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[Treatment] Recently diagnosed via at-home test
#1
Recently diagnosed via at-home test
Hi all, 32 y/o male here. I have struggled with daytime sleepiness/fatigue/brain fog for at least 13 years now. Sleep apnea crossed my mind in the past but I don't snore and I'm in good shape so I figured this wasn't the case. I finally got an at-home test done (WatchPAT One) and it found an RDI of 8.5, which qualifies as mild sleep apnea. Honestly, I'm feeling extremely relieved to finally figure out the potential cause!

The doctor I'm working with is prescribing an oral appliance to start. If my symptoms don't improve, then we'll go to CPAP. 

Do any other folks with mild OSA have experience with oral appliances and daytime fatigue? I'm reading that the side effects can be pretty bad in terms of teeth/jaw movement. Is this something to worry about? 

Also, can an RDI of 8.5 explain my symptoms? I know it's not that severe.

Would love to hear your experiences, successful or not. 

Thanks
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#2
RE: Recently diagnosed via at-home test
With that kind of number from take home, it's not likely. Take home is not all that accurate. But, I would try CPAP machines to see if it improves your sleep. It does come with lots of issues, but you can figure out ways to get over them (if you are an experimenter and solves problems on your own) and it may help.

What oral appliance? I would stay away from oral appliances (unless it's for TMJ, bruxism issues). Have your doc prescribe a CPAP to try out. I think they are rentals for 13 months and you own it after. So, it's like a trial usage.

I think people with AHI even 5 or under (clinically normal apnea level) can benefit from CPAP if the person gets sinus congestion (if caused by dry air), oxygen desaturates due to prolonged flow limitations during sleep despite the low AHI, as long as they can figure out how to deal with the issues that come with CPAP.

You can get crap sleep quality under 5 AHI. 5 AHI is just a number that is not a metric of sleep quality. There's lots of complexities of sleep people probably are not aware. The web will tell you that you need 7-8 hrs of sleep, but they do not mention quality sleep. You can get quality sleep less than 7-8 hrs and be better rested than somebody with 7-8 hrs of sleep. Sleep quality is more important than quantity.
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#3
RE: Recently diagnosed via at-home test
I do frequently wake up with bloody noses/congestion during the winter/early spring due to dry air. I wonder if that's related.
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#4
RE: Recently diagnosed via at-home test
I also did a home sleep test and like you had minimal events. I think it was 6 per hr. I ended up with a cpap machine and come to realize it also helps with my seasonal allergies, deviated septum and chronic mouth breathing. Which in turn was causing my sleep to suffer. Now that I been on cpap, I have taught myself to breath through the nose. Allergies are easier to handle and I sleep a lot better.
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#5
RE: Recently diagnosed via at-home test
I was recently diagnosed with moderate OSA and, like you (other than my advanced age), I wasn’t the stereotypical OSA candidate so I was skeptical about going on a CPAP machine. Because I knew very little about it, I found the idea of being on a CPAP machine to be horrible. So I went to my dentist who, by happy coincidence, is an OSA oral appliance expert. I was hoping he could recommend a simple oral appliance instead of the dreaded CPAP machine.  He said no, not in my case. There was nothing about my jaw, etc. that was likely to be contributing to my sleep apnea. He also said that was very good news for me because of all the potential very serious negatives of an oral appliance. He considers an oral appliance to be a last resort.

Of course, I have no idea if the oral appliance your doctor prescribed is something that could help or harm. But I can say that, for me, a CPAP machine isn’t at all unpleasant.
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#6
RE: Recently diagnosed via at-home test
Yes, an RDI of 8.5 could explain your symptoms. On average every 7 minutes something potentially disruptive to your sleep is going on. Did you get a copy of your sleep report? If so, you could black out your personal information and post a scan of it here.
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#7
RE: Recently diagnosed via at-home test
(05-14-2022, 12:23 PM)Dormeo Wrote: Yes, an RDI of 8.5 could explain your symptoms.  On average every 7 minutes something potentially disruptive to your sleep is going on.  Did you get a copy of your sleep report?  If so, you could black out your personal information and post a scan of it here.

Yeah, here's a copy: https://docdro.id/VzIKZpE

Thanks in advance!
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#8
RE: Recently diagnosed via at-home test
Most of your RDI comes from RERAs (respiratory effort related arousals), and you were snoring a lot. Here's some information about oral appliances from a trusted source:

https://my.clevelandclinic.org/health/tr...leep-apnea

I don't think a home test can establish this, but your results perhaps point toward UARS (upper airway resistance syndrome). I don't think there's a strong consensus among sleep specialists about the best way to treat UARS.

Some doctors advocate strongly for treating UARS with a specialized CPAP machine, either a bilevel machine or an ASV (adaptive servo-ventilation) machine. These are more expensive machines, and be aware that with your test results your insurance would be unlikely to pay for them.

If you want to consider trying an oral appliance, please be sure the dentist specializes in treating patients with sleep breathing disorders.

Before you decide what to do, you might want to visit an ENT doctor to see whether there are any obvious and treatable ways your airway is being compromised.
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