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[Diagnosis] Was the doctor pulling my leg?
#1
So the doctor on first visit after the sleep study told me I need surgery for OSA and I said that's out of the question.
Then he gave me a prescription for a machine and I got one. Had to pay $500 out of pocket without insurance. I got the machine 2 days ago but last night the doctor sent me a copy of the sleep report. My biggest concerns are that after 32 days of continuous use (30 trial, 2 my own machine) my excessive fatigue is exactly the same.

Here are my details from the report:

He had a sleep onset in 13.1 minutes and slept for 3 hours and 52 minutes with a sleep
efficiency of 69.1 % (normal: > than 80%).

Impressions: Data analysis was performed according to the current AASM criteria.
He had a sleep onset in 13.1 minutes and slept for 3 hours and 52 minutes with a sleep
efficiency of 69.1 % (normal: > than 80%).
He had: Stage N1 sleep: 10.3 % (normal: 5.71 %)
Stage N2 sleep: 57.2 % (normal: 56.89 %)
Stage N3 sleep: 18.7 % (normal: 12.46 %)
He had 13.8 % REM sleep (normal: 23.47 %) and a REM sleep latency of 167.0 minutes
(normal: 90 to 120 minutes).
There were 2 REM periods and 11 awakenings during the night.
He had 0 obstructive apneas and 0 central apneas.
There were 12 obstructive hypopneas of which the longest was 30.9 seconds in duration.
This gave an overall apnea-hypopnea index of 3.1 per hour in total sleep time (normal: <
5 per hour). The apnea-hypopnea index in the supine position was 2.6 per hour in total
sleep time and 3.8 per hour in REM sleep.

His mean blood oxygen saturation overnight was 96% and decreased to 93% during the
respiratory events.
Soft to moderate intermittent snoring was observed throughout the night.
His EKG showed normal sinus rhythm averaging 48.3 beats per minute overnight.
Occasional Second degree AV block (Mobitz type II) observed.
There were 0 periodic leg movements during sleep giving a PLMI of 0.0 per hour (normal:
< 5 per hour).
He had 37 spontaneous arousals, 11 respiratory arousals and 0 periodic limb movement
arousals giving an overall arousal index of 12.4 per hour (normal: < 10 per hour). Four
arousals from slow wave sleep observed.
Mild alpha EEG intrusion observed.
Diagnosis:
1. Primary snoring with a few respiratory events and arousals in sleep suggestive of Upper
Airway Resistance Syndrome (UARS)
2. Reduced sleep efficiency, an increase in stages N1 & N2 sleep, REM sleep latency and
arousal index are suggestive of anxiety
3. Occasional Second degree AV block (Mobitz Type II)

My doctor didn't send me to a cardiologist and wanted to do surgery for supposed OSA. But if my AHI without the machine is 3.1 wtf. However I do know that my breathing slows down to an extremely low level. This is why I can't really meditate because my breathing reaches extremely low levels. So my question is do I have any benefits with the machine or was I a money grab? I find that my breathing slows down to extremely low levels with the Auto CPAP and it's not helping with that.
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#2
We can give you some advice based on our personal experience with all kinds of sleep apnea but we need to see what your machine is actually doing for you. Install the Sleepyhead software and be ready to post some data. You/we will be able to see if your current settings are effective. Also make that appointment with a cardiologist. Some heart problems are also associated with sleep apnea. Finally put off that proposed surgery unless you want to help the Doc with a down payment on a new car.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#3
Quote:This gave an overall apnea-hypopnea index of 3.1 per hour in total sleep time (normal: <5 per hour). The apnea-hypopnea index in the supine position was 2.6 per hour in total sleep time and 3.8 per hour in REM sleep.

Your question is better directed to the physician, or for a second opinion. What I see is a low sleep efficiency with normal levels of AHI and blood oxygen levels, that would not typically be recommended for treatment by CPAP. If the doctor is a specialist, he may have seen some physical obstructions that he wanted to work on, but your results don't suggest a need for that. The comments do point to UARS as a possible source of the snoring and arousals. It is unusual for that to be recommended for CPAP therapy, but it can be an effective approach to reducing that problem. In that case, we would want to use a machine that detects RERA (respiratory event related arousals).

While you appear to have some sleep disturbance, it could be related to the clinic environment, UARS, or may be something to look into further. As to the fatigue, I would look to a full workup including hormone levels to see if there are any clues there. I can't comment on the cardiac findings. I suspect the doctor has put you on CPAP therapy for UARS, but it seems that should have been explained to you.
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#4
(12-17-2016, 09:32 AM)richb Wrote: We can give you some advice based on our personal experience with all kinds of sleep apnea but we need to see what your machine is actually doing for you. Install the Sleepyhead software and be ready to post some data. You/we will be able to see if your current settings are effective. Also make that appointment with a cardiologist. Some heart problems are also associated with sleep apnea. Finally put off that proposed surgery unless you want to help the Doc with a down payment on a new car.

Rich

No I instantly told him I don't want the surgery. He got angry and pretty much blew me off after telling me I need to get the machine. I'm going to see if I can get a refund for the machine but I doubt it since I used it. At least it's filtered air and is saving me winter costs on buying a humidifier I guess.
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#5
Install Sleepyhead and look at your data. You will get a really good idea of how you are sleeping and if there is any need for the machine. You will be able to see if breathing is associated with your waking.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#6
Sounds a bit like my doctor in Regina. He was more interested in selling a machine than my health. I would definitely get a second opinion. Best of luck to you as you figure it out!
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#7
I don't have an sd card reader. I tried the myair resmed site and it gives me a 94 score for one night with 0.1 events every hour.

I can't use the machine starting from tonight anymore as the store told me they will refund my money! But I have 2 days of usage data on the sd card, so is there anyway to transfer the data over without the need of a sd card reader or that's the only method?
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#8
Hi Mordi,
WELCOME! to the forum.!
Hang in there for more answers to your questions and good luck to you.
trish6hundred
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#9
It's not possible to get the data off the card without an SD card reader.
Someone you know should be able to copy it off for you; most current laptops or PCs will have a built-in SD card reader, otherwise you should be able to buy or borrow a card reader that plugs into USB port.
Many people have them to copy photos off a camera, so you probably know someone who has one.
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#10
Ok I managed to import the data to sleepyhead. Not sure if all that is needed is this but:

[Image: MxxMia.jpg]
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