Hello, new here with test results.

[MichelleFL]

So nice to have found all of you! Quite a scary thing to find out you have sleep apnea and they want you to use a cpap machine. I have some questions if you would kindly answer them..

First off I have been a heavy snorer since I was a teenager. In December of 2007 I had my whole thyroid taken out as it was huge. Since the surgery I became more tired so much that I felt like sleeping while driving and had to force myself to stay awake. Recently it has gotten better but my doctor sent me for a sleep study and here are the results.. Maybe you could help me decipher them please.

Impression:
1. Primarily REM dependent obstructive apnea of moderate severity which are associated with arousal (overall RDI 4.9 & REM RDI 15.0)
2. Nocturnal desaturation: (minimum SaO2 86%: range 94-86%)
3. Reduced slow wave sleep & REM with severe sleep fragmentation & alpha intrusion which can be seen with chronic mood or pain disorders
4. Moderately severe periodic sleep movements
5. Moderate snoring in all position (supine > non supine)

Recommendation:
1. CPAP titration
2. T4, TSH level is not done
3. Pain inventory & psychometrics update
4. Regular exercise and weight loss if applicable
5. Improve sleep hygiene

What does it all mean? I do have alot of pain through my whole body and was first diagnosed with Fibromyalgia but my new doctor thinks I have arthritis. I also suffer with dizziness and anxiety. I am working on loosing the weight since I have something major now to loose it for. What do they mean improve sleep hygiene?

I don't want to make this note too long and will ask my other question after you get to know me from this one..

Thank you very much!

[Georgio]

Hi,

I'm only 3 weeks into CPAP use, it is becoming easier, and I'm feeling improvement. It can be a little scary and hard to accept at first. I tried to ignore it for awhile, but that didn't work. You really are one of the lucky ones that is being diagnosed and getting treatment, because most go undiagnosed.

It isin't a huge life altering change, more like a few adjustments. And in return you get to live a longer, healthier life. And you are not alone, I think I read that as many as 60 million Americans are at high risk.

Get your titration as soon as you can. I think I had to wait 2 months. Most important if you are prescribed a machine, get a good one and use it.

You can read a lot about equipment here that will help you. I believe "sleep hygiene" includes things like going to bed and getting up at the same time each day. I experienced severe body aches that seem to be gone now. Good luck, sticking around here should help make it easy for you.

Georgio

[MichelleFL]

Thank you very much Georgio. I am not sure that my sleep apnea is something that is going to stick around for awhile. My symptoms seem to have worsened when I had my thyroid taken out last year. Maybe my TSH is off? I get my next blood draw to check it in November. It seems that from what I can read of these test results that I only had the most problems when I shifted from my side and layed on my back. Sleeping of course you are unaware of this. So what I have been doing is propping things behind me so that I stay on my side. That has seemed to dramatically improve my tiredness during the day. Not all of it but I am thinking because of the pain I have I am also waking up from that too. I am trying everything in my power right now not to use a cpap and am holding off the sleep study to calibrate one. I am going to load up on information here and be armed and ready if and when I do it..

[Georgio]

"everything in my power right now not to use a cpap" That's what I did for a few months. I got worse. I'm sure there are many here who went through a period of tuffing it out or just thinking they would get better. Unfortunately, OSA is a progressive condition and lack of oxygen can do a lot of damage to your body. If you feel poorly, and it is prescribed for you, it may take the cpap to help. Again, stick around here for lots of support and good advice here.

And also ask all the questions you want here. Folks here seem to welcome them and many are very knowledgeable.

Georgio

[ozij]

Thank you very much Georgio. I am not sure that my sleep apnea is something that is going to stick around for awhile. My symptoms seem to have worsened when I had my thyroid taken out last year. Maybe my TSH is off? I get my next blood draw to check it in November. It seems that from what I can read of these test results that I only had the most problems when I shifted from my side and layed on my back. Sleeping of course you are unaware of this. So what I have been doing is propping things behind me so that I stay on my side. That has seemed to dramatically improve my tiredness during the day. Not all of it but I am thinking because of the pain I have I am also waking up from that too. I am trying everything in my power right now not to use a cpap and am holding off the sleep study to calibrate one. I am going to load up on information here and be armed and ready if and when I do it..

1. Primarily REM dependent obstructive apnea of moderate severity which are associated with arousal (overall RDI 4.9 & REM RDI 15.0)
2. Nocturnal desaturation: (minimum SaO2 86%: range 94-86%)

Your sleep apnea is much worse when you enter the stage of sleep called REM sleep - rapid eye movement sleep. Thats when most of our dreaming takes place, and we need it. REM sleep is not position dependent, though sleep apnea itself may be position dependent. RDI - Respiratory Disturbance Index - you get choked at the rate once every 4 minutes once you body enters REM sleep.

