Treatment suggestions for mild sleep apnea

[clegge242]

Hello- I am a 45 year old male with normal BMI, I completed a home sleep study in May 2024, 2 nights, 1st night had 5.4 AHI (non supine 3.9) and 2nd night had 7.7 AHI (non supine 3.0).  I was previously diagnosed with UARS in 2019 based on an in-lab sleep study ( 10.7 RDI but all in supine position, 0 in non-supine).  I goto sleep at 10pm and get up at 6am, and get up every night at 3am and rely on ambien to get me back to sleep. I feel pretty good most days, but the days that i get less than 6 hours sleep I feel tired, moody, and don't enjoy life as much. In general I feel pretty well, exercise every day, don't sit down or rest, but i do have the feeling that i am coping with sub-optimal quality of life.
I started using sleep noodle positional therapy about a month ago and mouth and throat exercises a couple days ago.  Also i started a CBT program, and with sleep restriction have cut ambien way down and feel i will probably get rid of it for good!  However, i am only sleeping 6.2 hrs per night and am wondering if i am taking the best route here.  
I have seen 2 doctors, one is recommending i do another sleep test to see how positional treatment is working, and another is suggesting i go on APAP.  Doing a sleep test and followup will set me back a month and a half and part of me wants to just go ahead now and try APAP.  Any suggestions?

[Crimson Nape]

Hi clegge242! -
While Ambien (Zolpidem) is not considered addictive, it does create a physical dependency for sleep. Just ask my wife. She can no longer sleep unless she takes one. If you take this more than 3 nights in a row, I would consider trying something else, like Benadryl (Diphenhydramine).

As far as your sleeping hours, here is a link to a sleep calculator webpage that uses Circadian rhythm to calculate times to go to sleep based on the hours you wish to sleep or when you need to awake. If nothing else, it is a cool site to play around on.
https://sleepopolis.com/calculators/sleep/

Your AHI and RDI seem so low that I would also consider other causes, like bedding or sleeping environment.

Personally, I'm not a fan of the at-home sleep studies. Having gone through a lab sleep study, having more wires attached to you than a modern day engine has, I find it very hard to believe the accuracy, as well as, the specific conditions that are causing any event. But, that's just me. Ultimately, it is your decision. If they are your only 2 options, I think I'd pick up a slightly used Resmed Autoset 10. At least if it experiences an event, it can do something about it, and not wait ill the next day to tell you that you had a problem. One caveat, mask selection can be a whole new adventure, but that's for another post.

Good luck! Keep us in the loop about your decision and experiences. That's how we all learn.
- Red

[clegge242]

Thank you. My doctor is wanting to test to see if the sleep positioning device is getting my AHI and RDI down below 5 and then consider that good enough. My issue is that I am only sleeping 6 hours per night and am able to get through the day okay but i have a feeling i am not at my best.
Maybe i will ask him if i can start APAP and then the night of the home sleep test just use the sleep positioner...

[HalfAsleep]

I'm finding most doctors have a "one size fits all" approach. They also can't get you a machine on insurance if your AHI is under 5, 'cos they get paid on, yep, getting your AHI under 5. Same with the DME. But that figure doesn't mean you're sleeping well, as thousands of posters on this board can attest to.

If you don't need to use insurance, I would get a unit and get help here with settings. Re-sell the unit if it doesn't get you where you want to go.