Sanity Check before purchasing Resmed AirSense™ 10

[pulseoximeter]

I am young, otherwise healthy 25M. I suffer from daytime sleepiness and brain fog. I did an at-home sleep study through Lofta and got the following results: "REM related and Positional Obstructive Sleep Apnea (G47.33) - Mild based on a REM pRDI=9.7, supine pAHI=5.2, supine pRDI=6.1 and O2 nadir of 92%". My overall AHI was 1.5. The recommendation was to use a CPAP machine.

I used a Wellue O2 ring to monitor my sleep some more, and I've attached the results. I noticed a couple significant SpO2 drops a night, as well as weird pulse rate spikes, even above 170. I know for a fact that I snore (even while nose breathing). 

I've received the advice to go in for a lab sleep study, and I think it's good advice, but I'm worried about the cost, and I think the outcome will likely just be the same (get a CPAP). My next step will be to purchase the Resmed AirSense™ 10 with nasal mask. Just wanted to sanity check with you knowledgeable folks about this step, because it is a significant investment for me. Any recommendations on sites to purchase from/anything to watch out for? Thank you.

[Deborah K.]

If your overall AHI was only 1.5, you don't need a pap machine by any criteria I know.

[DancesWithCats]

If you have high copays or lack insurance that will cover the cost of a sleep study and machine to a very substantial extent, a machine (from one of the suppliers in the list - which one depends on who's having a sale and potentially where you are and potentially if you can get a deal on a used one) will cost less (and then give better data) than a sleep study cost me with my alleged insurance, much less what I was then overcharged for the supposedly 80% cost covered machine and supplies. And my "new" machine had 1150 hours on the clock, too.

Not sure I grok the particular jargon of the reporting, but I have a vaguely similar "not normal" apnea presentation with "mild sleep apnea" (that probably wouldn't of itself qualify for treatment) with severe hypoxia (that made it qualify after all.)

Certainly my personal experience was to feel that I'd have been better off just buying the machine from a reasonably priced supplier rather than wasting the money on the sleep study and then getting shafted with the alleged DME my alleged insurance uses. YMMV. In your case, you've already had a sleep study, with a recommendation of getting the machine, so doing another one seems like throwing money away for probably not a lot more information, unless your insurance requires it and is picking up the vast bulk of the cost for it.

Zooming in on some of the desaturation events might make it clearer, but looking at the first one, it's quite some minutes, based on the scale, from when it starts dipping to 87% and when it returns to baseline, so not trivial excursions.

[SarcasticDave94]

As you tested at 1.5 AHI, you don't need CPAP at this time. Under 5 AHI counts as treated. You're there without a machine.

[pulseoximeter]

Thanks for responding. Yeah I agree that 1.5 AHI doesn't meet the definition of sleep apnea, but given how tired I feel all the time, I feel like I have no other choice than to try CPAP to see if it helps me. I don't know what else I can do. I could do a more comprehensive lab sleep study, but that would cost me the same or more than just buying the CPAP.

[Deborah K.]

If your main issue is drops in oxygen while you sleep, you may simply need to sleep hooked up to oxygen.  Your regular doctor can set this up for you.

[pulseoximeter]

If your main issue is drops in oxygen while you sleep, you may simply need to sleep hooked up to oxygen.  Your regular doctor can set this up for you.

Thanks for the callout Deborah. I hadn't heard of this, I will look into it.

[SarcasticDave94]

As best as you're able, try to use your primary doctor, even for CPAP & supplies, and oxygen if it becomes necessary. Primary doc would be cheaper on co-pays, etc. Specialists aren't required to get scripts for sleep study, CPAP, supplemental oxygen.

[DancesWithCats]

If you are hooked up to oxygen and stop breathing for long enough that you dip to 87% on air, the baseline on the graph moves up from the supplemental oxygen a bit but the nadir when you stop breathing only moves up that same bit. Since the baseline is sitting around 96/97% it can only move up 3-4% at most. 

The point here is not similar to many forum users with AHIs of 20 or more saying "well, under 5 is treated." The point is the length (and oxygen desaturation extent) of the individual events,  even if there are not that many of them. Which is why the sleep study you already had didn't say "Overall AHI 1.5, so nothing to worry about.."

Again, you have already had a (home) sleep study advising CPAP. Get an APAP anyway, they can do CPAP if you wanna dumb them down, but they are more capable machine with more options.

[Deborah K.]

I still think all you need is the oxygen.