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[Diagnosis] WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
#1
WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
32m, bmi 22 here, after dealing with fatigue, brainfog, nocturia, joint pain, waking up feeling unrested with a dry mouth, symptoms of depression, anxiety and ADHD, I ordered a WatchPAT sleep apnea test from Lofta. 

I received a diagnosis of REM-related OSA - 'Mild' based on a REM pRDI of 16.7 and an O2 Nadir of 90%. Some results:
  • AHI of 1.9
  • 4.3 RDI events/hr, 34 total (8hr)
  • Light sleep 45% (ideal 55% according to Lofta) Deep sleep 40% (ideal 20%) REM sleep 15% (ldeal 25%)
  • REM sleep is lacking and disturbed. 
I'll be bringing my Lofta results to an appointment with my primary care physican next week. I don't know how to navigate the U.S. healthcare system and insurance very well and need advice on where to go from here. 
  • From what I read, my numbers may suggest UARS. Should I see a specialist / get a lab sleep study to seek or rule out a UARS diagnosis? 
  • My dental arches are narrow and I had braces as a teen, and my tongue shows signs of being too large for my mouth. I'm thinking this sleep apena or UARS - if the WatchPAT is accurate - is a muscoskeletal problem. I had a full smile as a child and a narrow one after braces. 
  • I'm interested in palatial expansion anyway to fix my narrow smile and give my tongue more room. Would I have a better chance of insurance (Cigna) covering it if I get treated for sleep apnea though insurance, even if it's more expensive?
Currently looking at the Resmed 10 Vauto. It looks like this is going to be a long haul and I'd greatly appreciate any advice for me.
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#2
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
With mild sleep apnea, it is unlikely any solution other than CPAP will be recommended, and under some insurance you barely make it. Your comorbidities of fatigue, brainfog, nocturia, etc are the only chance of even qualifying for CPAP. That said, the Resmed Airsense 10 offers bilevel therapy with up to 3-cm of pressure difference between inhale and exhale pressure using EPR, so by far, the best outcome will be a script for a Resmed Airsense 10 or 11 Autoset CPAP, and recommendation for self-titration which will let you adjust pressures for comfort and effectiveness. I would not get to far down the rabbit hole with UARS or any other self-diagnosis. Listen to the doctor, and advocate for CPAP therapy based on the problems you re experiencing. The surgical issues for a narrow smile are going to accomplish nothing if you're not talking to a ENT or cosmetic surgeon. Just put that one down as a separate issue, and for your sake I hope you don't go through with it.
Sleeprider
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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
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Just ordered a Resmed Autosense 10 with 600hr run time, $115 shipped from a local fb marketplace seller that I'm going to try out while I wade through the medical system. Maybe it will give me some more information to work with.
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#4
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Don't forget, you will need a hose, mask, and SD card.  Possibly some air filters for the air inlet also.
Jeff8356
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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
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Small update, I have an in-lab sleep study booked for next month, and ended up acquiring a 2600hr Resmed AirCurve 10 VAUTO for $120. Going to try using it with OSCAR before the sleep study to see if it'll tell me anything.

The sleep center did seem knowledgable about UARS. Hopefully, I will find out what is happening. The sleep center tech did note a narrow airway and scalloped tongue, so it is very possible my tongue is falling back in REM sleep and blocking my airway.
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#6
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
The Vauto gives tremendous choices and you are fortunate to have found such a good deal. If you choose to try it out, I'll be happy to help you to optimize settings.
Sleeprider
Apnea Board Moderator
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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#7
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
I've ordered a resmed p30i nasal pillow mask, heated tube, filters for my AirCurve 10 VAUTO. Once I have it set up with OSCAR, I may make a new thread with my findings and questions on how to set it up better. Thanks everyone for your help!
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#8
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Having problems with tolerating cpap; I think I've only slept 2 hours with it on but I'm not really sure. I could post the OSCAR screenshot from then (AHI 5-6)
  • I can't seem to fall asleep while 'breathing manually' on the cpap
  • On the inhale stroke, the air boost seems to cut off while I'm not done inhaling, giving me a small anxiety spike feeling like I can't breathe 
  • Air leaks out of my mouth if I don't keep my tongue firmly planted on the roof of my mouth, which is another problem trying to sleep. My tongue is too big for my jaws, which is part of the issue. 
The settings I have now are: 
MODE VAUTO
MIN EPAP 6
MAX IPAP 16
PS 3 
All other settings default

If anyone could offer advice on which settings would be good so I don't 'run out of air' on the inhale stroke, or any other advice, I'd appreciate it.
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#9
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Try setting the Ti Max to 3.5. That should eliminate the sudden drop. Leave Ti Min untouched.
- Red
Crimson Nape
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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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#10
RE: WatchPAT sleep apena diagnosis low AHI higher RDI. Need advice
Thanks to setting the Ti MAX to 3.5 from the above user's suggestion, I was able to sleep with the VAUTO on for about 4 hours until I woke up around 04:15-04:30 in the chart (obstructive apnea event?)

It's only one night's chart, but if there are any setting tweaks I can try I am open to suggestions. Thanks everyone for your help so far! 

   
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