AHI of 6 been told dont need cpap..UK..chronic rhinitis

[Jamaicandon]

What should I do? I am tired constantly... never feel refreshed, I'm not as bad as some people but it is affecting my quality of life. Around 1pm at work I am exhausted and struggling to stay awake.


Should I just buy my own device? I am in the UK.

[kteague]

Do you have a copy of your test results where you were determined to have an AHI of 6? If your test did not have a lot of sleep time, did not have much REM sleep, did not have much supine sleep, and/or did not have much supine sleep while in REM, your test results may not be fully reflective of the severity of your condition on the nights these things occur. Not sure how things work in the UK. Maybe you could you ask your provider to look at your test and specifically answer these questions. Just based on your symptoms it seems a bit more investigation may be in order. If you do decide to self treat, be sure to familiarize yourself with the best machines for one who needs good data to dial in their treatment. All machines are not created equal.

[Thumper68]

Welcome to the forum. We have at least 2 experts on the UK health system, and they can help you navigate it. They are Rick Blaine and JAS. If you could go back to your original 1st post and edit the title to add UK in it, they would be more likely to see this thread and offer advise. Pugsy (our moderator) can also edit your title if she sees this thread.

Stick around and you will get some solid advise.

[rick blaine]

Hi kteague,

It's unlikely that the OP had an in-sleep-lab full-on sleep study. It used to be that only one in 10 patients referred to a NHS sleep-medicine department got such a study, and now it's even fewer than that.

So it's unlikely he knows the kind of results you speak of. Maybe supine vs not, but (I suspect) not REM nor ECG nor limb movement. It could be RLS and so on, but if that were to be looked for, his GP would need to send him back to another part of the hospital (say, neurology, for suspected RLS). The way treatment for OSA has evolved in the NHS means that – just to deal with the case-load – sleep-medicine departments have developed a bit of a narrow focus.

Hi jamaicandon,

If your AHI is 6, the sleep-medicine department isn't going to issue you with a mask and machine. The policy across the NHS is 'treatment starts at 15 and above.'

Yes, you can, if you want, buy your own machine – but you would need some doctor – and it could be your own GP – to sign the prescription form before any of the major manufacturers or retailers would sell a machine to you. And, btw, a new machine costs £600 or more, and a mask typically costs £120.

It is possible to hire a machine plus mask for a week at a time – to find out if CPAP treatment actually helps you. But it is expensive. There's one place in London hires out a machine plus mask for £100 a week. And given that the results of a first week might not be that great – because there's the process of getting used to treatment – you might need a couple of weeks to give it a fair try.

It's also possible that your tiredness is caused by reasons other than sleep-apnea. It may be that your GP referred you for a sleep-study as their first 'likely explanation', with a mental list of other diagnostic measures if that didn't prove conclusive.

Let me know which of these options you might want to take first, and if it's either of the first two, I'll put up some phone numbers.

Also, if you go up to the 'search' box in the top left-hand corner, and enter my user-name, you'll get all the posts where I've previously given advice to posters from the UK.

[Jamaicandon]

Hi kteague,

It's unlikely that the OP had an in-sleep-lab full-on sleep study. It used to be that only one in 10 patients referred to a NHS sleep-medicine department got such a study, and now it's even fewer than that.

So it's unlikely he knows the kind of results you speak of. Maybe supine vs not, but (I suspect) not REM nor ECG nor limb movement. It could be RLS and so on, but if that were to be looked for, his GP would need to send him back to another part of the hospital (say, neurology, for suspected RLS). The way treatment for OSA has evolved in the NHS means that – just to deal with the case-load – sleep-medicine departments have developed a bit of a narrow focus.

Hi jamaicandon,

If your AHI is 6, the sleep-medicine department isn't going to issue you with a mask and machine. The policy across the NHS is 'treatment starts at 15 and above.'

Yes, you can, if you want, buy your own machine – but you would need some doctor – and it could be your own GP – to sign the prescription form before any of the major manufacturers or retailers would sell a machine to you. And, btw, a new machine costs £600 or more, and a mask typically costs £120.

It is possible to hire a machine plus mask for a week at a time – to find out if CPAP treatment actually helps you. But it is expensive. There's one place in London hires out a machine plus mask for £100 a week. And given that the results of a first week might not be that great – because there's the process of getting used to treatment – you might need a couple of weeks to give it a fair try.

It's also possible that your tiredness is caused by reasons other than sleep-apnea. It may be that your GP referred you for a sleep-study as their first 'likely explanation', with a mental list of other diagnostic measures if that didn't prove conclusive.

Let me know which of these options you might want to take first, and if it's either of the first two, I'll put up some phone numbers.

Also, if you go up to the 'search' box in the top left-hand corner, and enter my user-name, you'll get all the posts where I've previously given advice to posters from the UK.

