My friend snores and stops breathing. Your comments ?

Physician wrote:Remember, he feels very energetic, has no daytime sleepiness, and his only complaint is that his wife complains of his snoring.

It's great that he doesn't feel the effects of poor sleep on a daily basis, but damage is being done every night. I'd ask him this: "If you found out that you had cancer, would you ignore its presence in your body if it wasn't yet impacting your daily life?" No, you'd treat it, because to leave it unchecked is to know that your life will end sooner rather than later, and the shorter lifespan will also diminish in quality.

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Poor sleep efficiency noted with fragmentation and WASO.

RERA's, Obst Hyponea, and Central apneas observed, and Sp02 desats seen with respiratory events.

Snoring reduced on higher therapeutic settings. PLMS were observed.

I'm guessing his sleep study in December was without treatment - a diagnostic PSG study - and this recent test was a titration ("higher therapeutic settings" mentioned in the last line). If that's the case, your friend's numbers dropped dramatically in this recent study (with treatment), so it seems pretty obvious that xPAP is being recommended.

Physician wrote:He will be resistant to using a machine.

Well, he's not alone there. xPAP has a high failure rate (due to poor support from the medical community, IMO).

Would any of us choose to sleep this way? Nope! But considering the risks of not treating my SDB, using a machine to keep me breathing steadily all night is a very small price to pay for a much-improved quality of life, both now and down the road. The morning after my titration study was the clearest day I'd had in years. I couldn't wait to get my hands on a machine of my own, and it gave me determination to make this therapy work for me. If your friend didn't feel any different after his titration, I can see how that might translate into: Why bother? My answer to that is below.

Does this data show that treatment of his apnea is mandatory ? His wife is not bothered by any PLMS.

My answer is YES, your friend needs treatment. He may not be feeling the ill effects of untreated SDB yet, but he can prevent further damage and spare himself a myriad of related medical issues down the road. (Bonus: I bet his wife will appreciate it if he gets on board with treatment. Even if the leg movements don't bother her, the snoring does, and she deserves a good night's sleep, too.)

What I'd tell a friend is: you are gambling, by smoking and by not treating a sleep-related breathing disorder.
You might win the gamble, i.e., enjoy good health until old age.
But the stronger odds are that some adverse event, such as stroke, heart disease, dementia, COPD or cancer is more likely to happen to you, and sooner than you'd like.

M.D.Hosehead wrote:What I'd tell a friend is: you are gambling, by smoking and by not treating a sleep-related breathing disorder.
You might win the gamble, i.e., enjoy good health until old age.
But the stronger odds are that some adverse event, such as stroke, heart disease, dementia, COPD or cancer is more likely to happen to you, and sooner than you'd like.

Thank you !!

Here is what his doctor wrote. Anyone strongly agree or disagree or recommend something different ?


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Sleep apnea both central and peripheral on a definitive inpatient sleep study. Restless leg syndrome. Proposed Rx Resmed ASV with settings EEP 6, Max PS 15 and Min PS 3, supine REM noted at this pressure with 93.5 minimum oxygen sat and RDI was 1.9. The setting kept 02 sat above 90%

Straight to an ASV? That's awesome, and proves how serious the doctor thinks this is.

Physician wrote:Here is what his doctor wrote. Anyone strongly agree or disagree or recommend something different ?


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Sleep apnea both central and peripheral on a definitive inpatient sleep study. Restless leg syndrome. Proposed Rx Resmed ASV with settings EEP 6, Max PS 15 and Min PS 3, supine REM noted at this pressure with 93.5 minimum oxygen sat and RDI was 1.9. The setting kept 02 sat above 90%

Sounds good to me.

Finding a mask that will let him sleep comfortably will be the next hurdle. Since he is so resistant to "doing cpap" he probably won't go to the time, trouble, and expense of finding a mask he can "sleep" with. Hope mask frustrations don't cause him to just toss the whole thing and quit. Hope I'm wrong, and that he is one of the lucky few whose first mask suits them well. Or at least that he's learned enough by now about the insidiousness of having sleep apnea when you think "Hey, I feel fine, I don't need that" to convince him to stick with it and find the right mask.