Understanding My Results After Sleep Study

Believe me I totally understand why someone would deny they have any medical condition and that when someone says they don’t have daytime sleepiness they just don’t realize how tired they are.

Yes, truly honest to god, that is just not how I feel. I feel great when I wake up and never have had an issue with staying awake or attentiveness. I don’t drink coffee more than 3 cups a week, so I don’t think I am over caffeinated and not noticing sleepiness. I actually feel that I sleep better now than I did 3 years ago. When I got rid of my alarm clock and switched to lights it was a life changing experience. It sounds crazy, but I would describe waking up now like the opening scene of “The sound of music” dancing among the hills of Switzerland, similar to the way some say they feel when they start CPAP. So when the doctor says that I just don’t notice how sleepy I am and how I really feel tired all the time, I have to call B$ on it.

I know that sometimes people with OSA fall asleep and do not realize. My uncle with OSA would fall asleep mid conversation while standing and wake up a few minutes later and pick up where he left off, and then not believe us when we said he fell asleep. So I understand what OSA is and know that it is a real thing. But I compare myself(now diagnosed with severe OSA) to my uncle and their is no comparison.

I work for the railroad but I’m currently an instructor for new hire train crews. So basically I teach class in the classroom and in the field. I also teach outside of work. So I’m always in front of people with a dozen or more people starring at me as I teach class. One of my huge pet peeves is people falling asleep in class when I’m teaching. With the number of times I bust shoes for others nodding off, I feel that they would quickly throw that back at me if I fell asleep standing up in front of the class.

One of the things we teach in our railroad class is fatigue awareness, one of our train engineers was involved in a fatal accident that was major national news a few years ago. That same night before NTSB even showed up on scene, people were talking about how that particular engineer would fall asleep all the time, and how irritable he was. Come to find out he had undiagnosed OSA. So I’m very aware about what this condition is and how catastrophic the results can be if left untreated. This being one of the reasons I take my sleep so seriously.

Thanks for the replies. I guess I should try to get the results of the home sleep study as well.

Get that home sleep study report.
It wouldn't be totally impossible for someone to have messed up names or something like that.

So, I received the results from the home sleep study. I also mentioned to the vendor that facilitates the study that I was interested in getting a second opinion, her suggestion was that instead of getting a second opinion I should just start the CPAP, very helpful lady.

Anyway... the home sleep study shows AHI 63.0, OAI 20 CAI 7, what is really troubling is that the lowest desaturation was down to 66%. That’s really bad from what I gather. I also had over 500 episodes of desaturation during the study. The duration of some of the arenas were over a minute long.

Yet, it shows I only snored for 0.2 minutes, we’ll thats good to know, I guess.

Any thoughts?

When is the second opinion appointment scheduled for? How far away?

Do you have a machine and mask yet?

No I haven’t received anything yet. The appointment is in 2 weeks.

I still find it hard to believe that someone with an apnea over once per minute (guessing most of the balance between 63 and the 20 + 7 OA/CA is hypopneas), some of them lasting a minute, awakens feeling refreshed and doesn't conk out during the day. Still, those numbers would drive me to that second opinion and test expeditiously. It isn't denial to confirm a diagnosis when you don't display the very common symptoms of the affliction.

What do you want to do?
What are you comfortable doing?
Are you still thinking that the results were wrong and questioning the results?

Any idea when they planned to get you a machine and which machine?
Is the place that dispenses machines have any relationship with the doctor that you saw that you didn't feel good about?

Keep the second opinion appointment.

Not everyone who has bad sleep apnea will exhibit marked symptoms.
The oxygen levels...they are troubling.
Would you feel better about the reliability of the test if you were to verify with your own over night recording pulse oximeter? It can easily be done.

What troubles me is that the doctor prescribed CPAP before ever giving me my results from the in-lab study. He also seems to be milking out each visit for no apparent reason, except to collect from insurance.

Last visit: How do you feel?
Fine.
How’s the CPAP machine going?
What CPAP machine?
You didn’t get it?
No
Oh, I’ll send the paper work in again. Come back in 2 weeks.

This happened twice, first time was with him calling the sleep lab, that is literally across the street to send them my info.

So yes, I lack confidence in this doctor’s trustworthiness.

But the doctor’s behavior aside, I’m hoping to see if the experience with the results I got from both tests are typical of someone getting diagnosed with OSA. Is such a big swing in results normal?

Oh yeah, not to mention that the vendor lost my info for 2 months. My employer called them to see what was up. They faxed my info to the vendor and received confirmation that it was accepted. But 2 months later they say they never heard of me or had me in their system.

