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3 Months Until Sleep Study - Hoagie73 - 11-15-2020

Hi Everyone! I pray everyone is well and sleeping great!

My name is Stephen, and I'm 47 years old. I'll make this brief.

I've been a loud chronic snorer for as long as I can remember. Several years ago I would get migraines preceded by visual disturbance (auras) shortly after waking up on occasion. About two years ago I would wake myself up at times gasping for breath while sleeping on my back. I requested a sleep study through the VA as I am an Army veteran. They brought me in and sent me home with a home sleep study device. I woke up half way through the night and noticed I had tore the nasal hoses off my face. I put it back on, but the test came back negative. The gasping events got worse. It got to the point to where when I was falling asleep I would jolt awake from the feeling of not breathing. This was while lying on my side. This has been the case on and off for about a year now. Two weeks ago I started waking up every hour or so during the night. However, this time I'm not gasping for breath. I just wake up. Some nights I get very little sleep. A week ago I started experiencing night sweats. I went to urgent care the day after my first night sweat. They checked my blood, heart (EKG), and took xrays of my heart. They said everything looked great. I told them I was worried that I had sleep apnea. They scheduled me for a sleep study. But they are backed up for 3 months. I'm quite sure I have sleep apnea as my wife has witnessed me on several occasions holding my breath, long pauses between breaths, and erratic breathing. I'm wondering if there is anything I can do to make sleeping any better until I get the sleep study...

Thank you Smile


RE: 3 Months Until Sleep Study - Nightynite - 11-15-2020

It doesn’t sound like the home sleep test was able to collect the necessary data due to the little time it was actually used.  

Maybe you just need to redo it.  Because of COVID everything takes longer. My wife just did the home sleep test and that actually was sent to her pretty quick.  

Don’t be afraid to keep the home sleep test a little longer then they say.  I had the same problem and kept it 3 nights instead of 1 just to be sure they had good info.  I pulled mine off also.


RE: 3 Months Until Sleep Study - mesenteria - 11-15-2020

You may have 'central' sleep apnea where your system doesn't get the signal to draw a breath when your CO2 level gets above a certain threshold.  For some people, CA shows up AFTER they have commenced therapy, although most often it diminishes substantially as the therapy is refined and extended.  A few people get 'complex' apnea where they have both kinds, obstructive and central. The gasping suggests to me that you startle yourself awake and only resume breathing upon that startle response.  If it helps the least bit, I use a nasal mask that only covers my entire nose, but I also mouth breath when I fall asleep.  The open mouth means the air blasts out of my mouth and I awaken.  I have to tape my mouth closed.  This remedy, if you could charitably call it that, works very well...too well.  At times my nasal passages close up just before I am fully awake and I find myself sitting up, clawing at my face, attempting to breathe.  Not what you'd call fun.  So, I can commiserate.  

You have no apparent obstruction, you don't wear a mask currently, and you still awaken gasping for breath.  To me, it means you simply stop breathing and go for up to 40-60 seconds on your lung's diminishing oxygen supply.  This makes me think you must have some kind of central apnea.


RE: 3 Months Until Sleep Study - Hoagie73 - 11-15-2020

(11-15-2020, 04:39 PM)Nightynite Wrote: It doesn’t sound like the home sleep test was able to collect the necessary data due to the little time it was actually used.  

Maybe you just need to redo it.  Because of COVID everything takes longer. My wife just did the home sleep test and that actually was sent to her pretty quick.  

Don’t be afraid to keep the home sleep test a little longer then they say.  I had the same problem and kept it 3 nights instead of 1 just to be sure they had good info.  I pulled mine off also.

Thanks NN. I will look into that and see if I can get another home test. Grin


RE: 3 Months Until Sleep Study - Hoagie73 - 11-15-2020

(11-15-2020, 05:25 PM)mesenteria Wrote: You may have 'central' sleep apnea where your system doesn't get the signal to draw a breath when your CO2 level gets above a certain threshold.  For some people, CA shows up AFTER they have commenced therapy, although most often it diminishes substantially as the therapy is refined and extended.  A few people get 'complex' apnea where they have both kinds, obstructive and central. The gasping suggests to me that you startle yourself awake and only resume breathing upon that startle response.  If it helps the least bit, I use a nasal mask that only covers my entire nose, but I also mouth breath when I fall asleep.  The open mouth means the air blasts out of my mouth and I awaken.  I have to tape my mouth closed.  This remedy, if you could charitably call it that, works very well...too well.  At times my nasal passages close up just before I am fully awake and I find myself sitting up, clawing at my face, attempting to breathe.  Not what you'd call fun.  So, I can commiserate.  

