Jade wrote:Are both AASM Recommended and AASM Alternative scoring criteria equally valid, or are they a way to qualify more people for cpap? What determines which method is used? I don’t think I would have had nearly as high an AHI if the lab had used the Recommended version.
Anyone with hypopneas who does not desaturate would not have as high of an AHI if the lab used the Recommended criteria instead of the Alternative. (That is evident in the article that I linked to.) People like me might go undiagnosed for another couple of decades (or probably just until menopause...). People who are thin are less likely to desaturate. You'll hear that from Dr. Guilleminault when you listen to the MP3. In my opinion, and apparently in Dr. Guilleminault's opinion, the Recommended criteria is too stringent because it won't include young, thin people who just work harder to breathe and will only capture severe apnea largely in the overweight population, who will desaturate more quickly. The lab determines which method is used.
Is arousals and hypops kind of a chicken-and-egg discussion, or do we know if there’s a causal relationship at all?
Hypopneas cause arousals. If you didn't arouse, you'd eventually obstruct more fully and then you'd either arouse or desaturate.
“Desaturations indicate something needs to be treated; however, the absence of desaturations doesn't mean there's nothing that needs to be treated.” And in the absence of desats or daytime sleepiness, naps, nocturia am I right in thinking that at this point in time there’s no more accurate or specific way to determine in an individual whether something is actually causing damage and needs to be treated?
I don't know. I was told that we don't know what the consequences of untreated SDB are to the brain, but desaturations carry cardiovascular risks. In the MP3 he talks about the risks associated with snoring, and some unclear risks of allergies, infections, or just the river running through the gorge (listen to the MP3 for that analogy that he used).
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly
