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Recently diagnosed with severe apnea - questions
#1
Hello all,

I am new to this message board. Thank you for taking the time to read this.

I had an in-home sleep study done several weeks ago and it showed "moderate" sleep apnea. Per my request, they did another in-lab study a coule of weeks ago, and that one showed "very severe" sleep apnea. I am a 34 y/o female. My questions/concerns:

1. I did not sleep very well during either sleep study, especially the in-lab one because I can't sleep outside of my own bed and with a mask on my face. I slept only an hour or so in the in-lab study so they got very little data. I got almost no REM sleep.

2. Most people with severe sleep apnea fall asleep during the day. I have never had that happen to me. In fact, I've gone without sleep for 2 days and was still able to function well during the day. This seems to contradict what typically happens.

3. I have breathing problems throughout the day that are not related to asthma. Doctor's can't diagnose.

I am not sure what to make of my results. Please help.
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#2
When I had my sleep study done 8 years ago, I had the same concerns as you. I was told as long as I did sleep some it was enough to diagnosis my apnea. I am interested in the replies you get since I am waiting for authorization for a new sleep study since my AHI range from 11 to almost 40 over the past 3 weeks. Until I got my new cpap I didnot realize how bad I was doing.
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#3
Welcome to ApneaBoard Sleepless12! You came to the right place!!

It is very common for those of us that have had to endure sleep lab tests and sleep lab titration tests to have a terrible sleep or lack thereof. I believe an in home titration with an Auto CPAP machine while being monitored is a much better way, but then again, I'm not a doc, just a patient! Hopefully they will have enough data to go on.

Keep us posted!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#4
Sleepless, there is just not enough information in your post to offer constructive information. If you can post the results, and breakdown of the AHI events, there might be more to suggest. In particular, it's important to know if you're seeing both obstructive and central apnea, or just obstructive events. Either way, your will need to work hard to find a mask that is comfortable and, once you are issued a machine, stick with the therapy to make it work.

None of your comments above are questions. The therapy approach for moderate or severe apnea is the same, so regardless of lack of data, you will need CPAP. A lack of titration data supports the need to prescribe auto-cpap so the machine can adapt to your needs.

Comments 2 and 3 are related to your individual experience. We're all different in how we respond to lack of sleep, and your breathing problems during the day are kind of outside the scope and expertise of people on this forum. I wish you the best in overcoming these additional challenges.
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#5
Hi Sleepless12,
WELCOME! to the forum.!
It’s pretty common not to sleep well in the sleep lab.
Hang in there for more suggestions and answers to your questions.
Much success to you with your CPAP therapy.
trish6hundred
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#6
I wouldn't dwell on it much, just get on with the treatment, CPAP is considered the 'gold standard' treatment
Sleep apnea is not going to go away, just will get worse over time without treatment
I was in denial for number of years, until it get really bad on day and then thought treatment

I recall the sleep study wasn't a good night but diagnosed with severe OSA, here is the report from May 2011
The patient reported that the quality of his sleep was worse than usual Sleep efficiency was poor (52.7%) with frequent awakenings and several prolonged wake across the night. sleep latency (33mins) was prolonged and the proportions of both slow wave sleep (3.9%) and REM sleep (9.3%) were reduced .continuous soft to moderate intensity snoring was reported by the overnight technologist.
Runs of repetitive hypopnoes and obstructive apneas occured during both NREM and REM sleep in all position ,and caused frequent arousals (arousal index 84.8) and moderate oxygen desaturations (min SaO2 85%) . small numbers of RERAs were noted . the overall RDI was 85.0 .there were no periodic leg movements. the ECG showed normal sinus rhythm (mean HR 68 bpm ). Severe OSA

Sleep Staging Data :
Light out : 10.22.58 pm Sleep Onset : 10.55.58 pm
Light on : 6.01.58 am Sleep Efficiency : 52.7%
Time in Bed (TIB) 459.0 min Sleep Latency: 33.0 min
Total Sleep Time : 242.0 min REM Latency 241.5 min

sleep Staging %Total Sleep Time Normal Values Total Sleep Time (min)
Stage 1 6.2 (5%) Stage 1 18.0
Stage 2 80.6 (50%) Stage 2 195.0
Stage 3 3.9 (10%) Stage 3 9.5
Stage 4 0.0 (10%) Stage 4 0.0
Stage REM 9.3 (25%) Stage REM 22.5
Wake During Sleep 182.5 min Total Wake Time 214.0 min %Wake 46.6%

