New to the forum here's my story

[BillHD28]

So I was just recently diagnosed with severe sleep apnea ill post results from my psg. . It all started with back pain and shoulder pain along with fatigue and brain fog. Which is what got the first sleep study done which was a HST and it came back with ahi of 3.9 and you'll from the in lab I'm much higher lol. 

I've recently started having some nerve type issues pains in my arms neck hands and face. Im hoping are because of the osa. Ive read studies as well as a few other people saying they had similar almost MS type issues taken care of with cpap therapy. 

I have to wait until December 2nd to get a titatration study but my dr said I could get an apap instead but he didn't seem to thrilled with that idea. My question is from the numbers here would an app be enough?

Lab results

CAI 2.2
OAI 1.2 
MAI 0
AI 3.4
HI 32.1
AHI 35.5 
RERAI 3.6 
RDI 39.1

O2 SATURATION 
# OF DESATS 175
DESAT MAX SPO2% 11 
MEAN SPO2 91.5
MIN SPO2 83
SPO2% < 88 (MIN) 40.7

[Sleeprider]

You will be diagnosed with obstructive sleep apnea, because everyone is, but I'm seeing a lot of potential complex apnea or upper airway restriction that may yield some unexpected results with CPAP therapy. Because hypopnea and RERA are far better treated by having some difference in pressure between inhale and exhale, I hope you will be dispensed a Resmed Airsense 10 Autoset CPAP machine. It is far more flexible and just better at treating individuals with your diagnostic profile than a Philips Dreamstation, because it is actually capable of providing bilevel therapy with up to 3-cm difference between inhale pressure and exhale pressure (IPAP/EPAP).

You will be prescribed CPAP and it is up to you to choose a provider (DME) that is in-network for your insurance, but that does NOT have an exclusive distribution agreement for Philips. There are many DMEs that cannot dispense Resmed. Research the in-network DMEs, research their reviews, call to ask if they can dispense Resmed. You should choose the supplier you want and one you are most comfortable working with. Ask the doctor to specify the Resmed Airsense 10 Autoset in your prescription. If you have very high deductibles or copay with insurance, then consider buying the machine out of pocket. You can get the Autoset from Supplier #2 for $539.00, so use that as a comparison point for your costs. It is common for suppliers to propose renting the machine to you for 13 months. You will pay all deductibles and copay requirements for that rental over a span of two insurance calendar years, so will have deductibles to meet twice! Don't fall for it. If your insurance allows for purchase rather than rental, it is always a better deal, and if rental is required, try to keep it to less than 3-months.

[BillHD28]

What is complex apnea??? Sorry I new to this. I wasnt aware the reras were an issue in my case but again I'm very new to all of this. They never mentioned the reras only thr hypoapneas

[Sleeprider]

Complex apnea is a mixture of obstructive and central apnea. The reason I mentioned it is that we sometimes see the central events increase with the use of CPAP pressure. RERA (respiratory effort related arousal) and hypopnea are both byproducts of flow limitation. Flow limitation occurs when upper airway restrictions restrict the maximum flow rate of air. This results in a less than optimal peak flow which of course increases the respiratory effort needed to get a full breath and reduces the amount or volume of air taken in with that effort (hypopnea). This is an extremely common form of sleep disordered breathing, where relatively few obstructive apnea occur, but the air volume is impeded to the point of causing oxygen desaturation, hypopnea and RERA. It is all related and you can consider flow limitaiton, RERA, hypopnea and obstructive apnea as degrees of the same problem. While CPAP pressure can help to open the airway and remove some airway restriction, we know that "pressure support" (the difference between IPAP and EPAP) can assist respiratory effort to effectively reduce or eliminate flow limitation and hypopnea. An analogy I sometimes use is, your upper airway is restricted which makes breathing harder when you sleep, like walking uphill is harder than walking on the flat or downhill. Pressure support is like getting a push from behind with each breath or step. The increase in pressure during inhale helps overcome the restriction making breathing easier. It is more effective and more comfortable to use pressure support than to use constant higher pressure, which also makes exhale more difficult. This is why we strongly recommend the Resmed over the Philips when we see upper airway restriction.

As far as I know, you have not been diagnosed upper airway resistance syndrome (UARS), but it sure looks like it from your results. Here is an article in our wiki that explains the relationship between flow limitation, UARS and bilevel therapy http://www.apneaboard.com/wiki/index.php..._and_BiPAP Take a look. Also note the wiki has definitions and acronyms that will help you to understand better some of the terms you may read here.

[staceyburke]

It is defined in WIKI on this site.

http://www.apneaboard.com/wiki/index.php...leep_apnea

[BillHD28]

So cpap may be help me??

[BillHD28]

My typing is awful today lol. So there is a chance from what I'm reading that a cpap will not work for me

[staceyburke]

Yes it will help you. If central events increase a great deal then another type of Cpap would be needed. But that is a long way off. Most centrals go away after pap therapy is used for a few weeks.

You will need to begin therapy before you can be evaluated for other pap therapy.

Any way the main thing is you get started. I recommend a ResMed s10 autoset. Don’t accept other machines.

[Sleeprider]

I think you will greatly benefit from therapy, especially considering the number of events, arousals and the oxygen desaturations into the low 80s. CPAP therapy can be very comfortable and improve your sleep, eliminate the night-time bathroom trips and prevent problems like A-fib and other health problems. It can also be a frustrating experience without help. We will try to keep your experience positive. Once of the most important aspect is to get a mask that is comfortable and effective. I recommend the Resmed Airfit P10 nasal pillows mask because it is very light, quiet and easy to use as long as you contain the air from entering your mouth. We don't really want you to start on a full face mask unless you absolutely can't use nasal therapy. Take a look at the mask primer in my signature links.

[BillHD28]

Thank you to all for the information.  So is that redmed machine an apap I take it.  From what I understand I can have them get me that machine earlier.  But to have the study with the machine I have to wait until December 2nd