[Diagnosis] first diagnosis help

[nate17880]

Hi guys ive recently joined the apnea tribe. I was wondering what my next steps are

Ive noticed on reddit that there's many different types of Apnea (central, obs, complex) and UARS. My study shows that I have mild osa but I was wondering, do I happen to have UARS instead? Also could someone recommend me a machine if possible and face mask?

[nate17880]

For most of my life as I can remember, I've always felt tired. Recently, I had a Neuropsych evaluation and I got diagnosed with ADHD-Inattentive and dysthymia. I feel like most of my mental health problems may be caused by sleep apnea but I am unsure. Also this is kind of random but I dont think ive ever woken up with morning wood so I think im going to get a t-panel done at a pathology center haha.

[DevinJones]

When you had this home sleep study with the WatchPat One, did you have a round sensor attached to your chest to detect respiratory chest movement? 

[nate17880]

Yea I did. It was a round blue sticky thing I think

[DevinJones]

That sensor is supposed to be able to detect central sleep apnea. Was CSA ruled out? I don't see in the report any mention of data from the chest movement sensor.

It seems as if everyone with a WatchPat One study gets a diagnosis of OSA and an order for CPAP or APAP, even if they have more than OSA and need another type of PAP device.

[nate17880]

That sensor is supposed to be able to detect central sleep apnea. Was CSA ruled out? I don't see in the report any mention of data from the chest movement sensor.

It seems as if everyone with a WatchPat One study gets a diagnosis of OSA and an order for CPAP or APAP, even if they have more than OSA and need another type of PAP device.

these were the recommendations made by the doc over at lofta. not sure about csa

Summary & Diagnosis
Obstructive Sleep Apnea (G47.33) - Mild based on (REM-predominant) pAHI= 10.3 and pRDI= 20.5, and O2 nadir of
89%.
Recommendations
1) A trial of Auto-CPAP set 4-20 cm H2O with heated humidity and mask/interface fitting.
Close follow up and monitoring is recommended locally in 4-6 weeks to adjust pressures if necessary.
2) Alternate treatment options including oral appliance therapy and/ or surgical procedures for OSA may be considered
if PAP is not tolerated.
3) Avoid alcohol, sedatives and other CNS depressants that may worsen sleep apnea and disrupt normal sleep
architecture.
4) Sleep hygiene should be reviewed to assess factors that may improve sleep quality.
5) If the patient has a BMI > 25, weight management and regular exercise should be initiated or continued.
6) Avoid driving and handling machinery/equipment if sleepy.

[DevinJones]

That's the problem with most home sleep studies. There just isn't enough data to know what the true diagnosis is. Is it OSA, CSA, or complex sleep apnea. No way to know for sure.

Also, I believe most sleep studies use an AHI score based on a 4% criteria. Your pAHI 4% score is 5.4, which is considered very minor sleep apnea. But then again, many or most home studies are not so reliable.

[nate17880]

That's the problem with most home sleep studies. There just isn't enough data to know what the true diagnosis is. Is it OSA, CSA, or complex sleep apnea. No way to know for sure.

Also, I believe most sleep studies use an AHI score based on a 4% criteria. Your pAHI 4% score is 5.4, which is considered very minor sleep apnea. But then again, many or most home studies are not so reliable.

I see. Would it be a bad idea to buy a cpap out of pocket? I’m really desperate to solve this fatigue puzzle. I’ve gotten a regular blood test done and there wasn’t anything to be found, need to try a T-panel but that’s about it.

[DevinJones]

One blood test is not an extensive medical workup by a good physician. I'd get a thorough medical evaluation to look for any medical conditions contributing to your problems, including your fatigue.   

I'd also wait for a response from one of the forum experts, who have a lot of experience interpreting sleep studies and determining the most appropriate PAP device for patients. Let's see what they say about your situation.