Recently Diagnosed with Mild-Moderate SA

Hi everyone!

I've been lurking here for a while now, ever since the notion popped into my head that I might have sleep apnea.

I've been wanting to get a sleep study done for months, but I never seemed to get around to it. I finally had one scheduled for back in September.

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Sleep Study 1:
*I work nights, so it was challenging to swap my schedule around for this, which may have exacerbated the problems I had during the evening*
I got there at 8:15pm for my scheduled 8:30pm appointment, but the sleep tech was nowhere to be found! I ended up waiting about 45 minutes and calling the clinic. The manager said that he overlooked the booking, apologized profusely, and had an off-duty sleep tech come to my location. He got there in about 1 hour from that call.

He had never been to that location before, so it took a while for him to set everything up, find what he needed to find, and get all the paperwork filled out. I was exhausted at that point, as I had already been up for nearly 36 hours (hard flipping schedules on short notice!). I finally got all the wires on me, laid down, and almost fell asleep -- but no, I had to do all those calibration exercises, and damnit, I was wide awake after that.

The night went on with me trying to fall asleep. I'd be staring at the ceiling for what seemed like hours and hours and I'd mumble that I couldn't sleep, but he'd tell me I would fall asleep, then wake up complaining that I can't sleep. He even said I had been asleep for almost 90 minutes when I felt like I had been awake the entire time!

Eventually, 6am rolled around and I was so, so ready to get the hell out of there. I went home after doing the morning checklist, and prompty fell asleep for another 10 hours, immediately putting me back on my night schedule. Hah.

All in all, that evening was a figurative nightmare. Not necessarily anything to do with the tech or the facility, but it just seemed like I caught a second (or third!) wind by the time it came time to actually go to bed.
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A few weeks went by and I got a call from the clinic telling me they needed to schedule another study, so I scheduled one for the following week. I had not heard any results at this point, so I assumed they did not get enough information during the study and needed me to do a repeat of the first night.

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Sleep Study 2: Titration!

As it turns out, they were able to get enough data the first night to diagnose me with mild-moderate sleep apnea with an AHI of 11.7.

I walked into the same hotel room as the first night, but I was greeted by a wonderfully friendly technician who had everything laid out and prepared for me. I saw the CPAP masks on the bed and that's when I realized that it was a titration study and not another diagnostic study. I was so relieved. The technician was the first person to actually inform me of the diagnosis from my first study!

He had me try out a nasal cushion, nasal pillows, and a FFM. For some reason, I feel much more constricted when only my nose is covered up, so after trying all three, I opted for the FFM, a Mirage Quattro. For me, it was easy to breathe out of and the technician was actually surprised by how easily I took to feeling the pressure. He said when he first started CPAP, he had to take the mask off several times because the pressure was just so uncomfortable. I admit, I have a slight advantage in that area, having slept with a fan blowing air on my face for 25 years. I'm rather used to air blowing at me. Lol.

Anyhow, it came time to put the mask on and go to bed. I must be one of the lucky few, because it was wonderful. According to the results, my onset sleep latency was 4 minutes and my persistent sleep latency was 12.5 minutes..Much shorter than the normal 1-2 hours it takes me to fall asleep.

He woke me up at 5:48am and I felt really quite refreshed. I asked if I had gotten more REM than I would have, and he said "yeah," which is about all he was allowed to say. I then did my morning survey and went home, putzed around for a bit, and then went to bed again and slept for another 8-10 hours. I don't know if my body just really wants me to be asleep during the day like it's used to, or if it wanted more of that sweet, sweet sleep that I'd gotten with the CPAP.
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Now, to more recent days, the clinic was finally able to send my results to my doctor and I was informed that they titrated me to 11cm. What's weird, as you'll see in the results, is that my AHI at 5cm (starting) was over 105! The tech quickly bumped me up to 6cm after only 1m42s at that pressure. I then had an AHI of 49 at 6cm. At 8.5 minutes, he jumped me up to 7cm. I stayed at that for about 15 minutes or so with an AHI of 7.7. At 8cm all the way to 11cm, I suffered either 0 AHI, with the exception of 0.3 at 10cm.

