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[Diagnosis] New to Forum and feeling worried
#1
Hi, I'm new here...

Where to begin..I just recently did an at home sleep test through singular sleep online..I currently do not have insurance and singular sleep online was recommended for me by a friend who had success with it. I received the results today and I'm a worried mess! 

I suspected I had sleep apnea as when I had my c-section the nurses commented on it as well as last July having my gallbladder removed and the surgeon telling my husband 
that he'd never seen sleep apnea so bad..being self pay my dr suggested losing weight and quit smoking. I am extremely tired and feel not my age of 35, was talking to a friend and she suggested doing the sleep apnea test through singular online..I am skeptical but hopeful. I do suspect I have had sleep apnea even as a child..

I'm currently overweight..and unfortunately smoke a pack of cigarettes a day..I have smoked off and on since I was 16 Quitting for 5 years during the time frame..sadly..after getting the results I crumpled them all up and applied a nicotine patch..all I can think about are my kids...and guilt of why I haven't taken care of my body..


So my results are these..can't figure out how to upload the pictures but will copy and paste some of the results. 


Summary
AHI
51.6
OAI
17.1
CAI
0.0
Lowest Desat
77



 
Oximetry Summary
 
Dur. (min)
% TIB
<90 %
78.6
16.0
<85 %
27.6
5.6
<80 %
1.0
0.2
<70 %
0.0
0.0
Total Dur (min) < 89
54.3 min
Average (%)
91
Total # of Desats
225
Desat Index (#/hour)
29.0
Desat Max (%)
16
Desat Max dur (sec)
74.0
Lowest SpO2 % during sleep
77
Duration of Min SpO2(sec)
8
Highest SpO2 % during sleep
97
Duration of Max SpO2(sec)
56

 
Heart Rate Stats
Mean HR during sleep
93.6 (BPM)
Highest HR during sleep
113  (BPM)
Highest HR during TIB 
118 (BPM)
Lowest HR during sleep
71  (BPM)
Lowest HR during TIB
35 (BPM)
 
 
Snoring Summary
Total Snoring Episodes
739
Total Duration with Snoring
220.2 minutes
Mean Duration of Snoring
17.9 seconds
Percentage of Snoring
47.1 %
 
 



Interpretation:
 
This home sleep study demonstrates severe obstructive sleep apnea. The patient was in the supine position for virtually the entirety of the study. There were several discrete episodes of continuous oxygen saturation <89% that were independent of respiratory events in a pattern to suggest the possibility of REM-related hypoventilation. Average oxygen saturation was borderline-low at 91%. 
 
Diagnosis:
 
·             obstructive sleep apnea(ICD-10 G47.33)
·             sleep related hypoxemia (ICD-10 G47.36)
 
Treatment Recommendations: 
 
·             Auto-BPAP and follow-up pulse oximetry on therapy
·             Evaluation for underlying medical etiologies of hypoxemia



I just recently had an ekg and it looked great, I also had a chest X-ray a year ago and he said it looked perfect. I do suffer with allergies badly, especially this time of the year. 
I'm still scared I have cancer or something bad..please tell me someone on this forum has experienced hypoxemia and it wasn't bad news. 

I will be doing the consult with the online dr within the next couple of days hopefully..

Until then I would love some positive, helpful remarks..and any words of advice..gentle words as I'm extremely nervous. 

Also if you have been overweight and a smoker and succeeded at healing your body. Because I'm so motivated to be here longer for my babies. 

Thank you all for taking the time to read this.
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#2
loosing weight is good for your overall health but will not help your sleep apnoea you need a Cpap device, as you do not have insurance I suggest you look on Craigs list for second hand machines you are looking for a Resmed A10 Autoset
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#3
I would also suggest going to the American Sleep Apnea Association as they have a link on their homepage to help people who cannot afford a CPAP.
RedBarron

"For I am not ashamed of the gospel of Christ because it is the power of God for salvation to everyone who believes, first for the Jew, and also for the Greek [Gentile]." Romans 1:16 CSB
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#4
G'day Momtotwins. Welcome to Apnea Board. You asked for some help and gentle words - we can give you that, but we also need to give you the facts, which may sound harsh but are truly not meant to be. Remember that we're not medical people here - we're all people with sleep apnea who have come together to help each other through. We'll give you our opinions based on our own experience, but you still need to deal with the doctors and the "system" (commonly known as the medical Mafia).

