Do I have Sleep Apnea?

I recently was seen at a sleep lab where the technician indicated on their report that starting and ending saO2 levels were 97 and during the lab I had "desaturations greater than 3%". Even though my report from the technician also said I had severe OSA, the numbers listed in my OP from that report would seem to indicate to me otherwise just based upon what I have seen on other boards or heard from others (high O2 saturation and small desaturation is what I read from the report). I also have had petit-mal seizures during and since leaving military service and one of my neurology doctors thinks that my excessive daytime sleepiness (EDS - which is why I went to the Sleep lab) is really further seizures due to Post-concussive syndrome from a combat head injury in service, while the doctor that sent me to the sleep lab is leaning toward OSA when he scheduled the Sleep lab appt. I would just like them to get it right so I can be treated correctly and want to make sure I ask the doctor leaning toward OSA the right questions when he does see me to discuss the Sleep lab results so he just doesn't diagnose something that he may be more familiar with without considering if the EDS could be linked to something else. Anybody got any questions I should be asking this doctor so he can put my mind at rest as to what is causing my EDS? Thanks.

Thank you for your service, and I'm sorry you sustained such a serious injury.

OSA is not just about desaturation. There is also the issue of fragmented sleep. If you are "micro-waking" many many times each night to keep breathing, it can leave you tired during the day, even if your O2 levels never got below 94%. You may not know at the time that you are being aroused slightly from your sleep, but what happens is you wake up just enough to fix the apnea/hypopnea, then fall back to sleep. This might be occurring hundreds of times a night without you ever knowing it.

As to whether or not OSA is the cause of your EDS, I do not know.

Questions to ask the doctor:
Are petit mal seizures visible on an EEG?
Would they be visible while I slept?

Could you please explain the stages of sleep and how normal mine were?

Did breathing problems interrupt my sleep? If so, how may time an hour was that?

Were my breathing problems caused by obstructions in my upper airway - like my tongue falling back, or were they caused by problems my brain has in instructing me to breathe?

O.

A question I would ask:
If the symptoms are caused by seizures (not OSA), would CPAP therapy cause any problems?

If the answer is "no", then you can try CPAP therapy and see if it helps with your EDS and O2 desats.

Ask the doctor if your sleep study results seem to indicate UARS (Upper Airway Resistance Syndrome.) If he says, "yes", UARS is also treated with CPAP.

________

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Upper Airway Resistance Syndrome
Links to info about UARS:

http://www.clevelandclinicmeded.com/dis ... /sleep.htm
UARS is discussed about halfway down the page at that site.

ncbi about UARS

http://www.chestjournal.org/cgi/content/full/115/4/1127

http://ajrccm.atsjournals.org/cgi/conte ... 161/5/1412

http://ajrccm.atsjournals.org/cgi/conte ... 161/5/1413



New Here/Need help with Sleep Study Results
sleepydave (RRT, RPSGT, manager of an accredited sleep lab) is the same person who goes by the nickname "StillAnotherGuest" on this board.

In that thread:
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sleepydave
Moderator [apneasupport.org]
Joined: 05 Jul 2005
Posts: 813
Location: In the Sleep Laboratory


What's UARS?

Hi Arline!
UARS is the acronym for Upper Airway Resistance Syndrome. It is characterized by respiratory events that are not severe enough to be classified as apneas or hypopneas still cause arousals. These respiratory events can be snores or minor narrowing of the airway, but the increased negative intrathoracic pressure trying to draw air through the restricted airway, as well as the arousals, can cause the same havoc as plain old OSA.
Here's an interesting blurb that should perk your ears up:

UARS

So it's still nothing to sneeze at.
Sure, continue to gather more info, including maybe seeing an ENT. Also keep in mind that surgery of the upper airway can have some significant associated hazards, so don't make that decision lightly.
See what the CPAP results bring, then maybe go from there.

sleepydave
__________________

my report from the technician also said I had severe OSA

You said it yourself. Yes you have OSA. Unless there is some reason why you can't use the CPAP, I'd say treat the OSA and see if it relieves the EDS symptoms. It's quite possible the OSA symptoms are masking other symptoms, once you get that under control, it might be easier for the doctor to identify what else is ailing you.

Does anybody know anyone that was tested for OSA and the results were negative? I don't. Obviously if that were the case, they wouldn't be frequenting this board, but it begs the question: what percentage of the adult population would test positive as to having some amount of sleep apnea? My guess is that it would be very high.

It took me five years and three sleep studies before I was prescribed my first CPAP. The results of the previous studies were always, "Well.........you just didn't quit breathing long enough or not enough times to cross that threshhold where we feel you could benefit from CPAP therapy." I always left asking myself, "Well, how many times does a person have to quit breathing in one night and for how long before somebody who doesn't quit breathing during their sleep recognizes it as a problem???" Cessation of breathing is a problem, period, one would think. Moreover, since I had all the symptoms for five years (sufficiently prevalent enough that they were ordering sleep studies) wouldn't you think they would have at least tried a CPAP machine on me during one of those studies??

When I finally did get the CPAP, what a huge difference it made in my life, health, and energy levels. All those years I was deprived of the therapy and the relative quality of life were lost forever. Last year, when it seemed the apnea symptoms were coming back despite the fact that I was using my CPAP nightly, another sleep study proved I needed EPR. I just started on that two weeks ago and it has made a huge difference already.

Jason S. wrote:....what percentage of the adult population would test positive as to having some amount of sleep apnea? My guess is that it would be very high.

One small study has found 50% of randomly selected people over the age of 65 have sleep apnea (AHI > 5). Someone here reported that a sleep doc made a presentation to his small veterans club and all 13 members (in their seventies) became suspicious and went to several different labs for PSGs. All 13 have sleep apnea.

There was another study (someone please post the link) of 8,000 workers at a large insurance company. 3,200 were found to have sleep apnea (AHI>5). That's 40% in a mostly healthy population of under age 65 workers.

I would bet if the truth is know, more than 50% of the population has SDB (not just apnea) or will have it as they age.