You have no apparent obstruction, you don't wear a mask currently, and you still awaken gasping for breath.  To me, it means you simply stop breathing and go for up to 40-60 seconds on your lung's diminishing oxygen supply.  This makes me think you must have some kind of central apnea.

I feel the central apnea is a correct assessment. I actually do believe I have some obstruction too though. Last year I went to an ENT. I forget what it's called, but he ran a small camera up my nose and down my throat and commented on how narrow everything was. I apparently have some damage from silent reflux going on as well. I've read about sleep apnea and feel I may have the complex type. When I'm sleeping on my back, I feel it is because of an obstruction that I gasp. But I've been taping a tennis ball to the back of my shirt at night to keep me from rolling over on my back. I also wear a makeshift chin strap at times to ensure I breathe through my nose as to not encourage a collapse due to heavy mouth breathing, and I still tend to startle myself when falling to sleep because I feel I'm not taking a breath. From reading it sounds like central sleep apnea is treated with an APAP? 

Thanks mesenteria. Smile


RE: 3 Months Until Sleep Study - SarcasticDave94 - 11-15-2020

I had a sleep study done a few weeks ago at a local hospital in PA, so the test is available during COVID. Light a fire under Dr. Quack McDuck and get the test scheduled. Don't sit there and put up with the poor sleep. Start squeaking.


RE: 3 Months Until Sleep Study - SarcasticDave94 - 11-15-2020

If CA are proven, here in the US you will likely be issued a CPAP and BPAP, then failing both as they both are the wrong machine. Then Dr. McDuck schedules you for sleep study 2-3 or titration xyz to add ASV into the mix. If you only have treatment emergent CA then APAP or BPAP/VAuto is fine. If you have CA that is pre-existing, ASV is the only right answer. There is an idiopathic CA that means medically unknown cause. That to means ASV is the right answer. The only definitive way to find out is a lab sleep study. Some but not all home studies will measure for CA/clear airway/Central Apnea. The best answer is take the lab test, post a redacted copy of the sleep study results, we look at them and see the event type and count. Then we know about CA regarding you.


RE: 3 Months Until Sleep Study - Hoagie73 - 11-15-2020

(11-15-2020, 08:30 PM)SarcasticDave94 Wrote: If CA are proven, here in the US you will likely be issued a CPAP and BPAP, then failing both as they both are the wrong machine. Then Dr. McDuck schedules you for sleep study 2-3 or titration xyz to add ASV into the mix. If you only have treatment emergent CA then APAP or BPAP/VAuto is fine. If you have CA that is pre-existing, ASV is the only right answer. There is an idiopathic CA that means medically unknown cause. That to means ASV is the right answer. The only definitive way to find out is a lab sleep study. Some but not all home studies will measure for CA/clear airway/Central Apnea. The best answer is take the lab test, post a redacted copy of the sleep study results, we look at them and see the event type and count. Then we know about CA regarding you.

Thank you, Dave! I am scheduled for a lab sleep study, but there is a 3-month wait. It sucks, but it is what it is I suppose. Sounds like if it truly is CA, I have a long road ahead of me.


RE: 3 Months Until Sleep Study - SarcasticDave94 - 11-15-2020

FWIW I made it down the rough ASV road so I'm sure you can. The biggest thing is to keep a notebook of symptoms and complaints to tell the doc the apnea/sleep issues you're dealing with. Demand attention to be properly treated. When you get the sleep study, post a redacted full detailed version here. We can help decipher the data dump.


RE: 3 Months Until Sleep Study - NewToSleepApnea - 11-15-2020

I suggest buying a recording pulse Oximeter. I wake up as my body’s response to a drop in O2. Essentially buying 1 piece of the home test.

I get the same feeling as “not breathing” but the cpap usually says OA instead of centrals. Seems to be more gradual shallow breathing. Won’t even register as an event half the time.