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Pretty lost at this point. Help would be greatly appreciated
#1
Pretty lost at this point. Help would be greatly appreciated
Hello, 
this is my forst post in this forum. I am a 21 year old non overweight male. I am waking up multiple times in the night, but before i would attribute those awakenings to other health problems like my bronchitis or the gastritis and reflux which i dealt with over the years, because of that  i would also attribute my incredible fatigue and more or less debilitating brain fog to these conditions. After many years of not getting proper treatment from the docs in germany finally someone mentioned the possiblity of sleep apnea. So i went and got tested for that.

I had one sleep test done at home and multiple in the sleep lap (2 different sleep labs to be precise). 

-The home sleep test came back positive (even tho i only slept 4 of the 8 hours the device measured). (20.06.22)
-The first in lab sleep test  came back negative (25.06.22 and 26.06.22), but the sleep test used weird guidelines (R&K and 4 % desaturation) which apparently leads to many false negatives, so i went to another sleep lab (11.07.22) and sure enough it came back somewhat positive (AHI of 3.5 or sth but many Arousals and RERAS ,  they still used R&K but 3 % desaturation). Since i got told multiple times that i should get an in lab with AASM 1A guidelines since those are the best i called the second sleep lab and asked whether they could rescore the test using AASM 1A. I am not sure what exactly they did but they rescored it ( but i dont think they used AASM 1A, it feels like they only wanted me to get over an AHI of >5) and then the same test came back with an AHI 0f 5.9 same RERAS and Arousals obviously.  
- Today i went in for a titration, but it was so weird. They didnt titrate at all they just put a range of 5-15 and said the machine would do the rest, why would i have to go to a sleep lab for that ... After the titration i talked to the doctor and he told me the results came back good, i asked him whether i could need Bipap since most people suggest a BIPAP for UARS but he said that an APAP which they used for the titration is way better and BIPAP is only for really overweight people, and he said that he is completly certain, that BIPAP would cause irregular breathing. I told him that i read that since BIPAP enables less respiratory stress since the exhale pressure is lower that it often decreases flow limitations (i prolly have very limited understanding of this topic, my brain really doesnt work properly anymore and it feels like that is because of the sleep apnea or UARS) but he assured me that  that is not the case.
Being at home now i went through the PSG from the titration and even tho the AHI and the RERAS went down there is still flowlimitation of 20 % and basically no deep sleep or rem cycle he didnt mention those parts at all. He even went as far as to say that there is no doctor in germany who dealed with more patients in need of PAP therapy to credit his opinion.
Also somewhat weird the nurse told me to not play with the settings of the apap. 

To be quite honest i am at my wits end and am somewhat loosing my mind. It feels like the overwhelming majority of Physicians in germany are thrash, even more so when it comes to sleep medicine. I got prescribed a RESMED Airsense 10 Autoset and will try to post my Oscar results of the first night ... 


I am sorry if my english or my writting style is unbearable (i am somewhat mentally fatigued and english is not my mother language)


I will include all of the Polysomnographs. 


I would really appreciate any help from you guys.


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#2
RE: Pretty lost at this point. Help would be greatly appreciated
Here is a link to all the PSG´s  :   https://we.tl/t-d5lZiplXuO
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