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[Diagnosis] Newly Diagnosed Yesterday (still sinking in)
#1
Question 
Hello all.. I am brand new to the community today.

A couple months ago I innocently asked my ENT doctor during visit for an ear infection about my snoring (my wife asked me to mention it).  He stated it might be a good idea to rule out OSA - something I have heard of but really know very little about.

I met with the sleep specialist who said with my symptoms, diabetes II, and high blood pressure it was more than 50% likely I had the issue.  My insurance would not cover the overnight study so I had to use the home testing system.

Yesterday I went in and met with the doctor.. he said that in his experience the home studies generally underestimate the issue.  The average it showed was 15 instances per hour and my lowest recorded oxygen was 86.  He said this put me on the borderline of the mild to moderate and recommends starting CPAP as the first treatment.

A CPAP sleep study has been scheduled for the first week in April although he states that the insurance may decline and state that an auto CPAP is to be used.

I guess my issue is - at this point... What Do I Ask?  How do i ensure I am getting the proper machine and that insurance is treating me properly in terms of the treatment?  What do I expect here this next month as I get started.

I am truly a newbie at this.  The thought of wearing a device every night (possibly for life) when I am only 43 right now is really daunting at the moment.

I asked the doctor - I do not seem to really feel tired during the day. I know I have trouble sleeping and feel tired some during the day but it does not seem to impact.  His response is that I may have had this for so long my body has gotten used to it.  That within a month or two I should notice a difference in how I feel as well as possibly some changes in my high blood pressure and even diabetes control.

I guess right now is still that "what?" stage of any diagnosis you were not expecting.  I mean I already deal with a few medical issues at only 43 and here is another potentially life long condition.

Thanks to all for ANY advice.  I look forward to getting to know the community.

Gregory Williams
Age 43
Munster, IN
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#2
G'day Gregory. Welcome to Apnea Board.

Sleep apnea is an insidious disease which creeps up on us, to the extent than many don't get diagnosed until they are in their late 50s or 60s. It may not feel like it at the moment, but you are lucky to be diagnosed while still young. It means that with proper treatment you will be able to head off some of the nasty co-morbidities of apnea.

Your doctor sounds sensible and I would follow his advice. Using an auto machine is a perfectly valid way to titrate your treatment - in fact I think it is far superior to a one night titration study in a lab. There are quite a few machines on the market, but I recommend you stay with Resmed or Philips Respironics. These are the industry leaders and there is a lot of support available for them. Other machines may be equally good, but are less well supported in the forums etc. Assuming you have plain vanilla obstructive apnea and not central apnea (confirm with your doctor) then you should be looking at a Resmed Airsense 10 Autoset or a Philips Dreamstation Auto. Both these machines will provide the data necessary to optimise your treatment and both are very effective at treating apnea. (Make sure you get those particular models and not lesser fixed pressure or non-data versions).

The thought of using a mask every night for the rest of your life is a little shocking when it is first presented. But you'd be amazed how quickly it becomes second nature to slip the mask on and press the start button last thing before you fall asleep. After three years as a hosehead I couldn't imagine sleeping without my machine any more - but it was a struggle at first.

Some people experience miraculous results the first night, but for most of us it's a journey. And it's often a case of two steps forward, one step back. It does take a certain amount of grit and determination to stay the course, but the long term results for your health will be well worth it.

OK, it's bedtime here in Australia, so I'm off to put on my mask. Wink I'm sure other members will chime in with some constructive thoughts and advice.

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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#3
I can't top what deep breathing already wrote, but I would just say welcome to the forum and don't feel alone. Indeed, as already mentioned you should feel fortunate that your apnea was caught early enough to do you less harm later on.

Similarly to you, I am also in my 40s (47) and I only got a sleep study because I snored. I ended up being diagnosed with severe sleep apnea after a score of 47 on the sleep test and I have used a Resmed Airsense 10 auto for the past month. That is the one I would also recommend to you.

I find I am less tired and have more energy during the day now and it has gotten much easier to sleep with my machine. Indeed, I now find it quite soothing.

Stick with it and never hesitate to ask for help here!
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#4
I am a strong advocate of giving a patient an auto CPAP and support, and allowing them to self-titrate. I had a sleep clinic diagnosis of very severe sleep apnea back in 2008 but was intolerant of the clinic for sleeping. I was given a Philips Respironics M-Series Auto and instructions to self titrate. I did very well with that, and used the data on the M-series (no so easy to get back then) and some forum support to get informed.

