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(07-17-2015, 10:41 PM)lowT Wrote: OK, so to be clear, one would need an Auto CPAP (also known as APAP, auto-titration CPAP, autoPAP, other). Basically the one that automatically adjusts the pressure as opposed to a standard CPAP (which has constant pressure). A basic bi-level would not be a candidate, but an auto bi-level should work as well? Anything that automatically adjusts the pressure and that allows recording since I guess the pressure would have to increase during an "event".
Once a device is identified, one would record and review what happens. BIG QUESTION: If there are no events (specifically respiratory events), would it be safe to assume that there is no need for a study? However, if there are events, then I would fall into a grey area where a study may help better identify the best treatment. In my case, I suspect there is a high percentage that I will not see any events.
The last question is doesn't a home sleep test provide respiratory event information as well? Those are only about $300-$350. The in lab cost is much more but tracks things like brainwaves, etc. Perhaps that is only recommended IF I fail the at home doctor study or fail the Auto CPAP self test though?
Last question first. If you can afford an in-home sleep study, that would be far preferable to DIY titration, and the results would be interpreted by a professional and a recommendation made. If you can do this, then I think the support for that option would be unanimous here.
Any of the machines with auto in it would be more suitable than straight CPAP. So, in Resmed the Autoset or VPAPauto in S9 or newer Airsense 10 series; and Respironics the Auto or Auto BiPAP in the 50 or 60 series. I would not get specialized machines like ASV or S/T at this point. In your case they would only be useful in the unlikely event you have complex apnea caused by CPAP therapy.
Once you use a machine, you can observe events in the data. In this case a low incidence of events does not necessarily mean no sleep disordered breathing is present without CPAP because you're using pressure. However combined with how you feel, you should have a pretty good idea of better or worse. Also, an auto cpap machine records things like snores and flow limitation and increases pressure to prevent apnea. If upon sleep the machine jumps up to 10+ cmH2O pressure, you kind of have an idea there is something going on. At that point the detailed flow data can be interpreted. Again, the home study option is best if that is feasible for you.
07-18-2015, 02:35 PM (This post was last modified: 07-18-2015, 02:43 PM by lowT.)
Sounds good. I don't mind paying the $350 or so for the home test. My initial concern was since the oximeter shows fine, that it would be a waste. But that is probably not true since I think it can detect respiratory events. The in lab test is the big cost one. But ultimately this is just going to cost money and I am going to have to bite the bullet. I will report back on what the sleep doc says late next week.
Thanks. I didn't see anything remarkable, but here is my graph for 2 nights. I did wake up 3 or 4 times, but went back to sleep within a few minutes. Is that a problem? I *think* the spike in the pulse is related to waking up. I will pay more attention next time to the times when this occur to see if it correlates.
I look forward to seeing how this works out for you, so stay involved and keep us posted. The more I see, the more I think your root problem is HRT rather than OSA, but you could end up with an OSA issue as a result of HRT. Is that clear as mud? Either way, I think you can clear the fog and feel more energetic by getting started with what you KNOW to be a problem, and keeping on top of the potential OSA issues.
Exactly, I totally agree with you. I don't think I have a sleep problem, but HRT is a serious decision. I want to rule out all possibilities and sleep is the last thing I am looking at. I have literally tried everything else.
Either way, I will definitely update things on here
Machine: REMstar System One with Autoflex Mask Type: Full face mask Mask Make & Model: Quattro AirFit F10 Humidifier: yes typical setting = 4 CPAP Pressure: 5-13 Autotritrating CPAP CPAP Software: SleepyHead
Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing
your charts look like they should (non-apnea) - like mine do while treated.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
(07-17-2015, 02:13 PM)lowT Wrote: I have a lot of fatigue and sleep a lot (about 10 hours at night and a 2 hour nap in afternoon). However, I also have low testosterone. Right now, one of the questions is if the low testosterone is due to poor sleep or is the other way around.
I am meeting with a sleep doctor next week to discuss the best approach (home sleep test, in lab test, or none). Perhaps I just need to get into a better rhythm for sleep too? I work at home and tend to push my nights until 2-3AM. I do have light blocking curtains though.
Anyway, so here is what I have done. I have used a couple iPhone apps and they suggest I don't move too much and I don't seem to move around at night. I also don't snore per the apps and per previous girlfriends. Recently, I have been using a pulse oximeter (CMS 50D+) and everything there looks normal as well (SpO2) remains above 95% and is an average of 98% throughout the night. I tried it for my nap and it is the same. I also remember dreams so maybe I am getting decent REM?
The questions I have are:
- Can a normal SpO2 overnight test still be associated with sleep dysfunction?
- Are there any specific questions I should ask the doctor?
- Based on the information provided, would a sleep test be excessive? The cost is out of pocket and about $900. I don't think an at home test is going add too much benefit since I my movement, snoring, and Sp02 all seem good.
- Are there any other "at home" tests I can do to get an idea? I am sort of a DIY guy and would also like to collect data over several days (instead of just one night).
- My worst fear is that I don't sleep "normally" the night of the test. In which case, would it be a waste? That is a LOT of money for something which I am not sure is necessary.
Thanks for any help! Looking forward to better understanding things.
Yeah. Low t will cause fatigue. It depends also on how low it is. Mine was 0 and I had bad fatigue. However, my osa didn't cause my low t, not sure it can. You should cover that with you dr. Low t can be caused by many things in my case I have Crohns disease and for some reason my immune system has attacked my glands as well. It helped me a lot to get on hormone replacement. I would ask your dr. About it, especially if it is causing such a problem.
Kinda. It depends on how "low" you are. It is a known fact that poor sleep can reduce testosterone by up 30% or so. But for some guys that are really low, an increase by that amount would not be sufficient. But for some, maybe it is just enough.
Either way, we know that the symptoms can overlap and it is a good idea to at least track it down and know for sure. The downside is that is can be costly to determine if sleep is an issue.
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