Is CPAP always the answer with OSA dx?

[kellyslp4]

Hi All!
I’m 39 y/o, 5’5”, 116 lbs and will be scheduled for an in lab sleep study in the next couple of weeks. My dentist recommended I get A sleep study five years ago because of bruxism and my mouth and airway being so small due to my anatomy and makeup.
Next, I saw a neuro who said immediately “you don’t have sleep apnea bc you don’t meet the typical criteria -obese male over 50 y/o but if you still want a sleep study I’ll recommend it”.
While waiting on insurance approval, I wore an overnight PulseOx (provided by sleep md at my dentist office) and the report stated I had 27 and 31 apeneic events per hour and rated me as severe sleep apnea. My O2 dropped no lower than 86.
No one has YET to mention seeing an ENT to get checked out which blows me away. I have a deviated septum, chronic stuffiness (comes and goes), morning headaches, daytime sleepiness, jaw pain, history of inner ear issues, some eustacian tube dysfunction (I believe), mandibular torri, the whole shebang...
I would rather wear an oral device over a CPAP and hoping the apnea isn’t THAT severe but my question to you all is can all of these sinus issues CAUSE sleep apnea or is that something that will be present and my nasal/anatomical issues just make it worse?
Have any of you had any experience with an oral appliance?
Sorry if I have TMI for my question at the end. I’m not sure what all is relevant at this point
Thanks in advance!!

[jnk...]

scheduled for an in lab sleep study in the next couple of weeks.

Excellent. Answers will likely be coming soon, then.

neuro who said immediately “you don’t have sleep apnea bc you don’t meet the typical criteria -obese male over 50 y/o

I generally discourage name-calling, but if that's an exact quote, that neuro needs an, um, education.

but if you still want a sleep study I’ll recommend it”.

OK. Neuro forgiven.

can all of these sinus issues CAUSE sleep apnea or is that something that will be present and my nasal/anatomical issues just make it worse?

At one point they may have been partially causative, but if you are now severe OSA, solving those issues may help PAP treatment be more effective and comfortable, although fixing usual sinus issues alone rarely solves sleep issues. There are occasional exceptions to that rule of thumb, so an ENT shouldn't be out of the question, of course.

Have any of you had any experience with an oral appliance?

Some. I used one leading up to PAP treatment and then later in conjunction with PAP.

PAP sounds less convenient than OA, but the gold standard of PAP properly executed is often less of a hassle than OA and has far fewer complications and is MUCH more effective in allowing you to get and maintain good sleep.

[Goofproof]

No not always, it's just the Best treatment that works for the most people with Sleep Apnea. There are many out there that are willing to take your money,tell you what you want to hear, what do they care as long as you keep buying into their products or cuts. Jim

[JimW159]

While waiting on insurance approval, I wore an overnight PulseOx (provided by sleep md at my dentist office) and the report stated I had 27 and 31 apeneic events per hour and rated me as severe sleep apnea. My O2 dropped no lower than 86. my question at the end. I’m not sure what all is relevant at this point.

Perhaps I am missing something here - what kind of pulse Oximeter provides any readout that reports on apneic events? Also, 27-31 falls across the moderate to severe boundary for apnea and 86 is below the O2 sat threshold for concern. See: http://healthysleep.med.harvard.edu/sle ... ng-results

[JimW159]

PAP sounds less convenient than OA, but the gold standard of PAP properly executed is often less of a hassle than OA and has far fewer complications and is MUCH more effective in allowing you to get and maintain good sleep.

On occasion the "gold standard' become the "gold standard" by virtue of the fact that it works.

[palerider]

y “you don’t have sleep apnea bc you don’t meet the typical criteria -obese male over 50 y/o but if you still want a sleep study I’ll recommend it”.

I don't agree with forgiving the neuro for his neolithic attitude about sleep apnea.

This is the 21st century, Sleep apnea isn't just for old fat men anymore!

[jnk...]

I don't agree with forgiving the neuro for his neolithic attitude about sleep apnea.

Well, then, is there any chance you can find it in your heart to forgive me for my being so overly forgiving?

[palerider]

I don't agree with forgiving the neuro for his neolithic attitude about sleep apnea.

Well, then, is there any chance you can find it in your heart to forgive me for my being so overly forgiving?

For you, anything.

[kellyslp4]

Thanks so much to each of you for your quick responses and straight-forward answers. I really appreciate it. Answers hopefully coming soon

[SewTired]

You CAN choose to have the surgery for the deviated septum first, but just realize that it may not eliminate your apnea. My sis was one of the few people who was able to eliminate the cpap after the deviated septum surgery.

