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Question about sleepyhead / Issues with diagnosis
#11
Arlene, one thing to keep in mind is that small numbers of apnea events (even central events) per night are normal. The measurement of the "seriousness" of sleep apnea is called AHI, or Apnea Hypopnea Index. It is the average number of apnea (obstructed + central) events plus hypopnea events per hour. [ A hypopnea event is just a partial reduction of breathing for more than 10 seconds, as opposed to an apnea event which is a significant or total reduction in breathing for more than 10 seconds. ]

An AHI value of 5 or less is considered "normal". An AHI value between 5 and 15 is considered "mild". An AHI value between 15 and 30 is considered "moderate". An AHI value above 30 is considered "severe".

Now, it turns out that patients often display "central" apnea events while being titrated (determining the proper treatment pressure) for obstructive apnea. These will often disappear as the patient grows accustomed to the CPAP therapy.

Having said all of that, almost none of us here are doctors. I'm certainly not. I've simply educated myself about my condition. With that in mind, if you would like me to have a look at your husband's sleep study result, I can give you my opinion.
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#12
His AHI was 26.8 per hour.


before CPAP, he had 1 obstructive apnea, none after
before CPAP, he had 9 central apnea, 7 after.
There are 33 hypopneas, spread before and after.

Im concerned, because the manufacturer told me that this machine is not used for CSA. I just want him to have the correct machine.
Can I post the study on this board as a picture?
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#13
Sounds like there's not very good communication with this doctor / sleep clinic.

The two possibilities are that (1) your husband actually does have central sleep apnea, in which case there's been a misdiagnosis if the diagnosis reads "obstructive sleep apnea," or (2) the diagnosis is correct but your doctor is failing to explain to you that some amount of central apnea events can be seen when using CPAP (even during the titration study) but are not worrisome.

I have some central apneas that show up every night and they showed up on my titration study too, but the doctor assured me that I did not have central sleep apnea. I learned more about it through this board. It's slightly embarrassing but I feel the need to share one of my early posts about it: http://www.apneaboard.com/forums/Thread-...7#pid38907

So it's quite likely that your doctor just isn't giving you the whole story and that his current machine is correct for him, but it's good that you're going to get a second opinion. You need to be sure.

If you have the report scanned in, you can just upload the pictures to some hosting site. One free one is http://www.postimg.org. Then you can copy the link here. Might be a good idea to use Paint or some other program to blot out your personal info from them.


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#14
OK here it is. Compressed.
Now I don't see it, can you?
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#15
The file is too large.
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#16
No, not seeing it.

If you're using the image hosting site that I told you about, then once you upload the image just click on the button I have circled below (click on it for a large view):

[Image: postimg.jpg]

And then paste that directly into your post here. It'll look something like this:

Code:
[url=http://postimg.org/image/k30nbbt59/][img]http://s22.postimg.org/k30nbbt59/postimg.jpg[/img][/url]

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#17
Ayealp1, if it will help you, send the file to me at apneaboard@gmail.com and I can post it here for you.

Also, I merged your two forum accounts into the new one (Ayealp1). You should have the same password - if you have any trouble, email me.

Coffee
SuperSleeper
Apnea Board Administrator
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
bear with me please

[Image: slp00.png]
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#19
Ayealp1, I inserted the picture you sent in email into your post, above. I don't have my reading glasses with me and it's kind of hard for me to read the fuzzy print, so I'll let others take a look at this for you.

Smile
SuperSleeper
Apnea Board Administrator
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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#20
(just my own opinion... not medical advice)

There are two diagnosis codes. The first one 327.23, is Obstructive Sleep Apnea. I can't see the second one clearly. Does it say 327.21? That would be Primary Central Sleep Apnea.

I think your doctor will have to judge whether those central components are CPAP-related or not. If they happen normally (without CPAP) then there could be other factors causing them.

For some reason they list the AHI while using CPAP as 0.0 (perfect). Does that mean that all the centrals were corrected by CPAP, or that they were excluded from the AHI calculation?

I would take those two questions to the sleep clinic, in person. That way they can't hang up on you.

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