Asking the experts aka "All of you"

[givemesleep]

Hey Everyone,

I was diagnosed with osa last December. My husband has been complaining for the past few months that he is really tired. He is a firefighter/paramedic and works 24 hours on, 48 hours off. So on the days that he is on shift his sleep varies depending on how many runs they make. He visited the doctor and she prescribed him Ambien, everytime he take it he thrashes about in the bed and I can't sleep! So he went back to get a different type so she gave him Lunesta this time.

Could he have sleep apnea as well? He is a light snorer at times and is 5'9" and around 180 pounds so he is in a good weight range. So I had him wear my CPAP last night so we could do our own little experiment. I have an auto machine and here are the numbers from the screen last night (I don't have the software)

Hours - 9.06
90% Pressure - 10
Leak - 35.5 (he used my F&P 431)
AHI - 4.7 (No sleeping pills were used last night)

So what do you all think? Could the apneas be machine induced because he doesn't need it or is there a possibility that he has it? He is certainly willing to have the test but we don't want to send him if he doesn't have it. Our out of pocket for the study is $1300.00.

Any thoughts?

[Guest]

See if he can check his Overnite O2 levels w/o a CPAP. A medic should be able to get this done.

[givemesleep]

I thought about the pulse ox already but they don't have one that records.

[Gerald]

You might consider purchasing your own Oximeter with software.....and running your own tests. My Oximeter cost less than $500....and my honey and I used it to see whether or not she needed CPAP therapy.

The cost of the Oximeter is far less than the sleep study....and you have a good tool after the diagnosis is made.

My honey discovered that her O2 levels were not where they should be......and she started using my spare M-Series Auto. Over a couple of weeks, she "self-titrated"...and with the help of good CPAP software, we found the best pressure for her.

Total cost for her whole system....mask, blower, oximeter, and accessories didn't cost what a sleep test would have.

Just remember......CPAP therapy isn't "Rocket Science".....Read everything you can get your hands on.....and use good common sense. Purchase everything your man needs from CPAP.com.....and use your Rx to do it.

My honey and I did the same.......and she didn't have to experience the super-miserable sleep test.

[freepostg]

Hey Everyone,

I was diagnosed with osa last December. My husband has been complaining for the past few months that he is really tired. He is a firefighter/paramedic and works 24 hours on, 48 hours off. So on the days that he is on shift his sleep varies depending on how many runs they make. He visited the doctor and she prescribed him Ambien, everytime he take it he thrashes about in the bed and I can't sleep! So he went back to get a different type so she gave him Lunesta this time.

Could he have sleep apnea as well? He is a light snorer at times and is 5'9" and around 180 pounds so he is in a good weight range. So I had him wear my CPAP last night so we could do our own little experiment. I have an auto machine and here are the numbers from the screen last night (I don't have the software)

Hours - 9.06
90% Pressure - 10
Leak - 35.5 (he used my F&P 431)
AHI - 4.7 (No sleeping pills were used last night)

So what do you all think? Could the apneas be machine induced because he doesn't need it or is there a possibility that he has it? He is certainly willing to have the test but we don't want to send him if he doesn't have it. Our out of pocket for the study is $1300.00.

Any thoughts?

Did the Doc run a full blood work when your husband went in for his visit? I assume that was done. If not, it's a must...although I do realize that in his line of work he probably has a full physical yearly.
His leak rate, to me seems high. Although, his 90% at 10 in a lot of cases is a dead giveaway for some obvious events happening. Too bad about the out of pocket expense as i was just about to tell you to request a referral. Why not try another night and see if you can get that leak rate down.

[gasp]

It is possible that you could monitor his oxygen levels and they turn out to be 90 or better, and he could still be having events. I had an AHI of 52.8 (if I remember correctly, maybe 58.2 . . .) with a SAT of 90. I have severe apnea even though my oxygen levels didn't reach dangerously low levels. A sleep study would also tell him if he has centrals.

I recommend that he spend the money to get a good sleep study done and know for certain what is happening with his body during sleep. Knowing if he has apnea that could be life threatening is an expense that his life and future health could depend upon.

[freepostg]

It is possible that you could monitor his oxygen levels and they turn out to be 90 or better, and he could still be having events. I had an AHI of 52.8 (if I remember correctly, maybe 58.2 . . .) with a SAT of 90. I have severe apnea even though my oxygen levels didn't reach dangerously low levels. A sleep study would also tell him if he has centrals.

I recommend that he spend the money to get a good sleep study done and know for certain what is happening with his body during sleep. Knowing if he has apnea that could be life threatening is an expense that his life and future health could depend upon.

Great point...I agree fully.

[Slinky]

A cheap way to start is to ask your family doctor to script an overnight oximetry. Insurance usually pays for it and even if not and you had to pay yourselves I've heard of them being done for anywhere from free to a maximum of $65.

You might also check around about these new "at-home" OSA screenings such as our local hospital's sleep lab offered FREE ApneaLink screenings. There are other screeners out there being offered now too. Some charge for them and I have no idea of the charges but its worth checking into. If OSA is indicated then most certainly a full in-lab sleep evaluation would be worthwhile. There ARE other sleep disorders besides sleep apnea and your husband may have one or more in conjunction w/or entirely separate from OSA.

I would also venture a guess that just the frequently occurring alarm awakenings whilst on shift at the firehouse "might" or "could" have aroused a "fight or flight" conditioning response to sleep.

[WearyOne]

Another one of those at-home studies is called SNAP, and should run around $100. It records snoring, oxygen, and heart rate.

Here is an excerpt from a quick thing I found from a study done in 2004:

Conclusion: "This study uses multiple styles of statistical analysis to determine that there is a solid correlation between SNAP and PSG in measuring AHI, a standard diagnostic measure of OSA. The authors believe these findings indicate that a take-home SNAP test may be proposed as an alternative to overnight PSG for the diagnosis of OSA, especially in selected populations. Furthermore, use of SNAP tests will expand the diagnostic and therapeutic prowess of the practicing otolaryngologist by offering an alternative OSA testing modality that is associated with not only less expense, decreased waiting time and increased convenience, but statistically proven accuracy. Interestingly, the researchers also confirmed that although the PSG remains the gold standard for diagnosis of OSA, it is plagued with inherent variability and problems with reproducibility." http://www.news-medical.net/?id=4861

But I also ready about another test saying that the SNAP was not comparable, so....

It should go without saying that the SNAP isn't as thorough as a PSG, as it doesn't measure as many things, but it could be an important tool, as the article states, for certain segments of the population, and is much more affordable.

My friend recently started working at a DME and they're providing these tests. One thing they're doing is working with local hospitals, providing the SNAP tests free for patients who screen "positive" for possible OSA when pre-registering for surgery. After the overnight tests are done and turned in, they're sent to the SNAP people, who send the results back to the patients personal physician, etc.

Anyway, just thought this might help.

Pam

[Gerald]

My honey and I found that a "one night" study wasn't enough to get a good indication of whether or not she needed CPAP therapy.

We ran the Oximeter study...every night....for almost 3-weeks.

By gathering a lot of data, we began to see patterns......and her true condition became apparent.

Gerald