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[Diagnosis] Had at home sleep study done not sure about results
#1
I have been fatigued/tired/lethargic for a long time but only recently about 5 or 6 months ago I've developed insomnia where I sleep for a few hours then constantly fully consciously awake the rest of the night every hour or so, usually during dreams so I feel even crappier now than before.

I had the study done to see if I had apnea and of course with my insomnia I had a hard time falling asleep and staying asleep and the machine was recording for around 8 or 9 hours so I know I didn't sleep the entire time, maybe 5 or 6 hours total, I'm not certain. Anyway the results show little to no apnea but I had a moderate amount of hypopneas. Overall the data showed I had 8.9 AHI with 11.5/h supine and 8.9 hypopneas supine. Oh and my pulse spikes to around 100 every once in a while, is this spike normal?

I gather this per hour includes all 9 hours it recorded? So in essence if I actually slept for that long the AHI would be much higher correct? The nurse just said I didn't have sleep apnea and sent me off. Would a cpap/apap help me at all? Is this home lab kit (NOX-T3) over or under estimating my sleep breathing issue, might I have UARS? Any help is appreciated.

Here are the results:
  • http://i.imgur.com/OTP6DQ5.jpg
  • http://i.imgur.com/QviU64c.jpg
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#2
I tried cutting and pasting your links and they did not go any where. It would be good to see what you are trying to show. Please check the links.

Car54
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#3
Hmm weird they work for me. it won't let me link without 4 posts, don't want to spam. I'll try to fix them though, thanks for looking.
  • http://imgur.com/OTP6DQ5
  • http://imgur.com/QviU64c
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#4
(02-15-2017, 07:17 PM)Bobbyjones Wrote: Hmm weird they work for me. it won't let me link without 4 posts, don't want to spam. I'll try to fix them though, thanks for looking.
  • http://imgur.com/OTP6DQ5
  • http://imgur.com/QviU64c

Photo Assist:
[Image: OTP6DQ5.jpg]


[Image: QviU64c.jpg]
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#5
Thanks for posting them
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#6
(02-15-2017, 06:48 PM)Bobbyjones Wrote: I have been fatigued/tired/lethargic for a long time but only recently about 5 or 6 months ago I've developed insomnia where I sleep for a few hours then constantly fully consciously awake the rest of the night every hour or so, usually during dreams so I feel even crappier now than before.

I had the study done to see if I had apnea and of course with my insomnia I had a hard time falling asleep and staying asleep and the machine was recording for around 8 or 9 hours so I know I didn't sleep the entire time, maybe 5 or 6 hours total, I'm not certain. Anyway the results show little to no apnea but I had a moderate amount of hypopneas. Overall the data showed I had 8.9 AHI with 11.5/h supine and 8.9 hypopneas supine. Oh and my pulse spikes to around 100 every once in a while, is this spike normal?

I gather this per hour includes all 9 hours it recorded? So in essence if I actually slept for that long the AHI would be much higher correct? The nurse just said I didn't have sleep apnea and sent me off. Would a cpap/apap help me at all? Is this home lab kit (NOX-T3) over or under estimating my sleep breathing issue, might I have UARS? Any help is appreciated.

Your results show mild to moderate mixed sleep apnea with mostly hypopnea.  This is accompanied by moderate oxygen desaturations to 89% and this would explain the sense of fast heart rate/tachycardia.  This is sufficient evidence for a physician or other professional to diagnose sleep disordered breathing and recommend or prescribe auto CPAP, or refer you for more evaluation with full PSG. 

Home studies have some inherent uncertainty and generally under-estimate events, so you may have more apnea than shown, and the reliability for detection of central vs obstructive is not perfect.  I would probably pursue an auto CPAP based on this and watch the data results after a period of adaptation to see if centrals remain a concern.  I think you'll do fine. 

Do you have a prescription, plannng to get one, or are you going to be purchasing online without one?  Little doubt you will benefit from CPAP.
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#7
(02-15-2017, 08:15 PM)Sleeprider Wrote:
(02-15-2017, 06:48 PM)Bobbyjones Wrote: I have been fatigued/tired/lethargic for a long time but only recently about 5 or 6 months ago I've developed insomnia where I sleep for a few hours then constantly fully consciously awake the rest of the night every hour or so, usually during dreams so I feel even crappier now than before.

