Apnea the norm?

[napstress]

Is there any such thing as a person who doesn't have apnea? Maybe it's actually the norm. Does anyone know what percentage of people leave their sleep studies without being diagnosed with Apnea?

[BlackSpinner]

Is there any such thing as a person who doesn't have apnea? Maybe it's actually the norm. Does anyone know what percentage of people leave their sleep studies without being diagnosed with Apnea?

Yes a friend of mine went for a sleep study because she was always falling asleep during the day but they said she did not have OSA. That was a bummer because now she doesn't know what the problem could be.

[builta]

Hi,

Really? The hurdles that are placed in your way to qualify for an insurance paid sleep study pretty much guarantees that you really need a XPAP and the sleep study is just the formal documentation of that fact.

But there are always those people who are willing to pay for their own studies because they just thrive on the pain and just like to have someone watch them sleep!

God knows that daytime sleepness and the inability to sleep at night have more causes then "Carter has little liver pills!"

Hope your friend finds the help that she needs!

Cheers

[robysue]

My mother-in-law has COPD which has been treated with full time nighttime O2, daytime nebulizers, and daytime O2 on an as needed basis for 10 years or so. She also has many other long term health problems, including high blood pressure (so-so controled), a weight problem that was aggravated when she was on Prednisone for approximately six months some 25 years ago when she developed a severe case of hives, major arthritis, and is known to snore loudly.

I don't recall exactly when it happened: But some time about three years ago my mother-in-law also started to become extremely fatigued and exhausted in the afternoon in spite of the 02 that she could use on demand. And she felt she was sleeping even worse than normal. So she had a sleep study done at the request of her PCP who suspected OSA for some obvious reasons. Results? Whatever her problems were (and are), they certainly were not being caused by SDB on her NPSG. I think she had something like 5 apneas/hypopneas all night for an AHI of around 1.something. Her PLM index was also much, much lower than expected and far below diagnostic levels for PLMD.

So, no, not everybody who goes for a sleep test gets handed a diagnosis of OSA.

I do think that a very large proportion of those tested for OSA during NPSGs do get diagnosed---but I think that's because there's pretty tight screening---both by PCPs and self screening by people themselves: I think that even if you report major EDS to your PCP, as long as you don't mention one or more of the following:

• snoring, bed partner witnessing suspicious events, waking up feeling like you were choking or drowning, waking up drenched in sweat (and you are NOT a middle aged woman)

you are more likely to be offered a prescription for sleeping pills than be sent to a sleep lab for a NPSG. And if you have one or more of these symptoms you are more likely to have OSA than a person who doesn't have them. Perhaps much more likely.

[nazanian]

Is there any such thing as a person who doesn't have apnea? Maybe it's actually the norm. Does anyone know what percentage of people leave their sleep studies without being diagnosed with Apnea?

I don´t know, but it is very interesting what you say. I know of a doctors wife who is concerned and notices his husbands apnea, but he say she is just exagerating. I bet that in a 5 years time, everyone will know someone using a machine.

[Lizistired]

2 friends went since I had mine. Both negative. One went because her partner said she stopped breathing in her sleep.

[rested gal]

There could be many reasons other than sleep apnea to cause daytime sleepiness.

However, if a person with excessive daytime sleepiness goes into a sleep study and comes out with no diagnosis of "Obstructive Sleep Apnea", that person could still have a sleep disordered breathing problem ... UARS (Upper Airway Resistance Syndrome.) CPAP can tried as a treatment for UARS, too.

A person with UARS might have respiratory events that don't meet the criteria to be scored as apneas or a hypopneas during the sleep study, yet be having reductions in airflow accompanied by arousals that fragment their sleep and wreck the sleep architecture.

[napstress]

For those of you who gave me examples of people who tested negative for apnea, thank you. I don't entirely trust my doctor. She has struck me as overcertain of my diagnosis from before I had the sleep study and slightly fanatical. She also gets a lot of things wrong when writing to my PCP. I don't think she's evil or incompetent. She just does shift work and has too many patients, so she tends to misremember our conversations. I am tempted to self-doubt; after all, I am the one coming to her in a state of sleep deprivation. But one example was that she attributed in a report to my PCP my having more events at the beginning of the night to the Xanax I took. But I didn't take it until the middle of the night. She corrected her report, but I had to bring it to her attention. There are other examples of lesser import.

Maybe I am still in the denial stage about my diagnosis. But the results with my name on them don't lie. So it's good to know that not everyone who goes for a sleep study turns out to have OHSA.

sleep architecture

Fascinating phrase!

[Lizistired]

Napstress, did you get copies of your sleep studies? That info told me more than any doctors. Then having my own oximeter sealed it. I are a hosehead

[OutaSync]

I know of two people who had sleep studies and came out negative for OSA. I know many more people who need to go for stdies and don't because they don't want to wear a mask the rest of their lives. They would rather not know so they can live in denial.

[xenablue]

I have a friend whose fiance has such a severe snoring problem that she often sleeps on another floor of the house, sleeps restlessly and has the potential to develop heart issues due to strong heredity. She finally talked him into convincing his doctor to prescribe a sleep study, which showed absolutely no apneas or any kind of sleep issues, including RLS. Had us all shaking our heads!

Cheers,
xena

[jromano]

napstress,

Is there any such thing as a person who doesn't have apnea?

As others have alluded to, yes. It does happen.

In addition to the detailed examples already provided, as well as rested gal's point,

However, if a person with excessive daytime sleepiness goes into a sleep study and comes out with no diagnosis of "Obstructive Sleep Apnea", that person could still have a sleep disordered breathing problem ... UARS (Upper Airway Resistance Syndrome.) CPAP can tried as a treatment for UARS, too.

A person with UARS might have respiratory events that don't meet the criteria to be scored as apneas or a hypopneas during the sleep study, yet be having reductions in airflow accompanied by arousals that fragment their sleep and wreck the sleep architecture.

..occasionally a sleep study doesn't capture enough data and/or high enough quality data such that events are improperly classified or missed altogether (ex: individual couldn't sleep a bloody wink). In this situation, a DX of OSA may be withheld.
ASAA's website alludes to this possibility. http://www.sleepapnea.org/resources/pubs/evaluated.html

That being said, advances in technology and diagnostics are rapidly eliminating these sorts of errors which will be, (here's hoping), one day non-existent.
Anyways, these instances aren't typical. Just another bit to file away.

Cheers,
Jess

[Sireneh]

I have a friend who has sleep issues and has had sleep studies done with no diagnosis of sleep apnea.

I remember telling my doc before my sleep study (they are not covered here in Canada, by the way... or at least in Alberta. I paid $800 out of pocket for mine) that my worst fear was finding out that I DON'T have sleep apnea because then what? He said we'd start looking for other things but that eventually we'd figure it out. He said he knew before my sleep study that I'd have sleep apnea because of my large tongue base and narrow airway anyway. No one ever told me I had a big tongue before!

[Pillowtoss]

Me... Here I am with a cpap.

[roster]

sleep architecture

Fascinating phrase!

Thanks for the idea: viewtopic/t63103/Architects-View-of-Sle ... cture.html