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[Diagnosis] Negative sleep study, still ordered a CPAP
#31
RE: Negative sleep study, still ordered a CPAP
The bit about your safety is bosh, but you might want to suspend CPAP use between now and the WatchPAT study. I've read conflicting opinions about whether using CPAP in the run-up to a sleep study can distort the results. So I'm offering my two cents for you just to be on the safe side.
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#32
RE: Negative sleep study, still ordered a CPAP
your flagged flow limitations are low but flagged and unflagged fl are pretty clear on the 2 zoomed screenshots (abbreviated, flat, slanted m or w shaped inhales). I doubted it earlier but second guessing myself: maybe you are particularly sensitive and suffer uars after all.
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#33
RE: Negative sleep study, still ordered a CPAP
(11-19-2020, 02:01 PM)Dormeo Wrote: The bit about your safety is bosh, but you might want to suspend CPAP use between now and the WatchPAT study. I've read conflicting opinions about whether using CPAP in the run-up to a sleep study can distort the results. So I'm offering my two cents for you just to be on the safe side.

Thank you.



(11-19-2020, 02:57 PM)sheepless Wrote: your flagged flow limitations are low but flagged and unflagged fl are pretty clear on the 2 zoomed screenshots (abbreviated, flat, slanted m or w shaped inhales). I doubted it earlier but second guessing myself: maybe you are particularly sensitive and suffer uars after all.

Are these patterns corresponding with someone with UARS? I honestly have no knowledge of UARS and don’t know what to to look for besides RERAs, but that’s what the upcoming WatchPAT is for.
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#34
RE: Negative sleep study, still ordered a CPAP
I have GERD too. Diagnosed in 2007. Fatigue started in 2015. Sleep study in 2016 showed 0 AHI. Fatigue is not always a sleep apnea issue. GRD can be a sign of bad gut health. Bad gut health can have a lot of causes. I would go to a doctor and get full thyroid panel which includes free t3 and t4. Also get a homocysteine test which will lead you to knowing if you have a mthfr gene mutation or not.
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#35
RE: Negative sleep study, still ordered a CPAP
(11-19-2020, 05:17 PM)weiss27md Wrote: I have GERD too.  Diagnosed in 2007.  Fatigue started in 2015.  Sleep study in 2016 showed 0 AHI.  Fatigue is not always a sleep apnea issue.  GRD can be a sign of bad gut health.  Bad gut health can have a lot of causes.  I would go to a doctor and get full thyroid panel which includes free t3 and t4.  Also get a homocysteine test which will lead you to knowing if you have a mthfr gene mutation or not.

I’ve had my thyroid checked, but they said nothing was out of the ordinary. GERD appeared after a nasty food poisoning. At the same time gut issues appeared. Will ask about the homocysteine test next time I meet with my GP again
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#36
RE: Negative sleep study, still ordered a CPAP
The extent to which you are affected by inspiratory flow limitation is very under-stated by the statistics from your therapy.  You highlighted two segments of sleep which were apparent on the whole night flow chart as periods with uneven respiratory flow, with spikes of inspiration and expiration suggesting arousals.  The closeup of period at 02:00 shows increasing flow limitation from 02:02:10 to 02:04, which terminates in a change in respiratory flow rate and resumption of a more normal flow by 04:04:30.  This is practically the definition of RERA (respiratory effort related arousal), and when this is repeated through the night is very disruptive to sleep.

Similarly, the period from 03:59:00 to 04:02:00 again shows a transition to increasing flow limitation becoming acute near the end and followed by an obvious arousal and restoration of normal flow.  This is not only a RERA but I'm surprised not to see a hypopnea flagged here.  We can only speculate on why your airway becomes less patent over these two examples, but there is a clear progression form near normal flow to serious flow limitation over a 2-minute period, ending in arousal.  High on the list of suspects is your sleep position, where your chin sags toward your chest obstructing flow, resulting in an arousal and change in body position.  The collar may help with this.

[Image: attachment.php?aid=28212]

[Image: attachment.php?aid=28213]
Sleeprider
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#37
RE: Negative sleep study, still ordered a CPAP
Hello folks. I just received the results from my WatchPAT study through the mail. Not entirely sure how to interpret this, seems there is something going on though. Sleep specialist wrote a message saying that my RDI is 15 and that a normal RDI is around 5.

Here are my results:

https://snipboard.io/36KWOP.jpg

https://snipboard.io/D1kgb6.jpg
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#38
RE: Negative sleep study, still ordered a CPAP
A mild AHI and mild-moderate RDI is not unexpected. Even with the use of EPR at 3 using CPAP therapy, some upper airway resistance is apparent, but seems mostly resolved. Your events mostly occur when you're in supine or on your left side, and is more prevalent during REM. Snoring is present at low volume for the most part, again supine and left, but mostly goes away when you sleep on your right. The RDI and snoring show airway resistance or partial obstruction. There is nothing especially remarkable about this WatchPat study. I think your best metric for therapy is how you feel with or without using the PAP. With an RDI of 15 and symptoms, the use of CPAP is easily justified. I assume it makes a difference in how you feel.
Sleeprider
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www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#39
RE: Negative sleep study, still ordered a CPAP
(12-02-2020, 11:08 AM)Sleeprider Wrote: A mild AHI and mild-moderate RDI is not unexpected. Even with the use of EPR at 3 using CPAP therapy, some upper airway resistance is apparent, but seems mostly resolved.  Your events mostly occur when you're in supine or on your left side, and is more prevalent during REM. Snoring is present at low volume for the most part, again supine and left, but mostly goes away when you sleep on your right.  The RDI and snoring show airway resistance or partial obstruction.  There is nothing especially remarkable about this WatchPat study. I think your best metric for therapy is how you feel with or without using the PAP.  With an RDI of 15 and symptoms, the use of CPAP is easily justified. I assume it makes a difference in how you feel.

Do you think using a BiPaP would make more of a difference? I’m able to get my hands on a Resmed Aircurve 10.
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#40
RE: Negative sleep study, still ordered a CPAP
It is possible a BPAP type may be more helpful if you're seeing one that's available for a good price. If you're getting a BPAP, I'd suggest the ResMed VAuto. If you're going through some kind of insurance, they may not go with the BPAP. If insurance is paying or if the BPAP isn't VAuto, then the AutoSet is fine.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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