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Strange Diagnosis and shady process?
Hi there. I was kindly directed towards this group from another site and would appreciate any thoughts on my situation (cross post from another site). I was feeling tired for many years and my doctor sent me in for a sleep test for apnea. They gave me a portable unit to use at home. The tech, a nice guy, told me that there were 3 possible outcomes: 1) I would be positive for apnea, 2) I would be negative and 3) It would be inconclusive. Since the machine itself was considered unreliable, results 2 & 3 would lead to a hospital stay study to get better data. Essentially, it seemed like I was just jumping through an insurance hoop in order to get to the next step (sorry, a little jaded when it comes to insurance companies). Anyway, I brought the box back in the next day and the person analyzed the data while I waited. I had figured that I would ge result # 3, since the machine seemed to be constantly warning me that one of the sensors wasn't recording. Also, I was on my back the whole night with it, which made me wonder if the experiment was flawed. The doctor said that I had 5.6 apnea events per hour. I had no idea if this was a little or a lot. He said that it was moderate. Does that sound right to you? Also, he went on to say that he'd be happy to order me a CPAP machine through my insurance and did I want to go ahead with that. I know very little about apneas & machines and asked to see a sleep doctor before making any decisions. I thought that it was odd that the next step was just to grab some rand machine. There seem to be so many out there with various features & masks. I had no idea how to use it. I called the sleep doctor and was told that I could make an appointment for a few months from now, but I had to have a month's worth of data before she'd see me. I'm left here with little information on what apneas are to start with machines and whether my test was even any good. My main question for this group is, does this sound right? Is this how things roll during an apnea diagnosis? I didn't want to be negative towards a system that's trying to help me, but I feel like I need to do some advocacy on my part before I start treatment. Does this make sense?

Many thanks for any insights,

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Hi Caseous - Welcome to the Forum!

As I understand it, most insurance won't provide coverage for CPAP therpay unless you hit an untreated AHI of 20 or greater, unless you have other medical problems.. Medically, an AHI of 5 or below is considered treated. If your sleep test came back just above the acceptable threshold for an acceptable "treated" level, I can't see a CPAP in your immediate future. My opinions are based on the limited information that you have provided and may be way off the mark.

What symptoms lead you to have a sleep study?
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Hi Caseous,
An AHI of 5.6 is considered Mild Sleep Apnea. I am assuming you had an overnight study.
You should ask for a copy of that study.

AHI = 0–5. Normal range.
AHI = 5–15 Mild sleep apnea.
AHI = 15–30 Moderate sleep apnea.
AHI > 30. Severe sleep apnea.

Call that sleep doctor back and tell them you just had an overnight study, and see if they would be willing to write you a script based on that study. I don't understand how they expect you to have a months worth of data.

If you have insurance coverage, call and find out exactly what they cover. They should have a list of sleep doctors and DME's to choose from.

In the meantime, do your homework. Here is a link to help you see what machines are available and which ones to avoid.
Apnea Board Moderator

Organize your SleepyHead Charts
Using Attachments to Post ScreenShots and Images.
Machine choices

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Many thanks!
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Thanks a lot. Even though it was 5.6, the doctor I gave the machine to said that I would "benefit from a machine." It seems odd. I have calls back to the sleep lab, a sleep doctor and my GP.

All of this was done with a home sleep study that seems like it had the potential to be pretty flawed. Also, I slept the whole night (as far as I know) on my back because of the thing strapped to my chest. Should I be measured when I'm on my side, as well>

To answer your question, my symptoms are daytime exhaustion, snoring and waking up gasping (both observed by me and my my sleep co-habitator).

I truly appreciate the help I'm getting with all of this from this community and am thankful that I found this board!

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Hi Caseous,
WELCOME! to the forum.!
Good luck to you.
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It may be that your doctor went on a different number than AHI. The RDI. RDI includes events that AHI would leave out. Also, even with an AHI of 5.6, if it shot up to 20 during REM, then it might be considered moderate.

You should acquire a copy of the sleep study, and ask what the diagnosis of moderate apnea is based on.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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AHI is only half (or less) of the picture. 5.6 an hour with a length of 10 seconds and 5.6 with a length of 60 seconds is the same AHI but vastly different on its effect on your body. It is just a rough index to let them draw lines in the sand.

You are very, very unlikely to get a false positive, even from a home test. Given that you habitually feel tired in the day, snore, and gasp for breath at night, it seems pretty certain that you do indeed have sleep apnea and need to treat it. Yes, it might have been worse on your back, but you normally sleep on your side and still feel horrible. That says you need a machine. I was not terribly thrilled myself, but the improvement in life quality is well worth it.

I was diagnosed with an AHI of about 10 during real sleep study. I don't understand why they did not get on a machine then. The result, a few years later, was not good.

Get a machine, suck hose, Sleep-well
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Make sure you get a data capable auto machine. An AHI over 5 will qualify you for a machine thru medicare and most other insurance
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My experience tells me that like you I knew something was wrong. I was not very trusting of the medical system. I was only hurting myself more by waiting and being stubborn.

CPAP helped from the first night, it helped more over time. It has taken about a year to reach what looks like the limit of body repair. Now is is a matter of staying as healthy as I can.

Lack of air, oxygen and removal of used gasses is very needed. even small gaps in this add up. The damage done and repair work missed all will take a toll on our life. Health and Happy go hand in hand.

Not taking action sooner has added to lifes challenges. I could have had a much better life had I started treatment sooner. The people I came in contact would have seen a much better person.

I view it like getting cut, keep the wound clean and avoid infection. CPAP is no different.


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