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Can I use my ResMed A10 Autoset to test AHI?
#11
(09-20-2014, 04:00 PM)herbm Wrote: I also think those Pulse Ox tests are better than they are given credit -- there are some issues with them, but when we consider that WITHOUT low saturation events, OSA would probably be pretty irrelevant.

Again, they aren't perfect but they are PROBABLY all that would ever be needed by 99% of the people out there. If you have a lot of desaturations, get a machine, if not (and your symptoms aren't noticeable) what could a machine do?

That's a common misconception, but it's wrong. Your 99% number is WAY too high.

Even with no O2 desats at all, apnea can cause a lot of physiological effects in your body.

Apnea can disturb your sleep. Some people get no REM sleep at all. Some may only get certain stages of sleep. Some are disturbed so often during the night, they're semi-conscious, but it's almost like not sleeping at all.

Imagine how you'd suffer if someone slapped you awake every time you dozed off for several nights. That's one way they torture people.

When you have an apnea, your brain eventually panics. Your heart races. Your glands release adrenaline and other stress hormones. Your heart races. Your blood pressure jumps up. Your breathing muscles start fighting to breathe. Your brain has a psychological response. You may wake up, or at least change sleep stages.

Eventually, you "arouse", get some air and the apnea is over. However, the hormones are still there. Your brain is still disturbed. Your BP and pulse are still elevated.

Some apneacs arouse and start breathing before their SpO2 drops, but there are still a lot of potentially harmful effects of sleep apnea. You don't have to have O2 desats to increase your risk of high BP, stroke, etc.

Doctors tend to emphasize O2 desaturation because it's easy for the apnea patient to understand. It's not the only thing to worry about, maybe not even the most damaging for many patients.

An overnight oximetry is a useful thing because it may give a strong indication of sleep apnea. It's not definitive. It's useful for screening. It's dangerous to assume a good overnight pulseox means you don't have apnea.

Think of an oximetry test as being like snoring. If someone knows they snore, there's a really good chance they have apnea. However, some apneacs don't snore. It would be dangerous to assume no snoring means no apnea.

There are other indications of apnea such as tiredness or not being able to sleep. Quite a few severe apneacs don't have these symptoms.



Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#12
Archangle; your post is the best I have read in a long time.
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#13
Kudos to archangle! A very well written answer.
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#14
You could just use a camera and record her sleeping. Maybe something to cover her eyes and low light. May not get the whole night but an hour or two will tell you lots. When I did this it only lasted 20 minutes, but within five minutes I was choking out every thirty seconds. It is a little unsettling to watch if there are problems but that was the same exact outcome of my full on sleep study 120 events per hour.

I think the machine will skew the results and it is hard for it to not treat the events it sees and then you won't see all of the events. I do hope you get something figured out, as you know when you need it you really need it.
Good Luck!

Doc J (despite my nickname I am not a doctor)

Remember to donate to the board if you can, it has helped a lot of people including myself.
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#15
Also you should consider using a small self contained digital audio recorder. It's a $30 item at Walmart. It will pick up the sounds of inhaling, exhaling, body movement and choking (and some other sounds that can be embarrassing). I was surprised at how sensitive it is. I used 2" wide clear packaging tape to hold it to the upper chest area of my tee shirt. It worked beautifully to record the ghastly sounds of a typical sleep apnea sufferer (me). It's also easier to convince the sufferer that they have a problem by playing their sleep sounds back to them as opposed to showing them a graph that they may not understand.

Upon replay, it displays the elapsed time (records 700 minutes) along with the sound track so you can correlate events to the time of night when they occurred.

I still use mine occasionally by taping it to my air hose near the mask just to see how my breathing sounds correlate with the apnea events that ResMed and Sleepyhead show. It's a splendid device for lots of other purposes as well.

HTH

Sleep-well

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#16
Based on last nights test, the chances of Carol having significant OSA are minimal to none.

She did manage to sleep with the mask with no real trouble (Hey, it's a P10 and I taught her just enough to deal with it including using Lanolin before putting it on and trying to avoid messing with it.)

The pressure stayed down around 4 to 6 and she had less than 1 event per hour, mostly around times she was waking or going back to sleep.

Is it possible the low pressure managed a real case of OSA? Yes, but not likely a significant one.

It was pretty surprising to me that she didn't have more events and/or the pressure didn't need to come up quite a bit higher.

I was expecting 'indeterminite' results AT BEST (maybe 5-ish and with some higher pressures.)

BTW, she did report that I SNORED and it surprised her, "Hey, I haven't heard that noise in many months." Smile


Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#17
Very interesting and thanks for the report. One question...did you hear her snoring or did she sleep more silently than usual? I'm not implying that the lack of snoring would mean that the low pressure could have indeed cured her of OSA but it might tend to justify further testing.
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#18
I don't usually hear her snoring (only sometimes and usually only softly when I am already awake) so "not hearing" it last night was not a significant change.

It's a valid enough result that I am going to stop encouraging her to see the sleep doc (she has been procrastinating on that possibility for months at my suggestion.)


Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#19
(09-21-2014, 09:45 AM)herbm Wrote: The pressure stayed down around 4 to 6 and she had less than 1 event per hour, mostly around times she was waking or going back to sleep.

Is it possible the low pressure managed a real case of OSA? Yes, but not likely a significant one.
Those events that the machine did not prevent, we don,t know how many events that the machine managed to prevent

The machine have limitation, cannot diagnose sleep apnea, you need a sleep study for that

Did she wake up with headache this morning like other mornings or no headache and feeling somewhat better


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#20
Headache -- pretty much as usual.

Since there were essentially no real events it is HIGHLY unlikely the machine helped her.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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