Can someone help me understand this?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
littlecarmelite
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Joined: Sun Apr 19, 2015 4:05 pm

Can someone help me understand this?

Post by littlecarmelite » Sun Apr 19, 2015 4:19 pm

Hello,
I'm new here, and to all of this apnea stuff. So I knew I had apnea because I'll wake up feeling like something is catching in my throat and gasping. My brother also told me when I was a baby I had it as well and apparently I did as a child too. That being said, I started getting almost narcoleptic type things happening where I could fall asleep anywhere, anytime, sitting up and I have a new job starting so I don't want to get fired obviously, so I went to the dr specifically for a sleep study to be done.
They sent me to some sleep dr place that did a home study on me and I have an appointment this coming week. I also went to my PCP last week since nobody wants to tell me anything other than "you have sleep apena" duh. I knew this I'm a very hands on patient. I like to know exactly what the results are and all info I can to take charge of my own health (this comes from working in the health insurance industry I guess). I managed to get my PCP to tell me that I had 13 apneas (I'm assuming they meant ANI of 13?) but that my oxygen went down to 75% consistently. If I'm assuming correctly, this would be considered mild correct? But I know that my oxygen going down to 75 is pretty bad as well, so do they really just look at the ANI to gage the severity or somehow factor in the oxygen?
Here's another question I have as well, if I wore this sleep study machine (which was super uncomfortable btw) all night, but woke after 1 hour and just laid there trying to go to sleep for 4 more with literally no sleep (ended up watching a movie even), is it possible that they would count that 4 hours I laid there awake but barely moving as sleep or would the equipment pick up the difference?
I guess I want to have all my ducks in order before I discuss with the dr.
No clue what machine they have for me as I don't have it yet. I already requested an apap instead of a cpap which they first ordered due to the fact that my weight is changing right now (losing) and I don't have the time to be running all over to figure out how to reset the settings etc. I also requested a full face mask even though I think it will be awful but I have allergies and breathe through my mouth, so I don't know that there's another option for me.
Anyway, anything you can help with would be great.

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Pugsy
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Re: Can someone help me understand this?

Post by Pugsy » Sun Apr 19, 2015 5:04 pm

littlecarmelite wrote:do they really just look at the ANI to gage the severity or somehow factor in the oxygen?
It's AHI and not ANI that determines "severity" and it's just a number and oxygen levels aren't factored in.
It is misleading at times. There are people with "severe" AHI in terms of number (I have a friend with AHI of 60 something and her oxygen levels never dropped below 93%) without big desats and there are people like you who have more modest AHI numbers but some really ugly desats.
The duration of the event also is important but no way to factor it in.
littlecarmelite wrote: is it possible that they would count that 4 hours I laid there awake but barely moving as sleep or would the equipment pick up the difference?
It's very unlikely that awake time would be mistaken for asleep time even with a home study unless the only thing they checked was the oxygen levels. There are varying levels of comprehensiveness to home sleep studies...some are the most basic and only do the oxygen thing with a pulse oximeter and others offer much more data available. Did you have other stuff attached to you for the sleep study besides the pulse oximeter on your finger?...like leads on the face, forehead, legs...and/or did you wear some sort of chest belt?

If you were awake for the bulk of the night and still had those desats...and that means you had those desats while awake...you would have some serious issues going on while awake period and that means daytime awake too.

Full face masks aren't so horrible if you find the right one that works for you. It may be a little bit more of a challenge to find the right one but there are lots of people successfully using full face masks.
Make sure you understand your DMEs mask swapping/trial policy so that you can make full use of it while you can.
Most of the time it is 30 days...don't spend 21 days fighting a mask and then swap...you will be stuck with the second choice as time runs out until your insurance allows another mask....unless you want to buy your own and that's an option.

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LSAT
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Re: Can someone help me understand this?

Post by LSAT » Sun Apr 19, 2015 5:08 pm

Your AHI of 13 means that there were 13 events per hour (Apneas or Hypopnias). At the sleep center, with all the wires attached, they would be able to tell if you were awake or sleeping. I think with as little as an hour or two they can get a pretty good idea of your diagnosis. When you see your doctor ask for a copy of your sleep study results and a copy of any machine he prescribes. Keep those copies for any future needs.

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littlecarmelite
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Re: Can someone help me understand this?

Post by littlecarmelite » Sun Apr 19, 2015 7:26 pm

Pugsy wrote:It's very unlikely that awake time would be mistaken for asleep time even with a home study unless the only thing they checked was the oxygen levels. There are varying levels of comprehensiveness to home sleep studies...some are the most basic and only do the oxygen thing with a pulse oximeter and others offer much more data available. Did you have other stuff attached to you for the sleep study besides the pulse oximeter on your finger?...like leads on the face, forehead, legs...and/or did you wear some sort of chest belt?

