Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Requesting Sleep Report Analysis & Second Opinions
#1
Requesting Sleep Report Analysis & Second Opinions
Hi all,

My journey has been long and still trying to weather the storm, here's my long CPAP optimization thread: http://www.apneaboard.com/forums/Thread-...R-Analysis

Thanks to everyone's input so far, great community and great wisdom being shared for us just starting out this journey of figuring out what's going on.

Quick backstory to explain this sleep report: Early 2019 I did an in-lab test but was on Seroquel (75mg) and Cymbalta (90mg) nightly for "symptoms of depression, anxiety and insomnia", the test came back with the doctor's diagnosis of "mild sleep apnea" and my AHI was 5 (non-supine) and 7 (supine). My recommendation at the time was 1) stop Seroquel and 2) focus on side-sleeping using various methods. I discontinued both medications with the help of my family doctor and after a short period of discontinuation symptoms, my brain and body finally moved on. However, sleep was getting worse and daytime fatigue/somnolence was lingering so I did an at-home test which resulted in an AHI of 11 but I felt this test was extremely surface-level so I chased another in-lab test which took months to land of course and voila here we are today.

The attached sleep report quite frankly shocked me, I didn't expect the arousals and AHI to be this high, at least not after a year or so from being only 5 & 7. Weight was not a major difference during this year (maybe gained 10lbs total) but I suspect that either 1) the medication was doing something quite magical or 2) there's a discrepancy in how either of the test's data was extracted.

If there are any sleep doctors here, or well-versed users in analyzing this sleep report and maybe providing some out-of-the-box possibilities of what might be going on, I would greatly appreciate it. The only thing I'm still working on currently is dropping my weight, I'm 6"1' and was around 215lbs when I did this test, ideally I'm looking at getting down to 180lbs and seeing if that changes anything. I have a history of seeing multiple family and psychiatric specialists who continue to claim that my depression/anxiety is causing disturbed sleep, but for me right now in life it's not a matter of mood or anxiety, it's the physical symptoms that I can't seem to keep under control (low oxygen, panic attacks, severe fatigue, crushing headaches borderline migraines, on and off nausea, lack of energy) which all seem to point to sleep apnea, which clearly this sleep report is confirming.

My issue is that the current sleep doctor only gave me a "you need CPAP" and nothing else, I pushed for further clarification and specifically asked about potential for complex sleep apnea, UARS, and anything else that might be going on, but CPAP was the only conclusion. I'm hoping someone out there can provide better input than this; two in-lab studies and two different sleep doctors both of which did not give me what I expected from someone as "highly experienced and skilled" as they are claimed to be.

Thanks for your time ya'll!

Sleep Report Page 1: https://imgur.com/vRnvrdX

Sleep Report Page 2: https://imgur.com/ad1Zavr

Sleep Report Page 3: https://imgur.com/lVPYwNB

*Note: apologies for the slight blur in some sections of each photo, I received a physical folded copy and had trouble with the camera.
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Requesting Sleep Report Analysis & Second Opinions
Well the first problem is your quack diagnosed you with obstructive sleep apnea and prescribed CPAP, when you clearly have central sleep apnea and need ASV. You need a smarter doctor. You are aware of this, right? In your 9-page thread you were told a dozen times your problem is central apnea and ASV is required. This test clearly proves it is not therapy onset central apnea and you need a COMPETENT physician to prescribe what you need, or you need to self-fund ASV. We can help.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#3
RE: Requesting Sleep Report Analysis & Second Opinions
seconded.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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.
Post Reply Post Reply
#4
RE: Requesting Sleep Report Analysis & Second Opinions
OK I am not sure what guidelines you follow up north in Canada, but in Dave's world, 1 Mixed, 57 CA, 301 H which are likely IMO central-based, sounds to me like you may want an up close doctor visit and suggest very strongly to test for an ASV or you fire him/her and replace with one with a lot more competence. The numbers I see as above mentioned scream this is ASV only territory. You might AVOID some of this on CPAP, BPAP will likely be incredibly bad, and treated on said ASV. If this were my test, Dr. Dolittle would be getting told we will start the path to ASV NOW or I'm leaving to get someone else to get results.

Why these vary this much from the last test? No clue here, but this viewpoint of mine is these are the numbers to account for. If your country mates wish to chip in with the "how to get to ASV" info, bring it. I'd say this clues us in on the fatigue and such.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Requesting Sleep Report Analysis & Second Opinions
Thank you all for the prompt response. Was just reading a guide on how to read the sleep report and was questioning specifically what you pointed out with centrals, and here I thought the worsening symptoms while on APAP/CPAP was simply part of the adaptation process.

I’ll be sure to start looking into this ASV route. Thanks again y’all rock!
Post Reply Post Reply
#6
RE: Requesting Sleep Report Analysis & Second Opinions
Just make sure to get the ResMed AirCurve 10 ASV if at all possible. Keep us updated. And any questions on any of this, post and we'll have an answer. But do give Doc some smelling salts. He's passed out at the wheel.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#7
RE: Requesting Sleep Report Analysis & Second Opinions
(07-21-2020, 09:13 PM)SarcasticDave94 Wrote: Just make sure to get the ResMed AirCurve 10 ASV if at all possible. Keep us updated. And any questions on any of this, post and we'll have an answer. But do give Doc some smelling salts. He's passed out at the wheel.

