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Diagnosed with mild OSA, unsure how to proceed
Diagnosed with mild OSA, unsure how to proceed
I'm a young man who happens to have a mild case of OSA. At the very beginning of the year, I took part in an at home sleep study that pegged me at an overall AHI of 7, overal RDI of 13, Overall AHI-4% Desat of 5 and a mean SpO2 of 96.2%. This was noticed from a valid recording time of 5.85, but I'm not entirely sure if this mild case is what's behind my mental health issues.

The most disruptive problem I have with sleep is insomnia, that can affect me in either falling asleep or staying asleep. Some nights it's both, where I wrangle my brain to sleep with melatonin and magnesium and can't help but wake up after 5 or 6 hours of sleep. These nights usually see me going to bed in a very activated and stimulate mood, where I try to close my eyes and feel mild muscle spasms around my face and eyelids, restlessness, and hot body temperature. When I wake up in an insomniac episode I'm often very hot and energized, but will crash a few hours later because I obviously didn't get enough sleep.

My most present issues related to my mental health are this fog. It feels like I'm perceiving everything through a veil and have this enduring brain fog, that makes me feels spacey and clouded. I used to be very, very good at remembering things, but over the past few years, I find myself becoming prone to short term memory loss. I also find myself facing difficulty focusing on tasks at hand. Working and studying from home during the pandemic has been very difficult to remain focused, and I'm often mentally exhausted at the end of the day after finishing my work a bit late. Even finishing this post is taking much longer than expected to gather my thoughts. Even outside of an insomnia episode, I find myself quite tired throughout the day, and unable to muster the energy to pursue fitness or extracurricular goals.

All of this is difficult for me, and I've taken a number of tests over the years that have found nothing out of the ordinary. The only test to have an answer is the mild OSA diagnosis I was given, which makes sense to me. But I have some reservations that the mild nature of my OSA may be having a significant impact on my day-to-day life at all. My options are limited too, because the machines are cost prohibitive.

A doctor who's been working with me notices I have some ADHD tendencies, but not enough symptoms to warrant a full blown diagnosis. He'd rather see if treating my mild OSA will have an impact. I also happen to have TMJ, which means a mouthguard device related to OSA is probably out of the question. So I'm left with the option of purchasing a CPAP at around $1,000 CAD. This same machine is available for cheaper on Amazon, but not by much. The option to trial a machine and see how it works is no longer there; I tried to get used to one during finals season, and the beginning of our pandemic, and the stress of finishing assignments and studies was so great that I wasn't having a good enough sleep anyway. So, the results of that trial in relation to how I feel are inconclusive.

So, what do you think? Do you think there is a connection between what the sleep study says I have, and my cognitive difficulties? Or, do you think this is something that doesn't necessarily relate to it all?
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RE: Diagnosed with mild OSA, unsure how to proceed
My definitive answer is it depends. Some of the insomnia symptoms sound similar to what I went through a few years ago that had my primary doc send me for a sleep study. My data counts were higher by quite a bit. If you have a copy of the sleep study and want to post it, please do so. Make sure to redact/black out personal info so it's not visible. The detailed version would be much more informative than a summary version.

Mild numbers such as yours can indicate that apnea and related aspects are disrupting sleep and adding to insomnia. But, yes, the mild range of apnea indicated also could have nothing to do with your sleep issues. There is the third choice of apnea and other issues being the cause. If you can supply the info, it will help to find out more on what is actually going on. Has a PAP machine been scripted or has it not progressed to that point yet?

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RE: Diagnosed with mild OSA, unsure how to proceed
As far as a purchase, a slightly used Resmed (best machine) can be purchased for around 300 dollars. I purchased mine from Supplier #2 on the supplier list on the black ribbon at the top of this site. Great service and my machine had 250 hours (less than 1 month)
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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RE: Diagnosed with mild OSA, unsure how to proceed
You have obstructive sleep apnea.

It has disrupted your life enough to make you pursue some help.

Mild.  How not-mild does it need to be for anyone to care?  And what does mild mean anyway?  Even though you hold your breath x times an hour, you only do it for y amount of seconds each time.  And since you don't do it more than x times, then meh they'll just call it mild.  And since you don't do it more than y seconds, then let's just call it mild.  So what, if you held your breath another 2 seconds, then it would be worth treating?  Or if you did it one more time per hour, then it would be worth treating? 

If you have mild diabetes, you'd still treat it.

If you had mild asthma, you'd still treat it.

If you had mild clogged arteries, you'd still do something for it.

I cannot comprehend how a doctor can deprive a patient of treatment for a disorder they legitimately got diagnosed with, simply because it's "mild".

I had "mild" OSA.  My sleep "doctor" recommended I 1) lose weight, 2) sleep on my side, and 3) give it more thought.  I told him I've had these symptoms for 25 years, even when I was a 100 pound adult.  I said I toss and turn and sleep however, and never feel any better. I said there's nothing I'm going to think about now which I haven't already thought about. And then I said these symptoms are impacting my life in a severe and negative way, so how about we just *try* a CPAP sleep study.  He went for it, and I felt AMAZING the next morning!  I was the Energizer bunny after mere hours on a CPAP.  Life changing!!!!!  So I got a CPAP, and have never looked back!  I'll never go without a CPAP again.  

