Newly dx moderate sleep apnea

[JenJen]

Hello all, I am newly dx with moderate sleep apnea. I have been with my Resmed autosense x 15 days approximately. I'm in love with the machine. I have been walking around in a stupor for about 5 years clueless as to why my fatigue was so severe.

I still fight fatigue around 10:30 in the morn and 2 pm in the afternoon. I get up at 0500 every morning and work as a nurse until all the cases are done.

I have yet to visit with the physician that will be managing my sleep apnea. I have tweaked my settings from orig 5-15 cm to 7-16 automatically adjusting. I have my events down to just one event per night.

I am scheduled to meet with the sleep physician in October.

My question for you all is what should I expect from this meeting?

Will he be busting my theoretical balls for changing my settings?

If I am still feeling fatigue at certain time points, would he be the one that prescribes me Provigil or nuvigil?

Are there any specific questions that I should ask at that visit?

Are there any specific responses that I should be prepared for when I go?

Any other information that you think I need to know would be greatly appreciated. I am currently using sleepyhead as well as Resscan. I read all I can about sleep apnea as well as the latest journal articles.

Thanking you in advance for any and all advice.

jen jen

[Rcgop]

Will he be busting my theoretical balls for changing my settings?

Sometimes it's better to beg forgiveness than ask permission.

[srlevine1]

If you haven't downloaded either ResScan or Sleepyhead to read your own data and prepare reports, I strongly suggest it. The details can be found on this forum. This is the starting point for almost all discussions of settings and treatments.

I wouldn't worry too much about your meeting. Most doctors devote 10 - 20 minutes per patient. They look at your data, mostly for compliance, and any outstanding anomalies like a high AHI, or increased number of events. If you have any questions, now is the time to ask them. Try to get alternative prescriptions for other masks if you wish to experiment. Get an undated (if possible) copy of your xPAP prescription for future use. Make sure you have a copy of your official sleep study.

You might find that many physicians simply go with the flow if you appear to be well-informed and can provide a reason for changing the settings. Make sure you bring your SD card for analysis and any reports you believe indicate problems, issues, or areas for discussion.

The only time physicians seem to become upset with changing settings is if you do it constantly on a short-term basis to attempt to "treat the numbers" rather than the patient. Gradually change pressure settings in small increments and wait approximately two-weeks to see how you feel over time.

If your "sleep doctor" prescribes medications, check with your primary and other specialists first. Also, check the drug interactions (including OTC supplements) with your pharmacist.

If your fatigue is time-specific, have you considered a blood-sugar study or other endocrine (e.g. thyroid) studies?

Good luck and best wishes.

[Tez62]

JenJen, welcome, just on the "If I am still feeling fatigue at certain time points", 15 days on CPAP isn't a long time in the whole scheme of things, your brain and body is still adjusting and healing if you like to the oxygen it was previously deprived of for a long time. Everyone is different, some people get a sudden burst of energy when they start using a CPAP, then taper off a bit, for others it takes longer.
There are no set times it takes us to heal.
Personally, I wouldn't go down the track of meds yet, but your sleep Physician would know better.
On your other questions, I would right down all the things you want to ask him, so you don't forget any and see what he has to say.
All Sleep Physicians are different, some are easy going and some aren't.

Good luck with yours.

[PoolQ]

look at a close up of you flow rate and see how consistent it is, does it have a lot of disruptions?

You either need more time to get used to it or some comfort setting is not letting you get deep rest. IMHO

[icyura10]

Hello all, I am newly dx with moderate sleep apnea. I have been with my Resmed autosense x 15 days approximately. I'm in love with the machine. I have been walking around in a stupor for about 5 years clueless as to why my fatigue was so severe.

I still fight fatigue around 10:30 in the morn and 2 pm in the afternoon. I get up at 0500 every morning and work as a nurse until all the cases are done.

Is your sleep pattern anything like mine?

http://imgur.com/byePr56

http://imgur.com/gYXjVhY

When I'm home (which is most of the time), I frequently take naps any time after about 10:00 and or 14:00 and then I start to bed anytime after about 20:00... then I'm up n' down like a pogo stick....

I just can't seem to get it all together.. my sleep is fragmented badly,

I wake up because a fly farts.

I have yet to visit with the physician that will be managing my sleep apnea. I have tweaked my settings from orig 5-15 cm to 7-16 automatically adjusting. I have my events down to just one event per night.

I am scheduled to meet with the sleep physician in October.

My question for you all is what should I expect from this meeting?

Will he be busting my theoretical balls for changing my settings?

Your comment made me hear this:

Mother, do you think they'll drop the bomb?
Mother, do you think they'll like this song?
Mother, do you think they'll try to break my balls?
Ooh, aah, mother, should I build the wall?

I won't address the aspect of how your physician may or may not react.. because only their hair dresser will know for sure

If I am still feeling fatigue at certain time points, would he be the one that prescribes me Provigil or nuvigil?

Are there any specific questions that I should ask at that visit?

Are there any specific responses that I should be prepared for when I go?

Any other information that you think I need to know would be greatly appreciated. I am currently using sleepyhead as well as Resscan. I read all I can about sleep apnea as well as the latest journal articles.

Thanking you in advance for any and all advice.

jen jen

Rhetorical question on:

Is the Dr. prescribing your ?PAP someone certified in sleep or are they your primary care?

My Primary care (an internist) initially took a whack at ordering my ?PAP after getting my titration. After they saw some of my sleep sessions / patterns and seeing how fragmented it is, like the ones above, they immediately referred me back to a sleep specialist for assistance.

My primary stated bluntly they would be remiss to prescribe any medication to assist me sleeping and would leave that to my sleep specialist.

My Sleep specialist is basically dead set against using any form of chemical assistance to assist keeping me asleep until all other options have been completely exhausted.

As it was put to me; using sleep chemicals for sleep fragmentation in patients with sleep disturbed breathing issues it's a drastic step and while it might work and it's FDA approved, they've seen all kinds of side effects that are almost worse than the daytime sleepiness.

At least when I get up, I'm clear headed, able to drive at a moment's notice and otherwise function outside of a fog, which is what this Dr. expressed his major concerns.

Considering I live alone, no family or support within several states, if I took some of these chemicals, they'd restrict my driving for 14 days until I could demonstrate I was very lucid after awakening at any time within my sleep period. Isn't that just grand? but it's for mine and everyone else s safety.

I can only imagine they've seen some really bad reactions and they are just being abundantly cautious and safe.

Oh, my sleep specialist pulled my data and when I got this new machine on 8/15, the settings have been re-jiggered... so it's going to take a few days to see what's really going on.. but it seems the fragmentation is still continuing.

Rhetorical question off

There is a study (I posted it here a while ago)

http://www.apneaboard.com/forums/Thread-...ONES-study

about some new product that's being trialed... that might help some of us with fragmented sleep.. but I don't know all the parts to the puzzle...

While my AHI's seem to be fairly good with some of these new settings on this machine, (in the range of 0-1 / n hours sleep) its the fragmentation that's the problem.

No I don't seem to have Narcolepsy

[Ghost1958]

Fifteen days you still have sleep debt.
I came off my first week feeling like i was 20 yrs younger.

Then spent the next three weeks sleeping 12 hrs a day almost everyday.
Then i felt great again for a while which I dont notice now because it became my new normal.
Poolq has a point. Some can have ahi by the mschine and still be constantly flow restricted.
Might need a bit more min pressure.
Im betting sleep debt.