New & Learning

Hi to all. Here is my story: Questions in red

About 3 years ago, did a home sleep study and was told I had mild to moderate sleep apnea with an even mix of OSA and Central. The biggest concern was the drop in O2, as low as 78% and never above 88%. It was suggested I either start using a PAP machine or do an overnight sleep study. They were really pushing a machine they sold and I left as I felt the whole thing was nothing more than a huge racket as my family said I only snored softly, worse with a head cold or allergies. Stayed with my oxygen machine for sleeping.

In Dec 2017 got sick, ended up with pneumonia and again in Jan. This started the downward spiral. Asthma turned severe and uncontrolled. Will leave that nightmare out at this point, just mentioning it so you can see why all the testing has been done. No GERD, though that took forever to prove since all were convinced that I must have it because I am over 100 pounds overweight. Kept stating I needed to have a sleep study done because of the previous home study showing some OSA.

Kept putting it off as I am a very light sleeper and never sleep well away from home. Finally broke down and had it done a few weeks ago and yes it was miserable. I slept very little and then very restless. It was suppose to be a split night but never got to the PAP study as I didn't sleep until the last part of the study. I don't even believe I slept as long as the study showed because I was constantly looking at my phone for the time as I just wanted the night to be over with. Would start to hear myself snore and wake up. I am use to sleeping with a fan and the noisy O2 machine, lol.

Here is my data:
Female, age 60, BMI 50

Total recording time 447 mins
Total sleep time 263 (I guess just starting to dose off all night counted for something)
Sleep efficiency 58.8%
Wakefulness after sleep onset 170.2 mins
Sleep latency 14.2 mins
REM latency 310 mins

Patient's sleep architecture revealed (I don't understand this one at all and would like someone to help me understand this better):
22.05% Stage N1
72.05% Stage N2
0% Stage 3
5.89% Stage REM

Respiratory events consisted of:
2 Central apneas
8 Obstructive apneas
20 Obstructive hypopneas
0 Central Hypopneas

Minimum O2 71%
Mean O2 87.7%
Total mins less than 88% 181 in sleep

Everything else was normal.

With the above they decided I was mild OSA and severe sleep hypoxia.

They wanted to send me home with an APAP or a full night sleep study for titration. Decided on another titration, though since then I am thinking it might be better for a home study or even the APAP if it is also monitored. What do you all think??

Here is my biggest issue. Sounds like it is a major racket with the pushing of a machine when the sleep apnea is only mild. I have an O2 machine, so I get that at night. I sleep on the sofa because of the noisy O2 machine and husband snores like a train and twitches all night (yes, he needs to go in). Daughter tells me I stop breathing all night long, choke, gasp, moan when waking from not getting my breath. So there wouldn't have been an issue with them telling me I has severe OSA and needed BiPAP (because of the asthma), but to tell me I needed a machine when they couldn't say it was worse than mild, leaves me not trusting that apnea is even a real issue.

No, I am not trusting of the medical community nor big pharma. Yes, I can see a good reason that I need a machine, but does anyone else feel like it is just a new money making thing?

Wouldn't my O2 machine be just fine even if the apnea is severe? I mean, it is pushing the oxygen and that is all that matters in the long run.

Still skeptical but willing to learn and understand,
WhiteAngel

Welcome to the forum

You might read this for help in understanding the sleep study results.
http://adventures-in-hosehead-land.blog ... -test.html

Sleep stages also explained here
https://en.wikipedia.org/wiki/Sleep_cycle
https://www.tuck.com/stages/

WhiteAngel wrote: ↑

Thu Aug 22, 2019 10:18 am

Wouldn't my O2 machine be just fine even if the apnea is severe?

If the airway is blocked then that O2 has no where to go and if you aren't breathing you aren't getting the O2.
Obstructive sleep apnea means the airway is blocked.
If adding O2 was all that was needed to deal with OSA then we would all be using added O2 instead of cpap machines.

