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Cured??
#1
Question 
I had my original sleep study about 12 years ago. Actually they did it twice, because I didn't sleep enough the first time (like anyone could with all the wires and CPAP). So I turn 65 and am starting Medicare and my new Pulmonologist can't find my original sleep study so orders an in-home study. You basically wear chest and abdominal belts, a finger sensor, and oxygen tubes and the machine does all the monitoring. Now mind you, I am the heaviest I've ever been (working on that), my health is a lot worse than it was 12 years ago, and my wife who is a nurse says I still snore and have apnea when I fall asleep in the recliner. So this new in-home study apparently shows I do NOT have sleep apnea. The nurse calls to tell me that and when I ask her if I am supposed to stop CPAP, they go in to consultation mode and will call me back. Has anyone ever had this happen?  Tom Airsense Auto CPAP (P=10 ave) ResMed Airfit N20
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#2
I suspect that there is something wrong with the recording software. Gaining weight does not improve apnea. Smile You do have an auto machine right? Can you download Sleepyhead and import your data and upload a graph? Better yet, you could switch to apap mode and see what pressures you NEED versus what you were ASSIGNED.
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#3
Yes to the above! Let's see what an auto machine sees your body as needing.
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#4
If you've been using the machine and it has a good wireless connection you can log onto Remed's MyAir site and see your AHI reported as events per hour. It's not a substitute for SleepyHead but it does track AHI pretty well. You may nered to set up an account if you don't have one but it's easy.

I agree with Mosquitobait that you should use SleepyHead but MyAir would give you and immediate answer. If you have 5 or more events per hour you still have apnea.

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#5
Home sleep studies are prone to false negatives, that can result from incomplete data, improper attachment and setup of sensors, and dilution of study results with awake monitoring due to no EEG to determine sleep onset. These studies do not measure RDI but generally do detect OSA, provided that there is a good resolution in the flow monitor and respiratory effort belt.

It's extremely unlikely that you were spontaneously cured of OSA. You are an older man, presumably in your 60s now on Medicare, and your risk factors have increased. The home sleep test would have required you to discontinue your CPAP treatment on the test night, and that may also affect results, especially if you didn't sleep well. It would be interesting to view the raw output charts. I think you need to repeat a clinical study with PSG.

Your story points to the importance for each of us to retain printed copies of our own important health records, especially sleep studies whicih are very expensive to repeat, and usually required to be shown to qualify for insurance and medicare.
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#6
(03-17-2017, 04:07 PM)Melman Wrote: MyAir would give you and immediate answer. If you have 5 or more events per hour you still have apnea.

MyAir only shows treated apnea.  You could have an AHI of 67 untreated and less than 1 treated, so MyAir isn't all that useful for determining whether or not you still have apnea or not.
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#7
Thank you all for your comments. Sorry it took so long to respond, as I didn't get notices of posts (likely my fault). So to answer all the questions, I have an ResMed Auto 10 and my ResScan software shows Apnea Index of 0.4, Obstructive of 0.3, Hypopnea Index of 0.2, and AHI of 0.6. Mean pressure is only about 7.6. I, of course, wasn't using my CPAP during the two night home study. My previous BiPAP was about 12/7 based upon my original hospital sleep study.

I am in the process of getting my original sleep study from 15 years ago as well as my recent in-home study. My pulmonologist is reviewing everything and I am not looking forward to another hospital study, which I am sure is what he will schedule. Maybe they will give me something to sleep so that I don't have to do it twice again.

I will post more when I get it - thanks for the comments.  Tom
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#8
Tom, do ask ahead of time for a sleep aid. Most docs find it more important to get data than to worry about the small effect sleep aids may have on your data. If you don't sleep, no data! And please, something other than Ambien!! That stuff is scary.
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#9
As one who normally is very sensitive to meds, I didn't have any problems taking ambien for a sleep study.   Unfortunately, I only slept 3 hours which didn't prevent my getting a diagnosis but probably underestimated the severity of my situation.

As always, your mileage will vary with meds.

49er
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#10
(03-18-2017, 09:53 PM)Mosquitobait Wrote:
(03-17-2017, 04:07 PM)Melman Wrote: MyAir would give you and immediate answer. If you have 5 or more events per hour you still have apnea.

MyAir only shows treated apnea.  You could have an AHI of 67 untreated and less than 1 treated, so MyAir isn't all that useful for determining whether or not you still have apnea or not.

There was some confusion expressed in PM by my post, so let me clarify.  The AHI is accurate.  However, that number alone doesn't tell you whether or not you still have apnea. 

Example: your sleep study without a mask at all resulted in an AHI of 67.  Say you were given pressure of 10 and your AHI is now 1.  Now, move your pressure down to 6 and IF you were 'cured', your AHI should continue to stay 1 or less.  BUT, AHI does not factor in RERAs.  Sleep center had to fudge my AHI numbers to 5 to avoid paperwork, but my RDI was 33.  So, yeah, I had apnea, but MyAir isn't going to show RERAs, only apneas and hypopneas (and Medicare doesn't care about RDI whatsoever).  So, that is where Sleepyhead helps you a lot as it maps out all of that.

FWIW - discussions at Sleep Doctor conferences indicate that patients should be treated with an AHI of 3 or more, but Medicare mostly runs the show in determining what they pay for and insurance companies follow the dog.
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