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Need advice - newly diagnosed with mixed apnea
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dfries Offline

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Post: #1
Need advice - newly diagnosed with mixed apnea
I was recently diagnosed with sleep apnea and I am going to have a titration test in about a week. I am actually looking forward to the thought of not being tired and run down all the time. I am pretty sure I have had sleep apnea my whole life.

One friends has apnea and only has negative things to say about the CPAP and says that I will have a hard time adjusting and that its going to suck. (Dating, traveling, and the wallet). I feel like i will adjust fairly quickly, since i know i need to be treated to live a long healthy life.

Any positive advice would be greatly appreciated. I really want to make sure I make an informed decision when buying all of the equipment to treat my apnea

Here is a bit of information about me:
Age: 29
Sex: Male
Height/Weight 5'7"/200lbs

Results:
AHI 80.9 /h
Obstructive 8.2 /h
Central 5.4 /h
Hypopnea 67.3 /h

Lowest Sp02: 82%
Average: 93.1

Highest Heart Rate: 147.7
Lower Heart Rate: 27.6
Average Heart Rate: 63.8

Sleep Efficiency: 69.7%
12-26-2015 11:18 PM
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Sleeprider Offline
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Post: #2
RE: Need advice - newly diagnosed with mixed apnea
Welcome to the forum. Your attitude will make adjusting to positive pressure therapy much easier. The more involved you are in this, the better the outcome. Also, catching this problem in your late 20s rather than your 40s or 50s will spare you a great deal of potential damage to your health.

You have severe apnea, but it will resolve with the therapy. The fact you have both obstructive and central apnea means the titration will hopefully evaluate a progression of CPAP, BPAP (bilevel), and if necessary ASV. To learn more about titration, do a search for 'CPAP Titration Protocol'. You will find articles describing the flow chart of how a titration should be conducted to arrive at your prescription.

Lots of good information here on the forum. Be sure to read the Wiki articles, especially the acronyms. That will keep you from feeling overwhelmed by some of the jargon you might hear in responses. Good luck, and remember, it may still take a while for this all to come together. You may have to keep pushing to move things forward after the titration study, like a prescription, and equipment procurement.

One last question, how is your insurance in terms of deductibles and copay? The equipment costs are somewhat high, however alternatives exist to purchase equipment less expensively if your insurance is not up to the task.

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(This post was last modified: 12-27-2015 01:01 PM by Sleeprider.)
12-26-2015 11:44 PM
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DeepBreathing Offline
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Post: #3
RE: Need advice - newly diagnosed with mixed apnea
G'day dfries, welcome to Apnea Board.

While it's true that many people give up on CPAP therapy, a positive attitude and a good support network will go a long way towards ensuring success. You've already got the first, and the people on this forum will help provide the second.

The central apneas are only a small percentage of your total AHI and hopefully will resolve with therapy. Otherwise, as Sleeprider said, you may need an ASV machine. These are expensive and insurance companies won't normally authorise one unless you've been through a progression of cheaper types. Get in touch with your insurance company (not the DME) and find out exactly what their rules are and what you're entitled to.

Good luck!

DeepBreathing
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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.
12-27-2015 01:33 AM
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vsheline Online

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Post: #4
RE: Need advice - newly diagnosed with mixed apnea
(12-26-2015 11:18 PM)dfries Wrote:  I was recently diagnosed with sleep apnea and I am going to have a titration test in about a week. ...

Any positive advice would be greatly appreciated. I really want to make sure I make an informed decision when buying all of the equipment to treat my apnea

Here is a bit of information about me:
Age: 29
Sex: Male
Height/Weight 5'7"/200lbs

Results:
AHI 80.9 /h
Obstructive 8.2 /h
Central 5.4 /h
Hypopnea 67.3 /h

Lowest Sp02: 82%
Average: 93.1

Highest Heart Rate: 147.7
Lower Heart Rate: 27.6
Average Heart Rate: 63.8

Sleep Efficiency: 69.7%

Hi dfries, welcome to Apnea Board.

Here is a link to machine recommendations (and much more) by member Archangle:
http://www.apneaboard.com/wiki/index.php?title=Archangle:Links

Your sleep report shows you have very severe Obstructive Sleep Apnea (OSA). Very important to get treatment, and CPAP is the gold standard in treating OSA.

Also, I think your lower heart rate was unusually low. I trust you will inform your cardiologist about this result, just to keep on the safe side. I suggest buying (if feasible) a recording pulse oximeter to track your progress. A prescription is not needed for a recording pulse oximeter, but you can ask your doctor if he will write one, if insurance would cover it. The type which is worn on the wrist like a watch, with separate finger sensor, is more comfortable to wear all night. Supplier 19 sells these and is reputable. A link to the Supplier List is at the top of all forum pages. Or, special pulse oximeter models are available from ResMed or Respironics which plug directly into their CPAP machines, but those are about 10x more expensive.