You don't need us to tell you that losing weight and cutting out the smokes are the first steps to a long and healthy life. You know what to do, but it's not going to be easy and you will need all the help you can get. Luckily you will likely find it a lot easier to get motivated once the sleep deprivation caused by apnea is addressed.

As far as the sleep apnea is concerned you do have a fairly severe case (AHI = 51.6) but it's not extremely severe. Many members here have untreated AHIs higher than that, and with the use of a suitable CPAP machine and good advice they have the apnea beaten. In my case the untreated AHI was 62, and with a machine I'm down to less than two every night. But it's important to remember that there is no cure for apnea. The machine will control it, but you need to use the machine every night. This can be a challenge in itself, but as a wise man once said "life wasn't meant to be easy". Smile

The hypoxaemia can come from a number of causes including asthma, bronchitis, apnea and others. It needs to be checked out, but my guess is that if you cut out the smokes, get fit and healthy and address the apnea then the hypoxaemia will take care of itself.

I see your sleep study has recommended an auto BPAP machine. At this stage I need to give you a very quick lesson in the types of CPAP available But first, you should go to our wiki and watch the video Understanding Sleep Disordered Breathing at the bottom of the page. It takes a few minutes but explains things extremely well. http://www.apneaboard.com/wiki/index.php...=Wiki_Home

Types of Continuous Positive Airway Pressure machine:

1. Constant fixed pressure machine (basic CPAP): With these machines the pressure is fixed and stays the same all night every night. This is the most basic and is quite adequate for some patients.

2. Automatic (or auto-titrating) APAP machines. You can set an upper and lower pressure and the machine will adjust pressure as necessary within that range. The advantage is that the machine adjusts to your needs, generally running at a lower average pressure. If you experience an apnea or precursor (such as snoring) the machine will increase the pressure to had off any further events. It will then return to a lower pressure. Some patients find the pressure change can be disturbing, but most find the APAP machine more comfortable and efficient tan the fixed pressure machine.

3. Bi-level machines, often called BPAP or BiPAP. These machines are set to an exhale pressure and a slightly higher inhale pressure. There are many types, depending on the particular patient's requirements. Generally an auto bilevel machine combines the best parts of the APAP plus the ability to set the inhale and exhale pressures separately. Depending on the particular model there are lots of other settings which can be important for people with particular lung conditions. These machines are often used for people with ordinary sleep apnea who need higher treatment pressures - the bilevel can be more comfortable in that case. Bilevel machines tend to be more expensive, so doctors need to establish a need before prescribing them.

CPAP manufacturers

There are many manufacturers of machines, but my recommendation is to stick with the market leaders Resmed and Philips Respironics. The main reason is that the great majority of users have these machines so it's easy to get detailed support and advice. In addition, they are supported by a software called SleepyHead which you will use to monitor your progress. There are many other brands which may be as good, but these two are the standouts.

What machine should you gt?

Your doctor has recommended an auto bilevel machine. You need to discuss this thoroughly with him, as to why this type of machine is recommended and why an ordinary fixed pressure or APAP machine would not do the job. I had a very quick look at the Singular Sleep website and I see they supply the machine as well as carrying out the testing and prescription. Personally I don't like this business model as it can too easily lead to a conflict of interest where they try to upsell you to a more expensive machine. You should be prepared to investigate the market for machines and don't just take what Singular offer. Supplier #2 on our supplier list are known for honest service at good prices, especially for "gently used" and "open box" machines. You can also go via Amazon or Craigs List but personally I would not recommend that route unless you are confident in what you're doing.

Next steps

Read as much as you can. There is an excellent wiki here at apnea board and lots of other resources. Ask as many questions as you want - that's what we're here for.

