I'm new. I think I have apnea. Advice?

[Judge Nap]

I was leaning toward pulse oximeter, but would this make more sense?

viewtopic/t97340/Remstar-Plus--model-25 ... -sale.html

Again ... I don't know if I have sleep apnea regularly. But I'm pretty sure I've been having it some.

From everything you posted in this thread, I bet you have sleep apnea. Just about every man has it by the time they are 50. It's just a matter of severity and even so-called mild apnea needs to be treated.

And besides, if your doctor made a correct evaluation,

My doctor also looked down my throat and said I was a four.

,
the probability that you have obstructive sleep apnea is close to 100%.

I bet in the long run you would be very happy with a new machine. Shop around here and check back with members if you find something that appeals - https://www.google.com/search?q=resmed+ ... channel=sb

(Note that our forum host, cpap.com, will match any price you find.)

[BarnhartWill]

Update ...

It feels like a lot has happened since I last posted. Pugsy found a nice ResMed S9 on Craigslist in my area and also donated a nice pillow nasal mask. She helped me set up the machine and gave me feed back on my report. I really appreciate it. Thank you Pugsy, and thank you to everyone who cared enough to give their input throughout this.

I've been using the machine for 6 days and my average AHI is 2.18. Most of those are centrals. The machine is set on auto with a minimum of 4, maximum of 10. The average pressure is 5.74, but sometimes it will get up to 8 or 9.

Just being able to sleep however I want, rather than staying off my back has been very nice

[kaiasgram]

Update ...

It feels like a lot has happened since I last posted. Pugsy found a nice ResMed S9 on Craigslist in my area and also donated a nice pillow nasal mask. She helped me set up the machine and gave me feed back on my report. I really appreciate it. Thank you Pugsy, and thank you to everyone who cared enough to give their input throughout this.

I've been using the machine for 6 days and my average AHI is 2.18. Most of those are centrals. The machine is set on auto with a minimum of 4, maximum of 10. The average pressure is 5.74, but sometimes it will get up to 8 or 9.

Just being able to sleep however I want, rather than staying off my back has been very nice

Way to go! How are you feeling?

[Drowsy Dancer]

Thank you. It doesn't make sense that this has been an off and on concern for the last few years and I haven't done anything more than try some DIY treatments. HerbM said, "IF you think you MIGHT have sleep apnea, and you can in any way afford it the it is best to CHECK with a QUALIFIED doctor." I think I'll take your advice HerbM.

I appreciate everyone caring enough to give some input.

I'm coming late to this party, but it didn't make sense that I snored for years, and even self-diagnosed with OSA (and my husband agreed with my diagnosis), but I did nothing about it...until I fell asleep at a stoplight one afternoon. Scared the daylights out of me.

[BarnhartWill]

kaiasgram, I'm feeling better than I did. I tend to be a little restless in my sleep after 3am or so. But I feel much better about getting some resolve to the apnea concern I've had for a while now.

[musculus]

I think the figure is wrong. When do the scorign, you are not supposed to stick the tongue outside the mouth, as when you sleep, your tongue cannot do that.

See the figure in page 2 of Friedman's paper:
http://depts.washington.edu/ccor/studie ... 20UPPP.pdf

"The doctor seemed pretty sure I had a problem when he looked down my throat."

Hmmm, I've never had my sleep doc actual look in my mouth .... Others?

Yep -- mine did. Then he showed me this graphic and what he was looking for -- apparently this is one (only one) clue to potential for obstruction:

[blackrock]

Update ...

It feels like a lot has happened since I last posted. Pugsy found a nice ResMed S9 on Craigslist in my area and also donated a nice pillow nasal mask. She helped me set up the machine and gave me feed back on my report. I really appreciate it. Thank you Pugsy, and thank you to everyone who cared enough to give their input throughout this.

I've been using the machine for 6 days and my average AHI is 2.18. Most of those are centrals. The machine is set on auto with a minimum of 4, maximum of 10. The average pressure is 5.74, but sometimes it will get up to 8 or 9.

Just being able to sleep however I want, rather than staying off my back has been very nice

Wow this board is awesome for doing that.

Thats good. Does that mean you dont have OSA most likely??

[Pugsy]

Does that mean you dont have OSA most likely??

