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Newbie - seeking roadmap for Dx and Tx
#1
Newbie - seeking roadmap for Dx and Tx
Hi Folks,

Newbie here.
  • Male, age 42.
  • Physically fit, low body fat.
  • Blood pressure on the low side.
  • Have deviated septum, but not severe.
  • Have IBS, symptoms of which interfere with sleep (mainly pain/discomfort keeps me from falling asleep).
  • Wake at least once per night to pee, then remain awake for 30-60 minutes. Sometimes wake multiple times.
  • When I wake after 6, 7, or 8 hrs in bed, I feel the heavy weight of fatigue and just want to sleep more, but have trouble returning to sleep.
  • Regular daytime fatigue, can easily lie down for a nap and fall asleep during day or eve. Scored a 6 on the Epworth scale, which I understand is not very high.
  • I use blackout curtains, eye mask, earplugs. Home and neighborhood are very quiet.
Due to [insert rant about sh*tty state of U.S. healthcare system] a proper sleep study in a lab is cost prohibitive. This may change in the future.

So for now, what kind of roadmap can I follow to at least narrow down my diagnosis?
  • Check blood O2 levels?
  • Try CPAP machine (as noted on forums, much cheaper than a sleep study)
  • Other things I can try?
My goal is to find short term clues and relief, while acknowledging I need a full sleep study in the future.

Thanks all!

M4
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#2
RE: Newbie - seeking roadmap for Dx and Tx
First step would be a recording oximeter. This would tell if your O2 is dropping during the night. It will NOT say yes, you have sleep apnea, but it would reveal there is a problem. Also check during the day several times to see what your typical blood O2 is. Normal resting should be 96 plus. Normal sleep should be 90-92 and up.

If your blood O2 drops below 90 or 88 in your sleep multiple times, you have two options. One would be to rent a home study. No clue about the cost but it may be worth it if cheaper than an APAP. The other option is to get a data capable Auto PAP. You can use it overnight with the pressure wide-open (meaning 4-20) for several nights to see what is happening. You can view the data with several different types of software, depending on what device you get.

You can view the data to determine if it is sleep apnea and, if it is, you can determine what your treatment pressure is. We can help with that.

This is not a quick process! If you got a machine tomorrow, it would take at least 2weeks (usually more) until you came up with the treatment range and longer before you noticed any kind of difference.

You can find used machines on Craigslist, eBay, and from Second Wind (Supplier #2).
PaulaO

Take a deep breath and count to zen.




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#3
RE: Newbie - seeking roadmap for Dx and Tx
I'm from Canada and not familiar with the options you have in the US. I was just tested in Canada for Sleep Apnea. It was an at home test, not an overnight sleep test in a clinic. No idea of the cost as it was covered by our government health care system. But, since it is at home, perhaps it is cheaper??? It tests for apnea and gives you a very detailed report including oxygen levels. Most CPAP machines do not give oxygen. It does have to be read by a professional for the diagnosis. I guess you could check around in your area to see if that service is available and what the cost would be. It is called the Alice NightOne testing system. Here is a link to some information on it. There is a quiz to determine if you are probable to have apnea. There is also a link to find where the service may be available.

https://www.sleepapnea.com/diagnosis/in-home-testing
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#4
RE: Newbie - seeking roadmap for Dx and Tx
Paula,

Thanks so much! I'll start with an O2 meter and proceed from there. I can't even see a nurse for 10 minutes without paying 4X the cost of an O2 meter, so it's worth the cost.

-4M
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#5
RE: Newbie - seeking roadmap for Dx and Tx
Hi midori4000 and welcome to the forum, you came to the right place for some very good help. Along with the good suggestions already offered there will for sure be more to come. If it's within reason for you I recommend that you have a basic physical checkup along with blood work to hopefully rule out physical issues other than sleep apnea. I agree with the responses that you have already received. One approach might be for you to locate a friend or family member that has a backup machine available for you to use or, as has been mentioned, locate an affordable machine on E bay  or Craig's List. Masks and hoses are available on line and without Rx from some sources. Stay tuned for additional input stick with, it and I believe you will dig out of this hole. Keep us posted.

Stan
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#6
RE: Newbie - seeking roadmap for Dx and Tx
^ That's a really good (and intriguing) idea! I bet if you asked around, you'd find plenty of friends who have a CPAP in their closet. Maybe they'd let you borrow one!
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#7
RE: Newbie - seeking roadmap for Dx and Tx
Midori4000,
I have never had a proper sleep study. I was scheduled for one and the insurance company changed it to a home study because I was not an invalid. The home study was free! You might want to check with your insurance company about this. 

car54
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#8
RE: Newbie - seeking roadmap for Dx and Tx
(03-24-2018, 05:00 AM)car54 Wrote: Midori4000,
I have never had a proper sleep study. I was scheduled for one and the insurance company changed it to a home study because I was not an invalid. The home study was free! You might want to check with your insurance company about this. 

car54

A free home study sounds like a good deal. How long ago was that?
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#9
RE: Newbie - seeking roadmap for Dx and Tx
Hi All,

I've run the O2 meter a number of nights now. I've noted brief drops to 90, 88, and 86% SP02 over four different nights. I haven't gathered as much data as I'd like due to
  • The PulseOx meter I'm using has a bad UI (User Interface) so I've overwritten a few nights' data by mistake
  • Sometimes I dislodge the PulseOx meter from my finger while sleeping.
I'm not seeing frequent, alarming drops, but I admit I don't know how to interpret the data like a pro.

I'm wondering - is there some way to pay for a phone/web consult with a sleep tech? There are a lot of variables here, and I'd like to get an expert opinion.

As mentioned earlier, dealing with my local sleep lab will run major $$$, even for a brief consult.

Thanks.
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#10
RE: Newbie - seeking roadmap for Dx and Tx
If your data drops are spikes, then don't worry about them. They can be caused by moving or striking the sensor. You need to look at the overall trend of the plot.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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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.
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