Is my apnea serious?

[blizzard2017]

Hey, I was wondering what my prognosis is if I can't tolerate BIPAP therapy? I am about 20 days away from having the insurance company take my machine away and my doctor will not prescribe me any meds to help me sleep with the mask o despite repeated requests. All he wants to do is another sleep study since I lost 10 pounds. I feel like my sleep doctor is more interested in making money off of me than he is in treating me. I am tired all of the time and he won't help with that. Insurance will not pay for a pillow mask and the doctor only lowered the pressure on my machine to see if that will help when that is not the problem. I can't sleep with the mask on no matter how many times I try. This happens even when I use the ramp up feature. I have anxiety and can't get used to the mask over my face. I am thinking about calling the medical supplier and having them come by and pick the machine up and discontinuing treatment as they aren't even willing to work with me. I think an anxiety med will allow me to sleep for at least the minimum of 4 hours a night with the mask on, but the doc does not agree. Any how, I'm posting a pic of my titration study just to see if you guys think my case is severe. The doc says it is severe since my pressures are 20/24. I also had good oxygen on the titration test, but normally 99 percent of my sleep time is spent between 82 and 88 oxygen levels. Thanks for your advice.

I can't post an image, so here are my numbers.

12 central sleep apneas, mean duration 20 seconds.

22 obstructive apneas ranging 18 seconds in duration.

109 hypopneas ranging 28 minutes in duration.

81 percent in stage 2 sleep.

2.8 percent in REM sleep.

.8 percent in stage 4 sleep.

15 percent in stage 1 sleep.

18 percent was spent in stage wake.

I slept for 360 minutes.

AHI Nrem 20

AHI REM 30

No heart issues or PVC's detected. Normal characteristics of sleep noted. Sleep onset was 19 minutes.

[blizzard2017]

I meant to say I lost 30 pounds, My health is bad and another separate medical illness is causing the rapid weight loss.

[Sheriff Buford]

There is no "magic pill" to treat apnea. I would buy a nasal-pillow mask out of my pocket, call the insurance company and explain your situation.... and ask for another month. This is your health and life. You can make CPAP therapy work!

Sheriff

[ChicagoGranny]

My health is bad and another separate medical illness is causing the rapid weight loss.

What are you leaving out? Being tight with information on what the "other" problems is not a good way to seek good advice. Your "separate medical illness" could be the result of sleep apnea. We can't tell without knowing what this illness is.

[linuxman]

On getting used to the mask, you might try wearing it in the evenings while you're doing other things. You might be able to overcome your issues with the mask, and of course that adds to your compliance numbers.

If you think another mask will help, by all means just go buy one online. You'll need to get your prescription from the doctor so you can send a copy of it to the online vendors.

[Jay Aitchsee]

Is my apnea serious?

Yes

severe since my pressures are 20/24

Severity is not determined by the amount of pressure, but the number of events per hour.
Mild: AHI ≥ 5, but < 15 per hour
Moderate: AHI ≥ 15, but < 30 per hour
Severe: AHI ≥ 30 per hour

normally 99 percent of my sleep time is spent between 82 and 88 oxygen levels

There you go.

[blizzard2017]

Thank you guys for the advice. My other medical issues are diabetes, high cholesterol, COPD, Blood clots, and some really strange one possibly Disautonomia. I have severely high BP upon standing with very fast heart rate, but it goes back to normal when I sit back down. Some days BP is low and fast heart rate. It is really frustrating. I feel like death every day and too many things can be causing this. I have the blood clotting disease under control with blood thinners and my blood sugar never goes above 130 for long because I use insulin to knock the sugar back down. I have been able to successfully manage all of my other diseases, but using the BIPAP is so daunting for me. I put the mask on and I'm instantly wired up. I just can't fall asleep or stay asleep with the mask on no matter what I do. I even took an Ambien and could not stay asleep with the mask on. I also have chronic pain which makes it difficult to wear the mask, because the pain makes it hard for me to sleep. If I take enough pain meds to completely dull the pain, the meds will wire me up and I won't be able to sleep. So I have to compromise between lowering my pain levels at night and also not overdoing it on the pain pills. It isn't a stabbing pain, but it is a permanent soreness like I have a pulled muscle. The discomfort never stops unless I slam down enough pain meds to put a regular person in a coma. I don't do that very often, because I prefer to remain on a very low dose of meds (50 mgs a day). I have a special tea I drink sometimes that is so powerful it will take away all of my pain for two days at a time, but it leaves me too buzzed to function and I can't live like that either. So all this comes into play. The last thing that come into play is that I adopted a rescue cat a month before I got my BIPAP machine and she was in a cage for 4 years straight. She is extremely traumatized and the sound of the machine makes her hide under the bed. The problem is that she goes to the bathroom all over the house, unless she is locked in the bedroom with me at night. I can't run the machine with her in the room. So it is looking as if I might have to put off therapy for a few years until this cat passes on. She is 15 now and I adopted her because no one else wanted her. I knew it was my home or she would spend the rest of her elderly life in a cage. I might try and wear the mask sitting down for 4 hours a day, if not I can buy another machine in the future and not have to worry about having an insurance company breathing down my throat. I did notice that I feel bad but I do not have the insomnia that I had when I was 30 pounds heavier. I used to wake up choking and tossed and turned unable to get back to sleep. I still choke, but I dream a lot now. I will try again but I fear it's a losing battle for me. I know I'm doomed without the machine. I know how serious this condition is.

