Just got tested. 66% oxygen saturation?

Hello,

I've snored like a grizzly bear for years and I'm overweight (but losing it). I just had a test done and I couldn't believe my results. According to the lab, I spent 30% of my sleep time below 90% oxygen! with a LOW of 66% saturation. Has anyone ever had any lower that you heard of? That's pretty scary. My AHI was 88 and it said in the report, underlined twice with an exclamation point, "very severe OSA".

My sleep has really sucked for a really long time. I walk around like a zombie pumped up on coffee all day to stay awake. Will a CPAP really make me feel better?

The lab recommended an "auto nasal CPAP" and some kind of bite plate?? I don't know anything about this stuff. Anyone else have a bite plate and CPAP?

Welcome.

You're going to die.

Just kidding. You're only going to die if you don't do CPAP. That's pretty bad, but nowhere near record levels.

CPAP works pretty good for most.

Read up on the links in my signature line to figure out how not to get screwed by the medical mafia in the process of getting and using a CPAP. Most people get royally screwed by their DME (CPAP seller) and don't get good treatment because they have the wrong kind of machine.

BTW, skip the "bite plate" unless there is some particular reason you need one. The recommendation of an Auto CPAP is a good one. The "nasal" mask recommendation is a good one, start with a nasal mask. Some people can't use a nasal mask, and have to go to a full face mask, but always start with nasal unless you can't solve the problems with that.

You should get a copy of the complete sleep study for your own records and ask your doctor to schedule a titration study to see what type of machine and what pressure or pressures would be appropriate.

On the sleep study, look for central apneas, which is a type of sleep apnea that may suggest a particular type of machine that would be best for you.

Welcome to the club.

Before you get your actual machine, check back here for some discussion of what features you need and where to get software for the machine.

Sometimes the DME (durable equipment equipment) supplier will try to sell you one that only records hours of use.
That's a very bad idea since it will not give you any information on how well your therapy is going. You want one, and should insist on one, that records:
Hours of use,
AHI ( in all its types )
Flow limitations
Hypopneas
Breathing rate
Tidal volume.

Andone for which there is software you can get that lets you look at what is going on.
Hope everything goes well.

In my first sleep study, I hit 50% during REM sleep!

I do have a complete copy of the report. Looks like I've got a lot of learning to do.

From the report:

Two night study. Slept 10 hours. Sleep latency 3 minutes. Sleep efficiency 91.3%. Very severe sleep disordered breathing. AHI 88 based on 4% hypopneas desaturation criteria.

The apneas are accompanied by severe oxygen desaturation.

Snoring occurs for 40% of the time. I actually found this funny and sad at the same time:

Loud Singer: 50 decibels.

My snoring: Greater than 70 decibels.

I think 70 decibels is like the equivalent of a lawn mower starting up. Jeeze. No wonder the paint on my ceiling was coming off.

Prescribed auto-titrating PAP with pressure from 5 - 20 with download (whatever that means).

Overall RDI 92

Mean SpO2: 91.6%

Welcome to the forum. I almost caught you with my desats..73% Doesn't matter except to scare the hell out of someone so they don't fiddle faddle around anymore about getting therapy though...Mine never drops now.
Are you waking up with killer AM headaches...I was with my desats and those headaches leaving me were the first sign to me that therapy was working.

So you have some reading to do
Started with this link first and then do the seconds link.
http://maskarrayed.wordpress.com/what-y ... me-part-i/

http://maskarrayed.wordpress.com/
This page isn't updated for the latest 60 series machines but still otherwise excellent.

Naaa....no headaches or nothing. I just get really sleepy about an hour after waking.

I have a personal trainer kicking my ass now 4 days a week so that is helping a lot.

I was 2% away from 50% (can't recall if it was over or under so either 52 or 48) in my sleep study. In any case I remember a few curses running through my head given that I had a family member on O2 (not related to sleep apnea) and doctors were highly concerned that she was occasionally dropping into the 70s. I'm sure someone here had lower than mine though too.

