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New to CPAP and have questions about my diagnosis
#1
New to CPAP and have questions about my diagnosis
I have recently been diagnosed with SA, a couple of weeks ago after a barrage of tests to determine the cause and treat of Angina, I was given a sleep test. I scored 49.5 and was diagnosed with Severe SA. My Doctor wrote me a script for a CPAP machine, I was put on a 30 day trial  with a Resmed Airsense 10 autoset. The first day or two of my trial I had no SD card and knew little about the apparatus. After reviewing the Data (thanks to the knowledgeable people on this forum) the thought had occurred to me of a misdiagnosis of my initial sleep test. My AHI level has dropped from almost 50 to .5. Somehow, after reading stories on this board, of personal trials and results,  this seems a bit odd. Here is a Screen of my latest sleep data. 
Thanks for any help on this
Mike
   
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#2
RE: New to CPAP and have questions about my diagnosis
Congratulations on so successfully treating severe apnea, especially right from the outset.

It is very unlikely that a person who does not have apnea would show an AHI of 49 on a sleep study. I also note that you have periods of significant flow limitation, which also suggests that your airway easily becomes constricted.

Do you have a copy of your sleep study? If not, could you request one? If you blank out your personal information and post a scan of it, people here could take a look and give you a more informed response.
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#3
RE: New to CPAP and have questions about my diagnosis
Welcome to Apnea Board,

The AHI of 0.59 is excellent. And keep in mind this result is due to the ResMed PAP therapy. So this is a treated result, but you still have apnea. It's only treated if you use the PAP.

I see a moderate amount of Flow Limits, and with the fact that you're already using EPR of 3 full time, the only thing to do to address this is to increase the minimum pressure from 8 up some from there possibly 9. Also you may want to turn off or at least an edit of the Ramp setting as for the 20 minute duration you're at too low a pressure for good therapy.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 12:57 PM)SarcasticDave94 Wrote: Welcome to Apnea Board,

The AHI of 0.59 is excellent. And keep in mind this result is due to the ResMed PAP therapy. So this is a treated result, but you still have apnea. It's only treated if you use the PAP.

I see a moderate amount of Flow Limits, and with the fact that you're already using EPR of 3 full time, the only thing to do to address this is to increase the minimum pressure from 8 up some from there possibly 9. Also you may want to turn off or at least an edit of the Ramp setting as for the 20 minute duration you're at too low a pressure for good therapy.

My only concern about the AHI score is the drastic change. I am not upset about it, just a little skeptical considering the anecdotal evidence I have read here, I just talked to my doc and  she is going to send my sleep study so I will post that in the future. We shall see if this has a long term effect on my BP as well. Fingers crossed.
Thanks
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#5
RE: New to CPAP and have questions about my diagnosis
In 2017, I had an AHI of around 38 with centrals at 124 and obstructives at 24. I did have an AHI of 76 or so before losing 100 pounds via bariatric weight surgery in 2016. When my ASV machine was on the same page, my treated AHI was about 2 most nights. Your results sound real from what I see, and I think it is believable.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 12:45 PM)Dormeo Wrote: Congratulations on so successfully treating severe apnea, especially right from the outset.  

It is very unlikely that a person who does not have apnea would show an AHI of 49 on a sleep study.  I also note that you have periods of significant flow limitation, which also suggests that your airway easily becomes constricted.

Do you have a copy of your sleep study?  If not, could you request one?  If you blank out your personal information and post a scan of it, people here could take a look and give you a more informed response.

    As requested I just received this from my Doc
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#7
RE: New to CPAP and have questions about my diagnosis
lower ahi is precisely why you need cpap. it's a measure of how effective the treatment is. my ahi went from untreated 72 to treated 6 from the get go, even with the wrong machine and misguided settings form the sleep doc. it never occurred to me that the lower treated ahi might indicate a misdiagnosis. of course I had 7 sleep studies over many years and I was pretty much completely non-functional before finally getting treatment 30 years after my first diagnosis, so there was no question.
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#8
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 03:38 PM)sheepless Wrote: lower ahi is precisely why you need cpap. it's a measure of how effective the treatment is. my ahi went from untreated 72 to treated 6 from the get go, even with the wrong machine and misguided settings form the sleep doc. it never occurred to me that the lower treated ahi might indicate a misdiagnosis. of course I had 7 sleep studies over many years and I was pretty much completely non-functional before finally getting treatment 30 years after my first diagnosis, so there was no question.

Believe me I am quite happy with the results of the treatment.  Most of the results I have read are similar to yours but with the initial AHI being lower, however the treated apnea after the first bit always seems to be over 1 and quite often up to 5. I just can't imagine how I went from 50 to .5 after just 4 treatments, of course the period is short and these nightly results may change and likely will change a bit. This is the only reason I was questioning my initial study results. The results from the sleep study I posted were based on a single in-home test. So my questions is, before putting someone on a trial wouldn't the prudent thing be to repeat the test. Don't forget there are Covid 19 protocols in place at my DME center, I was handed the test equipment  through the door and given a link to a video (same way I was presented with CPAP) All appointments are done over the phone, and drop offs are into a tote outside the business door. I plan on continuing  the therapy and will attempt to master the CPAP Machine with some help.
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#9
RE: New to CPAP and have questions about my diagnosis
most people come here because like you they have been let down by their providers. it's very common to be issued a cpap and sent on our way. you mention 4 treatments. pap doesn't treat for a cure, so 4 treatments or 4000 treatments (if I'm understanding you correctly) isn't relevant. pap treats in real time and we revert to form the minute we stop using the machine. there's some night to night variability but it's not unusual to quickly go from 50 to under 5; consider yourself lucky to be one of the few with ahi below 1. most of us take a lot longer tweaking and optimizing to get there, and many never do that well.
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#10
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 04:23 PM)sheepless Wrote: most people come here because like you they have been let down by their providers. it's very common to be issued a cpap and sent on our way. you mention 4 treatments. pap doesn't treat for a cure, so 4 treatments or 4000 treatments (if I'm understanding you correctly) isn't relevant. pap treats in real time and we revert to form the minute we stop using the machine. there's some night to night variability but it's not unusual to quickly go from 50 to under 5; consider yourself lucky to be one of the few with ahi below 1. most of us take a lot longer tweaking and optimizing to get there, and many never do that well.

By treatments I mean sessions. I understand that PAP is not a cure. Wink
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