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Does my Brother need cpap?
#1
Does my Brother need cpap?
My brother went some time ago and had a home sleep study.  The doctor reviewed the data and said he felt he would not benefit from cpap as he says the patient was found to have very minimal sleep apnea Also he said there was no significant desaturation during the night.
I will give you the data I have,unfortunately I can't post the report.
Complaint is not waking up refreshed in the morning and feeling tired in the morning hours.  Also audible snoring is evident throughout the night.
Ahi:  10.2
8.4 when non-supine, and 11.5 when supine.
Snoring event flags.  5
snore index per hour 0.5
The patient had desaturations as low as 60 percent and spent 34.5 minutes with an oxygen saturation less than 90 percent.
Ca events  0 Index#/Hour

OA events 5.1 Index/Hour
Mixed 0.2        Index/Hour
Hypopneas 4.9 Index/Hour
Time in bed.  546 minutes

Total number of events:
CA  0
OA  46
Mixed 2
Hypopneas 45
Total  93

Thank you for your time.
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#2
RE: Does my Brother need cpap?
For someone with mild apnea at 10.2 AHI, this individual appears to qualify for supplemental oxygen. With the actual data we could correlate oxygen desaturation with apnea and hypopnea, but seriously, 34.5 minutes under SpO2 90% with a nadir of 60%? I'm really impressed with this doctor's tolerance for other peoples suffering.
Sleeprider
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#3
RE: Does my Brother need cpap?
Thanks for your reply Sleeprider.  
Would you suggest him trying to have an in lab sleep study to see if it correlates with the home study?
Thanks again. 
If it wasn’t for the desaturations wouldn’t that ahi qualify for a CPAP?
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#4
RE: Does my Brother need cpap?
My wife had an AHI of 9.6, all hypopnea and qualified. The desaturations are a concern, and the question is how is he feeling in other respect. Bascially with the existing test and a simple "Epworth Sleepiness Scale" test his regular doctor could prescribe Auto CPAP. You don't need to spend a fortune on testing and dealing with specialists with a degree in how to be an ass. Good medical care is listening and doing the right thing.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#5
RE: Does my Brother need cpap?
The desat figure alone is horrendous, and if I were in a position to do so I would report the 'doctor' to the state/provincial college.

The stated AHI, regardless of what they comprised, would qualify a person for PAP therapy.  Then, some bright bulb would say, "Hey, what if we factored the desats into the figuring...would that help at all?"  Awkward looks at each other around the hospital staff boardroom.

The 'patient' in this case is not sleeping...he's comatose.  I don't know of anyone who awakens from a coma feeling zippy and wanting breakfast in a hurry.
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#6
RE: Does my Brother need cpap?
Thanks to those who responded.  I definitely feel he should be on APAP also.
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#7
RE: Does my Brother need cpap?
One other issue which is often overlooked (and usually not reported) is the duration of the apneas and hypopneas. A number of short (10 second) pauses in breathing is one thing. But when those pauses extend out to 40, 50, 60+ seconds then you could be in pretty serious trouble. The AHI is a very crude measure of what's happening, but it's simple and allows doctors and insurers to draw a line.

I agree with SleepRider's recommendation - get out of the sleep industry and get your GP to write the prescription. Or a dentist or nurse practitioner.
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#8
RE: Does my Brother need cpap?
Same case with me, I had many sleep studies on some i had 9 on others over 60. one study isnt enough, hes got desats and hes got the symptoms. i dont know about you but i always make a few appointments with many doctors of the same specialization if i want to clear a problem. When i had chest pains i did 6 appointments with 6 different doctors in the same month, I wanted an MRI angiography, the standard is Coronary angiography with a catheder, which I didnt want. 3 of them didnt want to write the Rx but the 4th one did. I had over 7 sleep studies in one month with 7 different labs. That's how you roll, by the numbers.
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