I am trying everything in my power right now not to use a cpap and am holding off the sleep study to calibrate one.

Not such a good idea. You oxygen saturation goes below where it should be - if you were at 90% or less in the hospital you'd be give supllemental oxygen. You are in danger holding off till lack of oxygen will cause more harm to you body and brain.

Suppose your were told in the hospital that you need oxygen, would you put it off because you weren't sure the need was there to stay? Would you refuse to have your oxygen callibrated?

While pain may be a source of you frequent awakening and exhaustion, pain is not what is causing you airway to collpase. During some parts of the night, you are being literaly choked, and snapping awake because of it. Your ability to handle many of the bodily challenges caused by various diseases will improve once you're properly oxygenated all night through. CPAP titration is a highly necessary step for you.

Body aches - fibromyalgia or fibromyalgia-like often accompany sleep apnea.

And you should certainly find the sleep position that is most comfortable for you.

Hawthorne, who has arthritis and can only sleep on her back will surely chime in and tell you how using cpap at the right pressure affected her.

It may sound frightening - cpap is such and obvious indication of our body's inablity to such a basic thing as breathe properly when we're asleep. But you should be by far more frightened by the insidious effects of what choking on a nightly basis is be doing to you now and will do in long run.

Getting used to cpap is not easy for many of us - but we're here to help you go through it.
O.

[Guest]

MichelleFL - I have had Rheumatoid Arthritis for 19 years and was diagnosed with sleep apnea 6 years ago. I have been on cpap now for those 6 years. Coming to this forum and getting some help with my cpap has made the world of difference for me. The best thing you can do for your sleep apnea AND your arthritis (fibromyalgia is a type of arthritis - there are over 100 types of arthritis) is to get titrated and get onto cpap asap.

If I were you, I would also get to a Rheumatologist asap as well and find out just what type of arthritis you have and begin to deal with that too.

Your results recommend cpap and they also say to lose weight and engage in regular exercise "if applicable". If you have any type of arthritis, keeping at a healthy weight and a regular exercise program are totally necessary as well! By the way, don't exercise within about 2 hours of bed time. That, along with going to bed and getting up at the about the same time every day is part of good sleep hygiene.

Your results say that you snore no matter what your sleeping position is. For me, sleeping on my back is the only pain free sleep position. Trying to not be on my back all night caused more pain and less sleep! You will be probably be titrated on your back and, if sleeping on your back cause less pain, go ahead and sleep on your back. Your pressure will be set for you to sleep in your back so it will be high enough to keep your airway open in that position so, with cpap at the right pressure, you will sleep better (not stop breathing so many times in the night) and you will have less pain. Neither of these conditions will then be waking you up constantly and doing damage to your body.

Rheumatoid arthritis can do damage, not only your joints but organs in your body as well. You may not have rheumatoid arthritis but, it appears your doctors feel you have some type of arthritis. You need a proper diagnosis to slow that arthritis damage. Untreated sleep apnea also causes damage to organs in your body. The lack of oxygen many times during the night ( and especially for you when it is happening during REM - your most restorative sleep) will eventually cause damage to your brain and your heart. You need to deal with both conditions now.

With the help of several people on this forum, I am doing great with my sleep apnea. It is very well under control! I won't quote data to you because it might not mean much to you right now. WHEN you get titrated, I'll be glad to talk more about that if you want.

So - Get titrated and get onto cpap! See a Rhuematologist to confirm what type of arthritis you do have. Find your most comfortable sleep position and sleep in that position. (you may or may not stay in that position all night but do go to sleep in that position). For me, my body somehow knows that, on my back is the only pain free position and does not move from that position all night. The results of not treating both these condtions should frighten you more that going on cpap.

When you get onto cpap, come here and ask lots of questions! People here are able and willing to help you!

Let's hear from you as you proceed to feeling so much better!

[Guest]

Don't know why I am being posted as "guest". It's me, Hawthorne!

[Hawthorne]

I guess I figured out why I was coming in as "guest". I thought I was logged on but was not! Sorry about that.

[Georgio]

I'm glad some of the more learned members here have offered their advice. There are 33,000 other members here that would all probably offer the same advice, and most of them probably thought their sleep anpea wouldn't "stick around" at one time too.

I hope you will be one of the lucky ones and go on cpap rather than starve your brain for oxygen every night, or worse.

Good luck, stick arround and ask all the questions you have.

Georgio

[MichelleFL]

Many thanks to all of my new friends here.. {{HUGS}} I guess that I am trying to rationalize anything because I am so scared of how this air being forced into my nose would feel. Since my thyroid was removed last year before Christmas and I have had many episodes of choking while I am awake and not being able to breathe, anything now that deals with my throat, airway, breathing scares me terribly and I go right into a panic attack because of it. Some days my throat feels so tight like it's closing down that I can only imagine at nighttime how it must do so.

