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I had sleep apnea (now I don't) and confused
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justMongo Offline

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Post: #11
RE: I had sleep apnea (now I don't) and confused
Considering your PE and blowback on two valves, I would think the standard of cardiac care would be an annual echo and a stress test on a 2 to 3 year schedule. May I ask your age?

This is primarily a sleep apnea forum; but a number of members are being followed by cardiologists.
One reason is that sleep apnea, over time, has deleterious effects on the heart.

Some cardio docs will test more than others; still they are all under peer review and have a standard of care.

Sometimes arrhythmias come in episodic runs. Premature beats that come in doublets or even rare triplets are usually not of concern; an extended run is of concern. These are usually caught by a 24 hour monitor. There is a new monitor out that can run for up to 14 days. It's called a ZIO patch. Self contained with no wires to snag; and can be worn while showering. It's literally attached to the left pectoral area with superglue; and removed with acetone.

Then too, there are many reasons for feeling "bad." Too many to go into here.
Follow your physicians advice; and nudge them to investigate when appropriate.

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.
01-06-2016 10:59 AM
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multime Offline

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Post: #12
RE: I had sleep apnea (now I don't) and confused
(01-06-2016 10:59 AM)justMongo Wrote:  Considering your PE and blowback on two valves, I would think the standard of cardiac care would be an annual echo and a stress test on a 2 to 3 year schedule. May I ask your age?

This is primarily a sleep apnea forum; but a number of members are being followed by cardiologists.
One reason is that sleep apnea, over time, has deleterious effects on the heart.

Some cardio docs will test more than others; still they are all under peer review and have a standard of care.

Sometimes arrhythmias come in episodic runs. Premature beats that come in doublets or even rare triplets are usually not of concern; an extended run is of concern. These are usually caught by a 24 hour monitor. There is a new monitor out that can run for up to 14 days. It's called a ZIO patch. Self contained with no wires to snag; and can be worn while showering. It's literally attached to the left pectoral area with superglue; and removed with acetone.

Then too, there are many reasons for feeling "bad." Too many to go into here.
Follow your physicians advice; and nudge them to investigate when appropriate.

I'm 37 years of age. My original post was more about asking why two sleep studies could be so different. My post kinda turned into the heart issue which I didn't really expect.

I did call my PCP this morning and got squeezed in today. She did another EKG which was normal. She could hear a defined regurgitation sound from her stethoscope.

She ordered an echo and a stress test to be done at my local hospital (chest and stroke center). I also got a referral for a cardio consult. She also sent me for a ton of labs. The only lab test that said STAT (same day result) was a test called a "D Dimer" test.

She said that she thinks that my sleep apnea was secondary to my PE and thus once this was addressed my sleep apnea issues reduced. She said that if my heart is the problem it wouldn't surprise her if I had another sleep study and had an AHI greater than 5.

Just got a call from the hospital and I'm set on Monday morning for an echo of my heart, CT of my heart and lungs, and the stress test.

So maybe my sleep apnea isn't a primary Dx but in fact a secondary Dx. Fix the primary issue and that fixes the secondary (sleep apnea) issue.
01-06-2016 03:11 PM
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surferdude2 Online

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Post: #13
RE: I had sleep apnea (now I don't) and confused
Now you're cookin'! Hopefully they will find something that is fixable or easily relieved.

Dude
01-06-2016 03:25 PM
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justMongo Offline

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Post: #14
RE: I had sleep apnea (now I don't) and confused
And BTW, the D-dimer is a test for a clotting factor in the blood.
You can read about it here: https://en.wikipedia.org/wiki/D-dimer

"echo of my heart, CT of my heart and lungs, and the stress test..."
Now that's a good battery of tests...

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.
01-06-2016 06:00 PM
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multime Offline

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Post: #15
RE: I had sleep apnea (now I don't) and confused
My test results showed up in my patient portal and I'm mad at my PCP again. When I asked her if my EKG was normal she replied that everything looks fine.

Well my EKG results show as abnormal and says I have Right Ventricular Strain. I called her office and tried to get an explanation. She said that everything looked okay as far as needing urgent medical intervention.

