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Newbie questions
#1
I'm 61, male. After years of sleeping lightly, waking often, feeling tired all day, and occasionally experiencing depression (& taking antidepressants), I had a sleep study. I had 5.3 events per hour over about four hours of sleep.

I have also noticed that I appear to have chronic nasal congestion. Using a spray decongestant helps; I feel that I sleep better but still not great (I followed my decongestant routine the night of my sleep study so the 5.3 events per hour was in a state of reduced nasal congestion.)

I'm just curious as to whether I really need, or am likely to benefit from, CPAP. My doctor says my diagnosis is "borderline" but probably worth treating. FWIW, the night of my second sleep study (CPAP titration) I found the mask to be not particularly bothersome and actually felt that I slept pretty well given the inherent "strangeness" of the surroundings, etc. I'm willing to give it a try but wonder if it's really warranted, or if there are other avenues that might be more fruitful. Any thoughts?

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#2
Welcome, JCB. What kind of doctor did you see? You may need to contact an ENT specialist about the chronic nasal congestion.

It appears you'd benefit from using a machine. The real question is whether your doctor will prescribe a CPAP for you. If you're in the US you'll need the script to get a machine.
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#3
It is borderline. I think many insurance companies would not pay for CPAP at an AHI of 5.
Many people who are diagnosed have AHIs in the 40 to 60 range. They strive for an AHI under 5 with therapy.

Nasal congestion has little to do with apnea. Obstructive apnea usually occurs when the airway is restricted by the tongue or soft palate collapsing into the airway such that even mouth breathing would be obstructed. CPAP splints the airway open.

Your condition may worsen with age.

Are you overweight? Losing weight could put off the need for CPAP.
Get a copy of your sleep study; and look at your oxygen saturation levels.

Talk it over with your doctor.

addendum: One night in the sleep lab is not the whole story. Every night can be different. You'll note that many people on the forum use machines that are Auto. They are able to adjust for the variations in a night's conditions. Set to operate within a range of limits, these machines do an auto-titration every night.
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#4
(05-15-2014, 09:29 AM)JCB7777 Wrote: I'm 61, male. After years of sleeping lightly, waking often, feeling tired all day, and occasionally experiencing depression (& taking antidepressants), I had a sleep study. I had 5.3 events per hour over about four hours of sleep.

I have also noticed that I appear to have chronic nasal congestion. Using a spray decongestant helps; I feel that I sleep better but still not great (I followed my decongestant routine the night of my sleep study so the 5.3 events per hour was in a state of reduced nasal congestion.)

I'm just curious as to whether I really need, or am likely to benefit from, CPAP. My doctor says my diagnosis is "borderline" but probably worth treating. FWIW, the night of my second sleep study (CPAP titration) I found the mask to be not particularly bothersome and actually felt that I slept pretty well given the inherent "strangeness" of the surroundings, etc. I'm willing to give it a try but wonder if it's really warranted, or if there are other avenues that might be more fruitful. Any thoughts?

According to medical standards and you doctor, you are borderline -- anything 5 or lower is not considered to be OSA or is considered "treated" for those on therapy.

I too am 61, with chronic congestion, and used nasal spray quite a bit to be able to sleep with my mouth closed. (Open mouth dried out and disturbed my sleep almost more than the apnea.)

Flonase has recently gone non-prescription so you might try that -- it doesn't have the 'rebound' effect of straight decongestants -- $12 for about a month, or in my case my sleep doc wrote a presciption so my insurance pays their portion.

I never expected to be able to use a nasal or nasal pillow mask but it turns out with a little help to get my nose INITIALLY clear, the CPAP itself through a nasal pillow mask seems to keep my nose open almost all night long almost every night.

This is a commonly noted effect. It works much like it does in the airway of the throat. This effect will NOT be present in a Full Face Mask (FFM) unless your mouth remains closed -- the nasal passage would have no usefully higher differential pressure.

However, even if you MUST use an FFM, the humidity control of the machine may make breathing through you mouth more comfortable -- although I doubt that alone would make up for all the other nuisances that come with CPAP.

If the cost (with insurance) doesn't disturb you, then you might try it but my suggestion would be to attempt to clear your nose and use a nasal pillow mask like the ResMed Airfit P10.

You are either going to find CPAP a marginal improvement or want to take advantage of the assistance to breathing through your nose.

For me, I would probably wear the Airfit P10 and continue CPAP even if there were NO long term health benefits, etc. I actually ENJOY wearing it since it is so non-intrusive.

Wearing it is more comfortable than not wearing it.

However, in my case, the reduction from AHI 49 to much less than AHI 1 means the long term health benefits are also extremely important.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#5
Hi JCB7777,
WELCOME! to the forum.!
It could be worth a try since you are borderline.
Hang in there for more suggestions and best of luck to you.
trish6hundred
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#6
I would give treatment a try. Ask to use an autoPAP so it can titrate for you.

If you are taking medications for depression, sit down with your doctor, either your GP or even your pharmacist, and discuss all the symptoms and counter-actions the medications can have/cause. Maybe one of them need adjusting.

If you cannot get the machine (cost, insurance, etc), you could try to put either a tennis ball in a pocket on the back of a t-shirt or even wear a backpack full of tennis balls, shoes, anything bumpy and uncomfortable, to keep you from sleeping on your back at night. This alone may help to reduce the apnea events enough to help you sleep better.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#7
So the doctor said try it for 30 days, if it really makes me feel better I'll want to keep going, if no change I can just stop - she's not worried about AHI 5 as an overall health risk. I'm two nights in, haven't had too much trouble adjusting to it. I like the deeper breathing it creates. Can't detect any dramatic difference in how I feel but presume that will take a little time.
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#8
(05-15-2014, 09:29 AM)JCB7777 Wrote: I had 5.3 events per hour over about four hours of sleep.

Just in case you would like something to compare to...I just began CPAP therapy 5 weeks ago. I had 66 events per hour. I was declared "severe", although I would have never guessed that. Immediately after starting CPAP, my AHI dropped...most nights it is under 1.0. I am certainly benefiting from therapy.

IMHO, your very mild apnea isn't the cause of your tiredness during the day. If you are sleeping very lightly and not getting good REM sleep, that is why you are tired. Is the mild sleep apnea the cause? I wouldn't think so...

But, what do I know?
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#9
My sleep study indicated I had "boarderline" apnea as yours did. The doc prescribed the machine for me based on other symptoms: I could not trust myself to stay awake when driving. I had moved into a remote area of the house to sleep so my wife would be able to sleep as well. I was tired all the time. I could only sleep on my side and I always woke up with either a hip hurting, or my back hurting. No way in the world could I sleep on my back.

So an auto-titrating Resmed S9 Autoset was prescribed for me.

I would never, ever consider going back to where I was before.

Now I sleep wonderfully, I do not fall asleep when eating my cornflakes or driving my car, my wife and I can actually sleep in the same bed again, and probably my favorite, I can sleep on my back or my side. I'm lovin' the livin'.

I would encourage you to try a pillows mask even though you feel you have congestion problems. I felt that way too, and learning to breath through my nose even though I do still use a chinstrap to help encourage my mouth to stay shut (I have to do that at night because when my wife is asleep she cannot reliably tell me to shut my mouth.) --- has been wonderful.
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