My titration results are here!

[Wonderingwoman]

Michelle,

I noticed that you have had Thyroid surgery. What are you taking as a Thyroid replacement? Please don't say it is Synthroid as it does not have the Thyroid enzymes you need once you have had your thyroid removed.

I have had my Thyroid eradicated with radioactive iodine. It's like not having the thyroid at all and have found that synthetic hormones do not work when you do not have a Thyroid gland.

Feel free to PM me on info as this would be way off topic I have lots of info in that area.

I wish you the best

[rested gal]

Pressure of 6 really isn't going to be very noticeable, compared to a pressure of 4, imho.

I really, really, truly think a straight CPAP machine...not an autopap...will let you sleep better.

I think they did get sufficient data at your sleep study titration, regardless of a lead having to be replaced several times.

The tech's impressions during your titration:

1. Obstructive sleep apnea and hypopnea resolved with CPAP
(post treat RDI 0.0 at optimum pressure)
That is excellent. CPAP at the pressure they used did what it is supposed to do.

2. Nocturnal desaturation: resolved with CPAP
(ave. saO2 95% @ optimum pressure) That's great, too.

3. Reduced slow wave sleep and REM with moderate alpha intrusionAlpha intrusions are often (as I understand it) caused by pain. You have other health problems totally unrelated to OSA that could be causing pain while you "sleep through it." But twinges of pain while you're asleep can cause arousals. Arousals aren't full "wake ups", so you wouldn't even know that repeated arousals were happening.

Write the sentence below in red on a post-it, and stick it on your bathroom mirror for future reference, because it's something we all really need to keep in mind if we get discouraged about not feeling super-duper-wowser-great after starting CPAP:

If you get on CPAP treatment and still have days when you feel fatigued or sleepy, don't assume that means "CPAP isn't working!" CPAP can be doing its part of the job perfectly...keeping the airway open. Yet there can be many OTHER health reasons, or sleep hygiene issues, that can make us feel bad on some days.

Pain from other problems can interfere with getting restful sleep even though CPAP is taking care of letting us breathe easily while we sleep.

4. Severe periodic limb movements and sleep fragmentation
Periodic Limb Movements. PLMD (Periodic Limb Movement Disorder) is a sleep disorder of its own. You sleep through it, but again, the movements can cause arousals, wrecking your sleep. Periodic Limb Movement Disorder is usually treated with meds. kteague's posts on this message board are excellent ones to dig into to learn more about that sleep disorder.

So, if you don't feel better on cpap later, remember...don't make the mistake of thinking CPAP isn't working, or that you need to change pressure, or get a different machine, etc. Instead of thinking that way, go read the post-it on your bathroom mirror... "there can many OTHER health reasons".... Severe PLMD could be a darn big reason.

5. Snoring resolved with CPAP That's great. And at a nice low pressure! Michelle, count yourself LUCKY that it takes so little pressure to keep your airway open. And lucky that all you need is CPAP for that. I'd start looking at the M Series Pro CPAP and the ResMed Elite II since both those CPAP do offer exhalation relief if you need that. I don't think you will, but still, such a feature might make exhaling feel more "natural" or comfortable. You can always turn an exhalation relief feature off. Also, those two machines will record data about AHI and leaks. Data you can see in the machines' LCD window the next day, even without software. Both those machines can use software too, if you want to see more details.

Go for the CPAP, Michelle. That's going to treat your OSA very well indeed. And you do have OSA that needs treating. That REM RDI of 15 means you were definitely having a lot of breathing problems when you went into REM. Good REM is extremely important during sleep.

You do need CPAP. Join the crowd!

[MichelleFL]

I noticed that you have had Thyroid surgery. What are you taking as a Thyroid replacement? Please don't say it is Synthroid as it does not have the Thyroid enzymes you need once you have had your thyroid removed.

I think it would be okay to post it here.. Just incase someone else is going through the same thing.. But yes I am taking Synthroid and it's been a very long journey for me. After my surgery I felt great except for the episodes of major sleep apnea while sleeping sitting up and awaking not being able to breathe and choking.. Scared me so much that I did not sleep for 4 days straight in a row. Talk about being tired! 2 weeks later I was started on Synthroid and I became very dizzy and blamed it on the medication. So after telling my dr that I thought it was from the medication and they said no it was not I begged them to let me try Armour as I had heard so much about it. Turns out that I am allergic to it and swelled my tongue twice it's normal size.. So then I have tried generic Synthroid and even Levoxyl. Still the same thing I am really dizzy on and off all day long. On a side note my Mom had dizziness so debilitating she could not even shower and they never found out what caused it. I have tried Meclizine which does not help and I think it's anxiety related. So that is another thing I will speak with my DR about on October 30th is to be put on medication for it. Other than that Synthroid has worked great for me and my levels are just where they need to be. Thanks so much for asking though!

