Trying this again...

[SedonaDreaming]

Hi all.

A couple years ago, I had an in-lab sleep study performed. Old, crusty lab with super uncomfortable beds and able to hear EVERYTHING in the office area all night. Any sleep I achieved totaled about 1.5-2 hours broken with the majority of the night with eyes wide open in the dark...this on top of a sleep agent.

Now, to complicate my non-sleep at this fabulous lab, I have a habit of holding my breath when deep in thought. I find myself doing this during daylight hours when at work or focused on something. Same thing was happening while I was laying there trying to fall asleep. I would catch myself doing it and then stop. It's never for log periods of time, but just a habit I guess.

Obstructive apneas..yeah. I have no doubt there are few. I have weight to lose (about 40 pounds) and know I snore like a chainsaw--a main reason I ended up at the sleep lab. As my weight fluctuates, I find less snoring, so obviously less obstruction.

Anyway, I walked away with a diagnosis of sleep apnea and have tried desperately on numerous occasions to embrace the dang APAP machine and nasal pillows, but fail each time. I have tried a chin pillow (pretty successful, but now that I really need a new on, the company isn't producing... , tongue retaining device (ouch), wedge pillow, you name it. Last visit I had with the sleep MD was very frustrating, got angry at his response to me (he more or less gave up after just a couple of visits and told me it was probably better that I don't use the machine if I am having that much trouble adjusting), followed by the last visit with a nurse practitioner who indicated that I have such mild apnea that it's my choice whether I felt I wanted to use the machine or just get by with an oral appliance. I really felt like a complete and total failure because I just have so much trouble tolerating the machine.

I keep dragging the machine out of the closet to give it one more try. I find that I wake up in the morning with the tubing laying across the machine nice and tidy, apparently removing it from my face after about an hour and turning off the machine. I never have recollection of doing it. Next day, rinse and repeat.


Anywho...Here are the results of my sleep lab study and just curious if anyone has further advice or insight. Is there any point in trying a home study where I have a better chance of actually sleeping without a sleep agent to see if the diagnosis is actually correct? If it's pointless and I just need to accept my fate, that's fine. I have just never felt really good about the impression gained from a study that didn't really include much sleep and the little bit I had was under the influence of an agent and broken up.

FINDINGS - IMPRESSION:
1. Mild to moderate obstructive sleep apnea is noted on this overnight polysomnogram. The AHI is 14.5,
and respiratory events are predominantly obstructive apneas. There are a few central apneas noted,
however.
2. Minimal hypoxemia noted. Mean saturations are 92%. There were a couple of very transient dips with a
low of 86% but no significant time spent with sats less than 89%.
3. Sleep statistics showed a good sleep efficiency of 84%. Sleep latency though was very short at 3
minutes but REM latency was within normal limits.
4. Sleep staging showed mostly stage II sleep. There was 19% REM sleep on the exam.
5. EKG, EMG, and EEG lead were free of significant abnormality.
6. Unfortunately, CPAP was not titrated as the AHI was just 14.5.

[kteague]

An AHI of 14.5 would be debilitating for me. Imagine if you'd slept well how many more there might be. Are there specific difficulties you are having adjusting to CPAP we might be able to help you with? As one who got off to a rough start and nearly gave up a few months in, I am a big advocate of persistence. Someone more knoweldgeable than I can correct me if I'm wrong, but I think there is more liklihood of a false positive in a home study than a lab study simply due to sleep stage detection. It's hard to get a false positive in a lab. Breathing irregularities when awake are not counted in the stats. Just one opinion, but I don't see much purpose in another study. You'd probably see more return for your efforts by evaluating your nightly machine data. Two common deterrents to adjusting to treatment are suboptimal settings, which the data can help pinpoint, and equipment discomfort, such as an ill fitting mask. Congratulations on your "trying again" effort. Wishing you success.

[Sheriff Buford]

Not too many folks are happy/satisfied with their sleep study. I was also one of them. We convince ourselves that the study was faulty in some way and not correct. I think you gotta decide you are gonna do this and take no prisoners. It's a pain in the butt.... I know.... but if you don't treat this disease, it will cause something in your body to eventually kill you. Try to find a mask that is comfortable and doesn't leak. Make up your mind that you are going to do this and don't turn back. we'll be here to help you thru your issues.

Sheriff

[realshelby]

Weight is less of a factor than most believe. Sure, less weight can improve apnea. But not by as much it seems as those that have lost a good bit of weight might have hoped.

You don't have to sleep well or for an extended period to diagnose the apneas. In fact, deeper sleep may increase them. So if you are getting 14 apnea events per hour that are true events getting on a cpap program will help. Sometimes a LOT. It is hard to put up with at first. But with the help here you CAN find the right mask, right machine, right settings to make using them comfortable.

I sleep better with the equipment. Look forward to going to bed. I feel better through the day and I know why that is. It is worth the trouble.

[Pugsy]

"Mild" to me or mild enough to ditch cpap would need to be AHI in the single digits...not close to the "moderate" line of 15 to 30 per hour criteria.

During an in lab sleep study the tech could discount any of those pauses in breathing that you might do while awake and not count them in the overall total because they can clearly see from the data available to them that you were awake. They don't count awake stuff in the final diagnostic numbers.

Where are you located?
In the US a 14.5 diagnosis earns you a machine and a titration.
In other parts of the world the AHI of 15 or more is used.