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So I don't have OSA after using Cpap for 6 months
#1
Unfortunately this isn't a door shut closed. As I never really trusted the sleep center I went to in Manhattan since they gave me a borderline diagnosis of AHI of 6, I was getting the tiredness etc.. and went ahead with the treatment and finally got used to it. Last week. I paid for a home sleep study but through a company that sends you the full test unit with EEG EKG, position, basically the same as a lab study but without the technician there. There were definitely differences positionally and supine was the worst at an ahi of 4.6. Sleeping on my left was 0. The physicians review said NO evidence of obstructive sleep apnea (i'm 15 lbs heavier than when I had the original test as well). Total Respiratory data for the test (night 6 hours) was 0 obstructive apneas, 2 central apneas, and 11 obstructive hypopneas. My average index was 2.4 per hour of which my supine sleeping was 4.5. This all being said, I did register a fair amount RERA's (respiratory effort related arousals) which at the end of the day I believe is not as harmful as OSA since I don't really stop breathing, but it does take a similar toll on my actual rest. It was interesting to see that I spent 21 minutes in N1 sleep, 220 min in N2, 0 in N3 and 77.5 in REM. My AHI did jump up to 4.6 in REM. There is way too much additional data to list here, but I am curious if anyone else here has this RERA thing. My total results were as follow, AHI 2.4, REM AHI 4.6, RD! 10.9. I didn't dip below SPO2 of 94% although that seems a bit low for me when I normally recorded 95%-96% with my pulse oximeter when I checked at night. They said that Cpap was still effective for this scenario and I'm in sort of a weird in the middle scenario, but that I might actually be a good candidate to see an ENT to see if there is anything that is causing the resistance that can be corrected with surgery (yechhhhhh). (this lab is in CA, so they have no benefit in any diagnosis). Any thoughts here?. As much as I got used to the Cpap, I don't want to use it if I really don't need to. Some of this is likely further exacerbated by my taking some muscle relaxants before sleep due to costochondritis.
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#2
(07-09-2015, 08:48 PM)Daso Wrote: Unfortunately this isn't a door shut closed. As I never really trusted the sleep center I went to in Manhattan since they gave me a borderline diagnosis of AHI of 6, I was getting the tiredness etc.. and went ahead with the treatment and finally got used to it. Last week. I paid for a home sleep study but through a company that sends you the full test unit with EEG EKG, position, basically the same as a lab study but without the technician there. There were definitely differences positionally and supine was the worst at an ahi of 4.6. Sleeping on my left was 0. The physicians review said NO evidence of obstructive sleep apnea (i'm 15 lbs heavier than when I had the original test as well). Total Respiratory data for the test (night 6 hours) was 0 obstructive apneas, 2 central apneas, and 11 obstructive hypopneas. My average index was 2.4 per hour of which my supine sleeping was 4.5. This all being said, I did register a fair amount RERA's (respiratory effort related arousals) which at the end of the day I believe is not as harmful as OSA since I don't really stop breathing, but it does take a similar toll on my actual rest. It was interesting to see that I spent 21 minutes in N1 sleep, 220 min in N2, 0 in N3 and 77.5 in REM. My AHI did jump up to 4.6 in REM. There is way too much additional data to list here, but I am curious if anyone else here has this RERA thing. My total results were as follow, AHI 2.4, REM AHI 4.6, RD! 10.9. I didn't dip below SPO2 of 94% although that seems a bit low for me when I normally recorded 95%-96% with my pulse oximeter when I checked at night. They said that Cpap was still effective for this scenario and I'm in sort of a weird in the middle scenario, but that I might actually be a good candidate to see an ENT to see if there is anything that is causing the resistance that can be corrected with surgery (yechhhhhh). (this lab is in CA, so they have no benefit in any diagnosis). Any thoughts here?. As much as I got used to the Cpap, I don't want to use it if I really don't need to. Some of this is likely further exacerbated by my taking some muscle relaxants before sleep due to costochondritis.

Hi Daso,

You might want to google UARS since having RERAs can be a sign of having that condition according to the interpreting physician of my last sleep study. And even though you don't stop breathing totally with RERAS, they can be just as harmful as OSA since they are still causing partial airflow blockage although without O2 desaturation and disrupting your sleep which affects your health. As a result, I would continue with the CPAP if you feel it is helping you.



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#3
You are absolutely correct in the UARS diagnosis.
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#4
I had a low AHI (5), but high in RERAs. I think the RDI was 38. The Cpap has definitely been helping. I am still waking too often at night though to feel refreshed. Hopefully, that will improve over time. Since you joined last year, I assume you've been using the cpap for awhile. Do you feel BETTER when you use it? Or just not enough to feel like it was really doing it's job, hence getting another sleep study?