[MichelleFL]

I'd start looking at the M Series Pro CPAP and the ResMed Elite II since both those CPAP do offer exhalation relief if you need that. I don't think you will, but still, such a feature might make exhaling feel more "natural" or comfortable. You can always turn an exhalation relief feature off. Also, those two machines will record data about AHI and leaks. Data you can see in the machines' LCD window the next day, even without software. Both those machines can use software too, if you want to see more details.

Thank you so very much I appreciate your help! I will try that then and it's certainly more cost effective for me. If I buy this outright or if Awake in America will help me out with a machine, do I really need the software to see what's going on? Or is that so you can see actual graphs and things? Say if I have a leak will it tell me exactly what it is?

[Hawthorne]

Given your titration results (titrated at 6cm), I agree with Rested Gal. I think you should try to get a data capable cpap machine. The Remstar Pro would be good. I don't know much about Resmeds. She did mention a comparable Resmed machine. These machines have exhalation relief if you need it. At a pressure of 6, exhalation relief probably won't be needed but you would have it.

With a Remstar Pro (and the Resmed one Rested Gal mentioned), you can get software and a card reader (if that is financially possible) to get data, even sometime in the future if you feel you want to know what is going on with your therapy beyond how you feel.

If it becomes financially possible, later on you may want to purchase an auto out of your own pocket. If you do that, buying online is your cheapest way to go.

As your first machine ages, you may well want a backup in case of problems. Then it might be good to think about an auto so that you can titrate yourself with help from this forum.

Don't forget that with any straight cpap the pressure can be changed if it looks like it is necessary by the way you feel. Of course, it will take quite a while for things to sort out in order for you to assess whether or not the pressure of 6 is good for you.

Right now, if I were you, I would just concentrate on getting a data capable cpap and get going with your therapy. Trying to convince doctors to give you an auto, with a titrated pressure of 6cm, is just going to delay therapy.

When you first joined the forum, you mentioned possible arthritis. There are over 100 types of arthritis. IT IS IMPORTANT TO KNOW WHAT TYPE YOU HAVE AND BEGIN TREATING IT.
When you get your cpap and still think it is not helping you, it may well be arthritis pain that is causing you sleep problems.

You DO have sleep apnea. You need therapy for that BUT you must also get this possible arthritis dealt with so that your arthritis pain is not interferring with the machine doing it's job for your sleep apnea.

I have Rheumatoid Arthritis and sleep apnea. I need to treat both conditions so that my sleep apnea therapy can help me with the apnea and the arthritis pain does not compromise my apnea therapy.

[MichelleFL]

I just had a full blood workup a few days ago to see if possible pain issues exist from arthritis and hopefully he can tell me from there. Only thing they did call me back on was that my liver enzymes are high and they want me to be tested for hepatitis. I have had this test before and told her it came out negative, but they want there own... Thanks for your help Hawthorne!

[Hawthorne]

Glad to hear you are taking care of that as well as your sleep apnea. Getting the right meds and the right exercise program are the keys to managing any kind of arthritis. Getting going on cpap is the key to managing sleep apnea.

You're doing the right things!

[Wonderingwoman]

I think it would be okay to post it here.. Just incase someone else is going through the same thing..

Okay you said it... I would like you to start here: http://personal.bellsouth.net/w/u/wurmstei/
There are a lot of links that will have you reading for days.

I was also on Synthroid at first but now am using Armour Thyroid...It's natural and has the enzymes you need to loose weight. I really had to go "doctor shopping" to find a doctor that would prescribe it. I have a relative that worked for an endocrinologist, that prescribed Synthriod only and the reasoning behind it was because he was "paid" to do so, however he did not even give it to his own wife.

Since starting on Armour I have lost the weight I gained because it has the T3, and reverse T3 as well as other needed hormones that help your metabolism. Synthroid only has T4. Actually I feel a whole of lot better.

I have Mary Shomans book as well, she has a few of them out concerning thyroid issues. You need to pick one up or I could send you mine if you promise return it.

Best wishes

Brenda
AKA Wonderingwoman

[MichelleFL]

Hello Brenda and thanks for the link... I totally agree with everything that has been written about Armour but I cannot take it as I am allergic to it.

As you said about doctor shopping most doctors do not want to prescribe it these days but I finally convinced my GP to do so. I could not believe how much my tongue swelled up after a week of using it, my tongue actually sat on my teeth and I could not put it back into the space between my teeth. I called my GP and she said to stop the Armour and take Benadryl ASAP! It took 3 days until my tongue was of normal size again.. I wish it would of worked for me, but it did not..

Thanks so much for trying to help though!