Could it be that I dont need my apap?

Hi Elena, interesting story. BTW I almost bought one of those massage beds to sleep in when we figured out at home that I had apnea, and an appointment was not to be had for months...

I also ditto the suggestion to ask for a sleep study at home. In the meantime do you have a pulse ox you can try overnight without the machine? Maybe you can rent one from your DME with your doc's prescription.

Jan's suggestion to try 4cm is also an interesting experiment...

Yup, this may not be the classical/typical OSA case. Perhaps the centrals are a bigger problem that we thought, and if your OSA is positional then perhaps the pressure is just inducing more CAs. Sounds plausible. I find it, uh, interesting that they say that YOU said the "quantity and quality of sleep were normal"! Sounds like BS to me!
I can't remember back to your other threads, just what is your current CA index?

What I do find worrying though is the severe oxygen desats reported on your PSG. I hope you don't abandon CPAP completely without digging further into what's going on, based only on some nights of sleeping better without it but with no data. Though I can imagine the temptation

read everything, I will come back when I get home to respond to all of you, thanks so very much for your replies and ideas..

dreamon,
Im HOPING the machine cured my nocturia and heart issues because I was sleeping on my back so much with it the first few months,
I didnt know what else to do with it, but youre right, maybe it helped because I do need it.

It will be interesting to figure this out though!

ok scratch my previous post and see what I wrote in your other thread with the graphs. IF straight CPAP doesn't give you good results then by all means try the experiments above, but I would strongly!!!! suggest listening to the advice in the other thread first. Just my 2 cents

elena i notice the results you posted are for a 53 year old female and that certainly does not seem to fit your avatar photo

BTW, I meant that you should only turn your bottom pressure down to 4 if you are running in APAP mode for "diagnostic" purposes--so you can see your true range while lying prone. Don't turn it down in CPAP mode or you'll suffocate!

Interesting..... I just had my first sleep study last Friday, and I questioned the lab tech as to how much sleep they needed me to have in order to get the information necessary. She said they need at least 2 hrs of sleep, but prefer more. I slept 5 hours, and I was lucky to be in a very nice environment....very clean, bedroom-like, and quiet.

I would question your study as being complete since you only slept for 1 hour. Seems like they would order you back for a redo. Why were you sent in the first place? Were you symptomatic? How could your sleep doc accept such an incomplete report and order your treatment based on that?

Good luck with your sleep! Sounds like it is either a great position for you (I cannot sleep on my stomach at all!), or it was a fluke. I hope you can get continued sound sleep and energy galore

When I went in for my sleep study I got to talking to the lab guy (he was all of 19) and he told me that less than half of the people that come in for the study stay for more than a few hours. I fell asleep right away but I'm not a sound sleeper (small kids) and kept waking up because he had to press a buzzer to open the front outside door. He buzzed in a pizza delivery around midnight and buzzed in the local "chicken wings" delivery around 2 a.m. when some of his friends showed up to keep him company. They watched Will Smith in Men in Black. I slept enough (always on my back) to get some data so what did I care. (70 AHI/ lowest oxegen 60%)

When I went back for the titration study there was a someone else. He was older, in his mid twenties and told me that he could never fall asleep. That's why he ended up taking the job. When I woke the next morning and asked him how things went he told me that when I slept on my side my apnea episodes dropped dramatically. One side in particular (I don't recall). He said when I was on my side the AHI dropped to 2.7 with a pressure of just "4" and O2 climbed to 90%. I have been on CPAP for over a month and I cannot get my AHI below 16 sleeping on my back. I think there's more to the positional aspect of CPAP treatment that needs to be explored. With my mask I have not been able to successfully sleep on my side. But there are some posts on this forum that show you some positions to try. It would be great to get some data if you can do it.

hi there!
Oh bless you all for all the great ideas and sharing of your stories! Thanks!

Bigdaddy, I agree an hour of a sleep study is a poor study, I will look into a home study, thanks!

Janknitz, Yes, one night a trend does not make, and this is probably pie in the sky wishful thinking but oh well!

Loq, It also puzzles me how they can end up giving you a diagnosis and a titration in ONE night! I know the night I spent in the sleep study
room was not the one night a trend would make either!

Dreamon, you are very likely right, I slept so well because I was so exhausted from having such crappy nights for awhile.. Maybe the apap changing
pressures IS keeping me from sleeping very well, and I will try cpap on nine or ten if this other adventure doesnt work out.. Thanks for all your concern.

Echo, Yes, on the questionaire after the sleep study, I thought I had slept two hours, so I wrote that down, and that was not atypical for me back
then.. two hours one night four the next. I slept for sixty six minutes, but I thought I slept twice that, which is normal for a raging insomniac..
I read your post on the other thread, thanks! I should probably buy a pulse oximeter, to see if I have desaturations on my tummy..