During your sleep study the number of Obstructive Apnea (OA) and Hypopnea (H) events per hour was about 15 times higher than the number of Central Apnea (CA) events per hour, but I think even 5 CA events per hour shows you are susceptible to central apneas. CA events usually are not reduced when using CPAP or Auto PAP or standard bilevel PAP machines.

CPAP and Auto PAP and standard bilevel PAP machines can eliminate nearly all obstructive events but cannot not treat central events. A special type of bilevel PAP machine called an Adaptive Servo Ventilator (ASV) bilevel PAP machine is able to prevent both obstructive and central events. However, ASV machines are much more expensive and usually are covered by insurance only after a standard machine has been tried and (during non-ASV PAP treatment) the central events are at least 5 per hour and outnumber the obstructive events.

Tip: don't be shy to ask your doctor to prescribe the exact CPAP model you would prefer. Also, ask the doctor whether the sleep lab can switch to an ASV titration if the number of centrals increases when being treated by CPAP or bilevel CPAP.

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: 12-27-2015 01:56 AM by vsheline.)
12-27-2015 01:34 AM
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Jimsp1 Offline

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Post: #5
RE: Need advice - newly diagnosed with mixed apnea
(12-27-2015 01:34 AM)vsheline Wrote:  
(12-26-2015 11:18 PM)dfries Wrote:  


Also, I think your lower heart rate was unusually low. I trust you will inform your cardiologist about this result, just to keep on the safe side. I suggest buying (if feasible) a recording pulse oximeter to track your progress.

Actually a average heart of 63.8 is in a very normal range. It depends a lot your physical condition and exercise history. In my case I'd be concerned if it went much above 63.8. I do agree that the recording oximeter is a good idea. I found one for $96. It's one thing to know many events you have but also good to know how much the desaturation was. It will also show your average and heart rate range.
12-27-2015 09:43 AM
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icewlf Offline

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Post: #6
RE: Need advice - newly diagnosed with mixed apnea
Welcome dfries. Sleeping with a cpap or higher isn't as bad as a lot of people think. I dreaded it when i was first diagnosed, but my body adapted quickly. The first few nights, I got very little sleep, but after that, I had very few problems. going into it with a good attitude definitely helps!

For me, the worst part was the titrations just because of all the sensors they have to hang off you. Depending on where and how your sleep study was done, you may have already gone through that once. My recommendation for it is, bring a comb to help get the goop out of your hair. I found using a fine tooth comb, and really really hot water got 90% out, and then the rest came out easily with shampoo. The first time, when I tried to just wash it out, it didn't work so well =P

Also, as was stated earlier, but sure to ask any questions you have, and be sure you are comfortable with the explanations. Its much easier going when they make you part of the treatment!
12-27-2015 10:18 AM
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vsheline Online

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Posts: 1,908
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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
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CPAP Pressure: 15 EPAP, PS 5-10
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Location: California, USA

Post: #7
RE: Need advice - newly diagnosed with mixed apnea
(12-27-2015 09:43 AM)Jimsp1 Wrote:  
(12-27-2015 01:34 AM)vsheline Wrote:  
(12-26-2015 11:18 PM)dfries Wrote:  


Also, I think your lower heart rate was unusually low. I trust you will inform your cardiologist about this result, just to keep on the safe side. I suggest buying (if feasible) a recording pulse oximeter to track your progress.

Actually a average heart of 63.8 is in a very normal range. It depends a lot your physical condition and exercise history. In my case I'd be concerned if it went much above 63.8.

Sorry for being unclear. I meant this reading:
Lower Heart Rate: 27.6

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: 12-27-2015 11:46 AM by vsheline.)
12-27-2015 11:44 AM
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trish6hundred Offline

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Post: #8
RE: Need advice - newly diagnosed with mixed apnea
Hi dfries,
WELCOME! to the forum.!
You have a great attitude and that will go a long way toward helping you through CPAP tharapy as you get used to it.
Much success to you as you start your CPAP journey and hang in there for more responses to your post.

trish6hundred
12-27-2015 12:47 PM
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dfries Offline

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Post: #9
RE: Need advice - newly diagnosed with mixed apnea
Thanks for all of the information!

my insurance seems to be pretty decent $500 deductible and i pay 10% out of pocket for the pap machine. it doesn't appear that my insurance is picky about which type. The worst part about the process is waiting for all the approvals. i feel like i am going to sleep like a rock when i finally get setup :-)

I was concerned about my heart rate, but my doctors(ENT, sleep center, and internist) all said my heart is fine. They just want me to get the machine soon, so i can start sleeping.
12-29-2015 01:14 AM
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cate1898 Offline

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Post: #10
RE: Need advice - newly diagnosed with mixed apnea
Welcome to the forum dfries! Sounds like you are off to a good start and your positive attitude will go a long way to helping you, it does make such a difference. Make sure you get a fully data capable machine so that eventually you can track your progress on SleepyHead (link at top of forum pages).

APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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12-29-2015 07:46 AM
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