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Normal AHI with moderate oxygen desat

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sleeplessswimmer +0 points · 6 days ago Original Poster

I’m a 44 yo male, a masters athlete/swimmer, 24.1 BMI, on 12.5 hctz for bp control (120/70 avg now) and just began taking a low dose of levothyroxine to treat a mildly high tsh (4.1). Back in September I began feeling fatigued, unable to concentrate at work and sometimes feeling a bit loopy or lightheaded. My md asked about my sleep but I was sure I didn’t have a problem there and wanted bloodwork done to check for anemia or vitamin deficiency. Nothing was really abnormal other than vitamin d in the upper 20’s and in December for a routine checkup my tsh had risen again to over 4 which has happened a few times in the past 4-5 years. Finally agreed to a home sleep study. Results as follows:

Ahi 3 Oai .6 Cai .4 Hyp index 1.8 Odi 2.6 Avg sat 95 Lowest desat 90 Lowest sat 82 Min pulse 45 Max pulse 136 Avg 58

4 osa 3 csa 13 hypop 113 snore

I know that I can slide my jaw back and more or less cut off my airway when I’m awake. I’m assuming this occurs when I sleep so I’ve been trying to sleep on my side or stomach. I do wake often at night. Sometimes with no consequence and I fall back asleep quickly. Other times I feel anxious with a heartbeat that isn’t high but feels strong and keeps me awake for hours. I do have an appointment with a sleep doctor but it’s not for another month so I’m looking for some insight. What might I be looking at for treatment? The centrals scare me a bit. Is that fear justified? Are these numbers enough to cause a person to feel fatigued and such? I’ll add that I do have days that are better than others. If I sleep well, most often on weekends, I have pretty good days. I almost thought I was through the woods this past weekend but then Sunday night I lost 2-3 hours of sleep tossing and turning.

Apologies for the long winded first post. Any assistance or advice is greatly appreciated!

-Matt

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Sierra +0 points · 6 days ago Sleep Innovater

I am not a medical professional, but from what I know about apnea, your readings are in the normal range except for the moderate desat numbers. Did your study make any note of RERA (respiratory event related arousal) events?

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sleeplessswimmer +0 points · 6 days ago Original Poster

No mention of rera in the report. Thanks for commenting.

Not sure if it matters but this was a home study over two nights. My first night I slept terribly. Maybe 2-3 hours and then awake for another 3 or so. They had me keep it and try again which yielded a 5-6 hour sleep window.

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Sierra +0 points · 6 days ago Sleep Innovater

Yes, if it was a home study, they typically do not flag RERA events. Most insurance companies will not approve a CPAP based on the RDI index which includes RERA events as well as apnea and hypopnea events. There is some controversy in the industry on how serious RERA events are. My thoughts are that if they lead to arousal, they certainly do not contribute to a good sleep. I would also expect that a CPAP would help reduce the incidence. That said, I still get 1 or 2 RERA events every night at 11 cm of pressure...

See this link if you want to take a deeper dive into RERA.

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sleeplessswimmer +0 points · 5 days ago Original Poster

Thanks. I’ll take a look at that.

It seems I’m an odd case. Insignificant number of occurrences but some of those I do have are severe enough to really impact my sleep. I’ve not found a similar patient while digging around online so far.

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