Hi yes, I had a home study... I have asked the respiratory department to provide me and my gp with a full copy of my sleep exam. When I get my results i will post them here..

I have chronic rhinitis and a sinus polyp.. these could be causing my disrupted sleep..I am told because the polyp is in my sinus is wont affect my breathing the rhinitis causes buildup of mucus.. I record my sleep every day using an app, I snore for 5-15% of my sleep time every night

I could buy a used machine for around 100, after my sleep exam I was discharged straight away without a chance to catch up with a consultant

[Jamaicandon]

Do you have a copy of your test results where you were determined to have an AHI of 6? If your test did not have a lot of sleep time, did not have much REM sleep, did not have much supine sleep, and/or did not have much supine sleep while in REM, your test results may not be fully reflective of the severity of your condition on the nights these things occur. Not sure how things work in the UK. Maybe you could you ask your provider to look at your test and specifically answer these questions. Just based on your symptoms it seems a bit more investigation may be in order. If you do decide to self treat, be sure to familiarize yourself with the best machines for one who needs good data to dial in their treatment. All machines are not created equal.

I will more than likely buy a used machine

[rick blaine]

Hello again, Jamaicandon,

I understand. You have chronic rhinitis which leads to swollen nasal tissue, and you have extra mucus production, some of which (I get from what you say) winds up in your throat.

The thing is, the primary causes of sleep apnea are (1) the tongue falling back and (2) the windpipe being flabby. And the air pressure which (3) holds the tongue out of the way and (4) keeps the windpipe from collapsing may not do anything about the swollen nasal tissue and the extra mucus production.

Here's the best explanation I know of what goes on with sleep apnea:

https://www.youtube.com/watch?v=-gie2dhqP2c

It may be that sleep apnea treatment is not what you need. And that what you may need is the chronic rhinitis and extra mucus production to be addressed directly. And for that, I would think you need to see an Ear, Nose, and Throat specialist.

Here's some publicly-available information about treating chronic rhinitis – including, as one of the options, surgery:

https://www.healthline.com/health/chronic-rhinitis

I suggest you go back to your GP and between you, work out if a referral to the Ear, Nose, and Throat department is your best next step.

[Jamaicandon]

Hello again, Jamaicandon,

I understand. You have chronic rhinitis which leads to swollen nasal tissue, and you have extra mucus production, some of which (I get from what you say) winds up in your throat.

The thing is, the primary causes of sleep apnea are (1) the tongue falling back and (2) the windpipe being flabby. And the air pressure which (3) holds the tongue out of the way and (4) keeps the windpipe from collapsing may not do anything about the swollen nasal tissue and the extra mucus production.

Here's the best explanation I know of what goes on with sleep apnea:

https://www.youtube.com/watch?v=-gie2dhqP2c

It may be that sleep apnea treatment is not what you need. And that what you may need is the chronic rhinitis and extra mucus production to be addressed directly. And for that, I would think you need to see an Ear, Nose, and Throat specialist.

Here's some publicly-available information about treating chronic rhinitis – including, as one of the options, surgery:

https://www.healthline.com/health/chronic-rhinitis

I suggest you go back to your GP and between you, work out if a referral to the Ear, Nose, and Throat department is your best next step.

I'm getting symptoms of sleep apnea, I have been to the ent but what they prescribe does not work.

[Geer1]

Make sure to review your sleep study results in detail, if it is a similar computer analysis like mine was your AHI could be understated.

My results had a few charts showing when apneas occurred and oxygen saturation levels, they showed me these charts but weren't going to give me a copy of them until I pushed to get them(only were going to give me summary sheet). The charts showed a period of severe desaturation with no apneas or hypopneas scored during that period and my AHI was only 9.5. They sent my data to be read manually and now my AHI from the same test is over 15. I haven't seen the new results yet but I am assuming the area of low oxygen saturation will now have apnea/hypopnea events.

I believe I have a chronic sinus issue that may be influencing this. In my results I had very few apneas, mostly just hypopneas which seems like it might make sense for a chronic sinus issue since it just makes it harder to breathe but doesn't block airway completely. I have tried rinses and steroids and it helps a bit but never solves the problem, I finally get to see an ENT next month so hopefully can get that figured out. If you have a known sinus issues and ENT isn't helping maybe need to try an other ENT? Get polyp removed?

My main oxygen desaturation periods looked to correlate with a REM sleep pattern. If you didn't sleep well the night of test (short interrupted sleep due to the equipment etc) your AHI may very well have scored less then it is most nights. If you believe sleep apnea is the issue you could ask to have a second test done, the place I went to was going to do a second test and direction was to make sure I was really tired and prop pillows up so I slept on my back most of the night. Little things that could give a better indication of sleep apnea because your body might be fighting it by sleeping on side more etc.