Would you please explain to me in the best possible way what it feels like?? Maybe this would help to ease things and make the appointment. But your all right and thank you for telling me like it is. I am scared of choking at night. My husband has it as well although he is undiagnosed. He will actually wake up and choke, and cough, and gasp for air as it has happened numerous times and I think his is severe. I told him just now, he is going to my doctor and getting an order for a sleep study. If I have to be on one, so does he!

Thank you again from the bottom of my heart..

[Guest]

Stick your head out the window of a moving car. For more pressure go faster. Your nose will regulate any pressure difference if you breath thru your nose. Now get on with it!!

Just how long can you hold your breath?

[Hawthorne]

MichelleFL - You are most welcome! Just giving back for all the help I've had on this forum --and because you also have arthritis!

Having the air going down your airway is "different" at first, I guess. Then is becomes natural and you feel better and actually look forward to the therapy. I do not find it painful at all.

It all takes some getting used to for everyone - the machine, the mask, the air. It is relief though, to go to bed knowing that your airway will be open all night and you will be getting restful sleep that will help you to have better days and you will be doing a good thing for your heart and your brain!

Your titration will give you some idea of how it feels,although you won't have all those wires when you get your machine and use it at home! You just need to relax and breathe slowly and think of something pleasant. Soon it will feel "normal".

Keep coming back to the forum! Ask anything you want! Soon you'll be encouraging new members too!

Sure sounds like your husband needs to get there too!!

[ozij]

Glad you've been reading, Michelle.
You know, I think that for some of us, the unconscious memory of choking as we sleep primes us to be even more wary of anything on our face and nose.

Titration means they start you at low pressure, and raise it gradually till they find you no longer have events. The air blowing in is not much of a problem. That pressure is there to help support your airway in an open state ("patent" is the formal term) - it won't ever attempt to "blow it open". And it is very much what Hawthorne said: once you get used to it, it's a relief to know you can go to sleep peacefully and safely.

I had the bad luck to have to spend a night without my machine 10 days ago. And there I was: Repeatedly falling asleep and jerking awake with a banging heart - typical symptoms from the past - unable to trust my sleep - unable to relax - miserable. It's a kind of anxiety attack that comes directly from the most primitive part of your brain that
yells: "Emergency, Emergency, Not Getting Enough Oxygen, Grave Danger, Wake UP!!!"

It's exhaling against the incoming pressure that is sometime weird, or even difficult, because having to breath out against something is not something we're used to - and even that feeling of resistance may remind us of choking. However, nowadays, many machines have ways of making the exhale smoother, and some have bi-level pressure - with the ability to figure out how to give you much lower pressure for when you exhale. I wonder if your doctor (pcp? surgeon?) can give you a recommendation to start out with a bi-level machine immediately - that's not standard, but your surgery may justify it. - That's just guessing, by the way, I have no idea how valid a suggestion this is.

Start telling yourself now that that mask and blowing air will be there to support you. That they will help you breathe when you learn to use them. And when you feel discomfort or even fear starting tell yourself (tell that most primitive, frightened part of your brain) "yes, I know you're terrified of choking - I realise choking is very dangerous, and that' why we're really trying to do something about it - we're neither choking you nor ignoring you".

Good luck to both you and your husband - and do keep us posted.

O.

[Hawthorne]

That's great ozij! I never thought of a bipap machine for Michelle. You're right -- she may just be able to get her doctor to prescribe one, given her thyroid surgery. That would be worth finding out about, Michelle.

If not, the exhalation relief ozij talks about is great too. I have it on my machine. The breathing out against the incoming air is the strangest part of cpap. With the bipap, as ozij said, the exhalation setting is lower. With the exhalation relief of non bipap machines, the pressure is also lowered (different than the bipap though) when you exhale. It feels like I am not breathing against any air at all.

It's probably hard for you to understand all these different machines and features right now.
If your doctor thinks a bipap would help, in your situation, that might be great. If not, try to get a prescription for a "data capable" machine with exhalation relief. An autopap would be good too. I'm trying to think but, do all data capable machines come with exhalation relief? Off hand, I can't think of any "data capable" machines that don't. I'm not sure about that.

Keep reading about different machines and asking here, maybe before your titration. People here will know about every machine there is,I think.

Sorry you had that night without your machine ozij. I dread that happening. It would be so like "pre therapy" days! Not pleasant to say the least!

[ozij]

PB's 420E (an auto) doesn't come with exhalation relief - but when you breath out against it, it backs down. On and aside: Rested Gal, that ultimate conoiseur of masks, machine and tweaks has always mentioned she felt the PB was easier to breath out agains than other machines - but that's machine's that don'th have pressure relief.

By the way, my machine was fine that night. The problem was that I couldn't get to it....
O.