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Hi I'd love some advice

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meaty +1 point · over 2 years ago Original Poster

Hi All,

So cliff notes - 35yo male had a sleep study that revealed i had AHI 16.8/Hour, RHI 17.6/Hour (Supine) so 81 hypopnoea and 2 Apnoea's.

I have longstanding anxiety and depression (but working on it and to be honest almost fixed it now). I'm often quite tired when i get home from work (E'g lying on my bed). Low libido is an annoying problem i cant figure out. Tiredness / LL could be due to mental health.. I often wake up with one nostril pretty clogged up.

Should i seek treatment, or is this really not likely to be affecting me at all? The women who rang me up to report my sleep study sounded quite disinterested and my mum thinks i should just not do anything about it.

I've tried sleeping on my side, which actually might make me feel a little better but it could be placebo. I think i'll focus more on positional therapy as that apparently helps.

The report suggested losing weight (im 92kg 5f7). The problem is I lift quite heavy and the gym and i'm pretty solid so i'm not that interested in dropping too much weight, although i could get down to 85kg i guess.

So i'd love your opinion, i'm a bit of a hypochondriac so i don't trust myself :)

Thanks

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

Both the main problems you have mentioned are common symptoms of OSA. The simple answer is to give treatment a go. I would not recommend ignoring it as it is only going to get worse with age. It's not a question of IF it causes a problem but WHEN. It would be wise to deal with it now, before it has damaged your body (hopefully), rather than waiting until after you have a heart attack. Have a go. You can only benefit if it works.

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meaty +0 points · over 2 years ago Original Poster

Thanks Sleeptech, I think its more a question of how to treat it? I read that CPAP is not a good idea for mild sleep apnea, and mine is at the high end of mild i guess. I tried sleeping on my side with a backpack filled up last night. It actually wasn't that uncomfortable but i woke up about 5 times throughout the night which was unpleasant.

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wiredgeorge +1 point · over 2 years ago Sleep Enthusiast

You just have to stop reading the junk you are reading wherever that may be. You have moderate sleep apnea. You quit taking in O2 when you quit breathing. If you quit breathing your O2 DIPS. When it dips, organs are damaged in the long run and you risk increased medical problems and a shorter life. Somewhere you read CPAP is not a good idea? And 202 lbs at 5'7" isn't the factor your should be looking at... body mass index is. If you are a 202 lb sack of blubber, of course loosing weight makes sense, not only for sleep apnea but also for your general health. If you are "pretty solid", losing a few pounds may or may not help with sleep apnea.

If your sleep tech doesn't sound interested, start doing some research yourself. What was your SPO2 levels through your study? If you don't know, get a copy of the report and see. For goodness sake, leave the backpack off and take on the issue head on. Don't expect your medical team to be proactive if you aren't.

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meaty +0 points · over 2 years ago Original Poster

Thanks George, i am trying to be proactive about it. The information that i was reading was actually empirically based medical journals. There seem to be a number of studies where sleep experts do not recommend CPAP for everyone. The other studies i found seemed to indicate that positional therapy (with a backpack in one study) actually reduced peoples Apneas considerably. However if you have experience or have heard CPAP is a good idea i'm certianly willing to try it. It's just a bit of a cost right now and i'm not sure if it would help. Thanks about the weight information that is good to know, i was skeptical that it would make a difference.

Here are my oxygen statistics

OXYGEN STATISTICS: Baseline Awake SpO2: 96 % Average NREM SpO2: 94 % Average REM SpO2: 94 % Average O2 desaturation Sleep: 3 % Nadir SpO2: 90 %

Saturation < 90% 0 mins 0 % Saturation < 80% 0 mins 0 % Saturation < 70% 0 mins 0 %

So i'd imagine those while not ideal aren't as bad as many? At no point did i go below 90% which seems ok?

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sophie +1 point · over 2 years ago

You asked for advice and you are receiving a consistent answer: get treated for mild sleep apnea. Talk with your doctor about either cpap therapy or a dental device. The sooner you get treated the better you will feel and protect your body from damage. Talk with your doctor about perhaps finding a reasonably priced cpap machine. Generally speaking, they really want to see patients get treated and may be able to help you. Good luck and let us know how it turns out for you?