[D.H.]

CPAP is the "gold standard' for the treatment of Sleep Apnea. There are other treatments, but CPAP is the preferred treatment. It's also very good since - unless you get a very old or very bottom of the line CPAP - you can get statistics and actually see how you're sleeping (or at least how many apneic events you're having).

CPAP has been in use since the 1980s with great success.

The current devices are small, quiet, and have available integrated heated humidifier. The original devices were large and noisy.


Among the other treatment are dental devices that re-position your jaw, the Inspire implant (which is a pacemaker like device to keep you airway open), and various surgeries.

[Goofproof]

CPAP is the "gold standard' for the treatment of Sleep Apnea. There are other treatments, but CPAP is the preferred treatment. It's also very good since - unless you get a very old or very bottom of the line CPAP - you can get statistics and actually see how you're sleeping (or at least how many apneic events you're having).

CPAP has been in use since the 1980s with great success.

The current devices are small, quiet, and have available integrated heated humidifier. The original devices were large and noisy.


Among the other treatment are dental devices that re-position your jaw, the Inspire implant (which is a pacemaker like device to keep you airway open), and various surgeries.

Old has nothing to do with it, my CPAP is 13 years old, provides the needed data and very good treatment. Meanwhile D.H. filling up landfills. Jim

[kellyslp4]

You CAN choose to have the surgery for the deviated septum first, but just realize that it may not eliminate your apnea. My sis was one of the few people who was able to eliminate the cpap after the deviated septum surgery.

Thanks again, everyone, for your replies and helpful info!
(To clarify on an earlier reply re: the overnight pulse ox I wore, it was a Virtuox device but just the pulse ox and wristband watch. No chest belt or nasal cannula)

[D.H.]

CPAP is the "gold standard' for the treatment of Sleep Apnea. There are other treatments, but CPAP is the preferred treatment. It's also very good since - unless you get a very old or very bottom of the line CPAP - you can get statistics and actually see how you're sleeping (or at least how many apneic events you're having).

CPAP has been in use since the 1980s with great success.

The current devices are small, quiet, and have available integrated heated humidifier. The original devices were large and noisy.


Among the other treatment are dental devices that re-position your jaw, the Inspire implant (which is a pacemaker like device to keep you airway open), and various surgeries.

Old has nothing to do with it, my CPAP is 13 years old, provides the needed data and very good treatment. Meanwhile D.H. filling up landfills. Jim

My older CPAP did not give anything but "odometer" stats. In fact, it does even less than an odometer. An odometer measures distance traveled, not idle time. A true odometer equivalent would measure only when the patient is wearing the mask and run faster at higher pressures. Perhaps you have a very fancy old one, but those were the exceptions, not the rule.

[Goofproof]

CPAP is the "gold standard' for the treatment of Sleep Apnea. There are other treatments, but CPAP is the preferred treatment. It's also very good since - unless you get a very old or very bottom of the line CPAP - you can get statistics and actually see how you're sleeping (or at least how many apneic events you're having).

CPAP has been in use since the 1980s with great success.

The current devices are small, quiet, and have available integrated heated humidifier. The original devices were large and noisy.


Among the other treatment are dental devices that re-position your jaw, the Inspire implant (which is a pacemaker like device to keep you airway open), and various surgeries.

Old has nothing to do with it, my CPAP is 13 years old, provides the needed data and very good treatment. Meanwhile D.H. filling up landfills. Jim

My older CPAP did not give anything but "odometer" stats. In fact, it dos even less than an odometer. An odometer measures distance traveled, not idle time. A true odometer equivalent would measure only when the patient is wearing the mask and run faster at higher pressures. Perhaps you have a very fancy old one, but those were the exceptions, not the rule.

Yes, very fancy 2005 Shoebox, wasn't even auto, plain CPAP, Lincare, FF Mask, F & P 431, they didn't steal the other sizes included in the package, Mask worked great but I couldn't stop it from "Farting", replaced it in 6 months with Comfort Full "M, problem solved for 5 years, then started using ComfortGel FF "M", even better, also using ComfortGel Nasal "M", as long as mouthbreathing stays low enough. (Allergies) Luck of the Draw, No Brick, not that I knew better at the time, I had bigger fish to fry, recovering from a Quad. The Sleep test even got the pressure correct, almost. I found this site, looking for software, got squared up on pressure. Didn't look back, couldn't not using my machine a must or die. Here I am still trying to wear the "Tank" out,but it just keeps shooting. Jim