Getting the second opinion, seems the way to go, but the vendor that I’m dealing with says don’t bother with a second opinion just call to get the CPAP. The vendor is the one who set me up with this doctor.

Do you still doubt you have OSA?

Forget that the doctor was a dumb ass....do you still doubt the diagnosis?

Pugsy wrote: ↑

Tue Feb 27, 2018 9:58 am

Do you still doubt you have OSA?

Forget that the doctor was a dumb ass....do you still doubt the diagnosis?

I’d hate to be a skeptic, but yes I doubt the diagnosis. If I had symptoms of sleepiness and gasping in the middle of the night(I do audio record my sleep) then I’d think it would make sense.

Plus if the in-lab study showed that I had OA during the night and that they were corrected I’d have not a leg to stand on.

Even if I had felt better than I normally do the morning after the titration study then I would say hey I can’t argue with feeling better.

But none of those are the case right now.

I read on here of others who say they wake up with out the foggy head in the morning now that they’re being treated and they feel so much better. But to be told I have severe OSA while not having the hallmark symptoms, just give me doubts. Doctor even said my airway isn’t narrow at all after looking in my mouth.

There still exists the possibility that the 4 cm of titration was enough to clear up all the OSA I’m diagnosed as having.

You still have doubts....get the second opinion.
If you and he still doubt the home study results...get an in lab sleep study without cpap and see what happens...maybe even do what is called a split study with the first half of the night without cpap and the second half with cpap if the diagnosis criteria is met during the first half.

And yes...it is entirely possible that 4 cm pressure held the airway open and prevented the collapses. Count yourself lucky if that's the case. That's a nothing pressure.....some people have to use 5 times or more to get desired results and it's like exhaling in a wind tunnel.

Until you are comfortable and accept the diagnosis...we can "what if" all day long and get nowhere.

I never felt sleepy for one minute prior to dx and only got tested when my (now) ex said I quit breathing at night. I did eventually start having night sweats and wild dreams, but still no overt sleepiness.

Same here, Julie. Always had tons of energy, never snored and thought I was sleeping pretty decently, always woke up bouncing out of bed, no lethargy or falling asleep during the day at odd times, no naps either. My score on the Epworth Sleepiness Scale was 1 or 2.

The real clues were resistant hypertension and a cardiac arrhythmia which an astute doc put together and suggested I have a sleep study.

Honestly, my diagnosis came as quite a shock.

I think though that getting an in lab overnight sleep study without CPAP is a good idea, Mr_Ipsum, just to confirm that there was no error in your original sleep study, mistakes do happen after all and unless you are 100% sure you might find yourself always wondering.

Do you you suffer from hypertension, diabetes/prediabetes, high cholesterol, any cardiac issues, overweight/obese, nocturia ....? Not everyone with OSA has sleepiness as a symptom, but very often have several of these co-morbidities that point to untreated sleep apnea.

Arlene1963 wrote: ↑

Tue Feb 27, 2018 1:06 pm

Do you you suffer from hypertension, diabetes/prediabetes, high cholesterol, any cardiac issues, overweight/obese, nocturia ....? Not everyone with OSA has sleepiness as a symptom, but very often have several of these co-morbidities that point to untreated sleep apnea.

Recently got a spectrum of blood tests done just before home sleep study, no issues except for high WBC. At the same time I had a heart scan done. Doctor said it was normal. I do take medication for HBP, but its under control now and has been since before sleep study. I was told I was having a stroke by my company medical department before the sleep study. But that's way too long of a story for here. Ultimately, it was found out that someone didn't know how to properly take blood pressure readings, unless blood pressure drops 20 units in 30 seconds. I just seem to have a black cloud over me when it comes to my employer's medical department.

Anyway, I did speak to one of the doctors at my job today, the one who wrote up the initial paperwork that started this whole sleep study process. They looked at my sleep study results with me over the phone and agreed I should get a second opinion based on the data. I was actually surprised she said and did that. She was very helpful.

So I'll wait until the date I meet with this other sleep specialist. Thanks for the help guys!

I'm very interested to see how this works out and please get back to the forum after you've got a second opinion.

For what it's worth, when I had my CPAP titration I didn't have a single obstructive apnea or hypopnea from 4cm through to 7CM, and only had 1 hypopnea at 7CM. The titration stopped at 7CM and I was prescribed CPAP @ 7CM. My original in lab overnight sleep study indicated moderate OSA (AHI 16.)