So the word "mild"?  I wish everyone would just eliminate it from their vocab when it comes to choking ourselves in our sleep and depriving our bodies of oxygen.
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RE: Diagnosed with mild OSA, unsure how to proceed
fwiw, I'm convinced my own ADHD, diagnosed 20 years ago at age 45, was/is caused, or at least significantly worsened, by lifelong sleep deprivation from apnea. while I'm still waiting for truly restorative sleep, I can honestly say that my cognitive abilities and inabilities have improved as sleep improves. by inabilities I mean ADHD symptoms like impulsiveness, short attention span, starting but not finishing projects, etc....

disordered breathing like apnea may not be the only thing affecting your sleep / keeping you awake, but good idea to treat your mild case to minimize the extent apnea is part of the problem. chances are high that your apnea will get worse as you age. might as well keep it in check rather than allow it to do more damage. in retrospect, I believe I've had apnea since childhood, but I didn't get cpap until I was 60. I have paid and am paying a price for that mistake.
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RE: Diagnosed with mild OSA, unsure how to proceed
First I have to ask, and I hope you won't find my inquiry too forward: Have you consulted an endocrinologist?  I'm wondering about your hypothalamus or your pituitary gland and their health.  Secondly, have you consulted a toxicologist?  I wonder if there is something in your environment, even if the exposure is only on weekends or something limiting like that.  The tremors/spasms and the heat flushes suggest to me either a metabolic syndrome or low/hi levels of metals or something else.  I realize you state that you have had tests, but....maybe a specialist, a more sympathetic or bored one, will jump all over your case.

Fact is we all react differently to life's stressors.  Two people in the same room describing the same circumstances will have different ways of describing what they have experienced and different ways of relating associated outcomes with those experiences.  Maybe, if you truly do have a low AHI, it's sufficient to put you over an imagined 'edge', particularly if something else is going on that is dragging you down some.

Your late day experience may be entirely unrelated to apnea.  It may be due to unregistered, suppressed, or forgotten matters that your subconscious is attempting to grapple with.  It could be relationships, life quality, finances, job satisfaction, unresolved matters between friends or former friends, guilt, restlessness due to feeling stalled or having lost momentum/enthusiasm for something (wanting, but not able to, continue formal education and advancement)...

This might sound a bit fluffy and not at all your cup of tea; do you keep a journal?  Do you talk to yourself, especially during long walks where only you and You are present?  Socrates tells us that the unexamined life is not worth living.  Have you recently made a concerted and honest appraisal of yourself and where you are headed?  Or maybe, as I suggested a moment ago, where you have come from and all the baggage that you're dragging?

You need to find, and to establish, peace and contentment in your life.  How you go about doing that is your problem, but if there is no underlying health matter that is more urgent, you might need to delve deeply into your being and to extract from the shadows things that need to be in the light.
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RE: Diagnosed with mild OSA, unsure how to proceed
I had similar symptoms, along with undiagnosed mild sleep apnea with AHI 13.5. Turned out I had hyperthyroidism (Grave's) which accounted for most of my symptoms, especially insomnia, anxiety, feeling hot all the time, restless legs, twitching eyelids, facial, and leg muscles, etc, all of which mostly resolved after the thyroid treatment by my endocrinologist. Recently diagnosed sleep apnea treatments are helping with residual tiredness, mental fog, and a general lack of restful sleep. I'm sure they checked your thyroid hormone levels, correct?
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RE: Diagnosed with mild OSA, unsure how to proceed
Nadnerb, there are a lot of good pointers and comments in this thread. I want to focus for a moment on your RDI of 13. The RDI, unlike the AHI, includes respiratory-effort-related arousals (RERAs).

The American Association of Sleep Medicine supports the use of RDI:


Summary: "The definition of OSA has evolved over time as research has continued to improve our understanding of the pathophysiology and significance of sleep-related breathing disorders. Current evidence emphasizes the importance of using arousal-based scoring of respiratory events when evaluating patients suspected of having OSA."

RERAs, like apneas and hypopneas, can disrupt sleep "architecture": the sequence of sleep stages that allow sleep to be restorative. Fragmented sleep can cause the kinds of cognitive problems you're experiencing.

An RDI of 13 means your sleep is being disrupted by breathing problems on average once every 4 minutes. If your RDI were 15, your diagnosis would be "moderate."

I would strongly recommend getting a prescription for a ResMed Airsense 10 Autoset For Her* machine, plus mask of your choice. You can then shop for a lightly used machine, as suggested by StaceyBurke. Your experience may not be as quickly transformative as Hydrangea's -- for most of us it's a more gradual process -- but PAP treatment could really make a difference for you.

I would also pursue some of the other medical questions raised in the thread. People's sleep can be disrupted by several factors, each of which must be addressed.

Keep us posted, would you?

* For Her just means it has one extra mode of operation; that mode can benefit men as well as women. If you can't find a For Her, get a regular ResMed Airsense 10 Autoset.
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