Help for mom

[sleep4]

Hi folks:

My mom is 69
She took sleep study (5 years ago) (attached).
She has mostly Hypopnea. AHI 16 I think.

Do you think CPAP therapy will help her?

Thank in advance.

[sleep4]

here is the last attachment

[srlevine1]

While people in the forum can provide an opinion, they cannot provide a diagnosis or medically-sound recommendation. Hence, one can't but help wonder what her physician, the one that ordered the sleep study, did with the information. 

Did they recommend a CPAP at that time or arrange for a DME to provide services? 

Did they request a follow-up visit? 

Was this a case of medical abandonment or simply a disinterested patient?

While it appears that a CPAP might be helpful if her symptoms worsened over time or condition warranted, what would be more helpful would be a discussion with her physician at this point in time -- including a full medical workup if warranted. Also knowing if she is experiencing any symptoms of sleep deprivation or has comorbidities (underlying medical conditions) that might be affected by sleep problems.

Best of luck.

[Sleeprider]

Well for heaven's sake, of course CPAP can help, and bilevel is better for the type of apnea she is showing, with respiratory arousals and hypopnea. The ideal machine is going to be the Resmed Airsense 10 Autoset For Her. With that, we have up to 3-cm of pressure difference between inhale and exhale pressure. Your mom is just a bit older an my wife and I, so I already know what is going to work, because my wife has a similar, or actually less-severe apnea profile.

Your mom has moderate, not mild apnea. I can easily suggest settings for the above machine that will work well, and then fine-tune them based on what the data indicates. Why are you asking us this question? She needs CPAP therapy, and the best machine is the Resmed Airsense 10 Autoset For Her. If you need settings ask. This is clearly a person in need of obstructive sleep apnea treatment. What is keeping her form getting the machine?

[sleep4]

thanks for the information...
The Dr. at the time did not prescribe CPAP, he only prescribed some sleeping medication because she had and still has insomnia.
I will advise her to take a second sleep test and let the Dr. prescribe her a CPAP machine. Just from my little knowledge, does CPAP help with hypopnea? I know that it is great for OSA. Just do not know much about hypopnea.

so from the data presented, I will tell her that CPAP with an autoset for her is a good candidate?

Thanks again..

[staceyburke]

Yes it treats all apnea including hypopnea.  If you do have a prescription have them specifically write it for a “ResMed s10 autoset for her”.  Do NOT accept a Phillips dream station, they just don’t give as good of therapy. The dream station costs the supplier less so it is the one they will try to give to you. 

[Sleeprider]

sleep4, does your mom have out-of-pocket costs for these tests? She does not need a second test (titration) in order to qualify under insurance for reimbursement of auto CPAP. The diagnostic test is sufficient for her to qualify right now for a prescription, machine and equipment. The prescriptions will be for Auto CPAP (preferably specify the Airsense 10 Autoset for Her) and self-titration. The CPAP will come in auto mode with pressure of 4.0 to 20.0. We will encourage you to start with pressure of 7.0 to 12.0 with EPR at 3 to resolve the hypopnea. After the first night with data we can fine-tune those numbers and no clinical test will be needed. As long as she uses the machine, she will pass her compliance period.

If she is on Medicare, 80% of the costs is covered, so the copay can really add up if she does not have good supplemental insurance. Her doctor is prescribing a sleep aid to resolve the arousals. This does nothing to treat the problem and may actually make it worse. According to the test she has 27 arousals per hour from respiratory events and an AHI of 18 per hour, mostly hypopnea. That is well above the necessary threshold to justify simply prescribing auto CPAP. The decision whether to conduct a titration test first, or to try to self-titration is both financial and personal. Please discuss it with her in that context.

[sleep4]

Thanks much I will let her know all this information and will let her check with her insurance..
definitely will recommend the "autoset for her" 

Thanks all...