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Very confused about apnea
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msmcintosh Offline

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Post: #31
RE: Very confused about apnea
What's different in the sleep study, besides all the wires they had hooked up to me? Is the data the same from the oximeter, but an MD is needed to interpret it?

I agree that more than one night is needed. But how come only one sleep study was needed? I should have done more research and got the oximeter when I had the sleep study. I was hoping the somehow be able to take opioids for pain, but it looks like I can't.

With sleep apnea, is snoring involved? loud snoring? quiet snoring?
(This post was last modified: 02-08-2013 10:23 PM by msmcintosh.)
02-08-2013 10:20 PM
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PaulaO2 Offline
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Post: #32
RE: Very confused about apnea
A sleep study does a lot. They track breathing rate, oximetry data, stages of sleep, body position, and body movement. Then they also track when you have an event, what kind of event, and what pressure it took to end the event (if titration or split study). Then they put all that into a tidy package that the sleep doc then uses to determine your treatment.

And your statement about it is why so many of us think sleep studies are flawed. Yes, they are necessary for the above reasons. But they are just one night, in a strange place, with wires and goo. Many people don't sleep long enough. Many don't sleep at all. This is why the follow-up with the doc and a data capable machine is so vital yet so rarely done. We, however, know of the flaw and want to ensure we and others monitor their data for longer periods of time. All we have to go by is the data our machines (or oximeters) give us. We don't know sleep stages, body position, etc. A week or more of data gives us a much better picture.

Obstructive Sleep Apnea is almost always accompanied by snoring. A snore is that material in our throat vibrating. So the snore sound is dependent on how long the snore lasts, how much the material vibrates, etc etc. Some folks snore so loud their spouse moves to another room. Some don't. Central Sleep Apnea does not snore since there's no vibrations. Again, this is a good reason for a sleep test.

I don't know why you think you can't take anything for pain. Like I said in the other post, it doesn't seem as though your O2 dropped that low. And it is just one night. If we were to use your single night of oximetry data, then we'd have to say you have nothing to worry about. But we know you probably do which is why we advise to keep using to gather more data.

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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.
02-09-2013 12:04 AM
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msmcintosh Offline

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Post: #33
RE: Very confused about apnea
No, based on the sleep study, the reviewing doctor pointed the finger at my opioid pain meds. My PM doctor read the recommendation and fearing for my life, made me stop taking them. I have been off them for 3 days now and in a considerable amount of pain. I'm in so much pain it's difficult to function.

I had been on pain meds since 2006 and in 2011 lost my private health insurance, so at that time I started at the VA. Immediately, I could sense that they do not like to prescribe opioids, saying too many Vets have been dying from them. There is so much propaganda against them. So I look at the sleep study as another reason/excuse for them to take them away. And they can cure my sleep apnea by me not sleeping anymore from pain.

It's so stupid that I have the sleep study in October of 2011. the report comes out in early November. I keep asking about it and finally, my PM doctor sees it when I go to my appointment in late December advising to stop taking the opioids due to the sleep apnea. That's almost 2 months later. Then I have to wean off into hell. Then I get a letter telling me I have an appointment on March 5th for a home oxygen unit to use while I wean off the opioids. Things move so slowly.

I have the appointment at the sleep clinic, which was setup 3 months ago and no one had told me why, it just showed up on my calendar. I really don't know what it's for. If I bring them reports like the one I uploaded they'll definitely blame the opioids and claim me cured. And then I get to go crazy from severe chronic pain, but better not to die of sleep apnea according to the VA. You can tell I angry and frustrated.

Last night I fell asleep with my glasses on and never hit record on the oximeter.

I still have Morphine and I could take it. The Morphine is time release and I imagine it builds in your body. I could do that to test with the oximeter. I don't know if it would be accurate for just one day and I'm not sure I want to go through withdrawals.
02-09-2013 04:50 AM
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msmcintosh Offline

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Post: #34
RE: Very confused about apnea
Here's another short report.
02-09-2013 09:08 AM
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Sleepster Offline
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Post: #35
RE: Very confused about apnea
(02-09-2013 04:50 AM)msmcintosh Wrote:  I have the appointment at the sleep clinic, which was setup 3 months ago and no one had told me why, it just showed up on my calendar.

I suggest you call the doctor's office and tell them that you are in so much pain that you just can't stand it. That should get them to do something.

Also get them to explain why you're scheduled for another appointment.

