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[Diagnosis] My short story so far. (Multiple Questions)
#1
My short story so far. (Multiple Questions)
About 2 weeks ago i underwent a sleep study after a family member witnessed me stop breathing while i sleep. 

It was quite easy to decide to do the study after that since ive always been tired, was already over weight and have an entire family history of heart problems. My concentration and memory problems i have always attributed to my ADHD.

The results where:
AHI : 96
AI    : 84
DESATURATION INDEX : 92
LOWEST O2   : 55%
AVERAGE O2 : 86%

According to my research this is quite severe and yet the same night i went for my study another patient came in for his titillation and he had similar results for his first study. If its so severe, whats the chances that i would meet someone with such similar results? (i think im just second guessing the diagnosis.)  My other issue is, if its so severe why havent i been experiencing the more severe symptoms i read about. I mean i have always been tired, kinda just assumed that's life but i have never fallen asleep while working or driving. Sure there has been close calls while driving but its always felt like it was the glare from the sun light that made me barely able to keep my eyes open... Yet i never actually fell alseep like all the websites claim. 


The other issue i have is, ive kinda always been tired. My over weight might be the cause of OSA (Im 24 now) but even in primary school i was always yanning and back then i wasnt over weight. How would i even know if i have a central apnea instead of OSA? I suppose this is something should ask the doc but my GP didn't study apneas and even told me he doesn't know anything about it. The place that did the test dont give advice, they only test. They would refer me after the titillation to another company that would supposedly give me some advice but they actually sell cpap machines, i doubt any of their advice would be unbiased.

I am to under go a titillation study in a couple of days. 

This entire thing has been quite rough since i really cant afford the 900 dollars a cpap machine cost in South Africa... Just as i was starting to plan on where ill get the credit my GP called and said someone had given him a Cpap machine which he would give me for free since he had no use for it and obviously the testing centre had forwarded my results to him. The Cpap is a resmed S8 autoset Spirit ii and a H4i humidifier with just under 70 hours runtime. I realise its not a machine recommended by this forum but i think for now, ill have to stick with it. Would anybody recommend i try to sleep with it the night before my titillation or would that scew the results of the
 study?
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#2
RE: My short story so far. (Multiple Questions)
Welcome to the forum.
Worst case is you have a good backup machine. This machine is 2 generations old. It was followed by the S9 series and currently the Airsense 10series.
Does this machine have a SD card in it? You will want/need one.
On the top of the page is link called CPAP Machine Setup Manuals (or something like that. Click on it and get a copy of the man.

Search this site for Rescan software. This will provide charts of how your machine did overnight. After your first night use post them here.

Use right away yes. With these settings

Mode Auto
Min pressure 7
Max Pressure 20
EPR 3

Many patients skip the titration study and are sent home from their diagnostic study with similar settings.

Expect us to suggest to change them after your first night.

Read the Mask Primer and the "Success" link in my signature and the organize link for Sleepyhead as that will say what charts we would like to see.

Keep your posts in this thread so there is a history.

Go ahead with the titration study as they will indicate your. Oxygen levels with CPAP.
I obviously don't have the details but in the US under Medicare you would qualify for supplemental oxygen overnight.

Fred
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#3
RE: My short story so far. (Multiple Questions)
G'day Smileyman. Welcome to Apnea Board.

The Resmed S8 series is somewhat obsolete now, but a low-hours machine will still give you good therapy. The problem is that they do not use a standard SD card like later machines, but a Resmed proprietary card which requires a special card reader to download to your computer. These are likely to be very hard to get hold of now. In the (unlikely) event your machine has the card and reader then you're all set. Otherwise, it's time to get Googling. If you can't get hold of one, then you'll need to use whatever data the machine displays on its screen.

Quote:I am to under go a titillation study in a couple of days.

Lolabove Sounds like fun! I think the word you're looking for it titration.  Smile
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#4
RE: My short story so far. (Multiple Questions)
Smileyman, that is a very impressive AHI and especially low oxygen saturation. I think S8 Autoset Sprint will provide good control of obstructive apnea, but without data it would be worthwhile for you add an inexpensive recording oximeter. A recording oximeter like the Contec CMS 50DL can be had for as little as $30, and the more comfortable CMS 50F which is worn on the wrist is about $100. You can find these on Supplier #19, and they should be available to you on Ebay, Alibaba and other auction sites. Alternatively your doctor may loan you an oximeter to verify the efficacy of your CPAP treatment. Your oxygen levels are dangerously low for your long-term health, and it would be helpful to know if CPAP helps to normalize them or if you should be considered for supplemental oxygen at night.

With regard to data, your machine produces some on-screen information on AHI that you can access. Be sure to order the free provider manual from Apnea Board to learn how to access it https://www.apneaboard.com/adjust-cpap-p...tup-manual
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#5
RE: My short story so far. (Multiple Questions)
(01-29-2019, 07:44 AM)DeepBreathing Wrote:
Quote:I am to under go a titillation study in a couple of days.

Lolabove Sounds like fun! I think the word you're looking for it titration.  Smile

My own sleep studies were anything but titillating, unfortunately. Being waited on by some cute & sexy sleep-techs would have helped, but no such luck.
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#6
RE: My short story so far. (Multiple Questions)
(01-29-2019, 04:55 AM)bonjour Wrote: Mode Auto
Min pressure 7
Max Pressure 20
EPR 3
Thank you. I have set it up for according to these specs for use tonight. I will report back as soon as i can but i will probably wait for the results on my titration aswell.

(01-29-2019, 07:44 AM)DeepBreathing Wrote: G'day Smileyman. Welcome to Apnea Board.

