[Diagnosis] Noob: Is Sleep Apnea the Problem?

[Gideon]

All, alright, MOST of us denied having any issue with apnea before we were diagnosed/treated, we didn't have any of those symptoms, what we all had was what we called normal (for us) sleep. We didn't know any other way. What we had was normal. I did the sleep study to shut my wife up. It would show I was normal and had no problem.

Normal was an AHI of 90!

Normal??????

[Hydrangea]

Ditto Bonjour. My DH said I was choking and gasping in my sleep. I thought I was sleeping like a rock. I was as tired (& brain fogged) as I think anyone could possibly be, but I'd been like that since high school, mentioned it to anyone (including doctors) who asked how I was doing, and everyone chalked it up to my lifestyle.

But I appeased my DH, and got a sleep study.

My AHI while supine was 16-ish, and I always sleep supine because it makes my back & neck feel better. But my AHI on my side was 5-ish, and that's the # my dr went with... and he told me I wasn't a good fit for a CPAP, that I should just sleep on my side more, and "think about things for a month".

I told my dr that I was confident that one month would make no difference in my thoughts regarding how dog tired and brain-fogged I was, while needing 10+ hours of sleep every day (+ 4 hours to wake up enough) to even try to function.

So he reluctantly agreed to let me do a titrated/CPAP sleep study. I felt AMAZING when I woke up from it, and was productive for 14 hours straight! When I went for my follow-up, he said I responded well to it, and then he set it at its lowest setting.

Now that I'm here, and have learned how to better optimize my pressure, I am a proud and happy (and functional) CPAP user!

So... my dr thought my sleep apnea was too mild to even warrant treatment, yet xPAP has completely changed my life: I now only need 8 hours of sleep (with 30 minutes to wake up and be functional), I can think straight, I'm hardly ever yawning or tired, and I'm now a productive member of my family and society!

[bguppy]

So he reluctantly agreed to let me do a titrated/CPAP sleep study.  I felt AMAZING when I woke up from it, and was productive for 14 hours straight!  When I went for my follow-up, he said I responded well to it, and then he set it at its lowest setting. 

This alone is enough to make me want to pursue CPAP. It sounds too good to be true. I've felt bad (though not as bad as you) for long enough that I've forgotten what it's like to feel good. At this point a "normal" level of fatigue would make me feel like superman.

Try taking some pictures of your exams and posting them here, for everybody to comment on them...

Not a whole lot of info other than what I already posted but here are a couple of shots with all of the useful info I was given. As mentioned before that was a good night of sleep. I normally don't have that high a sleep efficiency or sleep that long.

[Hydrangea]

Wow - there you go - an Auto CPAP is recommended by your dr.

[bguppy]

Wow - there you go - an Auto CPAP is recommended by your dr.

I think the part where they list an auto CPAP among the recommendations came from the sleep study lab. Pretty sure the "Unlikely to benefit from CPAP" at the bottom came from my doctor. If he gives me a hard time about it I'll use your post as ammo. 

Thanks for all the responses - this has been tremendously helpful. Keeping my fingers crossed that CPAP will work out...

[Hydrangea]

I do hear you. And I get it. But... it does diagnose you with obstructive sleep apnea.  

I'd go in at that angle.  "So I have OSA.  Let's pursue treatment for my OSA, since I'm obviously seeing you because I'm experiencing problems related to my sleep apnea."

If he tries the "mild" route, I'd say 2 things:
- I know several people who were diagnosed with mild sleep apnea, but whose lives were significantly improved by xPAP.
- If I knew I had mild diabetes, mild cancer, or mild MS, I would want to treat it. I feel the same about OSA, which is already significantly impacting my life.

Really - look at the problems OSA causes, besides quality of life (ie: heart problems, etc.). Is your dr really ok with that?

[Sleeprider]

Why doesn't the math add up? According to the sleep study, you had 465.5 minutes (7.75 hours) of sleep time, and a total of 42 apnea + 25 hypopnea =67. 67/7.75= 8.64 AHI overall or 42/7.75= 5.14 AI + 25/7.75= 3.22 HI.

So what happened here is that the technician or doctor erroneously divided apnea and hypopnea by the total recording time, not the sleep time; which dilutes the actual AHI. This person has mild sleep apnea, but not borderline. This would be what caused the doctor to state "may not benefit from CPAP". I'm glad to hear you have been recommended to receive an Auto CPAP for self-titration, but do bring the error to the attention of your doctor. Also, try to get the Resmed Airsense 10 Autoset. It's probably as simple as stating a preference.

[bguppy]

Why doesn't the math add up?  According to the sleep study, you had 465.5 minutes (7.75 hours) of sleep time, and a total of 42 apnea + 25 hypopnea =67.  67/7.75= 8.64 AHI overall or 42/7.75= 5.14 AI + 25/7.75= 3.22 HI.  

So what happened here is that the technician or doctor erroneously divided apnea and hypopnea by the total recording time, not the sleep time; which dilutes the actual AHI.  This person has mild sleep apnea, but not borderline.  This would be what caused the doctor to state "may not benefit from CPAP".  I'm glad to hear you have been recommended to receive an Auto CPAP for self-titration, but do bring the error to the attention of your doctor.  Also, try to get the Resmed Airsense 10 Autoset.  It's probably as simple as stating a preference.

I think the wording is misleading. It looks like the "42 apneas" is meant to include both the apneas and hypopneas. In any case 10 central + 7 obstructive + 25 hypopneas adds up to 42. So the AI would be 17 / 7.75 (~2.19) instead of 5.14. The HI would still be the same as in your analysis above. Looking at it that way the numbers in the report do add up.

That is a good catch, though - I will double check with them on whether that is what they meant to convey.