Sleep study results, not sure if I need to pursue treatment

[GSDgrl82]

Well I was right when I didn't think I'd slept much during my study, I have insomnia and have trouble falling asleep in my own bed let alone a strange one but I only slept a total of 82 minutes the night of my sleep study...

Summary:

Mild obstructive sleep apnea with 5.1 AHI and oxygen drop from 96% to 91%
RDI was 7.3 per hour
Insomnia and no REM sleep

Is there any other information that would be useful? If so I apologize I am new to this! My doctor never bothered to call me about results so I went to get them myself, I know I have OSA but according to the papers it's mild, would I need to a cpap for this? Honestly haven't a clue where to go from here. I feel like with such little sleep this may not be 100% accurate results, I thought they needed at least two hours?

[Julie]

Hi - Your results are about as low (good) as you can get and still be considered to have any OSA... how do you feel? Did you have many symptoms going in or why did you get tested? And have you had routine labwork done to look for any other potential causes of your symptoms?

Quite honestly, if I were you I'd make an effort to not sleep on my back (if you do that), not take any meds that might affect your sleep, and possibly try sleeping with a soft cervical collar which can help keep your airway more open, your jaw more closed and your head up a bit... all of which can contribute to apnea symptoms. I have friends who tested about as low as you, tried a collar and don't use a machine... but it would help if you could download free Sleepyhead software and see what actually goes on overnight in various parameters, to be sure. We are certainly not in the business of telling people they don't have apnea, shouldn't use a machine, etc., but sometimes a second look is worthwhile.

What machine and mask type do you have (if you have any lined up at all?

Sorry, just noticed you're not new here! But it would have been better to follow up in your other thread(s) so we have the history, which I haven't gone back to look at yet to see if there's anything that might contradict anything I said here (I still think your Hashimoto's might be the real culprit).

[GSDgrl82]

I had the sleep study suggested because of very bad daytime fatigue, if I say, get up in the morning and go do something with my dogs.. when I get back I will be very tired and fall asleep. Sundays I used to spend the day training my dogs in a dog sport, then when I'd drive home in the early afternoon I'd be so sleepy I'd have to focus hard on staying awake then when I'd get home I'd crash and sleep. When I was working I only worked 4-5 hour shifts and on the days I worked I couldn't do anything else because I was so exhausted. Honestly I'm shocked it's only mild, I thought it'd be worse based off my fatigue. I don't really snore and don't wake up gasping but I do wake up with sore throats and feeling weird in the morning sometimes and no matter how much I sleep I still wake up exhausted. I never feel rested. I do have hypothyroidism but my thyroid levels are within the normal range right now, I'm sure it factors in and contributes but making me this tired? I'm not sure.

[Pugsy]

Oh man, this is a tough one. On the face of it...not hugely alarming numbers but a couple of things really bother me.
The lack of sleep...and the lack of REM and even with the "small" number of events and the short time asleep the oxygen levels dropped further than I would want to see. Makes me wonder what would happen if you actually got much sleep and especially REM sleep.
REM sleep often causes OSA to be much worse. I speak from experience here. In non REM sleep my AHI is barely 12 but in REM sleep it was 53 per hour. It's not something that is rare...it's quite common for OSA to be worse in REM sleep (and when we sleep on our backs) and while we can sometimes alter sleeping position there's no way to do anything about REM and in fact we need REM along with the normal cycles of sleep and the % of time in each cycle.

I had some pretty bad insomnia pre cpap because every time I would go into REM sleep the OSA would fire up and I would wake up...created a really nasty circle.

Now I don't know if you are going to be like me in terms of the OSA being markedly worse or not but it's far from impossible and in fact is fairly common.

What symptoms of sleep apnea are you having?
We know the insomnia...and most likely daytime fatigue due to lack of quality sleep.
Is the insomnia just for falling asleep or do you wake often during the night for some reason (known or unknown)?
Anything else...like morning headaches....having to get up and pee during the night...snore...???

Edit...I see you mention sore throats but you don't think you snore...I had horrible sore throats pre cpap...never gasping for breaths but a lot of mouth breathing and some snores.

[Julie]

Your sore throats could be due to acid reflux (GERD), something that often goes with OSA and can awaken us without our realizing what did it... you might want to think about that and whether or not your meds could be responsible.

[GSDgrl82]

Oh sorry I didn't specify! I have a hell of a time falling asleep, once I am asleep I'm usually down for the count. 'But' I did go to the doctors earlier this year to have my kidneys checked because I started having to pee during the night, I'm only 34 so this didn't seem normal but everything checked out ok.

But yes that's what had me worried with my oxygen dropping so much within such a short amount of time and no REM. The sleep report said no snoring and no gasping but again it was only 82 minutes so. Seems like it might be good to just do another sleep study and get some sleeping pills prescribed? On the night of the sleep study I took two tynelol pms and ended up having to drink a cup of nighttime theraflu and still couldn't sleep. I don't normally take prescription sleep drugs but I'm just not going to sleep otherwise during a study. I guess I also need to address the insomnia which I'm sure is adding to the problem... my mind won't shut down and I have a lot of anxious energy. I usually end up taking theraflu or Benadryl to sleep.