Thank you very much! I am indeed feeling the need to get enough salt for BOTH “board-certified Sleep Specialists“ for the past year and hailing on them an early Christmas. The machine described is not cheap, at all, lol. Any recommendations on what I can do with my current AirSense 10 Auto CPAP machine and if I need to sell it myself for whatever cost I can manage? I bought it full well knowing it might not work out so it’s on me if I can’t resell, but I did have my employer’s insurance cover a majority of the cost. I’ll look into my options. Also hoping I can keep using the same nasal pillows/humidifier/hoses as it seems the machines are similar but not sure if carbon copy with fitting parts.

It seems I now need a new prescription for ASV before going down this insurance route, which means I need to find a doctor NOT on heroin to give me the proper prescription. The search for proper treatment continues!
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Requesting Sleep Report Analysis & Second Opinions
I think what is amazing, is how much CPAP has improved your central apnea and hypopnea as compared to the diagnostic baseline. CPAP has some ability to stabilize your airway, but is not intended as a primary therapy for CSA. ASV provides the stability of CPAP to your airway with a low pressure during exhale (EPAP), and then uses pressure support as needed to maintain your respiration rate and volume, eliminating variable breathing, hypopnea and central apnea. It's amazing how quickly people like you suddenly experience nearly zero events and get their lives back. You want to source a Resmed Aircurve 10 ASV or the older Resmed S9 VPAP Adapt. Self-funding is affordable and fast. You can get a lightly used machine from Supplier #2 for $1349 USD. Considering the denial in Canada that CSA even exists, it might be your best choice. This is the downside to social medicine...you can't always get what you need, you get what they give you, when they get around to it.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#9
RE: Requesting Sleep Report Analysis & Second Opinions
Touching on masks for you, the one(s) you have now assuming good fit and close to leak free will be fine with an ASV. I find leaks need to be more controlled under ASV therapy, but if yours are well controlled, you'll be OK.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#10
RE: Requesting Sleep Report Analysis & Second Opinions
(07-21-2020, 09:27 PM)Sleeprider Wrote: I think what is amazing, is how much CPAP has improved your central apnea and hypopnea as compared to the diagnostic baseline. CPAP has some ability to stabilize your airway, but is not intended as a primary therapy for CSA.  ASV provides the stability of CPAP to your airway with a low pressure during exhale (EPAP), and then uses pressure support as needed to maintain your respiration rate and volume, eliminating variable breathing, hypopnea and central apnea.  It's amazing how quickly people like you suddenly experience nearly zero events and get their lives back.  You want to source a Resmed Aircurve 10 ASV or the older Resmed S9 VPAP Adapt.  Self-funding is affordable and fast.  You can get a lightly used machine from Supplier #2 for $1349 USD.  Considering the denial in Canada that CSA even exists, it might be your best choice.  This is the downside to social medicine...you can't always get what you need, you get what they give you, when they get around to it.
Amazing thank you for the recommendation friend! And I do agree that at least initially, maybe for the first few weeks I felt slightly better than when I wasn’t on the machine, nothing magical but like you said I think the airway opening vs the usual hypopneas helped give me a bit of life. That didn’t last at all however, and I think into the 2nd month of consistent usage, especially after I dialed into really good data from OSCAR, my symptoms started relapsing and getting even worse than prior to the machine. The need for ASV seems to help explain this short-lived fairytale.

Although I have grown generally sceptical with any diagnosis or data compiled by machines at this point, thanks to my amazing track record of receiving incompetent explanations from so many different specialists over the years. I do like to think that the sleep report was a truthful reflection of what’s actually going on, given the science behind the data extraction, but I guess we won’t truly know until ASV proves to be the correct treatment; this however makes me think about the sleep report from last year and how those medications altered my state and the overall data.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  New to forum and to data analysis a2wheelerte 95 1,858 1 hour ago
Last Post: Sleeprider
  [CPAP] [mb635] - AirSense 10 Autoset Sleep Analysis mb635 36 1,160 Yesterday, 07:35 PM
Last Post: mb635
  [Pressure] Can someone take a look at my OSCAR Report flcpap17 2 126 10-27-2020, 08:09 AM
Last Post: flcpap17
  Do sleep aids effect sleep study results wking 12 264 10-27-2020, 06:51 AM
Last Post: dapal
  A deep report on sleep treatment racprops 35 1,340 10-21-2020, 07:05 PM
Last Post: racprops
  [split]AirCurve 10 CS PaceWave Analysis Request Bolsen 31 822 10-16-2020, 12:48 PM
Last Post: SarcasticDave94
Question First time poster, long time CPAP user with an OSCAR report. Afasterme 8 220 10-13-2020, 09:29 PM
Last Post: Afasterme


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.