No more OSA? 250 to 215 lbs.

[maxman]

Lost 35 pounds and had a diagnostic test and doctor says that my index is down to 3 whereas before was 8. I still snore without the mask, so he brought in an ENT doctor. He looked down my nose with that god awful nasal cam and checked me laying down and it showed that my throat isnt closed, so he said i shouldnt be snoring. He gave me 2 options, one is surgical procedure with the soft pallette and the other is mouthguard, both costing 1500 and insurance not covering it. So I decided to look online and I ordered SnoreRx and I bought an oximeter to see if my apnea really is gone. So basically I have a few questions. I forgot to mention that I only slept for 3 hour in the diagnostic test and I'm still tired when I sleep with and without bipap.
1. If I am to use an oximeter, do I use it during or after sleeping to test my oxygen saturation level? I have someone who can put it on my finger when I sleep.
2. Is it really worth buying a 1500 mouthguard that needs to be replaced every 2 years?
3. Is 3 hours enough to determine my index level?
4. Could there be another reason to my sleepiness instead of apnea?
5. Is it possible that I might not have OSA anymore? Because my bipap is still set with the pressure when my index was 8. 17/15 pressure setting.
6. My brother told me that I didn't have an apnea attack where I would stop breathing and gasping for air, and that I was only snoring very loudly. Does it still count as apnea if I only snore? This is during sleep without bipap.

[Stormynights]

i am just curious but did you snore when you used your bipap? Maybe tweaking your setting on your bipap might control the snoring. Might even set it to cpap.

[LSAT]

If you are buying an Oximeter you need one that will track you all night. Putting on your finger once or twice during the night will not tell you anything. Your oxygen level will fluctuate during the night.

[chunkyfrog]

Weight is really hard to keep off.
Don't get rid of the machine, even if the doctor says you don't need to use it.
Even if you stay at a good weight, your OSA could get worse as you age.
Congratulations, but keep an eye on your symptoms, especially tiredness.

[kteague]

Congrats on the weight loss. I have more questions than answers - some things for you to consider as you go forward.

Get a copy of your sleep study. Sometimes 3 hours is enough to see sleep apnea, sometimes not. It is generally considered the "worst case scenario" when one is in REM while supine. If in your 3 hours of sleep they captured quite a bit of data while you were supine and in REM, there's a better chance they got a full picture of your current condition. Unfortunately REM tends to be more later in sleep, so in 3 hours you may not have got much. You'd need to see the report.

I'm wondering - if your AHI was only 3, why are they recommending ANY treatment?

If your machine captures data, you could monitor it for a while, dropping the pressure in small increments and see if your AHI goes up. Or your doctor could order you a 2 week trial on an auto titrating machine. If your pressure increases during the night, you still need treatment.

One can snore and not have sleep apnea, but it can still cause fragmented sleep for some. As far as your continued daytime sleepiness, are you on any meds with this side effect listed? Have you been tested for diabetes or other health issues? At the far end of the spectrum if all efforts don't bring relief, narcolepsy is one thing to rule out. But it's hard to be evaluated for that when the picture is clouded by other nonresolved issues.

Good luck as you sort through things and keep working toward better health.

[RandyJ]

I lost 60 lbs and my pressure needs decreased about 3 cm, but my OSA didn't go away (nor would I expect it to). As was suggested above, making small pressure changes while monitoring your data daily may help you figure out a few things, as well as wearing the recording oximeter all night and checking for desats.

Even if my OSA minimized to the point of not meeting the required number of events for a cpap prescription, I'd probably continue to use cpap since it takes care of the snoring and provides a better quality of sleep, in my opinion.

[maxman]

No, I don't snore when I use my Bipap.

I just ordered an oximeter with 24 hour recording that can be uploaded to my PC.

The 3 hour sleep, the sleep doctor was talking to the student shadowing him that I had zero REM sleep. The doctor tried to get me an APAP, but the stupid Home Care Provider said I wasn't qualified for some reason. I'll try to get a copy of the results.

I don't know if mine can monitor data. I have Philip Respironic System One REMstar BiPap with humidifier. I was never taught nor told about my machine being able to monitor my AHI...

[Pugsy]

I don't know if mine can monitor data. I have Philip Respironic System One REMstar BiPap with humidifier. I was never taught nor told about my machine being able to monitor my AHI...

You have data available. Quite a bit of data in fact...it even records snores...
Go get SleepyHead from here http://sourceforge.net/projects/sleepyhead/files/
Make sure to get version 9.3 that is dated May 19.
See my install hints here if you run into trouble
viewtopic/t88972/Pugsys-PointersSoftwar ... hints.html

Look on the bottom of your machine...what is the model number...650 or 750?
If it is a 750 we can make it work almost like an APAP... No need to try to get DME or insurance involved.

Your AHI may not be all that remarkable now but if you still have a lot of snoring...those snores can be highly disruptive to sleep quality in general...causes little arousals and fragmented sleep...can be just as annoying as having those OSA events and you feel just as yucky.