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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.
02-09-2013 09:13 AM
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msmcintosh Offline

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Post: #36
RE: Very confused about apnea
Not enough space to attach it.
02-09-2013 10:06 AM
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Dawei Offline

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Post: #37
RE: Very confused about apnea
About snoring, I can share what the pulmonologist I've been seeing told me. He said it's believed that snoring and apnea are on a continuum with mild snoring at one end and heavy snoring turning to apnea at the other end.
While the search was going on for a correct min. pressure to stop my events (following a sleep study result that was incorrect), the doc considered my report of still snoring inside the mask as an indicator that the pressure needed to be adjusted again.
02-09-2013 11:06 AM
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msmcintosh Offline

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Post: #38
RE: Very confused about apnea
time : 06:10:00
Duration = 02:07:54
Event Data Spo2 Pulse
Total Events 18 16
Time In Events(min) 10.6 6.8
Avg. Event Dur.(sec) 35.4 25.6
Index (1/hr) 8.4 7.5
o/o Artifact 0.0 0.0
Adjusted Index(1/hr) 8.4 7.5
%SpO2 Data
Basal SpO2(%) 94.5
Time(min<) 88% 0.3
Events < 88% 1
Minimum SpO2(%) 84
Avg. Low SpO2(%) 90.8
Avg. Low SpO2<88% 84.0
Pulse Data
Avg Pulse Rate(bpm) 70.3
Low Pulse Rate(bpm) 59

I can't copy in the graph, but at approximately 7:30AM is when my SpO2 level dropped to 84%. At about 7:19AM and 7:23 it dropped below 90%, maybe 89%.
02-09-2013 11:26 AM
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vsheline Online

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Post: #39
RE: Very confused about apnea
(01-31-2013 02:57 PM)msmcintosh Wrote:  When I go to my appointment at the sleep clinic on 02/28, I'll ask then about the ASV CPAP. I don't really know what the appointment is for. I just noticed it on my online calendar.

(02-09-2013 09:13 AM)Sleepster Wrote:  I suggest you call the doctor's office and tell them that you are in so much pain that you just can't stand it. That should get them to do something.


Hi msmc,

At your appointment with sleep doc, I suggest you emphasize that your present non-opioid pain meds are not working. The severe pain without opioids is way too great to allow you to get the sleep you need; the pain is way too great to allow you to even function during the day.

Don't merely "ask about" an ASV machine: ask for an overnight ASV titration study with opioid pain medication so you can sleep the night of the study. You need to take pain meds before/during the study or else you won't sleep enough time to allow the ASV titration to be successful.

Unless your pain med doctor has by that time found something for you which is as effective as opioid medications, I think you will need to start opioid pain meds at least as early as the day of the ASV titration study. That way they can verify that an ASV machine eliminates the Central Apnea events (even while you are on opioids) which seem to have been caused by the two treatment approaches tried during the first sleep study, which were the Constant PAP and Bi-level PAP treatment approaches. Don't let them try Auto-PAP. APAP treatment is not fundamentally different than CPAP and BiPAP and cannot eliminate Central Apnea events, but ASV is fundamentally different (because it intervenes breath-by-breath to breathe for you when necessary) and can.

Treatment with an ASV PAP machine may avoid all CA events, even when you are taking pain meds sufficient to allow you to function during the day and sleep during the night. ASV machines record data that the sleep doctor and the pain med doctor (and you) can check as often as desired, to verify your pain meds (whatever ones you may need in future) and sleep aid meds are not causing apnea events.

In parallel (don't wait until after your appointment with the sleep doctor) keep calling and asking for adequate pain meds from your Pain Med doctor, as Sleepster suggested.

Find out by phone what appeal process is available to challenge the elimination of opioid meds, pointing out that you are not getting adequate sleep and your life is a living hell, and this is not at all acceptable. Do what you can to challenge and appeal. Sometimes more than one appeal is needed. Never give up.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 02-09-2013 03:23 PM by vsheline.)
02-09-2013 03:14 PM
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archangle Online
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Post: #40
RE: Very confused about apnea
(02-07-2013 10:50 PM)Shastzi Wrote:  Yes, msmc. You must be in "REM mode" in order to dream.
Remembering them afterwards is a toss up though.
You can get the big picture on the REM sleep stage from wikipedia.

We used to think that, but we now realize that's not true. We do dream during non-REM sleep. Look up the PBS Nova program "What are dreams?" for more info.

There are a lot of things we used to think about dreams and sleep that turn out not to be true.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
02-09-2013 03:57 PM
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