The Resmed S8 series is somewhat obsolete now, but a low-hours machine will still give you good therapy. he problem is that they do not use a standard SD card like later machines, but a Resmed proprietary card which requires a special card reader to download to your computer. These are likely to be very hard to get hold of now. In the (unlikely) event your machine has the card and reader then you're all set. Otherwise, it's time to get Googling. If you can't get hold of one, then you'll need to use whatever data the machine displays on its screen.
Unfortunately no such luck, im limited to the onscreen results.

(01-29-2019, 07:44 AM)DeepBreathing Wrote: Lolabove Sounds like fun! I think the word you're looking for it titration.  Smile
Big Grin Thank you, ill try and remember that spelling.

(01-29-2019, 09:37 AM)Sleeprider Wrote: Smileyman, that is a very impressive AHI and especially low oxygen saturation. I think S8 Autoset Sprint will provide good control of obstructive apnea, but without data it would be worthwhile for you add an inexpensive recording oximeter. A recording oximeter like the Contec CMS 50DL can be had for as little as $30, and the more comfortable CMS 50F which is worn on the wrist is about $100.
I'll start looking for one but it will probably be a month or two before I have the cash to acquire one.
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#7
RE: My short story so far. (Multiple Questions)
(01-29-2019, 03:16 AM)Smileyman Wrote: ... whats the chances that i would meet someone with such similar results? (i think im just second guessing the diagnosis.)  My other issue is, if its so severe why havent i been experiencing the more severe symptoms i read about. I mean i have always been tired, kinda just assumed that's life but i have never fallen asleep while working or driving. Sure there has been close calls while driving but its always felt like it was the glare from the sun light that made me barely able to keep my eyes open... Yet i never actually fell alseep like all the websites claim. 


...

Most of us don't know what's what until someone objectively tells us what's what.  It's a friend on a hunting trip, after three shots of good Scotch before bedtime, and one or more of you is raising the roof....or 'dead' silent.  Or it's the spouse, or a child who comes in to the bedchamber to ask you something and pauses while he/she counts to 25 until you happen to breathe before awakening you.

Many, a great many, of us have severe apnea.  Mine just qualifies at 31, yours is three times as bad.  You say you've always been tired, but otherwise you had no real adverse impact you can think of.  Same with pretty much all of us.  In fact, many of us complain that we feel markedly worse once we get properly titrated and are away to the races with our new machines.

So, to answer your first quoted question, about 1 in 2, or about 50%...I would think.  Second guessing a diagnosis is another matter, though, and probably a reasonable orientation any time someone tries to part you with a beloved routine, lifestyle, or chunk of cash. 

Falling asleep watching TV, or while driving- I rarely have sleepiness while driving, but the few times I have had it, they have been spread across 40 years or more.  But in front of the TV is now a daily event.  It was never an issue prior to my AFib and the polysomnography to figure out if I had apnea because other tests failed to find a cause for the AFib.  I was fully asymptomatic except for snoring, which my wife didn't object to and my daughter did when I was invited to go fishing at their cabin.  This was post the AFib event...the first one.

All this to say that you are rather typical in many ways.  Surprised, dismayed, somewhat in denial, a bit shaken, worried, looking for help and allies, seeking reassurances, and hoping desperately to restore some semblance of normalcy....the usual.  You may get lucky with that hope, but.....probably not.  Didn't work for me, and I'm pretty normal.
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#8
RE: My short story so far. (Multiple Questions)
Okay my result screen for my first night, reads as follows:

Press: 12.00
Leak: 0.04L/s
AHI: 6.1
AI: 1.1
HI: 5.0

It was an ordeal to fall asleep with the mask on but i managed it. I even took it off at about 3 in the morning. I came out of sleep and as i did i took it off, realised What i had just done and put it back on. I was fast asleep again very quickly.

Something came up and i had to request that my next appointment be moved up, so titration will be tonight. It will probably be a day or two before i have those results.

The skin between my nose and lip was a bit raw. Not sure whether this is an issue (maybe the mask was too tight) or something i have to get used to but ill work through the mask instructions on this site again before sleeping with it next.
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#9
RE: My short story so far. (Multiple Questions)
Not bad at all for the first night, in fact compared to your untreated numbers it's exceptional. I hear what you say about it being an ordeal. It is hard to adjust to a whole new way of breathing with a plastic alien strapped to your face and blowing air up your nose! Shock While some people experience immediate miraculous results, for most of us it's a journey - one step forward and two steps back. But your AHI is extremely good under the circumstances and will improve even further from here.

I see you listed a single pressure: 12.0 Your machine is designed to work within a range of pressures to give the best result and not subject you to unnecessarily high pressure all night. This is something to discuss with the therapist when you do your titration - they shouldn't be concentrating on a single fixed pressure but on an optimum range. However many in the sleep fraternity like to keep things simple by only giving you a single fixed pressure. If that's the case you can either accept it if it works and is comfortable, or come back here for advice on setting max and min pressures.

You shouldn't get raw skin from the mask, but sometimes it happens. Some people are allergic to the silicone material, or it may just be that you had the mask too tight. The leak is negligible, so I'd be inclined to loosen the mask a bit and see if it's more comfortable that way.

Good luck for your titration study tonight!.
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#10
RE: My short story so far. (Multiple Questions)
I set it to 

Mode Auto
Min pressure 7
Max Pressure 20
EPR 3

So im not sure if the 12 is what it determined itself or what. 

I also slept on my back, which isn't usual for me but with the mask it was the most comfortable position.

How long before people feel like a "brand new man". I have only used it one night but cant say the tiredness is gone.
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