Keep your appointment with the doctor and get as much information from him as possible. Remember what I said earlier about conflict of interest - you're the customer and you're under no obligation to buy from any given supplier. I suggest you do not sign up for any purchase contract but come back here and let us know what they had to say.

The really good new for you is that you've been diagnosed at an early age. You have the time and incentive to get on top of this disease and be a strong and healthy mother for those babies of yours. Very best wishes and good luck!
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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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#5
Lolabove what he said.

You can attach images.  The link to do so is below the field you type in.

That said read the links in my signature, they will help you get started. 

I also see nothing in your summary other than the recommendation for a BiPAP that would require one.  Ask why?  A BiPAP is definitely a very good machine  (I would recommend the ResMed AirCurve VAUTO) BUT based on the summary it may be overkill and is definitely more costly than the APAP machines 
  • ResMed AirSense 10 AutoSet (best choice) (E0601) (Fixed CPAP, Auto CPAP)

  • ResMed AirSense 10 AutoSet for Her (best choice) (E0601) (Fixed CPAP, Auto CPAP)

Definitely read the links in my signature. We at the forum can and will help you along this journey.

Fred
New to Apnea? Helpful tips to ensure success
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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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#6
Good day to you!

I am enthusiastic for you contrary to how you may feel about CPAP. You are 35 and found out you have sleep apnea and that's great because you didn't spend the next number of years going untreated for a condition that you may have never known you had.

Sleep apnea is treatable and you can work on your other issues while getting better sleep. I know it may be a bummer to find out that you've got another hurdle to overcome, but it's not insurmountable. I encourage everyone to develop a positive attitude and maintain a positive attitude. Many people struggle with CPAP therapy in the beginning but read this forum thoroughly. You will find the many success stories and the multitude of testimony of those of us who will not fathom a night without their CPAP machine.

You will not regret going after this therapy. Be aggressive about obtaining a machine and make sure you follow the great advice you will receive here and you can write your own success story.

Welcome to Apnea Board and ask many questions!
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#7
Thank you all for your advice, it is greatly appreciated.


I figured I had sleep apnea and most likely even as a child..

However I am most scared about having lung cancer..not really sure why..I guess googling hypoxaemia scared me. 

I have put a patch on as soon as I read the results..I'm hoping that this is just the wake up call I needed and not something worse. 

I will quit smoking and lose weight it isn't an option anymore and I will succeed. 

I was skeptical about doing the sleep apnea online, but wasn't really sure where else to do an online sleep apnea test. 

I will be asking the dr the questions posted. I have read up on the links that were posted as well as in this forum. Still confused but I'm sure it is a learning curve.

I plan to ask the dr. Why a bpap? Any other questions I should ask? 



I have a friend that recently lost over 100lbs and no longer needs her cpap machine, she is willing to give it to me if they suggest that it would work. Respironics PR System One REMstar PRO CPAP Machine 

What are you guys thoughts on that? Trying to do it affordably but may not even be an option to use the one she has.
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#8
The Remstar PRO is a traditional CPAP machine that delivers a single pressure, or a fixed pressure machine. A BiPAP or bi level CPAP machine will deliver 2 pressures. A pressure for exhale and a higher pressure for inhale. Fixed CPAP machines deliver typically pressures ranging from 4-20 cmh2o while bilevel CPAP will deliver 4-25 cmh2o. There are several reasons that you were possibly recommended a bilevel machine. Without seeing a sleep study, I can only speculate that you were likely recommended a bilevel machine for it's increased ventilation capabilities based on you o2 destaurations and hypoxemia.
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#9
Just added the attachments of the sleep study, hopefully that will help and it will post. Smile


Attached Files Thumbnail(s)
       
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#10
Thank you!

I stand by my ideas for increased ventilation for getting your o2 levels up. You were recommended further o2 monitoring to see if therapy will get your oxygen levels to normal levels. I believe the recommendation for a bilevel machine is accurate for your needs.
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