I ordered a home test on myself not thinking that I had sleep apnea but more out of curiosity since my family says I snore a lot, and I wanted to be able tell my patients what it entailed. To my surprise I have moderate Sleep apnea with AHI 20.6 per hour. I was also concerned about the desats to 81%.
Note to self- do not order a test unless you want to deal with the results!!
Here is the sleep report:
Clinical History
Rule out sleep apnea syndrome.
Report
This is an ambulatory Type III home sleep test (Alice PDx) performed for the evaluation of sleep-disordered breathing.
Findings
The duration of the recording was 300.0 minutes. During that time, the patient had 307 snoring episodes. There were 103 apneas and hypopneas which were mostly obstructive in type with an average of 20.6 per hour (AHI 20.6). These events ranged in duration from 10 to 43.0 seconds with a mean duration of 19.9 seconds.
There were a total of 88 desaturation events with the lowest SpO2 at 81% compared to an average value of 92% and with a desaturation index of 17.6. Patient spent 5 minutes with SpO2 below 89%. The mean heart rate was 65.2, and the highest heart rate was 83.
Impression
Obstructive sleep apnea/hypopnea syndrome of a moderate degree.
Recommendations
- 1. Treatment of choice for this patient is Nasal CPAP.
- 2. Auto PAP 7 to 15 cm H2O at home would be appropriate in the absence of co-morbidities such as CHF, COPD, or neuromuscular disease, otherwise In Laboratory CPAP titration is needed.
- 3. Follow-up with Physician in 4 - 6 weeks from initiation of CPAP to download compliance data and make adjustments as needed.
- 4. Patient should be cautioned not to drive if sleepy and not to use alcohol or sedatives close to bedtime.
- 5. If applicable patient should participate in a weight loss program with medical supervision to bring BMI to below 30.
Electronically Signed By:
Diplomate, American Board of Sleep Medicine
Signed Date and Time: Saturday, June 03, 2017 6:37 PM
I am doing this without insurance as my deductible is large. Before I found this site, I researched machines and decided to get Resmed AirSense 10 auto for her- so I accidentally bought a good machine. I am using the Dreamwear nasal mask and like it a lot.
Initially, I followed the suggestions from the test report to set the range from 7-15.
During the first week, I would often awaken with the pressure at 12.5- 13.I was uncomfortable and it was too much for me to go back to sleep. I would turn the machine off and on again to start at 7 again... then would awaken later and have to repeat the cycle.
The AHIs were between 5-6 with the CA 3-5 and OA 0.9 to 2. I did not feel good at all in the mornings.
I found this site and read that CA can be lowered with lowering the pressure or after a time the body adapts in some people and the CA get lower.
The second week, I changed the pressure range 7- 11.6 and lowered the EPR to 1. Can't remember how I settled on 11.6. I felt comfortable with this range and did not awaken due to the high pressure. I felt much better in the mornings and I won't sleep without the machine as it has made a big difference in how much better I feel. I am sleeping quite well now with these pressures.
The AHI are under 5. Most of the time between 3-4.5 with the OA 1.2 to 1.9 and the CA higher than OA.
I am wondering if I should give the CA more time to get lower or adjust the pressure?
I need to get to 4 posts to be able upload the sleepyhead for you to see any problems.
Thank you for suggestions.