Even though my sleep apnea is "severe", I knew I was tired prior to getting treatment but I was still fully functional. I've seen quite a few stories related on this board that people thought their world was ending prior to treatment, I never felt that way and probably never would have gotten treatment if it weren't for prodding from my significant other. I can tell I get more rest now that I am treating it and I plan to stay on treatment but I'm not overly worried if I miss a few nights on the machine.

I hit 56% and the difference with cpap was amazing. Some of it was subtle, like understanding stuff much more quickly, moods and a sense of optimism. It took about 3 months for all the effects to be felt.

Thanks guys.

As I sift through the posts, it appears there is a HUGE difference in machines.

Is there a "Mac Daddy" machine I should be shooting for with all the bells n whistles? What are some really good brands and model numbers of auto-nasal CPAPs?

phishinphil wrote:Thanks guys.

As I sift through the posts, it appears there is a HUGE difference in machines.

Is there a "Mac Daddy" machine I should be shooting for with all the bells n whistles? What are some really good brands and model numbers of auto-nasal CPAPs?

PR system 1 560 Or Resmed S9 Autoset (NOT ESCAPE)

You want to make sure you get data which shows you leak line and events. The will try to sell you a "brick" that has no data except hours used so they can make an extra $50 off you.

Get the prescription IN YOUR HAND when you walk out of the Doctors office. Call your insurance and find out who is in network and what they cover. If possible have the doctor write on the prescription "all efficacy data including leak data". Prepare yourself as if you are going to buy a second hand car from a shady dealer.

I would recommend either the ResMed S9 AutoSet or the Phillips Respironics System One 60 series Auto cpap model 560.

Minor pros and cons with either but none are deal breakers. So I suggest you zero in on those 2 brands and models.

They are both what we call APAP machines which just means they have 2 modes of operation..a single straight fixed pressure (cpap mode) or auto adjusting pressure single pressure (APAP mode)...so like having 2 machines in one.

Have you had the titration study yet where they hook you up to a machine and mask to find optimal pressure?
Or are they going to use an APAP machine to find the right pressure?

If your pressure needs are high (in the teens) you might benefit from a bilevel (dual pressures) pressure machine...as it would likely be a lot more comfortable.
If that is the case I would still stick with the 2 brand but the model names and numbers would be different.

BTW...pressure needs have nothing to do with the severity (or lack of) of the OSA. It's all about the airway tissue and how much pressure is needed to hold it open. A person can have severe OSA and need only 5 cm of pressure or a person can have very mild OSA and need 20 cm...makes no sense but that's the way it is.

No, I never had a mask on to do anything yet. I took the test through an olnine at home sleep study company. I just got facex a copy of the results yesterday and my primary doc was out today.

I guess I'll learn what my doc wants me to do next on Monday after my primary reads the results.

He may be okay with letting an APAP machine find the optimal pressure settings...it's not hard to do.
He may prefer an in lab titration where a live person finds the optimal pressure settings. There is of course significant cost involved in most cases depending on insurance.

The main advantage to an in lab titration would be you would know real quick if bilevel pressures are maybe needed in addition to a couple of other things (PLMD or centrals) depending on how extensive your in home sleep study was.

If going by the majority...chances of doing very well with APAP machine finding the optimal pressure are high.
If that is the case I would lean towards the ResMed S9 AutoSet (avoid anything with Escape in ResMed model name) because just in case you end up needing the higher pressures in the teens, the S9 exhale relief (called EPR) closely mimics a bilevel pressure machine..so you would have it available if needed. I have used both brands and I think that with pressures in the teens that the EPR exhale relief just feels better and offers greater comfort. Not to say that Respironics way of doing exhale relief is crap because it really does mimic natural breathing but the S9 3 cm drop using EPR is more dramatic and I think better when pressures in the teens are used and someone needs or wants that drop. It's sort of like a poor man's bilevel machine...those bilevel machines are pricey plus insurance often wants someone to "fail" at cpap before they will pay for the pricier machine.

Is insurance going to be involved or are you paying out of pocket? If paying out of pocket...for sure just get the S9 AutoSet.

1---Periodic home titration with your own auto machine is less expensive (and often more reliable)
than one-night lab titration. This is advisable if there is any chance your weight may change.
2---Also, some of us are much more comfortable with a range of pressures.
3---An Apap can be run as a cpap, but not the other way around.