I got the doctor to prescribe the machine I want, an S9 Autoset with the H5i humidifier and a ClimateLine hose (I even had the product code for the package ready) to help keep the hassle with the DMEs down to a minimum.

And now the waiting game is on! Let me tell you, now that I've been diagnosed and prescribed, it's so much worse waiting knowing that good sleep is just around the corner! Lol.

Anyway, here are some of my results and I hope I didn't bore you all too much.

START STOP TOTAL
Total Recording Time 21:27:28 05:37:38 490.2 min
Time available for sleep 21:31:57 05:37:28 485.5 min
Sleep Time 21:35:58 05:33:57 445.0 min
Sleep Latency 4.0 min
WASO 36.5 min
Total Sleep Efficiency 91.7 %


TABLE 2: SLEEP ARCHITECTURE — DIAGNOSTIC STUDY 8/21/13 VS CPAP TITRATION (All treatment levels are combined)
STAGE I STAGE II SWS REM
Baseline % of sleep 12.6 67.3 5.6 14.5
Baseline Min. of sleep 30.5 162.5 13.5 35.0
Latency from Sleep Onset 0.0 2.5 68.5 309.5
Treatment % of sleep 12.5 70.4 1.7 15.4
Treat Minutes of sleep 55.5 313.5 7.5 68.5
Latency from Sleep Onset 0.0 11.0 47.0 88.5

I'd post more, but damn it's a pain in the ass to format in this text box, and upon preview, none of the spacing I did for Table 2 stayed, so sorry for that!

and this is me. I didn't notice I wasn't logged in when I made the post

Pressure/Dur(report)/Dur(sleep)/Hyp/central/osa/mixed/AHI
5/0/0 0:05:31.0 0:01:42.0 3 0 0 0 105.9
6/0/0 0:09:31.0 0:08:31.0 7 0 0 0 49.3
7/0/0 0:20:33.0 0:15:33.0 2 0 0 0 7.7
8/0/0 0:14:27.0 0:12:57.0 0 0 0 0 0.0
9/0/0 0:38:2.0 0:36:2.0 0 0 0 0 0.0
10/0/0 3:30:0.0 3:11:0.0 1 0 0 0 0.3
11/0/0 3:07:15.0 2:59:15.0 0 0 0 0 0.0

Welcome to the forum.

Don't panic on that extremely high AHI at 5 cm...it's hard to explain but it's an extrapolated AHI based on what would maybe have occurred if you had stayed there for 60 minutes. They have to base there numbers on hourly indexes for reporting. It's unlikely that you would have continued having events of that number if they had stayed at the 5 cm point for an hour.
If that was the case your overall AHI from the initial diagnostic study would have been 10 times what you ended up with.
Example for ease in figuring. If you we are looking at one minute with 1 event during that minute at 5 cm..to make that into an hourly index they have to multiply everything by 60 minutes...so then we end up with hourly index of 60. In real life we may or may not have apnea events at the rate of 1 a minute over a real hour. Most often we have maybe a couple of events and a period of time with nothing and then maybe another event and then maybe another period of time with nothing happening.
The fact that your initial diagnostic study ended up with AHI 11 something tells me that you had some periods of time with nothing happening.
Now it is also possible that your AHI might have been a little higher if you had slept longer during the diagnostic study and had more REM if your OSA happens to be worse in REM. It doesn't really matter at this point though. You made criteria for needing the cpap machine and time to move forward with it.

Since you have been lurking here for some time I assume you probably have read some of the informational posts about what to look for in a machine but I will give you a couple of blogs to get you started just in case you haven't seen these.
full data machine information
http://maskarrayed.wordpress.com/

what to know and do before you meet your DME (cpap equipment supplier if you have insurance)
http://maskarrayed.wordpress.com/what-y ... me-part-i/

If you don't have insurance...you most likely can do better shopping online. If your sleep center also wants to supply your equipment...watch closely because sometimes they provide the most basic of machines and charge full retail so that the profit margin is greater. Know your models and which offers full efficacy data.