Unclebob,
" elena i notice the results you posted are for a 53 year old female and that certainly does not seem to fit your avatar photo "
Look closer at the gray hairline unclebob! That photo was taken just a couple months ago at karaoke night!
(but thanks for the compliment)


Janknitz, I will be sure not to set my apap on cpap at four, now that would be an adventure! OMG!

Emelia,
Im glad you slept at least five hours at your study, and had a nice room too.

"I would question your study as being complete since you only slept for 1 hour. Seems like they would order you back for a redo. Why were you sent in the first place? Were you symptomatic? How could your sleep doc accept such an incomplete report and order your treatment based on that? "

I thought for sure they would have me back, but they sent me home with an auto machine for a week. Why was I sent there? I went with my husband
to the doctor about his sleep problems, and he told his doctor I was a horrible insomniac, and he could never catch me actually sleeping.. so that doctor
got me to have an oximetry test.. another disaster like my sleep study, but that lead to a consult with a pulmanolgist, who examined my jaw, my throat,
my ears, and said, I really needed to have a sleep study with everything she saw. I NEVER had daytime sleepiness, but I was up all night with nocturia, and
would often wake up with irrigular heart beats, and terrible high blood pressure, and gasping.. when I was on my back. This had been going on since
college, and it got pretty bad about fifteen years ago, but as you know, nobody was looking at sleep apnea as problem back then.

Underdog, that is so intersting about your ahi situation on your back too! wow, that was one huge desaturation you had on your sleep study..
Good for you that you are doing so much better. Sounds like your study was a lesson in futilty, pizza, and men in black while you are trying to sleep!

Well, tonight I will try the nose pillows, sleeping on my stomach only, with apap pressure set from four to fourteen.. and if I have a few events,
that would be normal because I have them when Im awake too.. and if I have a bunch, then I will try cpap at nine or ten..

its so funny, one night does not a trend make, but if you get a sleep study, they believe that one night is YOUR trend for a long long time!

Just a thought on short sleep time during studies. I would be suspect of any negative result based on short sleep. But seems to me OSA could be apparent in just minutes of sleep. What would be missing is all the details as to the severity, different sleep stages, positions, oxygen, etc., but staying asleep longer won't make the events and desats seen early on go away.

By the way, I have used 4 different nasal pillows masks, and I sleep on my side. Even so, there are times I wake up on my back, and the wakeup is usually accompanied by the sense I had an event. My jaw drops when on my back, but not when on my side. I understand the sleep labs wanting to capture a person's probable worst case scenario, even if it's not their usual picture. I've never been told I HAD to stay on my back, but it was encouraged. I think the ideal study would capture some time supine in REM, but allow the patient to sleep in their position of choice the rest of the time for comparison. Too bad ideal is not a word one would associate with a sleep study.

here is last nights graph when I tried to sleep on my stomach with the nose pillows:


viewtopic.php?f=1&t=53853&st=0&sk=t&sd=a&start=45

Just a thought on short sleep time during studies. I would be suspect of any negative result based on short sleep. But seems to me OSA could be apparent in just minutes of sleep. What would be missing is all the details as to the severity, different sleep stages, positions, oxygen, etc., but staying asleep longer won't make the events and desats seen early on go away.

By the way, I have used 4 different nasal pillows masks, and I sleep on my side. Even so, there are times I wake up on my back, and the wakeup is usually accompanied by the sense I had an event. My jaw drops when on my back, but not when on my side. I understand the sleep labs wanting to capture a person's probable worst case scenario, even if it's not their usual picture. I've never been told I HAD to stay on my back, but it was encouraged. I think the ideal study would capture some time supine in REM, but allow the patient to sleep in their position of choice the rest of the time for comparison. Too bad ideal is not a word one would associate with a sleep study

I understand what you mean about sensing an event on your back, I feel that way too..

You are right, it can show up in one minute, as my doctor pointed out to me... on the graph, "oh look, you feel asleep for one minute here, only one
minute total, and you stopped breathing."

Still, it would be nice to have an "ideal" night at the sleep study, but that will never happen!

LoQ wrote: It always puzzles me, then, that sleep labs/doctors think they can come up with a diagnosis in a single night of study. And worse, some of them come to a sleep Dx and Rx BOTH in a single night. Just amazing.

And yet, their results are amazingly often correct. I'm sure if you asked for a two-week study, they would oblige. Not so sure your insurance would...

Bottom line, they make decisions based on a short timeframe because they have to. They don't have the luxury of trending that we do.