So how bad is my OSA, straight answer, no hype.

[inafog]

OK, I've already told you guys that I am a 60-year old female with OSA. My AHI in my study was 76. I am also borderline diabetic, hypertensive, obese (250 lbs. and 5'4" tall). I can now see that I have had OSA for probably two decades, but I think it got much worse the last three years due to the stress of my mother's death and two bad falls where I first broke three ribs and then a year later broke my sacrum, for both of which I was prescribed pain meds that I took at night to get in and out of bed (on top of the Mobic I was taking for the arthritis). Found out when I saw my referring doc yesterday and saw my full study results that 30% of the time my blood oxygen was below 80%, and for a short few minutes went below 70%. The neurologist that read my study said I clearly had 'OSA syndrome' (query what the 'syndrome' part means?). Even though I am struggling with finding the right machine and mask and settings, I am anxious to get to bed every night hoping that will be the night I won't wake up because of rain in the hose or a frozen nose. Until that day, however, I am a little less drowsy on the road and at my desk but still very deep in the fog, making me afraid of (i) the possibility of losing my job, which requires me to be on my "A" game 24/7 and constantly multitask (I am a paralegal to the General Counsel of a pharma company). and (ii) more importantly, losing my life.

So my questions are these, and I need honest but compassionate answers. I don't need to be scared straight, since I am already compliance motivated.

1 - How serious is my OSA 'syndrome', and can I be restored to some quality of life and ability to function better at my job, or is the fog, memory loss and cognitive skill impairment irreparable?
2 - And if the later, is there any chance of my being considered for disability because of this, or am I doomed to eventually join the unemployed or underemployed now that things have gotten this bad?

[Julie]

Hi... well, your odds should be excellent that you'll be better off though you might not yet feel better for many reasons, likely most of which can be dealt with by tweaking various things.

And you really should ask your MD what he meant by syndrome (unless he was generalizing and just threw in the word unnecessarily). I've never heard of it in the context of OSA and without having more to go on (have you Googled it?), again it's hard to say.

Yes you tested positive and had serious 02 desaturations as some of us have, but once on therapy it can be amazing how fast (often overnight at least to some extent) the numbers change. Your machine may just not have been set up very well (happens all the time!) and we can definitely help with that.

And the subject of disability has come up in the past and the great consensus is that it is not considered as such because once treated, we're almost the same as anyone else with some 'condition', and if well treated, there really is no disability to perceive.

Oh, and even if you tested as 'severe', that has little bearing on how much or little pressure you're prescribed because everyone needs a particular amount of pressure to keep their individual airway open and that does not correlate to how severe or not your OSA is.

[Pugsy]

Please add your equipment to your profile when you get a chance. That way we can tailor our responses to help with the mask and humidity and cold nose issues.
wiki/index.php/Registering_Equipment_in_User_Profile
I have some ideas but need to know exactly what you are using and at what setting.

In regards to your questions.
1...Yeah, it's severe but I have seen people with worse AHI (like in the 100s and oxygen levels in the 50s). You aren't the worst case that I have seen.
2...disability? That's an unknown but I doubt that OSA alone will qualify for disability.

We have no way of anticipating just how well you will respond to cpap therapy. Some people see huge changes and some people don't. I think there's often other factors involved that the cpap machine can't fix though.
All we know to tell you is starting using the machine and deal with each issue as they come up and so far you haven't mentioned anything that I haven't seen hundreds of times. Is it easy...for some yes and for some no but it is what it is and we don't have a lot of choices..

FWIW...my OSA is also in the "severe" category with AHI 53 in REM sleep and my oxygen levels dropped to 73%. I don't remember how long it stayed there but I do know that with cpap therapy it no longer drops at all so I really don't worry about that aspect of things anymore.

Take one problem at a time and work through possible solutions. Sometimes we get lucky and first idea works and sometimes we aren't so lucky and have to keep trying different ideas.

Mask issues I think are probably the hardest issues to sort through. Gotta find a good mask and get some good sleep before the machine can even begin to work its magic.
Mask issues can be sorted out though...not always easy or quickly but they can be sorted out.

[Jay Aitchsee]

A syndrome, in medicine and psychology, is the collection of signs and symptoms that are observed in, and characteristic of, a single condition.
You present with many of the conditions often associated with sleep apnea, i.e., hypertension, overweight, diabetes, etc., not to mention daytime fatigue and sleepiness.
See Sleep Apnea Syndrome for an overview and some other possible symptoms and signs.

[archangle]

Simple answer:

You got it bad.
There's a good chance for a big improvement in your life with CPAP.

Caveats:

The AHI number isn't everything, but at 76, you probably have it pretty bad.
Some people get miracle cures overnight, some have to fight with getting the the therapy right.
Even if you eliminate the apnea, some fraction of the people take a while to "heal."
Even if you don't feel better, an AHI of 76 is probably killing you slowly and will continue to degrade your health over time.
Don't forget that even if you eliminate your apnea, you can still have other medical problems.

Read the links in my signature line to avoid being screwed by your DME (CPAP salesman) and the medical mafia in general.
Expect to have to take an active role in managing your therapy.

[Guest1]

My diagnosed AHI was 75. O2 desats down to 77%. I started feeling better on an APAP machine almost immediately (within a week). And it has been improving steadily ever since.

I have no other dysfunctional physical markers (Blood Pressure, A-fib etc.). So I caught it before it could damage those.

But, over the last 5 years, not only was I off my "A" game. I think I was failing at my "D" game as well. I couldn't focus on anything consistenly and couldn't finish anything I started. I recently found out that I was also forgetting important things while untreated.

But APAP is improving things. I don't fall asleep in the afternoon on my PC, I don't doze off while watching TV and I can finish reading a long multi-page article, in one go.

After I got diagnosed, I read a lot of articles on pubmed about "executive function" and how untreated OSA takes it away. But it comes back with xPAP therapy. I can see it in my daily functioning.

So, my 2 cents will be
1) Commit to making this therapy work.
2) Don't think of this "disability" as any more severe than getting "reading glasses".

[Janknitz]

I've seen worse, but you've got it bad. Here's the scoop:

3 years ago I was diagnosed with an AHI of 79, my 02 sats went down to 73% for a good portion of the night. I am 5'3 and was about that weight, pre-diabetic, lots of pain, barely able to walk across a room because of pain and shortness of breath.

Treated, my AHI is consistently under 2. I've lost 75 lbs (not just with CPAP), not clinically pre-diabetic any more (if you're interested, I'll explain how), and I walk miles. I don't fall asleep at the wheel, at the office, at the dinner table. I can watch TV or a movie all the way through. I tell you this to let you know that things can and will improve with CPAP. So hang in there.

You've done the first and most important step--acknowledging that you need to take care of yourself. Post your issues with CPAP and there's a lot of help to be found. Your goals will be to sleep all night comfortably and without rainout, and you should be able to do that quickly and easily. Then as you get some restorative sleep and start to feel better, you can begin to work on the rest.