist makes to keep your airway open. My wife thinks it could possibly be something else, but I'm not going to mention what that is yet at this point.

Interested in hearing your thoughts. Thanks,

Dan

[Shastzi]

I think one night's sleep study does not make for a good judgement.

[vsheline]

So, here's an update. I went to the doc and did a home sleep study.

So you had an overnight home screening test, not a full polysomnography at an overnight sleep center?

Yours sounds like that rare case where an overnight sleep center study with full polysomnography (PSG) is needed to find out exactly what is happening.

I encourage you to seek one. Otherwise, your doctor(s) will be lacking some of the information needed to accurately diagnose and properly treat your condition.

Perhaps you are suffering from RERAs (Respiratory Effort Related Arousals) which are fragmenting your sleep (and keeping you from reaching deep restorative sleep) but are not apneas. Bi-level PAP therapy can eliminate RERAs, allowing achievement of the stage of deep restorative sleep. Or you may have some other condition for which a full PSG study would be able to accurately identify the proper treatment.

I think your doc doesn't know what he doesn't know. And I suspect he is at least unconsciously taking into consideration that a full PSG study is apparently unaffordable.

A sleep doctor specialist would be able to say whether a full PSG sleep study is warranted.

Look, I understand normal prices are very expensive, but if you obtain a prescription for a PSG sleep study and then shop around and be patient and persistent, you may be surprised at what deals may be accepted by some of the "hungry" sleep centers which are in need of business. Pre-negotiating the cost to less than $1,000 is certainly possible in some areas. It all depends on where you go and how much they think you can afford, and whether they are willing to make just a little income on one of their rooms, versus no income. I wish you good luck with this.

Take care,
--- Vaughn

[Vince Green]

I have the view that severe snoring can be as bad as SA. With SA you need to have an apnea of 10 secs or more to score. You might be hitting 9 secs regularly and not scoring.
A MA is worth a try, I'm surprised you haven't tried that already. Don't go to a dentist and get one made up just yet. You can buy a cheap one for about $5 on ebay. Its like a double sports mouthguard but it does the job virtually as well. Its what I use now, having had the made up ones in the past. They take some getting used to. Look for the one that comes with a blue case if you can.
Used in conjuction with a chin strap is recomended otherwise your mouth just drops open as soon as you fall asleep and the benefit is lost.