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OSA too mild to treat with CPAP? other sleep issues?
#1
OSA too mild to treat with CPAP? other sleep issues?
Both my parents have sleep apnea and use CPAPs. Mom wasn't diagnosed until after her heart attack, but Dad and his brother have had severe sleep apnea and have used CPAPs for decades. 

I'm female, early middle age, am not that overweight, and don't have an abnormally large neck. I sleep on my side and I've used phone apps to record myself snoring, and it's fairly mild. 

I've got multiple co-existing conditions some of which frequently occur with OSA, some of which cause insomnia or unrefreshing sleep for reasons unrelated to OSA

I had an in lab sleep study done somewhere around 15 years ago, which did not show sleep apnea or restless legs syndrome. They diagnosed Delayed Phase Sleep Disorder.

In the past 4-5 months I've been having issues where I'm having dreamlike episodes while awake if I close my eyes. They are extremely brief, 1-10 seconds, but like my usual dreams, tend to be bizarre and have no relation to the reality going on around me and/or are things that wouldnt happen in real life. Once in a while I get these things in situations where I'm almost certain my eyes were open or were just blinking. Twice Ive gotten them while driving. I do have difficulty going to sleep most nights, and I've also had these microdreams while trying to fall asleep - with a conscious train of thought before and after the dream.

Medical professionals I've talked to have described this as being hypnogogic hallucinations. Based on my research, it could also be narcolepsy, so I was pushing getting the version of the sleep study where they do the daytime sleep latency test afterwards. But my insurance wouldn't pay for it without doing an at home study.

I got the equipment to do an at home sleep study about a month ago. I fell asleep with the lights on while hooking it up, and only woke up and turned it on for the last two hours of sleep. The sleep lab had told me that I needed to have it on for four hours to have a valid sleep study.

I got a call back saying they needed to book the second part of the sleep study. So I figured that it was the in lab study with the sleep latency test. There was some confusion about scheduling the study, and they wouldn't tell me the results before my doctors appointment. And then I found out that the "second part" was actually the CPAP titration, so I must have sleep apnea.

I called back and begged to get my results, and found out that in those 2 hours I apparently had 12.1 AHI, along with an oxygen saturation of 88%

Two questions: 

1. With these kind of numbers, am I likely to have a noticeably better night's sleep? In terms of energy and mental clarity, both of which have been diminishing in the past couple years.

2. My dad told me that his DME supplier told him that he's due for a new CPAP. His current one looks identical to mom's Resmed Airsense Auto 10, but it's 5 years old. Since I'm unemployed, would I be able to use Dad's old machine if I disinfect it? Would  that keep me from getting supplies like masks and filters covered?
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#2
RE: OSA too mild to treat with CPAP? other sleep issues?
As long as you have a prescription it should be no problem. I would do a factory reset and delete all data before use.
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#3
RE: OSA too mild to treat with CPAP? other sleep issues?
I've done some research online, and there are medical articles that say that you shouldn't treat mild sleep apnea - with an AHI of under 15. Instead you should treat it with changing sleeping position or losing weight. However, I fluctuate in weight up and down about 15 pounds and I'm near the low end of my range. And I normally sleep on my side. I think I tried sleeping on my back for the short time the machine was recording.
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#4
RE: OSA too mild to treat with CPAP? other sleep issues?
That is a personal choice, one I didn't have. N advantage of having a CPAP is that you will know what your numbers are and can react to them appropriately.
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#5
RE: OSA too mild to treat with CPAP? other sleep issues?
IMO It's better to treat the apnea now as you already know it's there. Let it wreck havoc untreated for some time and you're probably opening the door on a bigger health problem, more apnea events or otherwise.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: OSA too mild to treat with CPAP? other sleep issues?
12 AHI with an oxygen saturation of 88% is not mild. What is your BMI?
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#7
RE: OSA too mild to treat with CPAP? other sleep issues?
I commend you for wanting to try CPAP/APAP on your own. I understand that being unemployed the medical system doesn't really allow for a cheap method to get diagnosed and equipment. So yes, if you can get your hands on an APAP machine, you can do your own titration and people here can look at OSCAR charts and guide you to the best settings.

You will need a prescription for a mask, unless you can get your hands on one that will work without leaks.

If you go this route, download OSCAR "and" Rescan. OSCAR is better for diagnostics. Personally, I think Rescan is better when you have to see a sleep doctor in the future for a new machine or ???. Nothing feels better than to dump Resmed proprietary software reports on a doctor's desk, and then be able to talk about your therapy.

Even if you do this a year or so from now. All you have to say is that you had a sleep study done 15 years ago and your current machine is almost 7 years old and here are is a report over the last year; the new doctor will fill in the blanks for you.

John
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#8
RE: OSA too mild to treat with CPAP? other sleep issues?
FWIW I've been unemployed for over 5 years. I'm soon to be approved for Disability, but in the meantime my PA welfare issued insurance has paid for sleep studies, the ASV, the supplies, and more.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: OSA too mild to treat with CPAP? other sleep issues?
Regarding using dad's machine, no need to disinfect if you buy new air tubing, mask and a humidifier tray. The machine itself does not require disinfection beyond just a wipe-down. The Resmed Airsense 10 Autoset is a good machine. Keep in mind several other models look identical to the Autoset, but are fixed pressure. For someone with limited insurance options, Amazon and Ebay as well as many online suppliers cost a fraction of what a local DME provider will charge. Online suppliers still require you to have a prescription, but costs are reasonable. Even machines can be acquired off Craigslist, offer-up and others at really low prices.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#10
RE: OSA too mild to treat with CPAP? other sleep issues?
(12-07-2019, 02:15 PM)JoeyWallaby Wrote: 12 AHI with an oxygen saturation of 88% is not mild. What is your BMI?

BMI currently is about 28. I've been at a BMI of 31 or 32 at my heaviest. If I'm stressed out, not exercising, and overeating or getting free catered food at work, it goes up.

I'm saying 12 is mild because of how mild/moderate/severe OSA is classified.

From Harvard Med Sleep Clinic:   "Apnea Hypopnea Index (AHI)

The AHI is the number of apneas or hypopneas recorded during the study per hour of sleep. It is generally expressed as the number of events per hour. Based on the AHI, the severity of OSA is classified as follows:
  • None/Minimal: AHI < 5 per hour
  • Mild: AHI ≥ 5, but < 15 per hour
  • Moderate: AHI ≥ 15, but < 30 per hour
  • Severe: AHI ≥ 30 per hour"
Despite being unemployed,  I do have health insurance. It's just a matter of paying the coinsurance for the CPAP. 30%? I think I might be close to the maximum out of pocket amount at this point.

I also know that a large number of people try CPAPs and either can't adjust to them or don't find them helpful.  I remember reading something that half of people don't make it through the first month, and another 25% don't make it through the first year. That may be that it's just too uncomfortable,  be mask fit, or bad CPAP settings, or that they really need a BiPAP or something like that. 

Mom's machine is an Autoset, Dad's isn't but looks like it. I think its an older model Resmed Airsense. The difference they see is that Mom's doesn't have the pressure come on for a little bit after she puts it on and starts it. Dad's starts right away. He doesn't have the product information about it and/or can't see well enough to tell exactly what model it is. So the machine I'm possibly being offered in a month or two isn't an Autoset and has been used for 5 years at a pressure of 11 or 12. Or I could get his old old machine from 10 years ago that was used up until 5 years ago right now.
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