Reversing sleep apnea diagnosis

[arunjb]

Hello,

I did my first sleep study in Oct 2019, AHI was 15.6. Started CPAP Dec 2019. My AHI compliance has been pretty good (> 7 hrs per day throughout). My monthly AHI < 1 throughout, past 6 mos monthly avg is < 0.5 even.. I have lost weight (155 lbs to 125 lbs) over the past year. My sleep doc thinks that I may not have sleep apnea anymore and should go for the sleep study again.. 

Is it possible that my at home AHI is consistently ~ 10 say but I have a good nite at sleep study & AHI < 5. My sleep doc is not able to give any assurances in this regard. but he did advise that I should go without CPAP for a week prior to the study and sleep supine in the study to get worst case baseline... 

he also said that if my sleep study comes back negative (ie AHI < 5) then insurance wont cover CPAP. So am very hesitant to go for the sleep study...

Would like to hear advise from experts here

thanks

[Heracles]

Hi,

part of your question is about insurance.

You said that you are afraid they will stop paying if the study is negative. Are you sure they will keep paying if you simply refuse the test ? If they stop paying, then there is no question and just do the test...

[arunjb]

Hi,

part of your question is about insurance.

You said that you are afraid they will stop paying if the study is negative. Are you sure they will keep paying if you simply refuse the test ? If they stop paying, then there is no question and just do the test...

Neither my doc nor my CPAP provider said that am required to repeat the test every so many years.. I asked my doc if I should repeat the test to see if my sleep apnea is gone bcos of my weight loss, that is how this came about

[arunjb]

My first (only) sleep study in Oct 2019 came back with AHI 15.6. Am on CPAP since then, my month AHI avg with CPAP has been <1 throughout and in fact < 0.5 for past 6 mos. I have lost weight (155 lbs to 125 lbs) over the past year. 

Can we infer anything re sleep apnea from cpap (oscar) data

1) Can we infer from very low AHI avg that I may not have sleep apnea anymore ? Or is CPAP working well for me (touchwood) and hence my AHI avg is low. 

2) My min pressure is 4, max is 10. my 95% level is ~8. median is about 6. Based on this ie the fact that CPAP pressure is kicking in quite a bit, am thinking that my sleep apnea is not gone, is that reasonable inference.
Am thinking for those without sleep apnea (ie sleep apnea is gone due to weight loss say) the pressure plot will be flat near the minimum ?? 

3) can we infer from any of the other plots ?

[Heracles]

Hi,

About not using the CPAP for a week, I would not do that myself should I face such a choice. Without the CPAP, you will not have any data to evaluate your condition, other than feelings. I would not let something as critical as this to subjective feelings, not even my own.

Your CPAP minimum pressure is already 4. What I would be willing to do myself would be to lower the maximum pressure to 4 and go that way. If you do need more pressure, your AHI should suffer and increase, being the evidence you need that you still need therapy.

Should your AHI remains in control, it can be either that you do not need therapy anymore or that 4 cm of pressure is enough for you.

[arunjb]

Hi,

About not using the CPAP for a week, I would not do that myself should I face such a choice. Without the CPAP, you will not have any data to evaluate your condition, other than feelings. I would not let something as critical as this to subjective feelings, not even my own.

Your CPAP minimum pressure is already 4. What I would be willing to do myself would be to lower the maximum pressure to 4 and go that way. If you do need more pressure, your AHI should suffer and increase, being the evidence you need that you still need therapy.

Should your AHI remains in control, it can be either that you do not need therapy anymore or that 4 cm of pressure is enough for you.

Thank you Heracles, That is exactly what I thought as well..  One question I have - is it ok to set min and max to be same ?

[Heracles]

My CPAP is a ResMed 11 and yours is a 10 but I do not see why the 10 would not be able to do that. I think that I saw others in the forum who did it. In all cases, you can do minimum as 4.0 and maximum as 4.2 if you wish. It would be basically the same...

[fishfinderG]

I don’t think that you will be able to conclusively tell by using your CPAP. Maybe get a recording o2 sensor and wear it at night without your machine and see if you have o2 drops? I think we would need to see your sleep study ti know what your sleep and o2 were like back when you were first diagnosed.

[KeepSmiling]

I am assuming you are using an auto CPAP which starts at 4our (not ramping up) and goes higher on its own.

What is the minimum pressure required for the AirFit P10? Any pressure increase over the minimum due to the mask in theory is what you need to keep your airways open for obstructive apnea.

If you now need a much lower pressure to keep your airway open, what if you misdiagnose yourself?

I would not risk the major medical issues that may happen in an assumption.

Just my body - A couple of years ago I lost 55lbs, went off blood pressure medication. CPAP treatment did not change other then tightening mask straps. Unfortunately due to other new medical issues and meds weight went up again. Then again even in my late teens and early 20s with a BMI of around 21, I was always exhausted.

[KeepSmiling]

I just answered in a different post.

I will ask you knew questions. Do you remember what your old sleep test showed? Can you post a graph of old test?

Depending on what the original data was I agree with using a finger to measure SpO2 level WITH an alarm if it falls off or the Oxygen level goes below 95% or some other level.


Copied here:
I am assuming you are using an auto CPAP which starts at 4our (not ramping up) and goes higher on its own.

What is the minimum pressure required for the AirFit P10? Any pressure increase over the minimum due to the mask in theory is what you need to keep your airways open for obstructive apnea.

If you now need a much lower pressure to keep your airway open, what if you misdiagnose yourself?

I would not risk the major medical issues that may happen in an assumption.

Just my body - A couple of years ago I lost 55lbs, went off blood pressure medication. CPAP treatment did not change other then tightening mask straps. Unfortunately due to other new medical issues and meds weight went up again. Then again even in my late teens and early 20s with a BMI of around 21, I was always exhausted.