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Not sure about CPAP therapy
#1
Not sure about CPAP therapy
I am not asking anyone to second guess the physician but I am wondering if using a CPAP is the right therapy for what looks like Obstructive Sleep Apnea.  I have scheduled an appointment with a new provider in hopes of either confirming or revising the diagnosis and perhaps revising the therapy as well.  I've attached the redacted documents from the current sleep doctor (initial sleep study and follow-up titration report).  I am also attaching OSCAR screen shots from one day of useage from my Phillips Dream Station 2.  I can pull together a compressed file of the OSCAR data file if that would help.

Again, I am not against what the original sleep doctor has prescribed but I am looking for some guidance on whether or not a CPAP machine is the proper therapy or if something else like a dental appliance or altogether different machine might be appropriate.

It looks like I will have to create another post in order to include the May 28, 2022 Daily Report to go along with the apnea documents that I attach to this post.  Thanks in advance for your patience and help.  If additional information or OSCAR files are needed please let me know.

(06-03-2022, 12:01 PM)KC8RXQ Wrote: I am not asking anyone to second guess the physician but I am wondering if using a CPAP is the right therapy for what looks like Obstructive Sleep Apnea.  I have scheduled an appointment with a new provider in hopes of either confirming or revising the diagnosis and perhaps revising the therapy as well.  I've attached the redacted documents from the current sleep doctor (initial sleep study and follow-up titration report).  I am also attaching OSCAR screen shots from one day of useage from my Phillips Dream Station 2.  I can pull together a compressed file of the OSCAR data file if that would help.

Again, I am not against what the original sleep doctor has prescribed but I am looking for some guidance on whether or not a CPAP machine is the proper therapy or if something else like a dental appliance or altogether different machine might be appropriate.

It looks like I will have to create another post in order to include the May 28, 2022 Daily Report to go along with the apnea documents that I attach to this post.  Thanks in advance for your patience and help.  If additional information or OSCAR files are needed please let me know.

This is an immediate addition to my previous post.  In this one I am adding the OSCAR Daily Report for May 28, 2022 as a sample.

Thanks again for your help.


Attached Files Thumbnail(s)
           

.pdf   WEL Daily Report 2022-05-28.pdf (Size: 1.05 MB / Downloads: 6)
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#2
RE: Not sure about CPAP therapy
Are you concerned because your daily report shows no Obstructive events? If so, there is some background info that may be of interest. 

First, the daily report (and your sleep study) shows no Obstructive events because of being on CPAP. Many patients have Obstructive events while on CPAP therapy, but fewer than in their sleep study.  Based on the small amount on info here, it would appear that you are one of the few lucky ones have Obstructive events eliminated completely. 

Secondly, the umbrella term "Sleep Apnea" includes three items and they all have specific definitions. Obstructive events involve complete blockage of the airway. Hypopnea involve partial blockage. Centrals are where there is no breathing effort because of the balance between 02 and CO2. May I suggest reading the Apnea Board Wiki to learn about the parameters and definitions. 

Thirdly, it's not just about the numbers alone. AHI of 0.0 is not necessarily the goal. The bigger issue is how do you feel, how rested are you.  
Sleep-well
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#3
RE: Not sure about CPAP therapy
Thank you for the reply. There was a lot of information to digest but I also wanted to include that I am pre-diabetic, have been diagnosed with cardiomyopathy since 1990, and that I have A-fib (diagnosed since 2012 and twice ablated).  My electrophysioligist at Cleveland Clinic wanted to see if there was any correlation between the A-fib and my possible apnea. I know that there isn't enough information presented here to verify or rule out the A-fib but I am trying to learn as much as I can before that upcoming appointment with a sleep specialist at Cleveland Clinic.
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#4
RE: Not sure about CPAP therapy
Yes, I agree with clownbell. The report is basically showing you do great by the numbers with CPAP. Without CPAP the sleep study shows an AHI of 12.6 with lowest sat 87%, with the OSA's totally resolved with the CPAP titration. And your OSCAR home data shows an AHI 2.29 for that night, which is also well below the cutoff of 5 for apnea rx.

Your apnea is mild, so you could consider a mandibular advancement device (MAD). BUT they do not control breathing as reliably. If you try it, I would strongly recommend you have a O2 sat monitor of your own to see how well it controls your desaturations. I have a MAD myself, and it helps me not be a mouth breather at night but does not keep up my O2 by itself.
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