[kteague]

The 3 hour sleep, the sleep doctor was talking to the student shadowing him that I had zero REM sleep.

Then there is a very good chance your results do not fully reflect the status of your OSA. It is really common (though not always) for OSA to be worse in REM. When I had little or no REM while supine, in the report the doctor termed the test "technically suboptimal".

[archangle]

Lost 35 pounds and had a diagnostic test and doctor says that my index is down to 3 whereas before was 8. I still snore without the mask, so he brought in an ENT doctor. He looked down my nose with that god awful nasal cam and checked me laying down and it showed that my throat isnt closed, so he said i shouldnt be snoring. He gave me 2 options, one is surgical procedure with the soft pallette and the other is mouthguard, both costing 1500 and insurance not covering it. So I decided to look online and I ordered SnoreRx and I bought an oximeter to see if my apnea really is gone. So basically I have a few questions. I forgot to mention that I only slept for 3 hour in the diagnostic test and I'm still tired when I sleep with and without bipap.

Something doesn't sound right about this. Be careful. Some ENTs are over eager to cut on you because of profit motives or ego.

If he's talking about a UPPP procedure, run like hell. It has a low success rate, lifetime complications, and may make it harder to do CPAP later. Even if successful now, many people need CPAP later. Google UPPP for lots of horror stories. Oral appliances have low success rates as well.

However, both procedures do work for some people. The people who sell such procedures often have a lower standard for "success" than the patient does.

I'm also very concerned about the idea of an ENT saying you shouldn't snore by looking in your throat. I can understand that he might see some abnormalities, but I think people with normal looking throats often snore.

By the way, while an oximeter might "prove" you have apnea, it won't prove you don't. Apnea can wake you up enough to start breathing without you ever showing an O2 drop. The sleep disturbance and stress can still really screw up your health.

Do you feel better with the BiPAP? Do you have some kind of problem with using it? If so, you might simply want to keep using it. If you needed it once, you'll probably need it again as you age. You may even still need it now if you only got a few hours of sleep during your sleep test.

By the way, please sign up for an ID and fill in the equipment on your profile. There's some info on how to do that in my signature line.

Take the water tank out before turning over your machine to look for the model number. And tell us what words are written near the display. Something like "REMstar BiPAP blahblahblah."

[Maxman190]

WOW, SleepyHead is an amazing program! I didn't know it existed. I have tons of data and it's going to be compatible with the oximeter I just ordered.

Now that I know my machine can record data, what should I look for and what should I aim for? Hours of sleep I had recently is disturbing.... Only 3 hours of sleep...

I'm afraid that's what the ENT was trying to do because he kept going on and on about how he did many procedures involving sleep apnea solutions. I do have a username, I just forgot to log on.

Also, my machine is 650P.

Edit: At least I think it is compatible with the oximeter I'm getting... It says it support Contec CMS50 oximeters.. Would this one work? http://www.medicaltestsupply.com/CMS-50 ... d-plus.htm I need to know ASAP because if it isn't, I have to cancel order before they ship it to avoid fees.


Someone explain to me what each row stands for, what it means and what I should aim for?

[Maxman190]

Am I suppose to aim for lower leak value? If so, then it's leaking pretty bad... There are no leaks from the edge of the mask, there's only air leaking from my left eye's tear duct... But, I didn't know it would leak that much...

[RandyJ]

Am I suppose to aim for lower leak value? If so, then it's leaking pretty bad... There are no leaks from the edge of the mask, there's only air leaking from my left eye's tear duct... But, I didn't know it would leak that much...

I think your leak rate is fine. The intentional leak (vent rate) for your mask at 15 cm would be 32L/min, and you are at 47L/min (that is your 95% number, if you look at your leak line in the daily graph you will see what your leak was during the course of the night. You may have been below 47 for quite a bit)... if you were leaking at 56 or above continually for the whole night, you'd have a leak issue... the rule of thumb is that you don't want to be more than 24L/min above your intentional leak rate (at least we use that number on the ResMed machines).

Here is a chart for Philips masks:

http://www.healthcare.philips.com/asset ... 111027.pdf

And the brochure for your mask is here:

http://www.healthcare.philips.com/pwc_h ... ifeOIS.pdf

It shows that the Resistance Control setting for your mask is "x1" since you are using a PRS1 machine.

[Maxman190]

Although the intentional leak rate is 32, it being 40+ is still kind of bad isn't it? What does RERA index mean? I know it's Respiratory arousal thingy, but what is a more dumbed down definition of it? What RERA should I aim for?

[RandyJ]

Although the intentional leak rate is 32, it being 40+ is still kind of bad isn't it?

Some leak is always expected. The machine is designed to cope with about 24L/min unintentional leak before it begins to affect therapy.

I encourage you to look at your leak graph for that day. You may not have been above 32 for a long time.