Guest wrote:And now the waiting game is on! Let me tell you, now that I've been diagnosed and prescribed, it's so much worse waiting knowing that good sleep is just around the corner! Lol.

Hi,

I don't know why they play this game. If you have a health threatening condition, and there is a treatment available, why don't they get you a machine that same day? I think I had to wait 3 or 4 days, and it was like agony after how well I slept in my titration study--which was the first time in years that I slept for than about 45 seconds at a time.

-john-

jweeks wrote:

Guest wrote:And now the waiting game is on! Let me tell you, now that I've been diagnosed and prescribed, it's so much worse waiting knowing that good sleep is just around the corner! Lol.

Hi,

I don't know why they play this game. If you have a health threatening condition, and there is a treatment available, why don't they get you a machine that same day? I think I had to wait 3 or 4 days, and it was like agony after how well I slept in my titration study--which was the first time in years that I slept for than about 45 seconds at a time.

-john-

That doesn't sound terrible to me. From start to finish, it took me six months to get my machine.

Two sleep studies, months apart. A couple of months later a titration study. Then a month after that I had an appointment with the DME.

I was lucky at the DME, because at that time I was clueless about the different machines, data recording ability, etc. They sent me home with an Autoset S9, no argument.

jweeks wrote:
Hi,

I don't know why they play this game. If you have a health threatening condition, and there is a treatment available, why don't they get you a machine that same day? I think I had to wait 3 or 4 days, and it was like agony after how well I slept in my titration study--which was the first time in years that I slept for than about 45 seconds at a time.

-john-

I hear you. I'd love to have already slept with it by now. I'm hoping I get a call Monday and can schedule the appointment for either that day or not long after.

Pugsy wrote:Since you have been lurking here for some time I assume you probably have read some of the informational posts about what to look for in a machine but I will give you a couple of blogs to get you started just in case you haven't seen these.
full data machine information
http://maskarrayed.wordpress.com/

what to know and do before you meet your DME (cpap equipment supplier if you have insurance)
http://maskarrayed.wordpress.com/what-y ... me-part-i/

Oh definitely. I've got the questions already listed out for when I call up my insurance =D

Guest wrote:
And now the waiting game is on! Let me tell you, now that I've been diagnosed and prescribed, it's so much worse waiting knowing that good sleep is just around the corner! Lol.

I was very similar. I had a split night study, and I dreaded it. They woke me up about 2 1/2 hours in and put me on the machine. I rolled over and slept for 5 hours. Amazing. The next night, at home, I had a dream where the doctor wouldn't schedule an appointment for 6 months. I was so angry as I wanted to get my machine. Then I woke up and realized it was just a dream. Amazing though that in my sleep, my brain knew it wanted a cpap machine right away. I didn't realize how bad my sleep was until that one good night showed me the difference.

zoocrewphoto wrote:

Guest wrote:
And now the waiting game is on! Let me tell you, now that I've been diagnosed and prescribed, it's so much worse waiting knowing that good sleep is just around the corner! Lol.

I was very similar. I had a split night study, and I dreaded it. They woke me up about 2 1/2 hours in and put me on the machine. I rolled over and slept for 5 hours. Amazing. The next night, at home, I had a dream where the doctor wouldn't schedule an appointment for 6 months. I was so angry as I wanted to get my machine. Then I woke up and realized it was just a dream. Amazing though that in my sleep, my brain knew it wanted a cpap machine right away. I didn't realize how bad my sleep was until that one good night showed me the difference.

I can't wait until I can start resting easy knowing I'm getting the kind of sleep I need. I noticed in the introductory paragraph of my titration results that I only got 1.7% N3 sleep, or 7.5 minutes. I had a dream before I got the results back that they recommended a 35cm pressure..I was thinking to myself in the dream That's not even possible! but thankfully it came back with a recommended 11cm.

I'm hoping that the call comes in from the DME tday wanting to set up an appointment -- and I'd be stoked if the appointment is today, too!