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holden4th +1 point · over 2 years ago

Let's put your results into perspective.

An AHI of less than 5 is considered as normal (though it really isn't) but it's the magic number that sleep specialists quote when considering whether or not OSA is being successfully treated. However, I know that I can feel the difference between a <1.0 night and a 5.0 when I get up in the morning. Between 5 and 15 is considered 'mild' sleep apnea but it's still apnea and will have an affect. from 15 to 30 is 'moderate' and would definitely require some form of intervention, the best of which is PAP. Moderate sleep apnea will definitely affect your daytime fatigue levels and will also impact on your health in the long run. Anything above 30 is severe and is quite debilitating. The only problem is you don't realise how bad it has been affecting you until you treat it and I'm talking from personal experience here

SPO2 levels should also be looked at seriously as they are the immediate 'effect' of OSA. Lowered oxygen levels in your blood directly impact your major organs, especially the brain and nervous system. Levels of between 96 - 98 are considered to be optimal. Anything below 94 is impacting on your bodily systems. Below 90 and it's serious and is usually seen in people with respiratory disorders (emphysema, COPD) and OSA sufferers.

Finally, your libido, and I'll go out on a limb here but I am fairly sure I'd be correct. One of the biggest issues for many with OSA is their mental state. This includes depression, poor decision making, adverse reactions to minor incidents etc. I know because this is what I was like before treatment but didn't realise it. There is a lot of research into the physiological and psychological factors that affect libido and poor sleep is well up there as a negative factor. It is pertinent that you, yourself have included it in this discussion and you are correct in doing so. If you treat your OSA your libido might get back to its normal levels.

So to sum up your situation: You have been diagnosed with moderate sleep apnea and this should be treated. As a result of your poor sleep your SPO2 levels drop at times to 90 which is below what is required for your body to effectively rejuvenate itself overnight. This leaves you with two options:

Denial (which is the state you seem to be in at the moment) or

Proactivity - accept that there is a problem and work to solve it.

Taking the latter approach has revolutionised my life.

Best wishes.

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

OSA does cause reduced libido. The research is pretty clear on that. So you are correct.

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meaty +0 points · over 2 years ago Original Poster

Thanks Sophie and also for your very considered reply Holden, it was the type of perspective and information that i was looking for. I do think its a little unfair to say i am in denial, i have been reading about the situation, making lifestyle changes and i've posted on this forum for advice. The sleep doctor commented that 'losing weight may be all that is required to treat my OSA'. It was also labelled as 'mild OSA' which suggested to me that some type of milder treatment approaches might work.

I am more than happy to trial a CPAP machine. I'll go to my doctor and discuss it with him in the next couple with days. I'll report back hopefully with some positive results for anyone interested. Thanks

**"John Doe's overnight diagnostic sleep study showed a fragmented sleep architecture with low sleep efficiency.

His sleep latency was long. Reduced REM sleep was observed and his sleep was predominantly observed in the supine position.

The sleep study shows mild obstructive sleep apnoea. This consisted of a Respiratory Disturbance Index (RDI) of 17/hr [normal < 5/hr]. The overall Apnoea Hypopnoea Index (AHI) was 17/hr. Obstructive apnoeas were seen in NREM and REM sleep.

Respiratory events were associated with mild oxygen desaturation to a nadir of 90% and the oxygen desaturation index was 17/hr." **

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

CPAP definitely is a valid option for OSA of any severity. If weight loss cures it in you case then that is ideal, but it doesn't work for everyone and many people find weight loss very hard. Really, it doesn't matter what treatment you use as long as it works, but don't discount CPAP just because your sleep apnoea was labelled (somewhat questionably) as mild.

Also, don't be put off by the negative talk about CPAP. It is by far and away the most effective treatment for OSA. This is why it is used by millions (if not tens of millions) of people around the world. Even if it is only unsuccessful for 1% of these people, that still equates to tens to hundreds of thousands of people venting their frustration about CPAP, while the 99% who are successfully treated are far less likely to make a fuss about it. The volume of negative talk about CPAP is simply a side effect of it being so a successful a treatment and so widely used.

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