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RE: Hypopnea and alpha intrusions - Dulce - 12-29-2017
Thank you, Sleeprider. I appreciate the advice and am pursuing an appointment with someone else who can help me. I did not see the doctor who interpreted the sleep study. It was ordered by my rheumatologist who has been trying to find the cause of my fatigue. He is, however, heeding the advice of Doctor who interpreted the sleep study, so I think I will try to obtain an appointment with someone else for a second opinion. I have an appointment with a friend who is a dentist next week to discuss a mouthpiece to aid in nighttime breathing issues. I will be checking back in with you for sure to let you know if I find success or need more assistance. Thank you so much for all your help.
RE: Hypopnea and alpha intrusions - DeepBreathing - 12-29-2017
I guess I have a philosophical aversion to mouthpieces for apnea treatment, but I'd be careful about committing to one if I was you. The mouthpiece (or mandibular advancement device MAD) can treat certain apneas / hypopneas if you have the right physiognomy and some of the members here use them, apparently successfully.
In fact my own GP uses one, but has no idea if it's actually working. And that's one of the problems - there is no real way of knowing if the thing is actually working. With a CPAP machine (all except the cheapest, nastiest ones) you can access breath-by-breath data which shows you exactly what's going on, and how you respond to changes in settings. With a MAD it's pretty much a matter of guesswork and "how do you feel"?
MADs can also cause problems with the TMJ, leading to pain and possible future surgery.
And they're expensive - a proper adjustable one will probably cost you more than a good CPAP from an Amazon reseller.
I don't know how it works with your insurance etc, but here in Oz most suppliers will let you hire a CPAP for a couple of months to see how it goes. There's usually a consultation fee, and they will help work with you to optimise the settings. If you then decide to purchase the machine the rental cost is deducted. Otherwise you can walk away and try something else. If this type of service is available to you, I think it would be a much wiser course of action than using a MAD.
RE: Hypopnea and alpha intrusions - Sleeprider - 12-29-2017
(12-29-2017, 01:10 AM)Dulce Wrote: Thank you, Sleeprider. I appreciate the advice and am pursuing an appointment with someone else who can help me. I did not see the doctor who interpreted the sleep study. It was ordered by my rheumatologist who has been trying to find the cause of my fatigue. He is, however, heeding the advice of Doctor who interpreted the sleep study, so I think I will try to obtain an appointment with someone else for a second opinion. I have an appointment with a friend who is a dentist next week to discuss a mouthpiece to aid in nighttime breathing issues. I will be checking back in with you for sure to let you know if I find success or need more assistance. Thank you so much for all your help.
Since the recommendation not to pursue therapy was made by a sleep doctor that never saw you, the best course is to talk to your primary doctor. You should point out that sedatives and sleeping pills are not an appropriate solution for you, and that the sleep clinic's recommendations ignores important facts, like a low oxygen level, miscalculated AHI and your sense of fatigue. The Sleep clinic probably assumes you are the average person with mild apnea that will not be motivated to comply with therapy. Your doctor can simply use the diagnostic results that show mild sleep apnea with moderate oxygen desaturations and general fatigue to recommend CPAP therapy using Auto CPAP to self titrate for patient comfort and apnea reduction.
With a prescription you can be covered for an auto CPAP that provides data and feedback so you can optimize therapy. Your pressure requirements are likely fairly low, so a starting pressure of 5.0 cm and maximum pressure of 12.0 in auto mode would likely be very effective. You should not take "no" for an answer.