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Newly Diagnosed - Unsure whether to start with CPAP or oral appliance
#1
Newly Diagnosed - Unsure whether to start with CPAP or oral appliance
I am a 22-year-old man from the US. I have suffered for two years with chronic, nearly debilitating fatigue. Doctors initially suspected a vitamin deficiency or autoimmune illnesses as the cause, but all tests came back negative/normal. However, when I started this summer to notice myself waking up and gasping in the night, my doctors decided to evaluate me for a sleep breathing disorder.

I underwent a home test and then an in-lab test. My in-lab test results were as follows:  my AHI was normal, but my Respiratory Disturbance Index was 11.3/hour. My lowest oxygen level was 82%, and my REM sleep accounted for just 10% of total sleep time. Based on these results, my doctor diagnosed me with mild obstructive sleep apnea.


My doctor has recommended an oral appliance as the first step for treating this condition, but I know that CPAP is a more common solution. I'm really not sure what the best course of action is. All I want is to reduce my fatigue levels and get my life back.

Any advice would be greatly appreciated.
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#2
RE: Newly Diagnosed - Unsure whether to start with CPAP or oral appliance
Welcome to the forum.

Here we have a decided preference for data, that and the gold standard treatment is CPAP.  Thus our preference is CPAP, specifically our choice would be for the ResMed AirSense 10 AuroSet or the AutoSet for her coupled with detailed data loaded into OSCAR.

That said there are those that have found that oral devices have worked for them.  The choice is yours.
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#3
RE: Newly Diagnosed - Unsure whether to start with CPAP or oral appliance
Did the doctor mention both alternatives and explain why he thought one route was better than the other?
Maybe he's seeing something with your facial structures and clearances in your throat?

If he only mentioned the one option.. ask him for his reasoning for both options.

Also.. did anyone test for Thyroid or Testosterone?  They are some of the usual subjects for fatigue (especially in older people) but it can apply to younger people too.
Maybe ask him for his thoughts on those too.

I went for at least a decade before we tested the correct things and diagnosed the multiple chronic issues I had been carrying.
In my case there were three conditions that could each explain fatigue and probably all contributed.

The key is to isolate the most significant root causes and then eliminate them one by one and see what is left.
Respiratory Disturbance Index has been demonstrated but I had multiple simultaneous issues.

If PAP is the best route forward.. you are in the right place to optimize your therapy.

Currently your Doctor is in the best position to explain his reasoning and convince you he's covered the obvious bases.
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#4
RE: Newly Diagnosed - Unsure whether to start with CPAP or oral appliance
CPAP is cheaper and more effective (if you actually use it and have the right machine and settings).
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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