[blizzard2017]

I have chronic pain because there are chronic blood clots in my right leg blocking circulation. It hurts to lay on that side and my leg will hurt more after I've walked that day. I also have dipping oxygen in the waking hours. I had a 6 minute walk test and my oxygen dropped down to 91 percent half way through and then bounced back up again. On the first two sleep studies they didn't see the whole picture. On the titration study I actually truly slept and they caught double the amount of apneas even though half the test was a titration. I probably have a higher AHI than 20. I also have high heart rate when walking, it will go to 130 BPM. If I push it and vacuum the house, HR will go to 150 BPM. If I vacuum the house fast, HR will go to 190 BPM. I have pictures of my pulse ox. My doc said it' normal to have high HR when vacuuming. I don't know how this ties into the apnea, but maybe it does. I think the central apneas came from the BIPAP treatment. They have a pattern programmed into the machine to force me to breathe even if my brain stops breathing. It's a shame we can't just go into some sort of chamber and sleep. I know when I was in the hospital with blood clots my oxygen levels were good at night, but I was on 2 liters of oxygen. That probably made a big difference. Any how, thanks for listening. I'm very disappointed in myself for not having more fight in this. I lowered my A1C from 7.1 to 5.4 in 1 years with diet and meds, my cholesterol is perfect now, and no more blood clots. But this machine is going to be the death of me.

[Goofproof]

Correction, your making up your mind not to make XPAP work will be the death of you. If they would just make a pill to correct peoples thinking so they could make their lives better, but the FDA has banned most mind control drugs,they save them for in house treatment. Jim

[EdNerd]

Anxiety issues are real. So is heart and brain damage from low oxygen. Oh, death, too.
Anxiety can be overcome. Heart and brain damage and death can't.

Personally, I would value my own life more than a 15-year-old cat.
I've got an older dog. Taking him to the pound is a death sentence.
But if he won't let us sleep at night and it's him or us -- it's us.

Yes, doctors want to make money. They also have a ton of regulatory hoops to jump through.
Ditto for insurance and Medicare. You will get nothing if you fail to cross one i or dot one t.
You get nothing unless you run the maze. Which many will not because death isn't real enough.

It's all your decisions.
Ed

[JimW159]

...making up your mind not to make XPAP work will be the death of you.

Literally

[Nealbopper]

CPAP.com has pillow masks for $35.00 on sale right now. I bought 2 yesterday.

[D.H.]

You shouldn't leave your Sleep Apnea (which appears to be severe) untreated, any more than you would leave your diabetes or blood pressure untreated. It is a serious illness and complicates most (maybe all) of the other illnesses that you seem to have.

[JimW159]

[i]...this machine is going to be the death of me.[/i]

Quite the opposite.

[49er]

Hi blizzard,

You mentioned your machine pressure was set to 24/20. Is that a straight setting or do you have a machine that auto adjusts? What do you have?

If you could please use the links in my signature to register for the forum so you can register your equipment, forum members will be in a better position to help you.

Regarding anxiety meds, would your PCP be willing to prescribe them? It also sounds like he/she needs to do a complete review of your meds since you are having so many problems.

I would also follow the advice to purchase a nasal pillow mask on your own if you feel that might help you be compliant with therapy.

I know you didn't ask about this but regarding your diabetes, I would visit this site, http://www.lowcarbrn.com. Even if you still need insulin, going on a high fat, low carb diet will lower the amount that you need.

Hang in there.