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Severe positional apnea: What can I do?
#1
Severe positional apnea: What can I do?
Hi, all. I've been diagnosed with severe positional OSA in a recent sleep study. I'm confused where to even go moving forward with this and my primary care physician had absolutely useless suggestions for me.

I'm a 24 year old male, ~230 pounds.

According to the interpretation of the sleep study I had in the hospital, EEG confirmed 410 minutes of sleep (yet I struggled to "fall" asleep). I slept in right lateral and supine positions. They note my AHI was 3 events per hour, RDI of 11 events per hour, RDI during supine/back of 36 events/hour, and an arousal index of 20 events per hour of sleep.

The only "recommendations" I got were to "avoid sleeping on my back", "avoid driving while drowsy", "avoid bed time alcohol use", and "lose weight" echoed back by my doctor from the sleep report.

I'm not trying to sleep on my back. At all. I'm not even aware that I end up on my back. I'm trying to lose weight. I know an AHI of 3 is supposedly "good" but it doesn't feel "good enough" to me, and I'm not sure what to do.

They did have me fit a mask right before my study and I swear I could have fallen asleep right there and then with it on (but this report makes no mention of anything of that), and I felt like my entire sleep during that study was terrible.

What makes this even worse is I'm trying to begin to study to become a private pilot and I definitely can't do that with any sort of untreated OSA.

What can I do? Should I try those tacky balloon pillows? Can I demand a second opinion? Should I consider the DIY route of a used CPAP, tracking down a new mask, and giving it a shot? I do have access to an older pre-07 Respironics REMstar Plus with C-Flex (and the manuals to program it), and I wonder if I should even try starting out low and giving it the college try to give quantifiable data back to my provider to assist in a second opinion. Hell, I'll go track down something newer and run it through SleepyHead if I have to... any price to pay at this point for good sleep.

I just can't go on much longer with poor quality sleep like this. I'm grumpy as it is in the morning (and beyond exhausted), and that's no good.

Cheers,
Dakota the "Kæt".
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#2
RE: Severe positional apnea: What can I do?
Start losing weight asap.
Buy an APAP online, one of the recommended models if you need while you loose weight.
If you don't need it after you got rid of the excess weight, great. if you still need it, then you already have it.
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#3
RE: Severe positional apnea: What can I do?
It sounds like your suffering with UARS. I haven't had to deal with it but usually the answer is a BPAP which can deliver greater pressure support than a regular CPAP. If you do buy a CPAP I wouldn't buy anything other than a Resmed AirSense 10 Autoset. They can provide up to 3cm pressure support. I'm sure Sleeprider will add more to this. He's more up to date on it.
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Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#4
RE: Severe positional apnea: What can I do?
If I get an auto CPAP I'm considering the S10 as it is. I plan on traveling in ~3 weeks to Dallas and they actually have a decent second-hand market available locally compared to my region on Craigslist. I might also, if I can't get my doctor to write a script out, just end up ordering masks in parts in the interim until I can convince them with data that I need a script.

The sleep study had me fitted for a nasal gel pillow DreamWear mask, which was amazingly comfortable.

And yes... I plan on losing (more) weight as I can. I lost over 20 pounds since last year at this time, which was (admittedly) a little difficult pushing myself towards that goal. This year I'm hoping I can get back down sub-200 if I can. It just takes time...
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#5
RE: Severe positional apnea: What can I do?
If your shopping on Craigs list look for a Resmed Air Curve VAUTO. It will probably help you more. It does everything an AirSense 10 does but can increase pressure support beyond 3cm and your can adjust air flow better than an Air Sense.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#6
RE: Severe positional apnea: What can I do?
The advice you were given is sound.
Take positive actions to avoid sleeping on your back and see how that goes. Try to make it work.
If you can't, or it does not help, then move on to PAP.
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#7
RE: Severe positional apnea: What can I do?
Surprised (but not really) they didn't prescribe something even if positional. Kinda stupid and along the lines of "your blood sugar is fine as long as you don't eat. we advise you then to not eat." or "you blood pressure is fine as long as you don't stand up. we advise you don't get up from a sitting position. Avoid doing that."

If you have a good relationship with your GP, you can get him/her to assist you in getting an APAP for 30 days. The two of you can then view the data.

Sleep apnea treatment will greatly assist with weight loss. But be aware that weight loss alone will not "cure" you of sleep apnea. It rarely happens.
PaulaO2
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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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#8
RE: Severe positional apnea: What can I do?
kota cat welcome to the forum. 
As paula said the xpap will help you lose weigh by increasing your energy level. My xpap started malfunctioning and I gained a lot of weight. Now that I am being treated properly I have more energy and am doing many things other than sitting in a chair. I have started losing weight.

Welcome
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#9
RE: Severe positional apnea: What can I do?
An RDI of 36 is certainly going to cause you drowsiness. However, the insurance company only looks at AHI. So, like others have suggested, get yourself an APAP Resmed or Respironics machine and set it to 6-20. Then upload your data here and folks can help you. APAP may or may not help you lose weight. Some folks have gained weight because they don't move around as much at night.

FWIW, the sleep study people fudged my data so that I would qualify. The only time I had apnea was during REM so my AHI was below 5. However, my RDI was 32. So, yeah, you got a problem and weight loss may not help. But in the meantime, you need to drive. If you want used, get it from Craigslist. If you want new, Amazon. Don't need a prescription either way. But DO look at the list of machines that have data in the sticky so you get the right one(s).
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#10
RE: Severe positional apnea: What can I do?
With UARS most users bet better results if they can control inhale and exhale (IPAP/EPAP) pressures separately. The only auto CPAP that will do that is Resmed Airsense 10 Autoset or the S9 Autoset. Any of the bilevel machines will perform with even more flexibility such as the Resmed Aircurve 10 Vauto, S9 VPAP auto, and Philips Respironics BiPAP Auto. Here is a link to an Apnea Board wiki article you should read. http://www.apneaboard.com/wiki/index.php..._and_BiPAP

If you are suffering from positional apnea, you should consider getting a soft cervical collar which can give you immediate relief until you get on CPAP. They are available at any pharmacy, Walmart and Amazon very inexpensively. You are looking for a soft collar with a 2-1/2 to 3-inch height and comfortable fit. The collar keeps your airway in alignment and prevents chin tucking from any sleep position. Many of the members here use them even with CPAP to reduce positional apnea, allowing lower CPAP pressures.
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