Women with sleep apnea

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Women with sleep apnea

Post by Pugsy » Sat Mar 16, 2013 8:26 am

mollete wrote:Did somebody on my Exclusion List say something!?
Of course and you know they did.

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SleepingUgly
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Re: Women with sleep apnea

Post by SleepingUgly » Sat Mar 16, 2013 8:26 pm

This place is like a comedy club.
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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mollete
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Re: Women with sleep apnea

Post by mollete » Sun Mar 17, 2013 4:57 am

SleepingUgly wrote:This place is like... comedy...
Well, periodically it does move into other genre, such as Fantasy:

Image

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DoriC
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Re: Women with sleep apnea

Post by DoriC » Sun Mar 17, 2013 12:15 pm

mollete wrote:
Pugsy wrote:
kaiasgram wrote:Oh mollete, you've been given such an opportunity here...
Can I hide and watch? Please????
Why? What happened?

Did somebody on my Exclusion List say something!?

Image
Ok, it's worth a chuckle but not up to your usual standards! Today is a rather long and boring day for me so I can use some really good laughs!

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SleepingUgly
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Re: Women with sleep apnea

Post by SleepingUgly » Sun Mar 17, 2013 12:58 pm

Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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DoriC
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Re: Women with sleep apnea

Post by DoriC » Sun Mar 17, 2013 5:18 pm

SleepingUgly wrote:Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!
I confess! But I know you'll skip this thread if it gets too "rowdy" because you're so sensitive!

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SleepingUgly
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Re: Women with sleep apnea

Post by SleepingUgly » Sun Mar 17, 2013 5:43 pm

DoriC wrote:
SleepingUgly wrote:Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!
I confess! But I know you'll skip this thread if it gets too "rowdy" because you're so sensitive!
I am VERY sensitive. And misunderstood. But a little stimulation never hurt a sleepy person.
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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mollete
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Re: Women with sleep apnea

Post by mollete » Mon Mar 18, 2013 4:37 am

DoriC wrote:Ok, it's worth a chuckle but not up to your usual standards!
Well, being that it's Lent certainly cuts down significantly on the available material, but you have to admit the Harry Potter-inspired banner is pretty clever!

stage0
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Re: Women with sleep apnea

Post by stage0 » Mon Mar 18, 2013 11:48 pm

i looked the hypop requiremtents and the desat is still associated with the event. I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.

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mollete
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Re: Women with sleep apnea

Post by mollete » Tue Mar 19, 2013 4:39 am

stage0 wrote:i looked the hypop requiremtents and the desat is still associated with the event.
I did not say "exclusively".

I said
mollete wrote:you don't need a desat to score a hypopnea.
because "Da Rules" are:
Da Rules wrote:There is a 3% oxygen desaturation from pre-event baseline or the event is
associated with an arousal.

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SleepingUgly
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Re: Women with sleep apnea

Post by SleepingUgly » Tue Mar 19, 2013 6:54 am

stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.
You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/
Never put your fate entirely in the hands of someone who cares less about it than you do. --Sleeping Ugly

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NotLazyJustTired
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Re: Women with sleep apnea

Post by NotLazyJustTired » Wed Mar 20, 2013 1:29 pm

SleepingUgly wrote:
stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.
You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/
Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!

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mollete
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Re: Women with sleep apnea

Post by mollete » Thu Mar 21, 2013 2:16 am

NotLazyJustTired wrote:
SleepingUgly wrote:
stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.
You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/
Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!
OTOH, this debate about "Da Rules" is a little myopic because is assumes (like everybody else on the planet) that the be-all, tell-all, know-all, key piece of information is "Da Number" (AHI), when it is not.

I mean, in re: desaturations, what is clinically relevant? 4% or 3%? What happens if you have a bunch of 2.9%'s?

It is more important to look at the whole picture ("Da Graphs")(and in some cases "Da Tables") which would allow successful interpretation of the data. Whether one uses AASM 2008 4A or 4B, or AASM 2012 is academic. No matter which rule one uses, arousals are recorded and documented. 4B and 2012 may end up associating them with hypopneas whereas 4A would not. If one chooses to score RERAs, then outlying respiratory events would then be accounted in the RDI.

In any case, if one chooses to use a hard line 4A and ignore everything else, one could still uncover underlying issues because one would see a big pile of "spontaneous" arousals sitting in the bucket which would need accounting for.

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mollete
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Re: Women with sleep apnea

Post by mollete » Thu Mar 21, 2013 2:32 am

However, and not wishing to generalize, let's say we do have a person with a ton of "spontaneous" arousals (who may now end up with a dx of "primary snoring"). In these cases, the sleep disordered breathing events would not necessarily be technically severe (little or no desaturation and waveforms having a flow limited appearance). These people may be candidates for alternative therapy (weight loss, positional therapy, oral appliances, Provent, surgical intervention, etc.).

However2, if you're having ≥ "drop-dead" desaturations, might not ncessarily be a good idea to stray too far away from xPAP approach.

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NotLazyJustTired
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Re: Women with sleep apnea

Post by NotLazyJustTired » Thu Mar 21, 2013 5:57 am

mollete wrote:
NotLazyJustTired wrote: Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!
OTOH, this debate about "Da Rules" is a little myopic because is assumes (like everybody else on the planet) that the be-all, tell-all, know-all, key piece of information is "Da Number" (AHI), when it is not.

I mean, in re: desaturations, what is clinically relevant? 4% or 3%? What happens if you have a bunch of 2.9%'s?

It is more important to look at the whole picture ("Da Graphs")(and in some cases "Da Tables") which would allow successful interpretation of the data. Whether one uses AASM 2008 4A or 4B, or AASM 2012 is academic. No matter which rule one uses, arousals are recorded and documented. 4B and 2012 may end up associating them with hypopneas whereas 4A would not. If one chooses to score RERAs, then outlying respiratory events would then be accounted in the RDI.

In any case, if one chooses to use a hard line 4A and ignore everything else, one could still uncover underlying issues because one would see a big pile of "spontaneous" arousals sitting in the bucket which would need accounting for.
I agree to a point. My insurance isn't covering my treatment because my AHI is below 5. I have to pay for everything out of pocket. In that sense, that little number and the way that it is scored is significant, at least to me.

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