This is such a copout and she just doesn't get why this ticks me off. So it seems that this ekg result can be related to an PE. Now I know why the D Dimer test is being run.

My D Dimer results came back abnormal. My results say that the normal range is <500. My result just says >500 H but doesn't show a specific result like 800 for example.

So I have no idea of the risk yet of having a PE but my doc ordered only light activity and bed rest until my tests on Monday.
01-06-2016 07:55 PM
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heyheyhey Offline

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Post: #16
RE: I had sleep apnea (now I don't) and confused
It might be a reaction/side effect to your new medication. My husband was put on a different hbp medicine and it caused MS-like symptoms.
01-07-2016 10:15 PM
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player Offline

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Post: #17
RE: I had sleep apnea (now I don't) and confused
If it was me, I would buy your own APAP machine. Get a used one and use Sleepyhead to monitor your progress. An oxygen monitor that SH supports would also be good.
01-08-2016 06:15 PM
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vsheline Offline

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Post: #18
RE: I had sleep apnea (now I don't) and confused
(01-06-2016 03:11 PM)multime Wrote:  My original post was more about asking why two sleep studies could be so different.

You should have a copy of the full reports (usually includes 2 or 3 pages of detailed data) both for the diagnostic study (no CPAP) and for the titration studies.

One possible explanation for the difference would be if the new study was not done properly. For example, if too little time in REM sleep occurred while sleeping flat on your back (supine position) the results would tend to underreport your AHI and RDI.

OSA is usually strongly positional, with the supine position usually the worst. Also, OSA tends to be worse during REM sleep stage. So every sleep study is supposed to include a certain amount of REM stage sleep while in the supine position.

And if RERAs were not scored, that would totally invalidate the Respiratory Disturbance Index. It is the RDI (which is the sum of Apneas plus Hypopneas plus RERAs per hour) which is what the insurance companies should be using to determine eligibility for a 'PAP machine, not the AHI. If they are using AHI instead of RDI, then shame on them.

(01-08-2016 06:15 PM)player Wrote:  If it was me, I would buy your own APAP machine. Get a used one and use Sleepyhead to monitor your progress. An oxygen monitor that SH supports would also be good.

I agree. Your heart issues and other symptoms in the last 6 months could have been caused by sleep apnea. Your original CPAP prescription is still valid for replacing a machine. CPAP prescriptions don't expire like prescriptions for drugs do.

That your insurance does not cover continued use of a 'PAP machine is no reason to stop therapy unless you are sure it would not help you. Right now a fully data-capable APAP machine with Central Apnea Detection would provide you important information on your health condition and may help prevent further damage to your heart. Your last sleep test covered just a few hours of one night. A data capable APAP machine can provide a mini titration every night, and data on all events.

I would suggest either a gently used ResMed S9 AutoSet or a gently used Philips Respironics System One REMSTAR Auto DS560 with heated hose option. Supplier #2 usually has these in stock at reasonable prices and 6 month warrantee. (A link to the Supplier List is in the header at the top of all forum pages. An APAP can be set up like a fixed-pressure CPAP if that was what the original prescription was for. And once you have it there is no law which says you cannot adjust your own legally-obtained machine.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 01-10-2016 04:50 PM by vsheline.)
01-10-2016 04:11 PM
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multime Offline

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Post: #19
RE: I had sleep apnea (now I don't) and confused
I'm going to post my sleep study results to see what you think I should do. My previous DME went out of business (Univita) so I can't get my past Rx from them. My PCP refuses to give me a copy of my older lifetime Rx based on the grounds that my latest sleep study shows I don't have sleep apnea.

So I have no Rx to buy my own machine nor can I get a new Rx.

My at home study is attached with the others coming soon.
(This post was last modified: 01-11-2016 05:29 PM by multime.)
01-11-2016 04:05 PM
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multime Offline

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Post: #20
RE: I had sleep apnea (now I don't) and confused
Home sleep study results.
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(This post was last modified: 01-11-2016 05:52 PM by multime.)
01-11-2016 05:43 PM
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