Apneas Less ... Without Treatment

[debtheveg]

I was diagnosed about four years ago with moderate sleep apnea, 23 per hour. Tried CPAP for two months, then moved on to a mandibular device for several months. A sleep study with the mandibular device showed 15 per hour. Discarded that treatment and have gone untreated for OSA since then. Had a study last week, hoping to qualify for the Apnex trials of their implant and have found out that I am not severe enough, only having 8.9 per hour.

Has anyone else found their sleep apnea less severe after a few years? Without treatment? I'm a bit perplexed ... Disappointed on one hand at not qualifying for the trial but, of course, extremely pleased that I'm almost 'normal'. I'm still around the same weight but the only thing I can think that may have had a bearing is that over the last month or two I've been doing neck exercisers, primarily to help with my double-chin! So who knows .....

[LinkC]

Change in weight? (That's rhetorical...no need to answer!) That's the most obvious game-changer.

CPAP just treats the symptoms, it doesn't really "cure" anything. Consider what else has changed physically.

[debtheveg]

No, I'm aware CPAP isn't a cure, just a nightly treatment. Nothing else is different weight-wise or physically, only the fact that I've been doing neck exercises. I'm just wondering if others have different numbers when having sleep studies a year or two or more apart. During this last study, I felt I hadn't slept very much at all, but they tell me I slept enough to get the readings.

I'm just curious if this is a normal thing to happen.

[SleepingUgly]

Did you have the AHI of 23 and the AHI of 9 done at the same lab? If not, I absolutely can see how you could get an AHI that different. First of all, if your events consist largely of hypopneas, then do the labs score the hypopneas the same way? See this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/

Also, there is night-to-night variability in respiratory events, as well as body position, how much REM you had, time slept, etc. that can impact the overall AHI. It's not as though your AHI ever was 23 every single night, and it's not the case that your AHI is 9 every night now.

[chunkyfrog]

True, and all the more reason to have an automatic machine--even if you use it on CPAP mode most of the time.

[ozij]

Any change in your vitamin D levels?

[debtheveg]

Yes, the first studies were done here in Canberra and the study last week in a hospital in Sydney. Also, the one last week was sent to the Apnex people in America to score and I was told they do score it slightly differently, however, there does seem to be a large discrepancy between the studies.

As for Vit D, I've never had it actually tested but would be surprised if it has ever been low as Canberra has one of the highest rates of sunny days in Australia and I'm always outside gardening etc. More at risk of skin cancer than Vit D deficiency, I'm afraid.

I'm just hoping that perhaps the neck exercises (for my double chin, ha) have, in some way, strengthened the muscles internally.

[SleepingUgly]

Have the neck exercises done anything externally?

[debtheveg]

Yes, I'd have to say I think they have. Been doing them now for nearly two months, most days. You can google exercises for double-chins and there are some youtubes as well. Things like looking at the ceiling and jutting your chin out ... you can feel the stretch. Making very exaggerated movements with your mouth saying the vowels i.e. A, E, I, O, U. Looking over your shoulder and again jutting out your chin and holding, then the other side. Opening your mouth wide and sticking your tongue out to touch your chin. There's lots of ideas plus I have a stretchy sort of funny bandage thing that goes over my head and around my neck that you wear twice a day but I haven't had that as long as I've been doing the exercises.

But yes, my chin is definitely a little more defined and I'll keep it up as it certainly is no big deal. You can do it in the car ... best not at the lights though or you'll get funny looks.

These exercises are the only difference I can think of between previous sleep studies and the most recent one so, perhaps, in my case it has helped. Would love to know if anyone else has had a similar experience.

[kteague]

I'm just wondering if others have different numbers when having sleep studies a year or two or more apart. During this last study, I felt I hadn't slept very much at all, but they tell me I slept enough to get the readings.

A difference in sleep position, total sleep time, and the time spent in deep and REM sleep could make a difference in the results seen. If you placed your reports side by side for comparison it might give some clarity on if that's in play here. I wouldn't count on that one result being reflective of your usual sleep apnea since, by your description, it wasn't a good night's sleep.

I know you are disappointed about not qualifying for the trial. What is your plan now? Even if your AHI of 8.9 is a new normal for you, that's still about 70 events over the course of an 8 hour night. Hard to imagine you could feel and function well with those numbers. Best wishes as you move forward.

[Drowsy Dancer]

Things like looking at the ceiling and jutting your chin out ... you can feel the stretch. <snip> Looking over your shoulder and again jutting out your chin and holding, then the other side.

I do hope you're not doing these ones while you're driving!

[chunkyfrog]

Two ways to discourage people from staring at you at traffic lights:
1) tinted windows.
2) picking your nose.

[Janknitz]

During this last study, I felt I hadn't slept very much at all, but they tell me I slept enough to get the readings.

It might be a good idea to look at the entire study, not simply the AHI. I'm wondering if you had very much REM sleep, compared to the previous study?

I'm not sure I would take that score to mean anything about whether or not your AHI is improved. It was being used to see if you met the criteria for the study, not for determining your individual treatment parameters. It doesn't sound like they needed to dial in precisely how much apnea you have in various positions and stages of sleep.

[archangle]

I would not be at all surprised to see a difference of 23 vs. 9 AHI on two different nights in exactly the same conditions in the same lab.

More if anything is different, especially something like a full face mask pushing your jaw back, you getting more or less REM sleep, etc.

The one night sleep study the medical mafia likes to worship is a really bad way to collect data on how your sleeping over time since we vary so much from time to time. It's still ONE data point measuring a complex and variable phenomenon.

[NightMonkey]

It might be a good idea to look at the entire study, not simply the AHI. I'm wondering if you had very much REM sleep, compared to the previous study?

Yes, you need to compare both studies in great detail. You might be lucky to find that most of your breathing events occur while you are on your back and that you breathe healthily or nearly healthily while on your side or stomach.

It is also worth noting that some of those exercises that you are doing strengthen the airway muscles. This could have an impact. However, as others have noted, most of us would show significant night-to-night variation in AHI due to many factors.