I had the study done to see if I had apnea and of course with my insomnia I had a hard time falling asleep and staying asleep and the machine was recording for around 8 or 9 hours so I know I didn't sleep the entire time, maybe 5 or 6 hours total, I'm not certain. Anyway the results show little to no apnea but I had a moderate amount of hypopneas. Overall the data showed I had 8.9 AHI with 11.5/h supine and 8.9 hypopneas supine. Oh and my pulse spikes to around 100 every once in a while, is this spike normal?

I gather this per hour includes all 9 hours it recorded? So in essence if I actually slept for that long the AHI would be much higher correct? The nurse just said I didn't have sleep apnea and sent me off. Would a cpap/apap help me at all? Is this home lab kit (NOX-T3) over or under estimating my sleep breathing issue, might I have UARS? Any help is appreciated.

Your results show mild to moderate mixed sleep apnea with mostly hypopnea.  This is accompanied by moderate oxygen desaturations to 89% and this would explain the sense of fast heart rate/tachycardia.  This is sufficient evidence for a physician or other professional to diagnose sleep disordered breathing and recommend or prescribe auto CPAP, or refer you for more evaluation with full PSG. 

Home studies have some inherent uncertainty and generally under-estimate events, so you may have more apnea than shown, and the reliability for detection of central vs obstructive is not perfect.  I would probably pursue an auto CPAP based on this and watch the data results after a period of adaptation to see if centrals remain a concern.  I think you'll do fine. 

Do you have a prescription, plannng to get one, or are you going to be purchasing online without one?  Little doubt you will benefit from CPAP.

Well the doctor didn't even talk to me, it was a nurse and basically said I don't have sleep apnea and to go back to my PCP, so I might have to just buy a cpap device myself, I was looking at Respironics dx500t11 and I'm not sure what mask, I'm pretty sure I don't breathe through my mouth ever, or suffer some more and try to get an in lab study done. This was my first sleep study. Thanks for your help.
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#8
Notice that you do much better not sleeping on your back.
Obstructive apnea is 6.5 times higher on your back (2.6 vs 0.4 )
Hypopnea is about 3.4 times higher on your back (8.09 vs 2.6)
Central apnea is 7 times higher on your back, though there aren't many of them (1.4 vs 0.2)

If sleeping on your side is not your normal position, you may find that a good bolstering pillow or reading wedge will help keep you propped on your side. Another small pillow between your knees may improve your comfort by keeping your hips aligned.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#9
I don't understand your doctor's conclusion. Home studies are good screening devices, and this one says mild sleep apnea. My wife had a full sleep study with a result of 9.4 AHI, mostly hypopnea, and was subsequently given a titration study and auto CPAP. This was insured. I would expect if you took a full polysomnograhy study, your results would likely increase, not decrease. So under insurance and medicare guidelines I'm familiar with, you qualify at 6.9 AHI overall with higher events supine. This link is the current Medicare Decision Memo for coverage. https://www.cms.gov/medicare-coverage-da...romdb=true You qualify for coverage under 2.d. and 3.b. Based on the results of your 3-channel home study and the symptoms you summarized in your first post, your PCP can prescribe based on your results if you wish. Online suppliers like Supplier #30 would look at this and issue a prescription ($99 prescription service). So it's your choice if you want a valid prescription and insurance coverage.

With a prescription, you could work with your insurance and an in-network provider to get suitable equipment. If your deductible and copay are relatively high, then getting equipment from an Amazon vendor is an obvious winner. If you go that route, take the time to inquire with the seller if they are an authorized seller of the equipment and can provide warranty support. Also look carefully that the package is complete with the humidifier, heated hose and carry case, and the seller is based in the United States. For a mask, I like the Resmed Airfit P10. It sells on Amazon for $65 and includes all 3 sizes of nasal cushion (pillows).
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#10
(02-15-2017, 09:21 PM)Beej Wrote: Notice that you do much better not sleeping on your back.
Obstructive apnea is 6.5 times higher on your back (2.6 vs 0.4 )
Hypopnea  is about 3.4 times higher on your back (8.09 vs 2.6)
Central apnea is  7 times higher on your back, though there aren't many of them (1.4 vs 0.2)

If sleeping on your side is not your normal position, you may find that a good bolstering pillow or reading wedge will help keep you propped on your side. Another small pillow between your knees may improve your comfort by keeping your hips aligned.

Yes I noticed that too, I actually feel more comfortable sleeping on my sides but some how I end up on my back at some point while sleeping. I will try wedging a pillow and see if that helps.
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