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Confused about by sleep study and next steps
#1
Question 
Confused about by sleep study and next steps
Hi everyone. I'm new here and trying to figure this whole apnea thing out. Here's the deal...

I snore terribly (according to my wife), although I don't seem to have a lot of other apnea symptoms. I did an at-home sleep study in January and just received the results yesterday. My overall AHI was 19.4, so I have moderate apnea, which is about what I expected. What I didn't expect was the huge variation depending on my sleep position. Sleeping on my back (which is not typical -- only an hour during the night) my AHI jumped to 51.5. Sleeping on either side it was 4.5.

Is that big of a difference common? Do I really need to look at treatments, or should I try one of the many tricks to keep me from sleeping on my back? I'd rather not have to deal with a CPAP unless I absolutely need to.

My doctor was uniquely unhelpful. The discussion was pretty much:

Doctor: Hi. You have mild apnea. You can choose Inspire surgery, CPAP or a dental appliance. Which one?
Me: Uh... CPAP? I guess?
Doctor: Great. Set up an appointment on your way out.

And that was it. I know I should have asked more questions and stuck around until I got the information I needed, but I was caught off guard, and still mentally trying to process multiple pages of sleep study data in real time. So here I am trying the get the details I didn't get from the doctor.

Is there a benefit to trying CPAP even if my side-sleeping AHI is only 4.5? I snore even when sleeping on my side, so do I try it just to see if it helps with the snoring?

I'm very confused.
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#2
RE: Confused about by sleep study and next steps
Ugarte,

I'm new here too, so I may not have a great answer... BUT, they do make pillows to keep you off your back (google: positional sleep belt).  You might want to try that and see if it helps.

As far as whether you should advance your therapy with a CPAP machine... at 4.5, that's just below the 'normal' range and could have just been a measure for the night you took the test.  (Meaning, it could possibly go above that range, on other nights).

I would call the Dr. to discuss the matter and see what he thinks.... (a phone call might save a trip and save a visit).

Wishing you the best, whatever you decide!!
DreamBreather  Coffee
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#3
RE: Confused about by sleep study and next steps
Hi Ugarte,

And welcome to the Apnea Board. Since you're dealing with an overall AHI of 19.5, if it were me, I'd rather choose CPAP than either of the other choices. Most that do those other methods still need a CPAP eventually anyway.

You remind me of myself in that I didn't wish to get a CPAP. It came to a point that I delayed treatment for a while and I'm worse for that delay. I'm not going to kid you, for some, getting used to CPAP can be real hard, but be assured it's well worth your effort to do it.

I ask you to view the beginner info in my signature below to learn a little bit. Everyone here at Apnea Board will do all we can to help with therapy, tips, and encouragement. But it's your choice to do this or not. Not attempting to be anything other than helpful.

Again, a warm welcome. Ask whatever you want to assist in learning.

lots-o-coffee

PS if you choose getting a CPAP, we have info on helping you decide on a good machine choice. I ask you to view that info and the DME info too. A DME represents those that sell you the device and mask.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Confused about by sleep study and next steps
I just had a sleep study done as well. My results indicated I have a far higher apnea rate when sleeping on my back. I suspect a CPAP is your best solution if you are willing to stick with it. I was very very reluctant to use one, but I am being slowly won over. The first night I was ready to get up and throw it out the window, but actually stuck it out and got about 6 hours of actual sleep.

Are there any insurance issues. With a moderate AHI rating as you have, some insurance companies will only pay for a fixed pressure CPAP rather than an Auto model. If you can manage it, I would go for the Auto model. I think it is easier to get started. The ResMed AirSense 10 AutoSet is commonly used model that gives good results, based on my research. I have one on order.

Are there local companies that will give you a trial machine at no cost. That is commonly done here, but most often they want a very high price when it comes time to buy it. On line companies offer much lower prices.
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#5
RE: Confused about by sleep study and next steps
FWIW Here's a link to our wiki Patient Empowerment It has DME selections, machines info, etc. I believe it will be helpful at this beginning stage. Thanks and best to your success in getting healthier.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Confused about by sleep study and next steps
Ugarte,

It is not uncommon to have an experience with the doctor where they say you've got a problem and these are your options so what are you going to do about it?

The key is you are ultimately responsible for your healthcare and that's good because no one knows you better than you. ScarcasticDave had some great advice about clicking the links on this website and educating yourself.

You will find that even when dealing with equipment providers and resperitory therapists you are going to get shoved through the system. You've come here in time though, as you start this process, because you need to go into your appointments informed and fresh with ideas that will get you the right service from these medical providers the first time.

Read up and ask lots of questions. This website is very informative and everyone is eager to help.

Welcome to Apnea Board!
Jesse


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#7
RE: Confused about by sleep study and next steps
Thanks everyone for the information.

I have an appointment set up in early April at the doctor to figure out the CPAP, so I guess the doctor's office is the DME. Is that typical?

The doctor mentioned that they have ResMed and Phillips. Other than that I have no idea. I'll give them a call on Monday and see if I can get more details on equipment and pricing. I'll also need to call my insurance and figure out exact coverage. The doctor said my insurance has a "lease to own" program where I pay for 12 months and then own it. I'm not sure of the details, so I clearly have some additional homework to figure it all out.
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#8
RE: Confused about by sleep study and next steps
Positional differences are common and can be dramatic. If you have an OSA diagnosis, get the CPAP. Surgery is pretty serious, has a low rate of success, and a high rate of OSA recurring during the first year. CPAP might seem like a pain in the rear, but once you get used to it it's no big deal.
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#9
RE: Confused about by sleep study and next steps
(03-24-2018, 06:10 PM)Ugarte Wrote: Thanks everyone for the information.

I have an appointment set up in early April at the doctor to figure out the CPAP, so I guess the doctor's office is the DME. Is that typical?

The doctor mentioned that they have ResMed and Phillips. Other than that I have no idea. I'll give them a call on Monday and see if I can get more details on equipment and pricing. I'll also need to call my insurance and figure out exact coverage. The doctor said my insurance has a "lease to own" program where I pay for 12 months and then own it. I'm not sure of the details, so I clearly have some additional homework to figure it all out.

I strongly encourage you to do the math before you commit to buying a machine from a Doctor/DME. Go in with notes on what a machine costs buying it from an online seller and compare his offices costs. Don't get duped, you have options.
Jesse


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#10
RE: Confused about by sleep study and next steps
Do the math.  Check online prices for the CPAP, you might pay significantly less than your deductible that way.

Get your first mask from the DME and don't be shy about asking to try different masks until you can find what works best for you.  After that, buy replacement masks online.
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