Sleep Institute, Diagnosed mild/moderat Apnea

[emreee93]

Hello All,

I posted on here before about self treating myself with mild apnea.

So I went to the Dutch Sleep Institute(where I got my sleep study). I asked them to review my sleep study again beceause I was still very tired and frequent awakenings during the night, dry throath etc.

I had a talk with the sleep doc and het said that I had an 12 stops per hour ! I was shocked how is that possible?

https://imgur.com/a/z03m0

We are going for treatment with the Mandibular device. I also bought a dreamstation this week as I prefer the APAP. But I am so confused beceause antoher sleep study I did showd no apnea at all. And this one shows it clearly. On insight at how that is possible? I am also going to ask him about UARS beceuase my RDI is 12

[Julie]

Your link is not in English... can't read it.

It's possible your 2nd study was done when you were on your back more of the time and that creates many more events... labs often purposely ask you to sleep like that to get a baseline (worst case scenario), but if you normally sleep on your side, and therefore don't get enough apneas to qualify for Cpap, then you shouldn't have a problem. I'd talk to a pulmonologist and see what they think.

You didn't give any info re the 'other' test that showed no apnea and it would help to know more about it - how and where it was done.

I wouldn't necessarily jump to a device just yet - they are definitely known to cause problems for people - until I understood more about what might be going on otherwise.

EDIT Later - I just looked at your other posts where it looks like you probably don't really have apnea but are determined to use a machine to 'treat' what isn't real. Hard to understand why you aren't looking at other issues to deal with your symptoms, but possibly you may be depressed and should look for help there.

[jnk...]

. . . I had a talk with the sleep doc and het said that I had an 12 stops per hour ! I was shocked how is that possible?

It appears he may have been speaking of the RDI of 12--which includes changes in breathing that are not stops but that appear to have disturbed your sleeping.

Of course, although it is true that disturbances in breathing can affect sleep, it is also true that disturbances in sleep can affect breathing. It isn't always clear which is causing which--or if something else is causing both, for that matter And that is one reason that RDI can be useful information for some and not for others. All of it can be an inexact science and highly individual. Why is that important to know? It is because it teaches us all that the diagnosis itself is not really the prime thing for some with "mild OSA" or "UARS"; successful treatment is. Since you did show disturbances in breathing that appear to have disturbed your sleep, then it is worth it to try PAP therapy. If PAP therapy helps your breathing and, in turn, your quality of sleep, great! If it doesn't, though, then other aspects of sleep and other forms of help may hold the key to better sleep for you.

In other words, a diagnosis (OSA/UARS/other) may indicate what may help, yes. But if something helps, it shouldn't really matter to us as patients why it helps or what exactly is being treated. It either helps or it doesn't.

Personally, I would always suggest that someone with an RDI above 10 should TRY PAP therapy to see if it helps them feel better and sleep better. But I would not put pressure on them to STAY on PAP therapy if, after someone gives it a worthy try, it doesn't help the person sleep better or feel better. On the other hand, if someone has an actual AHI above 20 or so without treatment, then I would put pressure on them to remain on PAP therapy as a treatment whether it seemed to help them sleep better or feel better or not. That is because, according to present scientific understanding, an AHI above 20 (or so) seems likely to have effects on health even when the person doesn't feel tired or sleepy during the day.

In summary for you, though: you took the test; it suggested that PAP may help; however, it may not. Either way, it is worth it to give it the full try, if that can be done safely, inexpensively, and logically. If it does not help, try other things. It is usually best to try one thing at a time, though, so that it becomes clear what actually helped.

[emreee93]

Julie: Thank you for your advice I can see where you are coming from. However here in the Netherlands RDI is the same as AHI so it includes apnea's hypoapnea's and RERA's. According to the sleepdoctor who is a pulmonologist/ lungdoctor (longdokter in dutch) I do have mild/moderate apnea with most of them hypoapneas and according to my symptoms that are clearly sleepiness and not just tiredness he made this diagnose. How can you say that an AHI of 12 is not significant enought to be apnea? I am not an expert at all, but I read so many stories here on the forum of people with low AHI that have devastating consequence's. I never EVER woke up frequently in the night and since my illness I do so consequently every night.

I have done all the bloodwork even b12, vitamine d etc. nothing comes out. I am going to an chronic fatique centre, that basically does fystiotherapy and psychology to help you "cope" with the symptoms not so to say "treat" them. My GP is a good docter he says he has done everything and my body is healthy. I even went to a psychiatrist who wanted me to use an anti-depressant just to help me relax. I refused because I know I am not depressed, he also confirmed this.

My only way to go is to a neurologist but he wont be able to do anything either. I feel very confused as well but it seems like this is something I need to try and like jnk said: I will fully try to work on it now with the diagnosis, if it doenst work than I can savely say it isnt sleep disorder breathing.

jnk..: the treatment for me to start with is the mandibular device. Here in the Netherlands they start with that treatment for mild/moderate apnea if it doesnt work they switch over to cpap. thanks for your advice I will try it out if it doesnt work I can also say I tried that traject indeed !

[Julie]

Just consider the positional possibility as being a problem (back sleeping) and do more research on the device before making decisions.

[MrsRinPDX]

Position will have an impact on your apnea index (AHI) and since AHI is a component of RDI, ultimately your RDI. Laying on your back allows the soft tissues in your throat to collapse more. I can certainly tell when I've been sleeping on my back because my AHI jumps higher even with the machine.

So I can see how one study can differ from another. And remember, any study is a snapshot in time. Your index isn't fixed. It will show some variation daily, even with the machine.

If you're surprised by the number of events you are having, remember that the study is measuring the number of 10 second periods with reduced or stopped air flow.