p123 - Therapy Thread - Just diagnosed

[Sleeprider]

In another thread you posted your results using the Philips Dreamstation 2 CPAP with a pressure range of 5.0 to 12.0.  These results suggest that CPAP is of no benefit to you and your AHI is the same as your baseline. Your respiration rate is only 9.8 breaths per minute due to the extreme number of apnea.  You will need much higher pressure to avoid these events with a Philips machine, and I'll suggest you set the minimum at 9.0 and maximum at 15.0. In addition, you need to look into using a soft cervical collar to see if any of these events can be relieved by addressing a positional issue. https://www.apneaboard.com/wiki/index.ph...cal_Collar  

I have to repeat, you need to see a doctor as soon as possible. These results are damaging and we know your oxygen saturation at least is very low.

[p123]

Your sleep breathing disorder is not only very severe, it is dangerous with over one-fourth of your events resulting n greater than 20% desaturation and an average low SpO2 of 81.  Your average SpO2 is at a level that qualifies for supplemental oxygen in the U.S. if exceeded over 5 minutes per night. In your test, there were 178.7 minutes out of 198 spent below that threshold!  Have you had blood work to evaluate your PCO2 (carbon dioxide)?  CPAP is probably not going to resolve this alone, and some kind of bilevel ventilatory support and supplemental oxygen looks appropriate.  Are your medical consultants really not alarmed by this?  If these results are valid at all, you should not be self-treating and should get a clinical evaluation as soon as possible.  Has a doctor even seen these results?

Right ok thanks.....

This was a home test paid for privately. Not sure what qualifications the person doing the report has.

I'm on the waiting list for NHS treatment here in the UK but the wait list is around 12 months.

Fortunately, I do have private health insurance and have an appointment to see a sleep consultant in a few weeks. Plan is I'm going to be showing him this report.
Quite possibly he'll want to do his own test again though which, from what you've said, makes sense.

[p123]

In another thread you posted your results using the Philips Dreamstation 2 CPAP with a pressure range of 5.0 to 12.0.  These results suggest that CPAP is of no benefit to you and your AHI is the same as your baseline. Your respiration rate is only 9.8 breaths per minute due to the extreme number of apnea.  You will need much higher pressure to avoid these events with a Philips machine, and I'll suggest you set the minimum at 9.0 and maximum at 15.0. In addition, you need to look into using a soft cervical collar to see if any of these events can be relieved by addressing a positional issue. https://www.apneaboard.com/wiki/index.ph...cal_Collar  

I have to repeat, you need to see a doctor as soon as possible. These results are damaging and we know you oxygen saturation at least is very low.

This was just one night. I'm aware that I need to get some decent results captured too.

Yes as above post I'm waiting to see a doctor.

Also, I've got a cervical collar arrived today so I'll try that tonight.

[Sleeprider]

It would be very helpful to see a "typical" CPAP result. We may want to look at some zoomed images of the respiration and see if we can discern what is going on. Please inform us of any health or medication issues that might be contributory to these results so far.

[p123]

That's all I've got with regards to the report I'm afraid.....
I guess it is what it is. They send you the equipment and they send you a result like this.

I'm trying to get consultant appt sorted asap to discuss this report. I guess at this point they may want to not rely on this report and get another one done..... Sort of makes sense.

In terms of underlying health, yeh I'm fairly overweight which I guess is not great. Just been diagnosed with high blood pressure too so started taking meds for this.
Bottom line I think I need to loose weight.

Prob been like this for a while/ Been overweight for years and wife has been nagging me for a while to get something looked at.
Better late than never I guess..... 

Many thanks sleeprider for pointing these things out. Its made me a bit worried but thats probably good because its making me take action.

[Sleeprider]

All I can suggest is that the CPAP result seems to affirm the WatchPAT result, and there is enough concern there to warrant escalating this to a professional evaluation on an expedited basis. You should provide these documents and communicate a good description of your health impacts, and request expedited scheduling of your appointment, it may get you closer to the front of the line. Other things you could do is to wear an inexpensive recording pulse-oximeter to monitor and document your nightly oxygen and use that data to expedite proper care. I respect that NHS has worked very good for some people, but the 12 month delay is certainly based on the assumption you have a routine need for obstructive sleep apnea. With persistent hypoxia and a very high event rate, you need to make the case that this is not a routine case of suspected sleep apnea, but a serious health concern that is affecting your life and health.

[p123]

Thanks Sleeprider - yes I hear you. Like I said, I'm in the fortunate position that I won't have to wait for a routine NHS referral.
Alas, getting that escalated may prove difficult anyway to be honest - such is the nature of the NHS I'm afraid. Only person I'll have access to is GP who likely doesn't have much knowledge of sleep apnea so won't know whats more urgent and whats not.

Hopefully, I'll get to see a consultant in the next week or so. I know that hes the same guy who runs the NHS sleep center locally (this is often the case in the UK, consultants work for the NHS, but also do paid work in the private hospitals). 

Whereas my insurance coverage may have limits for private coverage (it doesn't pay for CPAP etc) I guess once I'm seen - if he considers it serious then I'll be able to seen on the NHS a lot quicker. Not cheating the queue but getting visibility for something that, like you said, is more than just suspected.

[p123]

Bit of good news. Heres last nights OSCAR data (well half the night). Am I right the figures are better? 15 which is better?

This was using a cervical collar. Took me about 4 orders from amazon to find one that fits.....
Still find it difficult to get to sleep initially - not sure if this shows?

Got an appt to see a sleep consultant in 3 weeks time.

[Sleeprider]

Please consider raising your minimum pressure to 8.0 and turn off Ramp. Your chart should include the pressure graph so we can see your response to pressure.

[p123]

OK will do - sorry hes a better graph