I will add this here too because I know it's probably an issue but I am addicted to diet sodas and drink them all day long, but I was drinking them before I had insomnia... I know I need to give it up, it's my one vice lol.

As far as meds I take my thyroid med and 100mg of tramadol a day for chronic pain.

[GSDgrl82]

I am on the hunt for a new doctor so I am going to look more into my thyroid issue as well... but I get blood work done every few months and my doc always said it's normal. I have had my vit D levels be very low before so I will try to get a full panel done along with iron, etc just to try and rule other things out. But I am over 100lbs overweight and seems likely SA would be an issue for me as well. I was actually trying to get a diagnosis of SA to get cleared for a bypass surgery. I eat keto, very low carb and clean, no gluten, etc. Exercise has been tough though due to the exhaustion. The exhaustion only started to get very bad this year and has been slowly and progressively getting worse.

[Pugsy]

Nocturia is a common symptom of sleep apnea that a lot people don't realize.
It relates to a stress hormone called ANP or Atrial natriuretic peptide
https://en.wikipedia.org/wiki/Atrial_na ... ic_peptide
Google "sleep apnea and nocturia" and start reading.
The short version is when we have apnea events it puts stress on the heart and then the heart produces the ANP stress hormone and when the stress hormone get to the kidneys the kidneys respond by going into overdrive...and when kidneys work hard ...urine is the by product...hence the need to pee during the night even with restricted fluid intake prior to bedtime.

This was the first symptom of OSA that I had that totally went away immediately once I had my therapy optimized.
The second was the reduction of the killer morning headaches.
Just not having to get up an pee 3 to 5 times a night was worth it to me.

Something to think about...maybe might be worth considering a trial on cpap for a few months just to see if it helps or not.

[Julie]

The sodas (now known to be just as damaging as 'regular' ones) for sure can aggravate GERD (it's often called silent GERD because it doesn't necessarily wake you - at least not consciously) and the tramadol could be a factor too - look up side effects and consider taking your meds in the a.m. if nothing else and if your MD ok's it. Have you had your blood sugar checked recently?

[GSDgrl82]

Yeah I get tested for diabetes every year and it's always normal thankfully! I don't eat sugar or processed foods but I know I need to get the weight off, it shot up when I had to have my thyroid radiated(they decided to do that because the hashi's was throwing my thyroid into hyper drive and I was hyperthyroid) but I have lost about 35lbs so far once I got my levels more normalized.

[GSDgrl82]

Also forgot(the irony) over the last six months I've been having terrible short term memory problems.. it affected my work badly. I honestly feel like a 70 year old lady, not 34 at all.

[kteague]

My personal take on this is that yes you should pursue treatment, or at least investigate further. You could ask to be retested and make prior arrangements for medication if you want to be sure before embarking on treatment. Nothing wrong with that. I suspect based on your symptoms you will end up needing treatment, so I'm thinking an auto adjusting machine and getting on with the process is your quickest way to get to some relief.

[palerider]

I am addicted to diet sodas and drink them all day long,

well, at least, try to go with caffeine free ones.

[GSDgrl82]

My personal take on this is that yes you should pursue treatment, or at least investigate further. You could ask to be retested and make prior arrangements for medication if you want to be sure before embarking on treatment. Nothing wrong with that. I suspect based on your symptoms you will end up needing treatment, so I'm thinking an auto adjusting machine and getting on with the process is your quickest way to get to some relief.

Thank you! How do I get on with the process since my doctor is useless and didn't even bother to tell me my results came in.. do I need to go to a different doctor? If I call my insurance and find a supplier, will the supplier help me? I'm not quite understanding how to get a machine. My report from the sleep doctor didn't really specify or recommend any sort of treatment so I'm not sure if that means if I even qualify for a machine. This is really frustrating trying to figure this out by myself when my brain is so muddled with exhaustion.

[Julie]

You need a new doctor.

Do NOT count on dealers for useful advice - one in a million might have some to go along with a written script, but they are basically there to take your money and in any case cannot make decisions on what equipment to give you - must only follow prescriptions.

Talk to your present doctor about having to have a proper result that specifies if you need a machine and why or why not. If you don't get good answers go to your state board or whoever is appropriate there (I'm in Canada) and tell them what's happening, but do keep in mind you may not qualify for a machine after all (but also consider the tips you've been given about how to sleep so you avoid even a few apneas that might otherwise wake you and/or the occasional oxygen drop), as well as deal with potential GERD.

IF it turns out that you need a machine - even if you have the odd symptom it doesn't mean you need a machine for the rest of your life - then come back here and we'll recommend the best type to ask your MD to script for (one that does more data than just compliance, and auto-adjusts).

Remember however that given that you feel lousy, your symptoms aren't new after all, and you likely won't 'die' in the near future - take the time to get these ducks in a row. Ask for a referral to a nutritionist who's familiar with thyroid problems to help you lose weight... it can make quite a difference.

And you need a doctor who you can discuss present meds with (all meds, including OTC ones you take on your own) to maximize therapy of any kind, not affect your sleep and deal with the Hash's.