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Newly Diagnosed with Apnea - Have I been screwed?
#11
Carrie asked me if I would post a copy of her sleep study for her since she's used up her first day's allottment around here. So here 'tis. At first glance to me, it does seem she has moderate apnea. But to me, the question still remains: Did her apnea cause her weight gain and other symptoms, or did her weight gain cause her apnea?

http://i58.tinypic.com/2cx97qd.jpg


http://i60.tinypic.com/35k0235.jpg
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#12
My ResMed AirSense 10 is fully data capable and supports "automatic" APAP mode. Does the machine have a slot in the back with an SD card in it?

I'm one of the group here that advocates the ResMed Airfit P10 nasal pillows. Not knowing any better, I started with a nasal mask, read a bunch of people here advocating nasal pillows, and bought a P10 mask online out-of-pocket. Much more comfortable. I don't have leak issues. I sleep longer.

Your employer gets to pick how your co-pays and deductibles work. My last employer had an Aetna plan where the plan paid 50% of durable medical equipment. Then negotiated Aetna rate for the rental was a bit more than $50 and I was paying $26/month. Filters, mask/pillow parts, and replacement mask parts had a cheap negotiated rate where I paid half, too. I had a $500 deductible that was eaten up by the first sleep study. Every plan's deductible and co-pay are different. My new employer has zero deductible and DME is covered at 100%. My machine and all the spare pieces are "free".

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#13
(04-04-2015, 01:27 PM)retired_guy Wrote: At first glance to me, it does seem she has moderate apnea. But to me, the question still remains: Did her apnea cause her weight gain and other symptoms, or did her weight gain cause her apnea?

That is not an easily answerable question. At age 50, there could be all kinds of hormone-related causes where the weight gain triggered the apnea problem.
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#14
This from Carrie:

"In response to the weight gain - I started gaining weight because I'm too tired to do anything. Prior to the onset of this overwhelming fatigue (which has grown progressively worse the less 18 months) I was not overweight. I worked out at the gym 3x a week, hiked and camped every other weekend, and taught scuba diving classes. My physical activity decreased as the fatigue increased. My weight has slowly been increasing due to the lack of physical activity.

I am not hypertensive or have diabetes. My doc tested for everything under the sun to include lyme disease. Every test came back negative. The doc thought maybe it could be depression, because he couldn't find anything wrong with me. Initially he didn't think I could have apnea, because I don't fall asleep during the day. The sleep study was ordered to rule out apnea."

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#15
(04-04-2015, 11:35 AM)carrielsal Wrote: -Reading through the boards, it sounds like I have been given a very limited machine. Shouldn't someone have talked to me about CPAP machine options?

On the front of the machine, the model name is shown immediately under the "AirSense 10". If it only says CPAP then I think you have the lowest base model. I think the base "CPAP" model only reports compliance data and a single AHI number per night. It does not distinguish obstructive versus central apnea.

You want the model name to say AutoSet, or (much better, I think) AutoSet For Her. Both the AutoSet (which in color is black) and the AutoSet For Her (which is beige) can be set to fixed-pressure "CPAP" therapy mode, but only the AirSence 10 AutoSet For Her reports RERA events. Although no RERA events were noted during your diagnostic study, RERA events may crop up in future and its best to have a machine which will report them, especially if you are not feeling rested even though your AHI is small. Also, only the AutoSet For Her model allows the machine to use the standard AutoSet therapy mode or the new gentler For Her therapy mode, which both men and women may prefer.

(RERA events are arousals from sleep caused by excessive respiratory effort and are disruptive to sleep but are not counted in the AHI because the extra effort was managing to keep the airflow high enough that an Hypopnea did not occur.)

Actually, I suggest you stop using the machine (if it is not at least the Elite model) and return it to the provider, informing him that you will be looking for a DME who will supply the AutoSet For Her model, even if it needs to be set up in fixed-pressure "CPAP" therapy mode.

Although an APAP machine can be used in fixed-pressure CPAP therapy mode, it may make everything easier if your doctor will change the prescription to a pressure range, no matter how small the range may be (such as 1 lower than the pressure you're using now, to 1 higher than the pressure you're using now). If the prescription is changed to a range, the DME would need to provide an APAP model.

Any doctor can write a CPAP prescription; it does not need to be a sleep specialist.

Take care and good luck,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#16
(04-04-2015, 11:59 AM)carrielsal Wrote: My family doctor told me I should start feeling better after a few days of using a CPAP. I didn't expect an immediate cure, but after a week of faithfully using the CPAP I don't feel any relief from the overwhelming fatigue.

