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Severe Sleep Apnea New User
#1
Severe Sleep Apnea New User
Hey guys and gals, I'm new here and kind of worried pretty terribly about my OSA/CSA. I'm 23 years old I live an active life as much as possible. I'm outside every day for work and usually when I get home I'm out of it. I recieved my sleep study results back today and the news along with the results have me really worried. Summarized doctor said i was one of the worst patients to come in this year.  Not breathing 110.4 times a minute with my oxygen falling to 57%.  Arousal index was 100.8 an hour. Pretty much the doctor said a cpap and bipap will not work for me because I have OSA and central sleep apnea. so I'm getting a call tomorrow to schedule another appointment for a asv test. Doctor said I had 3 options. Asv machine, bipap ts, or a trach. Does anyone have anything comparable to me and if so is there any guidance or tips that could be offered from experience?
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#2
RE: Severe Sleep Apnea New User
Justin, welcome to Apnea Board. Before I even finished reading your post, I suspected you needed ASV due to your age and severity of apnea, and sure enough that's what they are looking at. We have many members here using ASV, and most find the best results using the Resmed Aircurve 10 ASV vs the Philips Respironics BiPAP Auto SV. Both are good machines, but that's been the feedback by users here over several years.

You are very fortunate to have a doctor that is not going to try to treat your complex obstructive and central apnea with a CPAP or bilevel that is not appropriate to your condition. Most of the time, patients are required to fail at CPAP, and bilevel before they get the bilevel with backup. Even then many doctors get it wrong and prescribe an ST machine. The ASV is a very advanced positive air pressure (PAP) machine, and it provides pressure like a CPAP to resolve your obstructive apnea, but also has pressure support during your inhale cycle that can cause you to take a breath, when you fail to take on spontaneously. These are fantastic machines, and while it usually taks a while to adapt to their use, the AHI is often at or near zero events.

Relax and be happy that your doctor is one of the exceptional ones that is looking out for your needs and moving you quickly to the best possible treatment. Feel free to ask us questions, and don't overlook our Wiki articles that also cover central and complex apnea. You are in good company here, and will find a surprising number of members also using ASV, that can help your through your journey to adapt and become comfortable.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#3
RE: Severe Sleep Apnea New User
I'm just worried now about sleeping without a machine because of the severity of my sleep apnea. It has me paranoid.
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#4
RE: Severe Sleep Apnea New User
There is a saying in my other hobby, beer. Relax, don't worry, have a Homebrew.

You are heading down the right path. Many take years just to get where you are right now.

Untreated I stopped breathing over 90 times an hour, not your 110 but close enough, but all obstructive. No Centrals.

Of importance is that the ASV corrects your desats, CPAPS of any type significantly improve desats but that should be verified.

I don't promise it will be easy, but I'm confident that it will be effective.

Don't be paranoid, but be concerned.

Start an apnea folder to keep records in. These should include a full copy of your Sleep Studies,not just the summaries, but all the charts and tables, and a copy of your prescription. These will come in handy in the future, especially if you or your doctor move.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#5
RE: Severe Sleep Apnea New User
Speaking of desat, what exactly is that.
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#6
RE: Severe Sleep Apnea New User
Quote:Speaking of desat, what exactly is that.

A desat is when your blood oxygen level decreases by more than some given amount, usually either 3 or 4%.  Ideally, your blood oxygen should not go below around 90%.

Desat is just short for desaturation.
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#7
RE: Severe Sleep Apnea New User
Gotcha. So with my "treatment" when they put me on a cpap and bipap the sleep study night throughout the pressures my desat ranged from 15-63
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#8
RE: Severe Sleep Apnea New User
Just to take the saturation a bit further... The oxygen carrying component of the blood is haemoglobin. If every molecule of haemoglobin carries oxygen then the saturation is said to be 100%. If 90% carry oxygen then the sat is 90% and so on. So it's really a measure of how much oxygen the blood is carrying compared with the theoretical maximum amount it can carry.
DeepBreathing
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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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#9
RE: Severe Sleep Apnea New User
The desaturations mean you aren't getting enough oxygen to fully oxygenate your blood, and that is simply because you aren't breathing well.  We can all tolerate some desat during work, rest, or play.  When sleeping, though, we are meant to REST.  If you keep arousing yourself to the point where you can 'manually' correct your desats by breathing, you aren't getting rest.  

So, arousals are bad, desats are bad because they cause arousals, and bad breathing is bad because it causes the desats. Fix your breathing and all the rest goes away.  That's what the machine is for, but it's more complicated...as you are learning.  The right machine must be used to treat each 'flavor' of apnea. In your case, you are going to get the Cadillac because that's the only kind of machine that can treat your severity and complexity of apnea.

If you can accept your condition mentally, and if you can buy in to the remedy that PAP offers, you'll be halfway to success in dealing with the changes that are coming.  The rest comes from fiddling with types of masks and headgear, with the settings on the machine, and you adapting to the impositions on your sleep that all these things will bring.  The idea is to not look at them as impositions (having to wear stuff, clean it, monitor it, make adjustments if/when they are needed), but to look at it like you do brushing and flossing so you don't have to spend thousands in a dentist's chair and endure what that involves.  This is going to be GOOD FOR YOU.

I wish you success, and right away.
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#10
RE: Severe Sleep Apnea New User
(07-16-2019, 07:02 AM)JustinJ Wrote: Gotcha. So with my "treatment" when they put me on a cpap and bipap the sleep study night throughout the pressures my desat ranged from 15-63
Post a copy of your sleep study (redacted).  That will help us to answer your questions.  15-63 are not making sense to me.
There are 2 type of sleep studies.
The first is a diagnostic study
The second is typically a titration study where the goal is to find the correct settings for your apnea.

Desats: part of the study was to measure if/or how far below critical levels of oxygen saturation and for how long.  Medicare states that O2 below 88% for 8 minutes total is cause for supplemental oxygen overnight.  There are inexpensive Recording Oximeters that are compatible with OSCAR.  These will tell you if you go low.  Doctors will typically followup a finding with an overnight test on certified equipment.  Several members here use them.
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
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.
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