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[Diagnosis] A bit lost after WatchPat result
#1
A bit lost after WatchPat result
[attachment=31892][attachment=31892]I have suffered from unexplained fatigue for much of my adolescence, which has only worsened as i progress through 20s. Doctor's in the UK have refused to give me a sleep test as I don't meet their weight requirements. As a result, I payed for a private WatchPat test, the results of which are below. Their conclusion was that I don't have apnea. I was wondering what people on this forum thought of my results. Thank you in advance for any help offered.


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#2
RE: A bit lost after WatchPat result
Hi Hms123!  -  Welcome

EDIT: I misread your sleep results when making the post below. - Sorry!

Based on the following chart copied from Harvard's website, you have severe borderline mild apnea.  Please take this classification with several grains of salt.  I feel that it is more a scare tactic than being truly informative.  Many of us have had pretreatment AHI values in the 80s to the high 90s.   Based on the accepted chart below, we would be well past redemption. Big Grin   The bottom line is something is effecting your sleep.  Your RDI is of significance, followed by your AHI.  If you decide to do it on your own, look for an auto-titrating CPAP.  The most recommended is the Resmed AirSense10 Autoset.

Harvard.edu Wrote:Apnea Hypopnea Index (AHI)

The AHI is the number of apneas or hypopneas recorded during the study per hour of sleep. It is generally expressed as the number of events per hour. Based on the AHI, the severity of OSA is classified as follows:
  • None/Minimal: AHI < 5 per hour
  • Mild: AHI ≥ 5, but < 15 per hour
  • Moderate: AHI ≥ 15, but < 30 per hour
  • Severe: AHI ≥ 30 per hour


Please keep us informed of your decision.

Good luck!
- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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#3
RE: A bit lost after WatchPat result
Welcome to the forum.

IMHO you just missed a diagnosis of Mild OSA in the states. Your AHI was 4.8 with 5 needed for a diagnosis.
With RDI of 17.2 and AHI of 4.8 you likely have a mild/moderate UARS, Upper Airway Resistance Syndrome.

Note: This may or may not be causing your fatigue.

Dr. Krakow has said that UARS, RERA, and Flow Limits may be considered the same thing. The best machine for this is a BiLevel such as ResMed VAuto.
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#4
RE: A bit lost after WatchPat result
Dr. Krakow has said that UARS, RERA, and Flow Limits may be considered the same thing

He may have said that but they really shouldn't be - they each describe distinct phenomena. A flow limitation is flattening of inspiratory portion of the flow curve. When a sequence of flow limitations lasts >10 seconds and ends in arousal, it becomes a RERA (assuming it doesn't meet the criteria for hypopnea). When someone has an AHI <5, but RDI (AHI + RERAs/hr) >5, they were historically considered to have UARS. Someone with an AHI of 10 and RDI of 15 has RERAs and flow limitations, but they do not have UARS. Someone with occasional flow limitations without arousals does not have RERAs or UARS.

Under current AASM definitions, an RDI of 17 is moderate sleep apnea. Historically, AHI <5 and RDI >5 was considered UARS, but now UARS and sleep apnea are considered the same disease, and the AASM considers RDI >5 to be sleep apnea with symptoms, or RDI >15 regardless of symptoms. 


https://aasm.org/resources/clinicalguide...ng-osa.pdf

> The third edition of the International Classification of Sleep Disorders (ICSD-3) defines OSA as a PSG-determined obstructive respiratory disturbance index (RDI) ≥ 5 events/h associated with the typical symptoms of OSA (e.g., unrefreshing sleep, daytime sleepiness, fatigue or insomnia, awakening with a gasping or choking sensation, loud snoring, or witnessed apneas), or an obstructive RDI ≥ 15 events/h (even in the absence of symptoms).23 In addition to apneas and hypopneas that are included in the AHI, the RDI includes respiratory effort-related arousals (RERAs). The scoring of respiratory events is defined in The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.3 (AASM Scoring Manual)
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