If you were awake for the bulk of the night and still had those desats...and that means you had those desats while awake...you would have some serious issues going on while awake period and that means daytime awake too.
I had some pokey thing in my nose (completely irritating but it was like what they use for oxygen I guess.. just hated that thing because it tickled my nose all night), a finger light, and a belt that went around my chest but wasn't on very good (I'm a woman, things seemed to get in the way). No, the oxygen was only while sleeping. The test was over multiple days also, so that's why I wondered because the first night I didn't sleep hardly at all.

littlecarmelite
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Re: Can someone help me understand this?

Post by littlecarmelite » Sun Apr 19, 2015 7:29 pm

LSAT wrote:Your AHI of 13 means that there were 13 events per hour (Apneas or Hypopnias). At the sleep center, with all the wires attached, they would be able to tell if you were awake or sleeping. I think with as little as an hour or two they can get a pretty good idea of your diagnosis. When you see your doctor ask for a copy of your sleep study results and a copy of any machine he prescribes. Keep those copies for any future needs.
Thanks, I'll do that but so far I haven't had much luck getting any information out of these people. You'd think a patient would be able to get their own results, but they seem very tight lipped about it all. This is why I want to go in with as much info as I can.
They have to give me a copy of the prescription correct? (incase I want to get my own machine instead of a billion dollar one?)

littlecarmelite
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Re: Can someone help me understand this?

Post by littlecarmelite » Sun Apr 19, 2015 7:38 pm

Another question. In looking over some other posts on here, I see that people say a data capable machine is best?
I've literally never had one so I have no idea what to get. I mentioned I thought an auto machine would be best and they sent in for that, but I'll likely be getting my own online (insurance changes in of this month).
Any idea of what kind I should get that won't break the bank (I'll be paying cash because I'm going on a HDHP with an insane deductible). I'm thinking heated humidifier is going to be needed, and auto since I'm in the middle of losing weight... what else? Any certain brands I should be looking at or whatever.

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Pugsy
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Re: Can someone help me understand this?

Post by Pugsy » Sun Apr 19, 2015 7:54 pm

This would be my first thought for a machine based on what you have told us so far.
It will do everything that I think you might need unless by some remote chance you end up with pressure needs exceeding 20 cm and that calls for a totally different machine.
ResMed AirSense 10 AutoSet for Her...and the humidifier is built in.

https://www.cpap.com/productpage/resmed ... idair.html

Make sure it is the "for Her" model as it actually has an extra apap mode available that might come in handy.
The regular unit in this model line that is black and not the for her model lacks that one mode.
So the for her model is like 3 machines in one....1 cpap mode and 2 apap modes
Also that extra apap mode collects some data that the other modes don't and while it might not be a deal breaker...why not get everything you can because it's better to have something and not need it than need it and not have it.

Respironics also makes a good apap machine (the Phillips Respironics 60 series Auto CPAP model 560) and it will cost a couple hundred dollars less...but if it were me and getting the ResMed wouldn't take food off the table...I would get the ResMed if I were in your shoes.
There are other good machines out there but this one would be my choice if I was starting out new to therapy.
Based on what I know about ResMed machines, the data they collect, ease of use, quality, etc.

There are ways to get machines that are slightly used if you want to go that way and save a little money.
The AirSense 10 AutoSets are relatively new to the market (last Sept I think) and finding one is a little harder.

Now I do know one person who did have an AirSense 10 AutoSet for Her machine that she located...brand new and I think she was selling it for $675...but don't hold me to that exactly...and I don't know if she sold it or not but if you want more information on that machine or other private party offerings...send me a private message.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

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archangle
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Re: Can someone help me understand this?

Post by archangle » Mon Apr 20, 2015 7:33 am

Welcome. Sorry you had to join us.

There are lots of links in the Useful Links in my signature line at the bottom of this post. Some of them will help you avoid being screwed by the medical mafia with a bad CPAP machine.

Unfortunately, a lot of us have to do most of the work to properly manage our own therapy. The big box store assembly line style medicine we have today just doesn't meet the needs of a lot of us.

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Please enter your equipment in your profile so we can help you.
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littlecarmelite
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Re: Can someone help me understand this?

Post by littlecarmelite » Mon Apr 20, 2015 4:24 pm

Pugsy wrote:This would be my first thought for a machine based on what you have told us so far.
It will do everything that I think you might need unless by some remote chance you end up with pressure needs exceeding 20 cm and that calls for a totally different machine.
ResMed AirSense 10 AutoSet for Her...and the humidifier is built in.
That's funny. I just got off the phone with American Home Patient (who my dr's office apparently sent the script to without even asking me). I had actually decided on this one you mentioned before even reading this (or it was my top pick which is why I came back to the board to see what everyone said before making a final choice). So I see that multiple places you can get it for like $875 but of course, when I questioned American Home Patient about their price they tell me $1700.00 hahahaa... yea, no thank you. Sure, it won't go toward my deductible and I'll have to pay it up front instead of payments but I'm not about to pay double.
Not only that, they tried to tell me I didn't get a choice of machine...it's taken me 2 months of fighting with DR's and this company and I still don't have a machine.. it's really getting old fast.
I have an appointment with the sleep DR on wed, and I'm going to make him give me a paper script and go buy one myself....
Did anyone else have this kind of trouble just to get a machine?