Respiratory Data :

Central Obstructive Mixed Hypopneas
#of Event 2 108 3 218
Mean Duration (sec) 12.0 18.2 17.3 24.3
Max Duration(sec) 14.0 37.5 19.0 71.0
Total Duration (min) 0.4 32.8 0.9 86.8
REM Non-REM Total Sleep Time
AHI/hour 37.3 85.6 81.1
Total RDI/hour (incl RERAs) 42.7 89.4 85.0

Oximetry Data:
Average SaO2 during wake 92% Average SaO2 in Non-REM 93%
Average SaO2 in REM 92% Minimum SaO2 value 85%

Positional Respiratory Data Time in position (mins) AHI/hr
Supine 61.8 100.0

Arousal Data:
Total number of u-arousal 342 Total number of arousal >15 sec 10
Apneas (with desats ) 196 Number of Awaking/Movements 57
Apneas (without desats) 100 Leg movement with arousal 0
Respiratory Effort Related Arousal 17
Spontaneous 31 Arousal index 84.8/hour

Periodic Limb Movement Data :
Leg movement with arousal 0 Leg movement with arousal index 0/hour
Leg movement without arousal 0 Leg movement without arousal index 0/hour

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#7
(11-19-2015, 04:03 PM)Sleepless12 Wrote: Hello all,

I am new to this message board. Thank you for taking the time to read this.

I had an in-home sleep study done several weeks ago and it showed "moderate" sleep apnea. Per my request, they did another in-lab study a coule of weeks ago, and that one showed "very severe" sleep apnea. I am a 34 y/o female. My questions/concerns:

1. I did not sleep very well during either sleep study, especially the in-lab one because I can't sleep outside of my own bed and with a mask on my face. I slept only an hour or so in the in-lab study so they got very little data. I got almost no REM sleep.

2. Most people with severe sleep apnea fall asleep during the day. I have never had that happen to me. In fact, I've gone without sleep for 2 days and was still able to function well during the day. This seems to contradict what typically happens.

3. I have breathing problems throughout the day that are not related to asthma. Doctor's can't diagnose.

I am not sure what to make of my results. Please help.

Most people don't sleep that well in a lab, but it was obviously enough for them to diagnose you with apnea. You're either breathing normally at least once every 10 seconds, or you're not. Smile

Also, I was diagnosed with severe apnea (AHI = 32) but never fell asleep during the day. Many people simply adapt to the condition and thus do not necessarily have episodes of involuntarily falling asleep.

As for your 3rd concern, I'm afraid I have no knowledge of respiratory conditions other than sleep apnea and thus cannot comment. I imagine that will be the case for most of the members of this board, as well.
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#8
Thank you everyone for your comments. I have not received a copy of the report yet, but I was told I have OSA and the AHI was 64.
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#9
One of the things that I read in your original post, Sleepless, was some denial. When I was first diagnosed with sleep apnea, I was in denial for some time. I think that a number of us have been there. Now, as comfortable or uncomfortable as my CPAP system is, I can <not> go to sleep without the mask on and the system running.

I went through a whole spectrum of feelings about CPAP. First was denial, which slowed my acclimatization. I had a couple of mask issues. Then I had a week or two where I felt really great and energized. I felt, in some respects, like I was at least 20 years younger.

Then some of my previous symptoms started to re-appear. I started looking around - trying to find out how to get back to the feeling I had for the 2 great weeks. That was when I found Apnea Board. I learned a lot here and corrected a number of things.

At this point, I am somewhere between how I felt for my 2 great weeks and how I felt before CPAP but it is still a definite improvement.

I guess my advice is.... Try it you may like it. And you will reap health benefits from the therapy

Best Regards,

PaytonA
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#10
An AHI of 64 is considered severe OSA. A number of us here are what you might call reformed pappers. Once we accepted the fact that we needed treatment we improved our lives and decreased the chances of other illnesses/diseases by getting on the cpap treatment. Fortunately, the cpap technology today is far superior to what most think it is which makes it a whole lot easier to adapt to and tolerate. Machines are always relatively quiet and are patient friendly. Keep us posted. Good luck.
Coffee
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