Hello and welcome. You aren't the first to go into this with skepticism. Hopefully some of the responses you get will alleviate some of your concerns. Do be mindful that your study is just a glimpse of one night and by your own description you got very little sleep. Had you been especially tired or maybe comfy in your own space, getting into some deep sleep (which you were lacking) and some REM sleep (which you were short on), your numbers could have been significantly worse. Not sure how much of the REM sleep you got was while supine, but unless a study has captured a good chunk of time in REM while supine, there can't be much confidence they have captured your worse case scenario. Now, this varies for everyone, but it is common to see events worsen during REM due to lack of muscle tone, and while supine probably due to the tongue collapsing back into the airway. Those who wanted you to get a machine know the test was what my doctor terms technically suboptimal. Just saying all this to say don't get too comfortable thinking your OSA is "just" mild. Even mild sleep apnea can wreak havoc on one's sleep and health. I would trust your daughter's description of your breathing struggles while you sleep as a motivator.

About you using oxygen... is it because of your asthma or is something else going on with your lungs? Do you use it during the day also? You mention possibly needing a bilevel due to your asthma. I am not familiar with which machines are best for specific disorders but others on here might be. It is wise to look at the full picture before selecting a machine. Some insurances require failing on a cpap or apap before approving a bilevel unless there is an acceptable reason to go straight to that machine. I think most bilevel prescriptions require an in lab titration, but things may have changed. Best wishes figuring things out.

And regardless, mild means mild, not nonexistent.

As for supine, I never sleep on my back. 90% of the time it is on my left side, been this way since I was a child. Once in awhile, I will sleep on my right side. Hope that helps

I can actually feel my tongue sliding back and blocking my airway as I am dosing off

Honestly, no one ever bothered to figure out why I needed oxygen at night and why my stats dropped so low. With the asthma, sometimes during the day time, it drops below 90%, usually when the breathing is bad or I have a cold or something like that. I smoked for years, quite in July 2018, though I do vape from time to time, and no COPD.

I have most of the classic day time symptoms; tired, napping, foggy, night time sweating, etc.

All of this is being done through National Jewish Hospital - leading lung place in USA. My pulmonologist is the one who said they would likely need to put me on the BiPAP so that carbon dioxide levels don't build up to high - severe asthmatics have trouble getting air back out, so it builds up and with a CPAP, the constant pressure would make it hard for most asthmatics to eliminate carbon dioxide.

So it would be best to do another overnight study with the titration? I know, from what I have read, everyone hates those studies, lol

The report I received was only two pages and I plan to ask for a much more detailed one. I am one of those people that wants ALL the info, so I am make up my own mind. Doctors and medical personnel are human and mistakes are made way too often.

True on mild being something....though in my honest opinion from what daughter says and the fact I am beyond fat, it is probably more severe.

Being overweight is now often thought to be a result of OAS, not the other way around.

Have you read the latest on vaping? It's considered to be very damaging very early on and was not tested in asthmatics, more so in generally younger otherwise healthy people. You need to stop yesterday if you're still doing it.

Julie wrote: ↑

Thu Aug 22, 2019 11:54 am

Being overweight is now often thought to be a result of OAS, not the other way around.

Have you read the latest on vaping? It's considered to be very damaging very early on and was not tested in asthmatics, more so in generally younger otherwise healthy people. You need to stop yesterday if you're still doing it.

I’m trying. Lowering mic levels but hopefully better than smoking. Never had horrible asthma until the beginning of 2018 and smoking never bothered it unless pneumonia was going on.

Thank you for reply

Forgot to mention, OSA causing weight gain? 100 pounds of it?? Seriously? All I know is I am always hungry and always tired

Julie wrote: ↑

Thu Aug 22, 2019 11:54 am

Being overweight is now often thought to be a result of OAS, not the other way around.

Have you read the latest on vaping? It's considered to be very damaging very early on and was not tested in asthmatics, more so in generally younger otherwise healthy people. You need to stop yesterday if you're still doing it.

