Mild Apnea with multiple risk factors

[rileyrd22]

Hi All,

I had my sleep study completed and got the results about two weeks ago. The initial call reported that i had some apnea and would get full details at the doc appt. The good news was that I was diagnosed with only mild apnea with a AHI of 5.1. 24 events total. Lowest O2 was 92. Felt pretty good about results. Was offered an oral appliance which I declined for now. Docs said CPAP was overkill for those levels. I do have several risk factors including high blood pressure, Type 2 diabetes, and evidence of two small strokes. I am wondering if I should re-visit the idea of CPAP with the docs although i an not hopeful.

I am toying around with buying a used machine from craigslist to do a trail to see if it would help reduce my level of risk. I can get a mask from Amazon or order the parts from online vendors and put together myself.

Would love your thoughts.

[Goofproof]

Make sure it collects full data and is compatible with the Sleephead software at the bottom of my sig. Jim

I'd say with your other problems, your doctors reasoning is faulty. Get a APAP, and use it. Better to be prepared to make your health better, than try to repair it later. Welcome

There are a few people here that sell machines on the side that are honest, and have good deals.

[Mark55]

While it probably isn't a necessity, using CPAP/APAP certainly isn't going to hurt you. If you can afford buying a machine, and the rest on your own, I would give it a shot.

I am a 'private pay' user as well, and there are plenty of ways to get what you need for a reasonable price without going through insurance. I have great insurance, I just got fed up with the DME, and the sleep doc and decided to eliminate them from the equation.

[D.H.]

They say that below 5 is negative for SA, so you're barely positive, at least according to current guidelines.

Remember that 5 means an event every twelve minutes (on average). I find it hard to believe that that should be considered acceptable. Also, the fact hat you have these other risks should tip the scales in favor of treatment.

[chunkyfrog]

AHI is only a report of the number of events, not of their duration.
One long apnea . . .
Well, you mentioned a stroke . . .
Insurance guidelines are meant to save MONEY--not LIVES.
The ball is in YOUR court.

[D.H.]

AHI is only a report of the number of events, not of their duration.
One long apnea . . .
Well, you mentioned a stroke . . .
Insurance guidelines are meant to save MONEY--not LIVES.
The ball is in YOUR court.

Presumably, if the events were of such long duration, the O2 level would have dropped; a lot! I would hope that would have been a trigger to diagnose a higher severity than 5.1 would otherwise indicate.

[Goofproof]

AHI is only a report of the number of events, not of their duration.
One long apnea . . .
Well, you mentioned a stroke . . .
Insurance guidelines are meant to save MONEY--not LIVES.
The ball is in YOUR court.

Presumably, if the events were of such long duration, the O2 level would have dropped; a lot! I would hope that would have been a trigger to diagnose a higher severity than 5.1 would otherwise indicate.

All it takes is one event over 5 minutes, and you won't have to worry about the next one! Jim

[ChicagoGranny]

The good news was that I was diagnosed with only mild apnea with a AHI of 5.1

If you sleep seven hours, that is about 35 awakenings per night. How healthy is it to be awakened 35 times every night? What kind of impact does that have on ------>

I do have several risk factors including high blood pressure, Type 2 diabetes, and evidence of two small strokes.

?

If you start shopping for CPAP machines, let forum members help you make sure you get the right one. Even some new machines are just unacceptable. See ----->

Make sure it collects full data and is compatible with the Sleephead software

[rileyrd22]

Checked report.. the average event duration was 13.2

[chunkyfrog]

Oxygen is not the only issue. Stress hormones are, too.
Stroke is a HUGE danger alarm.
Sleep tests are ABNORMAL situations--often preventing the subject
from relaxing deeply enough to allow "normal" levels of apnea.
Test results are no better than the testing process/atmosphere itself.
The Heisenberg uncertainty principle: "The testing process affects the test results."

[Mogy]

Hi rileyrd22,
You don't say whether you have any extra weight to lose. Anyway, type 2 diabetes as well as OSA respond well to weight loss and exercise.

[chunkyfrog]

OSA not so much.
Even though repeated by foolish doctors and others . . .

[StuckOnRepeat]

Go over your report and try to determine how likely it is that the night studied gave enough information to believe they were able to capture your worst case scenario. Was there significant time in all stages, particularly REM? Time in REM while supine? Studies without much REM or supine sleep are what my doctor termed "technically suboptimal". In these cases, it could be that a person's events on another night might be significantly worse. Also, if your events were mostly clustered during a period of REM, you could be in distress during that time even though an average over the entire hours of sleep can give an illusion of no big deal. Considering your other medical conditions, I would not accept those results without a critical eye on the details.

[D.H.]

AHI is only a report of the number of events, not of their duration.
One long apnea . . .
Well, you mentioned a stroke . . .
Insurance guidelines are meant to save MONEY--not LIVES.
The ball is in YOUR court.

Presumably, if the events were of such long duration, the O2 level would have dropped; a lot! I would hope that would have been a trigger to diagnose a higher severity than 5.1 would otherwise indicate.

All it takes is one event over 5 minutes, and you won't have to worry about the next one! Jim

Of course, the length of each incident is recorded, so total time in breathing cessation is an accessible number. This number would be high if there were relatively few incidents, but they were of long duration. I would think that those who have incidents of very long duration have fewer of them, since you can't have a subsequent incident while the prior incident is still in progress!

Note the linked article which states the following:

The classification and severity of obstructive sleep apnea (OSA) are traditionally based on apnea-hypopnea index (AHI). AHI < 5 events/h is judged as normal, 5 ≤ AHI < 15 events/h as mild OSA, 15 ≤ AHI < 30 events/h as moderate OSA, and AHI ≥ 30 events/h as severe OSA [1]. However, AHI takes into account only the number of the breathing cessation events per hour of sleep neglecting the duration and morphology of the individual respiratory events.

The article is about two years old (at the time of posting), and is about sleep position. The suggestion is that this also needs to be considered a measure of severity.


Link ===> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804087/

[rileyrd22]

I had a follow up with my sleep doctor's PA and she agreed to start me on a 3 month CPAP trail due to my risk level. She has filed with my insurance and hopefully will hear within a week or two. If the trail shows positive results, we would continue on the CPAP. If insurance balks, i may look at purchasing a Resmed Autoset on my own. Wish me luck.