Tales of low-moderate treatment?

[Pugsy]

RDI: 15.7 events per sleep hour (29 episodes of hypopnea, 37 episodes of alternative hypopneas, and 26 episodes of flow limitation with arousal).
REM sleep: 12.4 events per sleep hour; non-REM: 17.1 events

This gets you the diagnosis. Something is messing with your sleep. There is more to Sleep Disordered Breathing than plain AHI numbers.

I would for sure get the narcolepsy test done but unless your poor sleep latency (66 minutes to fall asleep) was something unusual to the sleep study (which would be explainable..like who can go to sleep easy with all this crap stuck to us) it may not be narcolepsy but it sounds like it should be ruled out. Would at least give you peace of mind one way or the other.

You might also google Upper Airway Resistance Syndrome UARS.. see how much of it might apply to you.
If it does...guess what the treatment is? Yep...cpap machine.
UARS diagnosis is kinda new and not everyone has jumped on that band wagon yet.

For the doctors that don't think a cpap machine is necessary....do they have an alternative or an idea that might help you? I assume you are having some problems or you wouldn't have ever had the sleep study. Has anything been offered that might lessen whatever problems you are having?

[Kairosgrammy]

LOL, my dog (a very cute dachshund), when you blow on her, always licks the air. Why, I don't know. So on Saturday and Sundays, if she thinks I'm sleeping too long, she'll jump up in my bed and gets in my face. Then she feels the air from the mask and starts licking. Beats all I've ever seen.

I really appreciate everyone chiming in. I sent her the link a while back, and she's been reading everything. I'm the local SA advocate in our group

If she feels comfortable posting, we might be able to address some of the reasons she might have for refusing treatment. For example, I was irrationally worried that my pets would be scared of me. My cat still sleeps on my chest, mere inches from the exhaust port. She's not scared of the way I look or the air blowing out of me. I probably wake her up less since I'm not snoring.

[AnnaCanYell]

Sleep medicine can often be a sub-specialty of psychiatry but that's neither here nor there

I really have no idea why the results showed I took an hour to fall asleep. Pretty sure I would have remembered sitting in that bed trying to fall asleep for that long. I know I should go back and see how it goes with the CPAP...I just don't know why I'm so resistant!

[archangle]

I just don't know why I'm so resistant!

CPAP sucks. It's just that it usually sucks less than the other alternatives.

[kteague]

Your story sounds very similar to one I replied to recently. I suggest you consider the possibility that that your sleep apnea could really be more than mild and your periodic limb movement disorder could be more than moderate. I say that because of how the two can interplay in a sleep study. Both of these sleep disorders can cause arousals, and on any given night they can vie for prominence. Whichever one wins the most on the night of the study affects the counts relected in the report. Since both could possibly be affected by things like medications, caffiene intake, etc., it's doubtful that one night is reflective of your total sleep picture. My input here is based on personal eperience, so I am not claiming any professional medical expertise, but I would suggest you assume your OSA is worse on some nights and base treatment decisions accordingly.

As to narcolepsy, unless you have frank cataplexy, I would suggest you not have the MSLT test until your apnea and limb movements are resolved and you are getting consistent good sleep. Any unresolved sleep disorders just muddy the water in trying to pinpoint daytime sleepiness. I think your results at this point could be too skewed by untreated disorders to be very definitive.

Did the doctors who said you don't need treatment see your full report? Anyone can say a borderline AHI may not necessitate treatment, but they should consider other factors besides AHI. For instance, limb movements, for the above stated reasons. And did the report show the patient for a time sleeping supine while in REM? My studies where that did not happen were termed "technically suboptimal", indicating the results are based on incomplete information. Being FULLY informed is so much more than an AHI. Best wishes in sorting through everything so you can make fully informed treatment decisions.

[retrodave15]

Your story sounds very similar to one I replied to recently. I suggest you consider the possibility that that your sleep apnea could really be more than mild and your periodic limb movement disorder could be more than moderate. I say that because of how the two can interplay in a sleep study. Both of these sleep disorders can cause arousals, and on any given night they can vie for prominence. Whichever one wins the most on the night of the study affects the counts relected in the report. Since both could possibly be affected by things like medications, caffiene intake, etc., it's doubtful that one night is reflective of your total sleep picture. My input here is based on personal eperience, so I am not claiming any professional medical expertise, but I would suggest you assume your OSA is worse on some nights and base treatment decisions accordingly.

My sleep study showed very similar results, my sleep doctor had a hunch that there was something more going on with the symptoms I was presenting. She made the case for CPAP and I had my titration and I was titrated at a pretty low pressure - 7.0. She got me on a full data machine and we kept on increasing my pressure until we got the AHI down below 5. I had an AHI of 28 as recorded by the machine a couple time early on in my treatment.

She flat out said that sleep studies are not perfect and "do not represent a normal nights sleep, unless you sleep in a torture chamber." I love my sleep doc as she has a great sense of humor, uses CPAP herself, and looks at the whole picture.

I am not sure how old you are, but take care of yourself. I am playing catch up now as I am 43, and ended up on the heart cath table last September. I have stopped smoking, I am getting my cholesterol and triglycerides under control, I have my OSA under control as I have had my first week of AHI's consistently under 5, and my depression is getting better.

I wish I would have done this 5 years ago. I feel like I am 30 again.

[Kairosgrammy]

My recommendation is try the cpap. You have nothing to lose and everything to gain. Everyone here is concerned about your future. Go to a certified sleep specialist and certainly don't include a psychiatrist as a reliable opinion regarding the advisability of using or not using a cpap. As someone said, that's the same as a plumber fixing your car. I started out with mild sleep apnea. Now it is much more severe. Mine was treated but I ignored the warning symptoms that said things weren't going as well as they used to. And before you can make a definitive diagnosis of narcolepsy, you need to rule sleep apnea and moderate limb disorder as the cause of your problems. Not meaning to be offensive but seeing as I share this trait, it seems to me you are being a bit hard-headed.

AHI: 5 events per sleep hour (NOT 30, wow, that would have been crazy)

RDI: 15.7 events per sleep hour (29 episodes of hypopnea, 37 episodes of alternative hypopneas, and 26 episodes of flow limitation with arousal).
REM sleep: 12.4 events per sleep hour; non-REM: 17.1 events

My "sleep efficiency" 77.2%.
Sleep latency: 66.5 minutes
68.9% Stage N2 sleep, 31.1% REM sleep
Total arousals, 82, arousal index 13.8.

Diagnosis: Moderate OSA, mild hypoxia, moderate periodic limb disorder.

[Kilgore Trout]

I just don't know why I'm so resistant!

CPAP sucks. It's just that it usually sucks less than the other alternatives.

Yep. But it's a hell of a lot better than waking up a million times a night out of breath, crushing headaches in the morning, and an extra layer of depression.

Since removing the fog of sleep apnea, I've found out about a few of conditions I wasn't aware of that are pretty serious, and had been eating away at me.