Some people do respond quickly to CPAP therapy, but a lot don't. I've been using my machine along with supplemental oxygen for around four months now and just started noticing a significant improvement a couple of weeks ago.

CPAP doesn't fix what apnea did to your body. It just alleviates the cause, but it's up to your body to do the actual healing and everyone's body is different. The real question to ask is, are you getting worse? If you are then you need to insist on more professional help.

I was noticeably deteriorating before I started therapy, and the first thing I noticed was that I had stopped getting worse. It took months after that until I finally started noticing improvement.

You have removed the condition that caused your tiredness, but your body has to do the work of repairing all that damage your apnea did. Don't give up.
Ed Seedhouse
VA7SDH

Your brain is not the boss.

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#17
(04-04-2015, 12:48 PM)carrielsal Wrote: I have emailed the scheduler and asked her to send me a copy of my prescription (which I never received).

Also ask for a copy of the sleep study results. You'd like to find out what your AHI was with no CPAP machine.

Quote:I will be meeting with my family doc on Monday. I am going to ask that my machine is replaced with a fully reporting machine. I don't see any other way any doctor can evaluate the effectiveness of the CPAP study without performing another sleep test.

It may be that your machine is fully data capable. I just don't know. Download the ResScan software and see if you can look at your leak rate graph.

Since your pressure is so low, not having an auto-adjusting CPAP is not that big of a deal. You have a low pressure and a low AHI. I think you're lucky. I also think that sleep apnea is the most likely explanation for your fatigue and weight gain. They are the most common symptoms of sleep apnea.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#18
hopefully a thyroid workup was part of the labs that were done... furthermore, the "normal tsh" range is something like 1 to 5, but if it is much above 2 you may have hypothyroid symptoms (including major fatigue, depression and weight gain) certainly hypothyroidism is underdiagnosed in women who are 80% of the sufferers since it is correlated with childbirth and perimenopause hormonal changes.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#19
(04-04-2015, 10:05 PM)DariaVader Wrote: hopefully a thyroid workup was part of the labs that were done... furthermore, the "normal tsh" range is something like 1 to 5, but if it is much above 2 you may have hypothyroid symptoms (including major fatigue, depression and weight gain) certainly hypothyroidism is underdiagnosed in women who are 80% of the sufferers since it is correlated with childbirth and perimenopause hormonal changes.

^^^ WSS

I fought for years to get someone to take my hypothyroidism seriously. I gained 75 lbs in a year and was sleeping for 13 hours a day (I couldn't function without a nap). My TSH was 4.5 and I was told that I wouldn't have symptoms at that level because it was normal. Eventually, I found a doctor who looked at the actual hormones... my Free T4 was BARELY in the range (.9, range .8-1.8). My Free T3 was below the bottom of the range (210, range 290-420). That doctor saved my life, in my opinion, because he put me on thyroid replacement hormones and I lost about 90 lbs over the next 2 years. This was about 14 years ago, long before I had any knowledge of sleep apnea.

My snoring (according to my husband) tapered off after I lost the weight and I had a good period of about 10 years when I felt energetic. I got pregnant with my twin sons at 43 years of age. As I gained weight/hormones, I started snoring BADLY again. I thought it was just from being pregnant... kind of normal, but after they were born, it didn't go way. I gave it a year after they were born to let everything return to normal, but my husband told me the snoring was worse than ever. I went to several doctors that told me that I was tired because I "had twins at 44". I KNEW that wasn't it.

I eventually got a sleep study done. My AHI was "only 5" and my RDI was 15 or so on that study. So doc said that cpap wouldn't help me. I had been through this with my thyroid, so I saw another doctor. Another sleep study... again my AHI was "only 5" and my RDI was 36. But I have Diabetes, and I had started getting Premature Ventricular Contractions... so my doctor contacted the insurance company and they covered the cpap for me.

There wasn't immediate improvement, but I do feel a lot better now (about a month on cpap). My PVCs are still occurring, so I've had to tweak my thyroid meds some and stop drinking the enormous amount of caffeine that I'd become addicted to in order to try to alleviate the fatigue.

And yeah, perimenopause doesn't help anything. I'm 46 now (well, I will be next Friday) and my hormones are whacked out. I'm guessing that's my next battle to fight.


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#20
Hey! Another Texan!

OMM
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