Help with results of lab tests

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I can hardly believe that I am asking medical questions on a forum but I have a lot of respect for many of the forum members. Years of experience can perhaps give me some insight. Above are 2 conflicting tests. My overnight oximtry was done at the best medical facility that exists!! I have complete faith in them but I dont really understand CPAP and Apnea. After this test a sleep lab test was recommended. According to the sleep lab clinic ( also a recommended accredited facility) and the Neurologist I do not need CPAP. But 3 weeks later I am still waking uped and groggy. My BP has dropped significantly and for this I am pleased. On my way to losing weight and exercising more. I have been thinking of perhaps another sleep lab test but that would be additional expenses. I also am considering buying an oximeter with memory. I could monitor my blood oxygen levels and see if I do need another test. Any thoughts? Does this sound logical?

THanks

Bob

OK, no doc here but first impression is that something is going on that is not healthy. Desaturations are not normal when they dip below 92%...yours do. While you might not have shown any obvious apneas & hypopneas or even a lot of respiratory arousals, you might have UARS, upper airway resistance syndrome. I am guessing that if your airways narrow enough, you will experience desats perhaps even without the required % of reduction required & sleep stage shift to be scored as a hypop.

You can buy your own machine off Craigslist or have your primary doc write a script to buy at cpap.com or elsewhere. There is everything you need to setup a machine in this forum. You could get setup that way for less than another sleep study to see if that does help you feel better.

cortez356 wrote:I have been thinking of perhaps another sleep lab test but that would be additional expenses. I also am considering buying an oximeter with memory. I could monitor my blood oxygen levels and see if I do need another test. Any thoughts? Does this sound logical?

Bob,

I'd suggest having a recording oximeter to have as part of your bag of tricks. It is good to have this kind of data every once in a while to confirm that your treatment (once something that works is found for you) is working, and to make sure that you are not slipping backwards. I run mine for a night every 60 days or so. Kevin from the pulseoxstore.com posts here from time to time. I am sure that he can set you up with something. I have the CMS50E, which is about $100 these days. I does a pretty good job, and the reports are well done. I don't like the the somewhat big thing on my finger all night, so I'd prefer to have one that has a sensor on a cable rather than the big clip-on unit.

-john-

I'm not a doctor or anything in the health care field, but I'd move heaven and earth to put myself on CPAP if I saw these comments on an overnight oximetry test and on a PSG sleep study:

"There are grouped oscillatory desaturations throughout the study to a minimum of 86%. The 4% desaturation index was near 14 per hour."

"Abnormal study. Oscillatory desaturations are consistent with a sleep related breathing disorder."

"respiratory related arousals were observed, and may suggest increased resistance of the upper airway"

"moderate snoring was noted when in the supine position"

"Respiratory Disturbance Index 7.2"

Regardless of the low AHI (or RDI) produced during the PSG study, I'd want to at least "try" CPAP for a good, long time.

Oh, and about that low AHI --
http://www.pulmonaryreviews.com/sep02/p ... Index.html
(I agree with Dr. Sullivan.)

I'd strongly suspect UARS (Upper Airway Resistance Syndrome) just as Muse-Inc did:

Muse-Inc wrote:you might have UARS, upper airway resistance syndrome.

CPAP is used to treat UARS.

One caution I'd make about "trying" CPAP: until a person finds a mask that they can sleep comfortably in, and until a person gets used to trying to sleep with all this "stuff", the equipment itself can cause sleep disturbances. For awhile, one might be trading off sleep disordered breathing disturbances for sleep disturbing equipment issues -- usually mask issues.

That tradeoff can leave a person feeling more worn out than before CPAP. Could make a person think, "Well, CPAP makes me feel worse, so that's not the answer." Especially if no CPAP recommendation came out of the sleep study.

This forum can help immensely in getting used to "CPAP" -- in getting everything about using CPAP and a mask to be comfortable enough to actually be able to sleep.

I agree with what these posters said:

GumbyCT wrote:You can buy your own machine off Craigslist or have your primary doc write a script to buy at cpap.com or elsewhere. There is everything you need to setup a machine in this forum. You could get setup that way for less than another sleep study to see if that does help you feel better.

jweeks wrote:I'd suggest having a recording oximeter to have as part of your bag of tricks. It is good to have this kind of data every once in a while to confirm that your treatment (once something that works is found for you) is working

The CPAP machine I'd want?
I'd choose one of these -- wouldn't matter to me which one:

ResMed S8 Elite II (cpap)
ResMed S8 Autoset II (autopap)

ResMed S9 Elite (cpap)
ResMed S9 Autoset (autopap)

I'd ask around on this forum about where to get the ResScan software in order to download results data from those machines to my computer. However, even without software, useful overnight "AHI" and "leak" information can be viewed in the display window of the machine itself.

Thanks for all the replies. I am trying to handle this problem with some sort of logic. Part of my problem is that I cannot get any good advise in Canada due to the waiting period to even see a sleep specialist. My oximetry was done at the Mayo and the sleep lab at another accredited clinic. Here are my thoughts: I could just buy a machine and mask and try it for a month or so. Cost under $600 for an auto Intellipap. I would have to do all of this by mail order including the mask. Would getting the right mask be a problem? If I understand how the auto ystem works you set the perameters according to your sleep study and the machine will adjust to what you require would have to be able to get a prescription from the original sleep lab. Or I could have another sleep lab test. We are in Mexico right now and there is a lab 65 miles from us. Cost under $1300. All the replies are greatly appreciated.

Bob

Well, if it were me... I'd skip getting another sleep study. I'd do what you're considering -- get myself a machine. An autopap with software, preferably. But a plain CPAP with software would do the job, too.

If autopap, I'd start out setting it at 7 - 15. If cpap, I'd try a pressure of 8 first.

I'd use the software to do a download each morning. Leak rate is what I'd be most interested in seeing the first few days.

The mask is the real key to being able to do "cpap" at all, so I'd splurge and get three masks to start with:

1. ResMed Swift FX (nasal pillows mask)
2. ResMed Activa (traditional nasal mask)
3. ResMed Ultra Mirage FF (full face mask -- covers nose and mouth)

Only thing is unless you're purchasing for an example on Craigslist... you'd need a prescription.

Wrong.. you won't (necessarily) need a script on CL, only on eBay, and they don't even sell them anymore.

So Craigslist is now asking for perscriptions?

Bob, all good suggestions here. You also might try sleeping only on your side or stomach if you normally sleep on your back.
Good Luck, Keep us posted.

cflame1 wrote:So Craigslist is now asking for perscriptions?

No, I have one for sale on there now. Not sure what the other poster is calling "wrong" on. Like she was agreeing with you but calling you wrong????????

That's what was confusing me

Thanks for the hints and tips. Can someone explain the difference between apap and cpap? I am seriously thinking of buying a machine. Have not decided if I will buy a new Intellipap from Second wind or a used one of say craigslist, If I buy new I will need a prescription. I hope the sleep lab that did my test will provide this. We are in Mexico and I know a few Mexican Drs. One would write the script but how are these written? Does anyone have an example?

Bob

One other question. If buying used how do you go about cleaning the machine and the hose??

Thanks

Bpb