First sleep test AHI 18.8, second one AHI <2?

[ilatruman]

I was l diagnosed with mild to moderate sleep apnea/ sleep disordered breathing at 14/almost 15 (AHI and RDI both at 18., but was never told the results by my doctor, so I assumed they were normal. I was suffering from and have since suffered immensely with what I was told was depression and anxiety. I am currently in my early 20s. I have suffered from extreme fatigue, unrestful sleep (needing 10 hours sleep minimum to function), and memory/brain fog issues. My life has been turned upside down and it’s hard for me to imagine how different things could have been had I been given that diagnosis earlier.

I am now 30 lbs heavier than I was at the time of diagnosis and the reason I decided to pull up my old records (given to me on CD when I moved family doctors) is that my sleep has been particularly bad lately, I wake up so many times a night, I’m absolutely exhausted when I wake up and I have right sided jaw pain. People have heard my snoring through my closed bedroom door, which is a new development. I decided I wanted to be checked for sleep apnea again, especially since I am now very overweight (BMI 29). I went through my records and found

The weird part is I received a 2nd sleep study when I was 19 which came back as an AHI of <2. Since I was never treated for apnea and had the same BMI as I did in my first test, I am wondering if this must be a false negative. Without lifestyle changes or treatment, I can’t imagine the apnea would disappear especially because I continued to experience symptoms.

The first test was at the local hospital, then second was at a sleep disorders clinic.

I’m hoping to get a new sleep study but the earliest date they’ve given me for a sleep study is October 10th (I’m in Ontario, Canada) so I have a while to wait...

Any thoughts/help would be much appreciated.

———————————

Tl;dr
Was tested for apnea when I was 14 and got an AHI of 18. Dr never told me so I wasn’t treated. I tested again at 19 yo (still experiencing debilitating symptoms) and got an AHI of <2. Found my records a few days ago and discovered I had a diagnosis back when I was 14 that was never treated. I am 30 lbs heavier and experiencing increased symptoms of apnea. Could the 2nd test have been a false negative?

First sleep test results posted here: viewtopic/t171340/Is-this-a-positive-sleep-study.html

[Julie]

If I gain even 5-10 lbs I notice definite difference in sleep quality... and you apparently gained more not that long ago. You may need to either bump your min. pressure setting or try to lose the weight. And possibly consider other masks.

[D.H.]

Have you had any surgery since then, such as a tonsillectomy, or a deviated septum repaired?

[ilatruman]

No surgery (other than wisdom teeth when I was 17), and I’ve never been on CPAP.

I’m 5’5. I was 145 lbs (BMI 24) af my first sleep test which was AHI 18.8. Was never treated with CPAP because I was never told my test was positive for sleep apnea. I lost a bunch of weight when I was 16 (down to 130 lbs) and then gained it back at about 18. That put me at 145 lbs (BMI 24) for my second test. Now I’m 175 lbs (BMI 29).

[Goofproof]

I would use Sleepyhead, at the bottom of my post. That way I would have a sleet test every night, if I chose to. No middle men to mess up the data. No ins to mess with. Jim

[TASmart]

Op has never had an XPAP. Sleepyhead would do no good.

[ChicagoGranny]

No surgery (other than wisdom teeth when I was 17)

That's significant. People who have underdeveloped jaws often do not have room for wisdom teeth. Underdeveloped jaws result in narrow airways which are easily subject to collapse when sleeping.

If you have the money, you can buy your own equipment, and forum members can help you get the settings correct. Don't just run out and buy something. Use members' advice.

[Mogy]

Hi ilatruman,
Some of the numbers on the first sleep study don't quite add up.
RDI and AHI are not the same thing. You had respiratory disturbances that did not qualify as an apnea event.
Possible UARS?
Your AHI looks to be a lot lower than your RDI on that early test.
Losing some weight, exercise, and throat/tongue exercises would probably help you to get your apnea under control.

[Goofproof]

Op has never had an XPAP. Sleepyhead would do no good.

I stand corrected, in that case I would buy a APAP and a FF mask, then use Sleepyhead to see what was going on, after two screwed up sleep studies,you could get some answers on what is really needed. Jim

[ChicagoGranny]

Losing some weight, exercise, and throat/tongue exercises would probably help you to get your apnea under control.

Congratulations for dishing out false hope. None of that cures a narrow airway.

[ilatruman]

Hi ilatruman,
Some of the numbers on the first sleep study don't quite add up.
RDI and AHI are not the same thing. You had respiratory disturbances that did not qualify as an apnea event.
Possible UARS?
Your AHI looks to be a lot lower than your RDI on that early test.
Losing some weight, exercise, and throat/tongue exercises would probably help you to get your apnea under control.

I’m aware. The sleep test says my apnea index was 0.7, my RDI was 18.8, and my Apnea-hypoapnea index (AHI) was 18.8. The scoring on my sheet for the my A/H Index and RDI are exactly the same for each stage of sleep on the scoring sheet.

Just to be clear, this test happened several years ago when I was of a normal weight. My symptoms are now much worse several years and 30 lbs later, and I’m sure losing weight would be helpful but the antidepressant I’m on screws with my appetite and makes that extremely hard.

[jnk...]

A sleep test can be very valuable for getting an idea of what is going on during sleep, but it is still just a snapshot in time of one night. So for those of us with a lot of variation in our sleep from one night to the next, a sleep test may reflect that it happened to occur on a very good night for us or on a very bad night for us. Add on top of that the variations over the months/years in weight and treatments for other issues you deal with, and things can get a bit complicated when it comes to diagnoses related to sleep.

Bottom line is that if you are willing to give a PAP trial the full shot, let your docs know that. It may be that sleep-breathing isn't the primary factor with how you feel, but it MAY still be able to lessen a contributing factor to the extent that your quality of life may get a significant boost in conjunction with your other efforts. That likely will only happen if all of the extra energy you get from PAP is in turn invested in other healthy lifestyle choices with sleep hygiene and physical activities and healthy eating and other healthy habits--but it may be the spark that allows those things to improve. They may already be good/great, but how much of ourselves we invest in those aspects of life often is the key to doing what we can to dig out of any mental/emotional ruts we are attempting to steer ourselves out of as best we are able. PAP can give you a leg up on other issues.

You are showing clear thinking and problem-solving skills that will serve you well. So you may want to let your docs know what you are willing to do with PAP and then see if they agree it is worth exploring. They might not need too much nudging if they see some excitement from you on the matter. Going directly to an APAP trial may be the most cost-effective thing to suggest, if the docs are able to use earlier sleep tests as ammunition for getting that trial paid for. If you get AHI low for a few months and see no benefits in your abilities to pursue other changes and improvements in life, then at least you know that other factors beyond sleep-breathing might be where the bulk of your efforts should then go.

I have no medical training. So take what I say with a shaker of salt.

[palerider]

Losing some weight, exercise, and throat/tongue exercises would probably help you to get your apnea under control.

Congratulations for dishing out false hope. None of that cures a narrow airway.

Mogy makes me wonder why this villiage has to have so many idiots.

[Mogy]

Losing some weight, exercise, and throat/tongue exercises would probably help you to get your apnea under control.

Congratulations for dishing out false hope. None of that cures a narrow airway.

The OP has been diagnosed with a narrow airway? I didn't see that.
Even if you have a narrow airway, losing weight will still probably reduce your AHI.
Gerneral exercise has been shown to reduce sleep apnea.
Throat/exercise has been shown to reduce sleep apnea.
This is not false hope. It has been proven.

[jnk...]

This is not false hope. It has been proven.

Personally, I consider it proven that you provide false hope. Just my opinion.