I should add that some of my complication is a slow heart rate, which I'm guessing may be part of the RERA issue - not sure.
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#5
(07-09-2015, 08:48 PM)Daso Wrote: They said that Cpap was still effective for this scenario and I'm in sort of a weird in the middle scenario, but that I might actually be a good candidate to see an ENT to see if there is anything that is causing the resistance that can be corrected with surgery (yechhhhhh).

Well, I would avoid the typical surgery designed to treat OSA, but perhaps what they meant was something else. It could be something as simple as a tonsillectomy.

I would also check into a dental appliance.

Find out what your CPAP pressure is and let us know. That could be a factor in this decision.


Sleepster
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#6
(07-09-2015, 09:41 PM)Mosquitobait Wrote: I had a low AHI (5), but high in RERAs. I think the RDI was 38. The Cpap has definitely been helping. I am still waking too often at night though to feel refreshed. Hopefully, that will improve over time. Since you joined last year, I assume you've been using the cpap for awhile. Do you feel BETTER when you use it? Or just not enough to feel like it was really doing it's job, hence getting another sleep study?

I should add that some of my complication is a slow heart rate, which I'm guessing may be part of the RERA issue - not sure.

Hi, Yes, I've been using the cpap for 6 months steady now and as much as I don't like it, I'm used to it (it has forced me to have a kind of sleep actuator) and YES, I do feel better than before on the whole. Less afternoons of sleepiness, but I just felt like my sleep center just wanted me to lease the Cpap and the doctor who gave me the diagnosis just said you have sleep apnea and that's it. When you say slow heart rate, what is it. I'm 47, about 15 lbs overweight but in good general health although haven't been to gym in 6 months and my average resting heart rate is around 55 although I walk a fair amount daily. I haven't tried going off the cpap to see if symptoms of sleepiness came back
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#7
(07-09-2015, 09:51 PM)Sleepster Wrote:
(07-09-2015, 08:48 PM)Daso Wrote: They said that Cpap was still effective for this scenario and I'm in sort of a weird in the middle scenario, but that I might actually be a good candidate to see an ENT to see if there is anything that is causing the resistance that can be corrected with surgery (yechhhhhh).

Well, I would avoid the typical surgery designed to treat OSA, but perhaps what they meant was something else. It could be something as simple as a tonsillectomy.

I would also check into a dental appliance.

Find out what your CPAP pressure is and let us know. That could be a factor in this decision.

Hi, I actually have a dental appliance which I tried first, and it seemed to help but my slight TMJ became more aggravated by it and its effectiveness seemed to have lessened after a while so I deiced to start the cpap. Sleepyhead shows My Cpap pressure (auto) ranges from 4-9 with leak rates from 8-30. My nightly AHI ranges from .2 to a max of 1 (only once in a while). Avg around .5. I'm going to see ENT again next week

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#8
Quote: When you say slow heart rate, what is it. I'm 47, about 15 lbs overweight but in good general health although haven't been to gym in 6 months and my average resting heart rate is around 55 although I walk a fair amount daily.

If I'm sitting up, my average resting heart rate is 55-60. If I'm laying down, within about 5 minutes, it is down to 42-43. Having a heart rate in the 50s is slower than usual, but not necessarily abnormal, particularly since you exercise.

As far as surgery, you have to really think about that. My sister had surgery for a deviated septum that resulted in her no longer needing a cpap (this was 8 or 9 years ago). However, the cpap use was not the reason for the surgery, just a happy side effect. In general, surgery hasn't been all that successful at eliminating cpap use.
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#9
(07-09-2015, 11:14 PM)Mosquitobait Wrote:
Quote: When you say slow heart rate, what is it. I'm 47, about 15 lbs overweight but in good general health although haven't been to gym in 6 months and my average resting heart rate is around 55 although I walk a fair amount daily.

If I'm sitting up, my average resting heart rate is 55-60. If I'm laying down, within about 5 minutes, it is down to 42-43. Having a heart rate in the 50s is slower than usual, but not necessarily abnormal, particularly since you exercise.

As far as surgery, you have to really think about that. My sister had surgery for a deviated septum that resulted in her no longer needing a cpap (this was 8 or 9 years ago). However, the cpap use was not the reason for the surgery, just a happy side effect. In general, surgery hasn't been all that successful at eliminating cpap use.

I agree. Interesting about your sister as my ENT said I had a fairly deviated septum while explaining that everyone has one to a certain degree.
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#10
(07-09-2015, 10:15 PM)Daso Wrote: I'm going to see ENT again next week
I wouldn't rush, the doctor will always find something to operate on
If not broke, don't fix it

As for RERAs, ResMed AirSense 10 AutoSet for Her and PRS1 Auto report RERAs
My AirSense 10 AutoSet does not report RERAs but some forum members reported their with newer machine does report RERAs


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