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[Diagnosis] New here- questions for follow up visit
#1
Question 
I have been newly diagnosed, out of the blue. I mentioned being tired to my MD and he ordered a sleep study. I was expecting no results. What I ended up with was a split study and a lot of unanswered questions. During the first half of my SS I fell asleep for 105 minutes. My stats were alarming to me.
This is my breakdown of events-
AHI-95
RDI 99.4
67 obstructive events.
24 central apneas,
5 mixed apneas,
67 Hypopneas
and 12 RERA.
I spent 95% of my time in stage 2 sleep. Zero in stage three and zero in REM.
My question is what do I ask my specialist at follow up? How can I set myself up for a good start at managing this?Oh-jeez
The second half of my study was horrible. I wore a mask for 3 hours and only slept 2 minutes. Laugh-a-lot I had 5 centrals in those 2 minutes.
The sleep tech wanted me to leave I think. So she let me go.
Not looking forward to this adventure.
I need help knowing what to ask in follow up. All advice and encouragement appreciated.
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#2
Welcome SpeedyD to ApneaBoard! Glad you found your way here. Hopefully you will get your therapy sorted out sooner than later and start getting things under control.

There are a lot of helpful and knowledgeable people here on this forum and I am sure you will get some advice on what to discuss with your doc.

Keep us posted!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#3
Welcome SpeedyD, the good news is you have been diagnosed and can now move onto the treatment. My first suggestion it to read up on Sleep Apnea on here and other sites as much as possible and write down your questions so you don't forget anything.
Most CPAP's are simliar, get an Auto and Data capable machine if possible.
The mask is the hard part, there are 3 options, Nasal prongs that go in your nose, a Nasal Mask that goes over you nose but not your mouth and a Full Face Mask that covers your nose and mouth this is mainly used for mouth breathers. You may need to change masks a few times as this is the most important part of your treatment. The one you choose needs to be comfortable for you to use and allow you to get the proper treatment.
You will get a lot of suggestions, just take them in and ask as many questions on here that you like, good luck and keep us updated.
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#4
(11-15-2015, 08:00 PM)Tez62 Wrote: Welcome SpeedyD, the good news is you have been diagnosed and can now move onto the treatment. My first suggestion it to read up on Sleep Apnea on here and other sites as much as possible and write down your questions so you don't forget anything.
Most CPAP's are simliar, get an Auto and Data capable machine if possible.
The mask is the hard part, there are 3 options, Nasal prongs that go in your nose, a Nasal Mask that goes over you nose but not your mouth and a Full Face Mask that covers your nose and mouth this is mainly used for mouth breathers. You may need to change masks a few times as this is the most important part of your treatment. The one you choose needs to be comfortable for you to use and allow you to get the proper treatment.
You will get a lot of suggestions, just take them in and ask as many questions on here that you like, good luck and keep us updated.
Thanks. I have read so much for the last 2 weeks. A lot of info and then different requirements in different regions. When I did my split study I used a full mask but it felt like it closed my nostrils and it didn't really seal. I am a mouth breather and side sleeper most of the time. Looking forward to becoming informed but still wishing it would all go away.
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#5
When you see your doctor, ask him/ her how low your oxygen saturation got during the severe apneas. I didn't see that in your results list. Normal oxygen saturation in the blood on room air, 24/7, is 95-99 to 100%. Anything lower than 90% is significant, as that heralds a drop I. Tha amount of oxygen available to the brain. Blood oxygen saturations at 85% and less indicate hypoxia, a systemic lack of oxygen. OSA patients notoriously have very low oxygen sats; when I was diagnosed, my oxygen saturation dropped to 70% and stayed there! No wonder my brain never would descend into deep sleep. CPAP prevents upper airway/ pharynx collapse, letting you breathe continuously, without obstruction blocking the airflow. Low oxygen saturations = low oxygen in the brain = interrupted sleep cycle.

A "sleep study" is sort of an oxymoron, as it is really difficult to relax and sleep with about 100 wires connected to you, in a strange bed, with someone watching you. Then, halfway through, they put a weird mask on your face and expect you to just doze off. I hated mine; another patient was using the finger oxygen saturation monitor, so they hooked one to my earlobe, which pinched it.

Don't be afraid to ask your doctor every question you can think of. After all, you're the one using the machine, and you're in charge of your own treatment. Good doctors will answer anything you ask, and should strive to make you as knowledgeable as possible.
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#6
My O2 sats were under 90% but for less than 10 minutes. At 83% for 2 minutes 30 seconds. That was my lowest.
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#7
What stands out to me in your story is that during the titration portion of your sleep study, you had a number of centrals. That combined with a considerable number of central events during the diagnostic study means you may not resolve your problems with simple CPAP. I suspect they will treat you for obstructive apnea, and will probably specify an auto CPAP since you didn't have enough time to determine pressure levels.

What you want to discuss with your doctor is to ask his thoughts on the number of central events. If these continue to be present as you begin CPAP therapy, you may need a different machine that can treat complex apnea. That would be an ASV (adaptive servo ventilator) that can trigger higher pressure to cause a breath when you don't initiate one yourself, and that lets you breath on your own with positive air pressure when you do initiate breaths. Ask your doctor what his plan is moving forward to evaluate if the omplex apnea is a concern that needs addressed. Hopefully, you go home with a machine and have good results. If not, you may need to be prepared to go back and discuss complex apnea and an appropriate therapy for that.
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#8
Hi SpeedyD,
WELCOME! to the forum.!
Hang in there for more suggestions and answers to your questions and much success to you.
trish6hundred
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#9
(11-15-2015, 08:06 PM)SpeedyD Wrote: Thanks. I have read so much for the last 2 weeks. A lot of info and then different requirements in different regions. When I did my split study I used a full mask but it felt like it closed my nostrils and it didn't really seal. I am a mouth breather and side sleeper most of the time. Looking forward to becoming informed but still wishing it would all go away.

Unfortunately it won't go away, you will have it for life, try to be positive about it, that you have been diagnosed and may have saved you from some of the horrible illness's it can cause like depression, heart attack, high blood pressure etc, etc, etc
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#10
(11-15-2015, 10:03 PM)Sleeprider Wrote: What stands out to me in your story is that during the titration portion of your sleep study, you had a number of centrals. That combined with a considerable number of central events during the diagnostic study means you may not resolve your problems with simple CPAP. I suspect they will treat you for obstructive apnea, and will probably specify an auto CPAP since you didn't have enough time to determine pressure levels.

What you want to discuss with your doctor is to ask his thoughts on the number of central events. If these continue to be present as you begin CPAP therapy, you may need a different machine that can treat complex apnea. That would be an ASV (adaptive servo ventilator) that can trigger higher pressure to cause a breath when you don't initiate one yourself, and that lets you breath on your own with positive air pressure when you do initiate breaths. Ask your doctor what his plan is moving forward to evaluate if the omplex apnea is a concern that needs addressed. Hopefully, you go home with a machine and have good results. If not, you may need to be prepared to go back and discuss complex apnea and an appropriate therapy for that.

I'm glad somebody here understands the centrals. Do you think there is any chance they will start me on an ASV? The Cpap was miserable. I was sick for 2 days after!!
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