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do I need an Auto PAP machine for sleep apnea

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WM +0 points · 7 months ago Original Poster

Dear all, I am new to this forum, nice to meet you all online. my sleep study at home result is as follows: mild obstructive sleep apnea, AHI 5.7 Low O2 88%, desaturations under 90% for 1.7 minutes. note: I did not fall sleep at all the first night I wear the sleep study equipment, then I was very tired, and slept well the 2nd night. I think the above diagnostic note was based on 2nd night sleep as I have removed the equipment at 2:00am the first night. With this being said, I am not sure if my found sleep apnea was under measured or not.

for long time, I have had sleep problem, either have hard time to fall sleep, or wake up too early and then can't go back to sleep. I am tired in the morning and sometimes feel dizzy. I was told i have brain small vessel ischemia.

My question is: it looks my apnea is not that bad, do I really have to use an auto PAP machine?

many thanks in advance.

WM

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Sierra +0 points · 7 months ago Sleep Patron

An AHI under 5 is considered normal. So, you are on the very margin of needing a CPAP. At that low a level of apnea the discomfort of wearing it may not be worth it. In the UK the National Health Services will not prescribe a CPAP unless AHI is over 15. For lower levels of apnea there are dental appliances that may address the apnea. It is something you could discuss with your dentist, or a dental specialist.

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PutSleepApneatoBed +0 points · 7 months ago Sleep Commentator

As usual, the devil is in the details. An AHI of 5, means that you have been diagnosed as having, on average over the entire night, 5 apneas or hypopneas per hour.
Over an 8 hour night, that could be 40 “events” in total. Each one disrupts your sleep, and if you desaturate enough, can cause arousals, aka sleep disruptions. Also, many people experience most of their events during REM sleep-some to the extent that they cannot maintain REM sleep.

I had an overall AHI of 19, but it was 83 during REM (when I could sustain REM, which wasn’t often.) I stopped dreaming at puberty and had no idea why. It took me to age 56 to self-diagnosis my OSA, get a APAP machine and start dreaming again. (And not getting REM sleep is NOT good for your brain.)

The 5 AHI criterion is what insurance will pay to treat, not necessarily normal. (And even if it were, that shouldn’t be a reason for non-treatment. Presbyopia is “normal” for everyone over the age of 40. Does that mean older people shouldn’t wear reading glasses to help them see better to read?)

There’s another factor. The current diagnostic criteria are crude and rudimentary and based on adult male gender patients. To be considered an “event” the cessation of breathing must last 10 seconds and the person must desaturate in most cases by 4% (again, what insurance will pay for.) Women and children often have shorted cessations of breathing. (You didn't specify your gender.)

The bottom line is, you are clearly still pretty symptomatic. If the PAP machine helps you, I would keep using it. But if it doesn’t, I would keep seeking an accurate diagnosis of your sleep problems and/or more effective treatment of your OSA—possibly your need different pressure settings, a different mask or a different machine. There are a number of alternatives to PAP (more all the time, although PAP is still the “gold standard.”)

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WM +0 points · 7 months ago Original Poster

thank all for your kind reply. I am 51, male. it seems I need to move to have a machine as doctor suggested. If it will not help me, I will then stop using it and I will not lose anything except some money.

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PutSleepApneatoBed +0 points · 7 months ago Sleep Commentator

Assuming you have medical insurance, your insurer may cover it. Has anyone told you whether there is likely to be any relationship between your sleep problem and the small vessel ischemia?

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WM +0 points · 7 months ago Original Poster

does anyone know which supplier or retailer have auto CPAP machine? The one my doctor recommended will not have any until the end of next Feb. thanks

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Sierra +0 points · 7 months ago Sleep Patron

New machines seem to be in short supply and are expected to stay that way for the next few months. The best machine in my opinion is the AirSense 10 AutoSet, or AirSense 10 AutoSet for Her. Both are basically the same and sell for the same price new. The "For Her" version has an extra mode which you can use or not use based on setup. If you are in the US there is a place that sells second hand machines. They also sell new ones, but are probably out of stock. You could try them. See this link. Stay away from any DreamStation machine that is used. They have been recalled.

https://www.secondwindcpap.com/product-category/cpap-machines/refurbished-cpap-machines/

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PutSleepApneatoBed +0 points · 7 months ago Sleep Commentator

Machine availability is a huge problem at the moment due to the combination of the pandemic and the Philips recall. I would try the various websites re APAP availability dates and, if nothing is available, consider whether you could use a small travel unit in the interim. Some of those seem to be available.

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PutSleepApneatoBed +0 points · 7 months ago Sleep Commentator

I concur in Sierra’s opinion as to the RESMED Airsense10 autosets being the best machines- also the Gen 11 machines, if you can get one. The RESMEDs have proprietary algorithms that adjust to your changing pressure needs within three breaths. They are anticipatory. That’s very helpful in avoiding events….

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