Hi
DomP,
You say that "understanding everything first is key for me" - perhaps I can add to what you've already grasped.
The first thing is: you can have an up-to-90 pc blockage - that's an apnea - or you can have an up-to 50-pc blockage - that an hypopnea. Neither is good for you. And they get counted together.
Take the total number of events and divide by the hours of sleep - that's the Apnea-Hypopnea-Index, or AHI. It's the measure of how good or bad.
Sleep medicine professionals in both the UK and America have a range - 0 to 5 is 'normal'; 5 to 15 is 'mild-to-moderate'; 15 to 30 is 'moderate-to-severe'. Above 30 is severe.
You, at 85 per hour, were well into severe.
Second thing. Whenever I've talked to sleep-medicine professionals in the UK, they have been fairly relaxed about what the treatment goal is. And there is at least one professional source I found that said the goal is under 10. Unless the patient has heart disease, diabetes, high blood pressure, kidney disease, etc - in which case the target is under 5.
I'm telling you this because, lately, the idea has got around on, for example, the various UK sleep apnea forums on Facebook that the target in the NHS is under 5 - for everyone.
And I would add that you are visting an American forum here - with the national culture of ambition and improving one's self and doing better. Most of the members here, I think it's fair to say, regard under 2 as the target.
You may want to check with your consultant and/ or the specialist nurses and sleep physiologists you see at St George's
what target they have in mind for you. They may well regard the drop from 85 to an average of 10 as a pretty damn good result.
And bear in mind those same professionals are willing to let UK patients with an AHI of 10 go untreated - meaning they accept it as a tolerable level - because the NICE guidelines say: NHS treatment starts at 15 and above.
(And of course, anyone in the UK who is in the mild-to-moderate category is perfectly free to fund their own CPAP treatment. All they need is some medic to sign their scrip. See more on this below.
)
Third thing: the DVLA - you could do yourself a favour and search on this forum for what I've said in the past about the DVLA. (If you haven't figured it out, by now, I'm in the UK, and as a former medical journalist, I try especially to help out UK posters here.)
The fact is
the DVLA does not lay down a hard number for AHI. They are satisfied if your consultant and his or her team are satisfied. (I should add that they do now seem to have a clearer sense of 'a number or numbers' wrt to hours the machine is used per night - ie, greater than 4 hours, and nightly-usage that long for more than 70 pc of nights.)
Your consultant may sign you off with an average AHI of 10 - provided you are not reporting or demonstrating episodes of falling asleep during the day.
Fourth thing. Anything
Pusgy tells you is gold. In my opinion, she is easily at the emeritus-professor level when it comes to this field.
Fifth thing, this talk about possibly upgrading you to a machine which goes higher than 20cm of pressure. There are, as Pugsy sez, several made by the two main manufacturers. The thing is: will the NHS provide you with one?
They might. But a special application for funding would most probably have to be made - and as you know, money is tight.
It might be that you would choose to do what other UK people (for example, yours truly) have done - and that is: buy your own machine.
If you do, there's nothing to stop you continuing to attend your NHS sleep-medicine department as a patient. And you can thereby continue to get mask-part replacements, mask replacemements, and trials with new mask designs as they come along.
And coverage vis-a-vis the DVLA.
Anyway, this for now.
It's a good hospital, St George's. I lived in Tooting for a time. Used to jog round the common of a morning.
Best.