Today the machines are excellent, and we have very good data tools that are free. This forum is ready for you to use as support and a resource. I would personally avoid the titration study, get the auto and consider myself fortunate to have avoided a lot of the problems that lead to bad titrations, fixed pressure machines and a lot of dependence on doctors and clinics. Auto machines work as long as you don't have complex apnea, which is the main advantage of a clinic to identify. Guess what. Even if you have complex apnea, they usually still issue a dumb CPAP. You are better off doing this yourself. You will eventually feel better, but have realistic expectations. Weight loss and better health is hard work. The auto CPAP will help you to get the sleep you need, keep you from having to get up at night to go to the bathroom, and will keep loved ones from banning you and your snoring to a separate bedroom. The rest is kinda up to you.

Get the auto, request the Resmed Airsense 10 Autoset as the machine you want, and you will be on your way in no time. Welcome to the forum. With regard to the home sleep test, I agree with your doctor that results are underestimated. This happens due to sensor problems applied by the patient, and the fact awake hours are counted, and dilute sleep hours. You are probably easily moderate and possibly severe.
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#5
You've been given great advice. I was diagnosed with moderate sleep apnea 10 years ago and was given a constant pressure CPAP that provided zero data. Early this year I replaced it with a Resmed Airsense 10 Autoset which was set at the same constant pressure as my old CPAP. Upon finaly seeing data I learned that my apnea was not adequately treated, and probably had not been for 10 years. With the new machine and help from this forum I am using the autoset mode and my data look much better. I also feel better. It's great that you are in a position to start out with the right machine. Once you have it be sure to use the resources of this forum.

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#6
Hi gregoryjames,

WELCOME! to the forum.!
I would see if your sleep doc would prescribe you an Auto CPAP machine, (such as the Resmed AirScense 10 AutoSet or the Respironics DreamStation Auto,)and self-titrate at home, instead of going through another sleep study, in a strange bed, where you probably won’t sleep well.
I wish you good luck as you start your CPAP journey, you came to the right place for guidance.
trish6hundred
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#7
I want to respond without seeing others' responses first... so forgive me if I repeat what's been said. 

Welcome!  You are in the right place!  I love your thread title, as I can very much relate. 

First of all, it is a *good thing* to find out you have sleep apnea!!!  If you have it, it's better to find out!  Yes!  Then you can do something about it!!!  Otherwise, it'll contribute to bad things happening to you and you can't figure out how to prevent them. So yay!  Celebrate!!!

Second of all, it is a *good thing* to find out you have sleep apnea!!!  You've just figured out the solution to some of your medical problems; if not a solution, at least a helper.

Third of all, it's a *good thing* to find out you "have this potentially lifelong problem"!!!  If you've had it for a while, GOOD FOR YOU for figuring it out NOW rather than when you're 70.

I'm younger than you, and did NOT want to be dxed with sleep apnea, because I did not want to be lame sleeping with a thing on my face with a hose and a box and whathaveyou.  I was offended that my husband suggested I be tested. (Honestly, if anyone has a sleep problem, it is HIM.)

But you know what?  This hose box has been the best thing that has ever happened to me!!!!  In my lifetime, I can NEVER remember waking up refreshed, not once. I could go on about my symptoms, but I'll hold back. But wow the cpap machine has made my quality of life SO much better!  

I used to feel bummed and burdened by it. But after a week or so, I decided I'm empowered and healed by it!!!

Take heart!

Oh, and your dr sounds like a dream come true! Take the Auto!!! Your time with your machine will be so much more enjoyable.
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#8
One of the biggest hurdles is finding the mask which works best for you, whether it be pillows which snug up to the nostrils, a nasal mask fitting over the nose, or a full face mask. I'm a mouth breather, so I use a full face mask.

And, 2 tips:
1. If you have obstructive apnea, you may find you numbers improve if you sleep on your side, not your back.
2. Avoid positions which kink your airway - some folks discovered they were bending the neck to the point that the apneas increase. If you find this happening, a cervical collar or a small neck pillow may help prevent this.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#9
For me the big concern is sleep apnea has been linked to dementia and heart diseases. Maybe if I had started 10 years back, when I was 43, I wouldn't be looking down at incision in my chest right now.

Not to scare you.  But I think it helps if you buy into the idea that it will indeed reduce your risks, and improve your health. It really does help regulate your breathing.

I'm just getting going too. It's a challenge for me. The best I've done is 2.5hrs continuous and approx 4hrs for the whole night.

I don't have insurance, but I also don't have to worry about compliances, doctors, etc.. Nice to not have those extra concerns.
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#10
Take the auto machine and do not look back. Listen to everyone else.

That is a better solution than the overnight sleep center titration effort. Unless you have invested in wonership of a sleep center. Or unless you get kickbacks from the sleep centers. Did I say kickbacks? I meant referral bonuses. Dang. But only doctors would get those.

OMMOHY
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