My story is long but I'll try to keep it concise. Up until mid-April 2019 I was doing fine, a little overweight with diabetes and mild asthma but having no health issues otherwise. I never had any of the commonly described sleep apnea symptoms. I could describe the evolution of my symptoms but they are long and complicated over a 6 month period, 6 visits to the ER, many dozens of tests with multiple doctors with negative results. The symptoms included major muscle twitching, shakiness, shortness of breath as if I had been running extremely hard, high heart rate and high blood pressure. I would have good days and bad days, on the good days I couldn't tell anything was wrong, on the bad days I thought I didn't have much time left. Heart palpitations when I tried to sleep made me turn to the reclining couch where after months I started to feel better. Although I never got back to 100% again.
Then one doctor asked to do an in lab split night sleep study, an at home nocturnal oximetry test showed I never went below 89% saturation but I did have bradycardia with a low HR of 51 and a low respiration rate. The sleep study found extreme apnea during REM sleep, 67 AHI, 13 during no-REM sleep. While it took a number of weeks I finally got my APAP machine with a full face mask.
I've had no issues adjusting to wearing something on my face all night. I'm also wearing a recording SpO2 monitor and this is where I've started noticing an issue. I'm hopeful that if I post some of my machine data some of the more experienced individuals can help illuminate any issues. I won't be seeing a sleep specialist doctor until 06 November, where I live most doctors have long waits for new patients.
I have found that I'm getting worse sleep and lower O2 saturation since using the APAP machine. One night I found the machine was hitting 18 and the leaking woke me up, I didn't wear it the rest of the night. Another night I got the same thing and I found taking the mask off, turning off the machine and back on I was able to sleep the rest of the night. After reviewing my oximeter results and the APAP machine information I see a pattern in that from the moment I fall asleep to about 3 hours later my O2 saturation will swing up and down, some nights between 80% to 95 %. The APAP machine seems to be pumping up the pressure in stages during this period. After midnight I seem to sleep better with more normal O2 saturation.
Last night wasn't the worst night but it wasn't great either, AHI was 6.3, clear airway was 12, OSA was 9 and hyponeas was 26. I've been using the machine about 3 weeks, all but a few nights are 8 hours. AHI has generally been below 5. Most days I feel exhausted, I tire easily, breathing hard and sometimes it feels like my heart is clenching, like anxiety and with no pain. I've had a number of heart tests that indicate my heart is in excellent health, although the lack of oxygen during sleep can't be doing my heart muscles any good. The only thing that worries me is that I could have silent coronary artery disease, the cardiologist did say it is possible to have asymptomatic CAD and he'd be willing to do an angiogram. Justifying that with my insurance is the tricky part. I'd like to consider the sleep apnea before going down that road though.
I have asked my primary doctor to add an oxygen concentrator to my APAP machine, since my lowest SpO2 on the machine is about 5% lower than before I started using the machine; he has ordered it but I'm not sure how long before I'll get it. I'm at work but when I get home I'll post some images from OSCAR along with images from my oximeter before and after using the APAP machine.
Edit: Added OSCAR images and oximeter data, which I've linked to since the image comes out very large.
Here's from a decent night on 23 Sep with an AHI of 2.5:
23 Sep 2019 oximeter image
And here's from last night, which was not my worst night:
29 Sep 2019 oximeter image
One thing that came to mind was that my nights and oximeter data was better early on, before I changed a few things. I turned off ramp, turned flex to 3 and changed from a medium AirFit F20 to a large AirTouch F20. I felt like I wasn't getting enough air with the ramp at 4.0, thought the flex at 3 rather than 2 would make it easier to exhale. The AirFit F20 seemed too tight and didn't seal very well.
The only other thing I haven't mentioned is that I'm taking clonazepam for anxiety since the was the default diagnosis before the sleep study. Taking it or not doesn't seem to correspond with my good or bad nights but as a tranquilizer I assume it's slowing my breathing.
