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When is it time to get another sleep study done.
#1
When I took my first sleep study, I had a horrible sinus infection which blocked almost all airflow through my nose. I ended up with a AHI of 14, with 42 during the REM sleep from that study. Since then I have had sinus surgery and have had drastic improvements in airflow through the nose. I have been slowly dialing down the max pressure of my APAP and have noticed no change in AHI (<1.5 nightly). I am now at a min of 5.4 with a max of 9.0. Avg is 7.0.

Should I go get another study to see if I still have apnea after the surgery? I will have to pay a little out of pocket, but worth it if i can ditch the machine. Should I continue to dial down the pressure if I still have good results?

Thank you for your time.
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#2
Since the diagnosis imposes restrictions on you that affect your career, I think a re-test is definitely warranted. One approach may be to do a relatively inexpensive home sleep test as a screening tool. If you fail that, you won't likely pass a true PSG. There is plenty of reason to believe your nasal obstruction, corrected through surgery, could account for enough of your mild obstructive sleep apnea to warrant a re-test. A PSG test is the only one that will likely be accepted to remove restrictions on your license.
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#3
Thanks for the input. What about slowly dialing back the pressure? If get to a point that the pressure is so low and I still have a low AHI wouldn't that mean the CPAP isn't doing much?
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#4
Maybe; but would the doc take that and state you no longer needed it? Don't know.
                                                                                                                                                                                  
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I'm an epidemiologist, not a medical provider. 
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#5
(11-19-2016, 10:39 AM)duece12345 Wrote: Thanks for the input. What about slowly dialing back the pressure? If get to a point that the pressure is so low and I still have a low AHI wouldn't that mean the CPAP isn't doing much?

The lowest pressure the machine is capable of is 4 cm. I don't know why, but even though that is positive pressure, I invariably feel starved for volume at that pressure. It's not a realistic test of your AHI without therapy at all, but feel free to try. In your case a "do-over" would be interesting because of the relatively mild nature of your apnea originally and the fact you should have resolved at least nasal obstruction with the surgery. It's not an option for most of us.

Wish you best of luck. Give the surgery plenty of time to heal and to settle down. I would avoid the CPAP for at least 3 days prior to the test. Just like changes with CPAP therapy, suddenly stopping for the test would probably not yield very good results. Don't stay off for so long that you fall out of compliance for the current 90 day period or whatever is checked.
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#6
duece12345 -

I am on very low therapy pressure. But my AHI when not treated is severe. Therapy pressure is also related to your uvula structure. The pressure increases to open the airway. In my case, I only needed a little pressure to open the airway. My nightly average is less than 6. Last night it was 5.44 (median). Without therapy however I have severe OSA. You may be in the same boat as me.
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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. 
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#7
Interesting. I may need the CPAP just at a low pressure. Thanks for all the replies
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#8
(11-19-2016, 10:39 AM)duece12345 Wrote: Thanks for the input. What about slowly dialing back the pressure? If get to a point that the pressure is so low and I still have a low AHI wouldn't that mean the CPAP isn't doing much?

The lowest pressure is 4 cm. If you still have a low AHI then it's inconclusive. If you have a high AHI than it is conclusive -- you still need CPAP therapy.
Sleepster
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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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