You need to get your information regarding vaping from actual studies instead of Facebook shares.

Didn't you not notice the OP say she recently quit smoking and now vapes occasionally? Vaping has demonstrated itself to be the most effective tobacco cessation products used to date. The harm reduction, compared to tobacco products is 100 fold.

I'm not suggesting that people should take up vaping, nor that vaping is good for you, but vaping to stop smoking has saves thousands upon thousands of lives yearly, despite uninformed people scaring people away and trying to get it banned.

Your'e hurting people, stop.

WhiteAngel wrote: ↑

Thu Aug 22, 2019 12:02 pm

Julie wrote: ↑

Thu Aug 22, 2019 11:54 am

Being overweight is now often thought to be a result of OAS, not the other way around.

Have you read the latest on vaping? It's considered to be very damaging very early on and was not tested in asthmatics, more so in generally younger otherwise healthy people. You need to stop yesterday if you're still doing it.

I’m trying. Lowering mic levels but hopefully better than smoking. Never had horrible asthma until the beginning of 2018 and smoking never bothered it unless pneumonia was going on.

Thank you for reply

Forgot to mention, OSA causing weight gain? 100 pounds of it?? Seriously? All I know is I am always hungry and always tired

For some people yes. I have lost 35#'s and am still losing.

babydinosnoreless wrote: ↑

Thu Aug 22, 2019 12:19 pm

WhiteAngel wrote: ↑

Thu Aug 22, 2019 12:02 pm

Julie wrote: ↑

Thu Aug 22, 2019 11:54 am

Being overweight is now often thought to be a result of OAS, not the other way around.

I’m trying. Lowering nic levels but hopefully better than smoking. Never had horrible asthma until the beginning of 2018 and smoking never bothered it unless pneumonia was going on.

Thank you for reply

Forgot to mention, OSA causing weight gain? 100 pounds of it?? Seriously? All I know is I am always hungry and always tired

For some people yes. I have lost 35#'s and am still losing.

That would be so awesome. When younger I could drop weight easily....not so much now

Have to get that weight down. Never mind the apnea’s just having that much extra weight is going to severely have a negative effect in your life.

I know it’s easier said than done but it’s proven by science that weightlifting at any age is the best type of exercise for weight loss combined with diet. ( I’m university educated on the subject).

I’m not saying deadlifting and bench pressing huge amounts of weight. I’m saying join a gym and get some exercises demonstrated for you and learn to make it a part of life. This is important regardless of age.

Ograx wrote: ↑

Thu Aug 22, 2019 12:26 pm

Have to get that weight down. Never mind the apnea’s just having that much extra weight is going to severely have a negative effect in your life.

I know it’s easier said than done but it’s proven by science that weightlifting at any age is the best type of exercise for weight loss combined with diet. ( I’m university educated on the subject).

I’m not saying deadlifting and bench pressing huge amounts of weight. I’m saying join a gym and get some exercises demonstrated for you and learn to make it a part of life. This is important regardless of age.

Thank you for this info. Working on the weight loss. Exercise is another story until breathing and back issues are resolved. Need more radio freq. ablations on back but breathing is so rough right now can't do.

Since I slept so horribly the first time, they are giving me Ambien for the titration study.

Will this study, if I can sleep, show a better view of how how bad the apneas are?

Or should I ask for another split night study?

Or does it even matter at this point??

Doesn't really matter at this point. The O2 drops would scare the hell out of me.
I would take the Ambien and let them devote the entire night to the titration.

Pugsy wrote: ↑

Thu Aug 22, 2019 12:59 pm

Doesn't really matter at this point. The O2 drops would scare the hell out of me.
I would take the Ambien and let them devote the entire night to the titration.

71% scared me too but that was on room air for the study.
I’ve even thought of taking the Ambien AND Benadryl and maybe melatonin....I’m that light of a sleeper.