Help with the Diagnosis
First time poster and newly diagnosed too. However, I have some doubts about the diagnosis. I will truly appreciate your feedback and insight.
The TLDR version: My question is how effective are the results of the home-test machine when tested for a single night on a especially restless night (restless due to having the machine attached to chest, the ribbon around chest to measure movement, tube in nose, and a pulse monitor on the index finger)?
Recently I started noticing that when I sleep on my back, my airway becomes constricted as if some muscle has collapsed in my throat. Even though I rarely sleep on my back, I mentioned it to my primary care physician. She advised that it was most likely due to the recent weight gain that I have had and would likely go away if I get back in shape. She still referred me to a Sleep Clinic.
The Sleep Study
I saw a technician at the clinic who showed me to to strap a small machine to my chest and the probes that go with it. Following are the details of the machine
1. It was a small sized rectangular black box (size of Apple TV I guess or a little larger than that)
2. There was a ribbon that went over my chest (to monitor chest movement I guess)
3. There was an attachment that went over my index finger (to monitor pulse I guess)
4. There was tubing with two little inlets that I had to put in my nose and tape the tubing
He programmed it for lights-out at 11:00PM and Out-of-bed at 6:30AM.
So feeling like RoboCop, I slept exceptionally poorly, woke up several times during the night, and actually had a sleep-deprivation type headache the next day and returned the device and scheduled an appointment with a sleep doctor.
At the follow up appointment, the doctor asked me a bunch of questions about sleeping. Most pertinent ones were:
1. Do I Snore? Yes I do. Mostly softly and if I turn on my back, which is rare as I have been cultivating a habbit of sleeping on my sides to minimize snoring (and not disturb the wife) and most recently after my throat starts to collapse in sleep and I wake up.
2. Do I feel tired or sleepy during the day? Nope. Only feel tired or sleepy when I do not have enough sleep (have a baby so some nights are worse than others) or if I am too physically exhausted when I go to bed (like after a day spent hiking)
3. Does my wife hear me snoring? Yes she does some times. Does she feel like I stop breathing? not really sure as I do go quite when I stop snoring.
4. If I have hypertension or other conditions? No.
She made me say Aaaaa! and proclaimed my airway naturally narrow after examining it.
She also made me bite a few times and confirmed that my lower-jaw sits behind the upper jaw.
The results from the nightmare machine were following:
• Out of some 450 recorded minutes, time in supine position was 0.5%
• Snoring was observed
• AHI of 20 per hour
• ODI of 22 per hour
• Apneas: 19 obstructive; 130 obstructive hypo, 2 central, and 5 mixed
• Minimum Oxygen Saturation: 79%
• Mean Oxygen Saturation: 94%
• Total time with less than 90% oxygen saturation: 3.2 minutes
• All leads to the conclusion: Moderate Obstructive Sleep Apnea
She gave me following treatment options to decide from:
1. Do Nothing: Not recommended but she said that statistically speaking my Apnea at this stage was not at the level to cause the cardio and other issues associated with severe Apnea. Also and option because I did not seem to be suffering from lack of energy. However, if I go this route, I should regularly get tested as Apnea likely to get worse as I age (I am in early thirties)
2. Get a Dental Device: Pushes lower jaw out, some 40% success rate, can de-shape the jaw over long term. around a thousand bucks after insurance and what not
3. Some soft tissue surgery UPAP or APAP or something like that to tone the tongue and muscles to open up the airway. Success rate around 50-65%. A decent chance of Apnea coming back as I age (as muscles de-tone). It will be a free operation (God Bless Canada!)
4. Jaw Bone Reconstruction Surgery to basically break my jaw bones and let them heal to give me a “perfect” bite to open my airway: Relatively new procedure (first generation with this treatment still alive). Success rate in high 80%. Very low chance (but a chance nonetheless) of it returning with age as its the bone that is fixed. Some CAD 18,0000 in cost as not covered by government (insurance may cover some portion or may not)
5. CPAP: Insurance will cover all cost of the machine and will replace it every 5 years and masks and stuff as often as needed or recommended by manufacturer.
I asked for a one month trial of the CPAP machine: They gave me ResMed S9 Auto with H5i Humidifier, climate controlled tubing, and a Nasal mask (Mirage FX).
I also asked to set up an appointment with the surgeon to discuss soft tissue surgery in more detail.
The CPAP Experience
First night, I put it on for a couple of hours but found the breathing out extremely uncomfortable and after some two hours, took it off and slept soundly afterwards, waking up refreshed as usual.
Next night, I scolded myself for the lack of discipline to really give the machine a chance and kept it on the entire night. Have had the mask on for 3 full nights now. Have gotten used to the mask and the machine now but there are two issues:
1. I wake up with an extremely dry mouth - I have found that its due to having my mouth open during sleep. I will get a jaw strap or a full mask on my weekly checkup for trial and see how those solutions work.
2. I have kind of gotten used to the machine and I took a break for one night from it. I do not feel ANY MORE energy whether I sleep with or without machine. Makes it demotivating to have to put on the mask every night for some possible long-term benefit with no real short-term benefit.
The New Results
Sleepy head has stated that, counting my two hour first night and 3 full nights with the machine, I have an AHI of around 2. So seems all is good.
As I were never experiencing any troubling symptoms of sleep apnea, I have been feeling quite sorry for my self and kind of depressed that I have to sleep with a mask on for the rest of my life.
So my question for you experienced folks is that is it possible that I may have had a false positive with the exceptionally crappy night that I had with the sleep study machine? I mean is it like the digital blood-pressure machines because they tell you crap with just attempt (and values change with different types of machines)? or is it something more accurate and it is pretty much done deal that I have sleep apnea and either should get a surgery with mixed results and chances of apnea coming back or sleep with a mask on?
Thanks for reading.. I kind of feel better after posting all of this stuff. Looking for your feedback earnestly.