He most likely has OSA or at least enough flow reductions to cause the machine to make significant and sustained pressure increases.
The AHI of 2.18 is with treatment. Without cpap therapy there's a real good chance it would be significantly higher.
If he didn't have something going on with the airflow the machine wouldn't be increasing the pressure.
We don't know how bad it might or might not have been but at this point it doesn't really matter.
It's the end result after therapy that matters...and the most important thing...he's feeling better.

[BarnhartWill]

Another update ...

I thought I was feeling somewhat better after starting with the CPAP treatment, and it was a relief to not struggle to stay off my back, but I've still been struggling with daytime fatigue. I've assumed that it would be worse without the machine because the pressure would rise to 6 or 7, or even 8 or 9, so I thought it was doing something to help. But last night, as a test, I set the machine to straight CPAP at a pressure of 4. If the machine was helping, then my AHI would go up if I kept the pressure at 4, I thought.

Well, my AHI when up slightly, but it was mainly with centrals and hyponeas. It didn't seem to make a difference with obstructive apneas. Perhaps hyponeas can be due to partial obstruction? But I don't really understand hyponeas very well. When I zoom in on my flow the periods of hyponea hardly look different than my regular breathing.

I'll put up a screen shot of last night and the night before. Any insight you can give me would be very much appreciated. In general, since my AHI is under 5, even with pressure at a steady 4, perhaps my fatigue is due to a more general bad sleep or other reasons rather than apnea? Maybe I should not use the machine except for those times when my throat feels slightly swollen and I feel like I might be having trouble? Or, what do you think?

Thank you.

[Pugsy]

You might study up on UARS Upper Airway Resistance Syndrome. Not saying that is what you have going on here but something is causing the machine to want to increase the pressure in auto mode.

[kaiasgram]

You might study up on UARS Upper Airway Resistance Syndrome. Not saying that is what you have going on here but something is causing the machine to want to increase the pressure in auto mode.

Agree, and compare the Flow Limit numbers for the two nights. Would be interesting to see what the FL graphs look like.

[BarnhartWill]

I don't think I understand flow limitation, but there is a difference between the two nights. Does the difference mean I should continue to use the machine?

Last night:



The night before:

[kaiasgram]

Will, flow limitation is some resistance in the airway. In APAP mode our machines increase pressure when airway resistance increases. You can see this by looking at the Flow Limit graph and Pressure graph together -- here are a couple of examples:





When you look at your own data in APAP mode, do you see this effect?

[BarnhartWill]

kaiasgram, I do see the correlation. I'll attach screen shots that show flow limitation and pressure. I'm trying to determine if I should continue with the machine every night. Maybe I would sleep deeper without it. Any suggestions?

[kaiasgram]

Will -- Your question about whether to stay on the machine is a tough one, partly because there hasn't been a valid sleep study with an 'official' diagnosis and partly because the results of your fixed-pressure experiment didn't really answer any questions. Had your AHI spiked with the low fixed pressure then there would be no question whether you need to stay on the machine.

But several things make me think you ought to stay on the machine (APAP mode) for at least a while longer:

First, because of your initial suspicions and the symptoms that brought you here in the first place.

Second, you've only been using the machine a little over two weeks (started around May 1, correct?) and for many people that's just not long enough to feel substantial improvements. Though you did say in your May 8 post that you were feeling a little better.

Third, in APAP mode the pressure is responding appropriately to something (I think you said your pressure has gone as high as 8 or 9). So we know you've got something going on. Whether your flow limitations are clinically significant I don't know -- again you'd need a sleep study with EEG to determine whether and how much those FLs are causing microarousals and disrupting your sleep.

Fourth, and probably related to the FL issue, your doc examined your airway and said that you are a "4" which suggests small airway. I'm not sure if this is part of why Pugsy suggested you read up on UARS, but having a small airway raises the index of suspicion.

Fifth, even with your experiment of fixing the max pressure at 4, you were still getting some therapy, so your results do not necessarily reflect what would happen if you didn't use the machine at all.

Sixth -- Darn, I can't think of a sixth thing. I was hoping for a nice clean half-dozen things for you.

You could use the machine at fixed pressure of 4 for a few more nights (assuming that low pressure is tolerable for you) to see what happens since just one night is not a good basis for seeing a trend. And/or, put the machine back in APAP mode and give it more time to see if you get more improvement in how you're feeling over time. Ultimately to be sure about what's going on, you'll need to get a good sleep study, one way or another.