Recovering attorney, retired. Suffered from OSA misdiagnosed as insomnia for most of my life, which led to DM2 , etc. Interested in mass screening,and testing.
CT and FL, USA.
As a point of disambiguation, the 3.2 number you were seeing on your machine’s sleep report was likely your residual AHI, I.e., the apneas and hypopneas that remained despite or AFTER treatment. And that number isn’t too bad. The AHI of 21 was probably the average through the whole night without treatment. Those numbers are in no way contradictory or inconsistent. So, if that’s the reason you are questioning the test results, I think you can relax. But if it is for some other reason, let the folks here know.
It’s also important to note the difference between your AHIs during REM and nonREM Sleep, which can be very different, plus your O2 desat levels. For example, I had an average AHI of 19, but obstructed 83 times an hour during REM Sleep (when I could even get into REM sleep, which wasn’t often. There was an overlooked clue:from puberty on, I never remembered dreaming, but the reality is, I WASN’T dreaming, because I coildn’t remain in REM sleep.
I would also regularly desaturate below 60, which is life threatening and very hard on your cardiovascular system. It also kills beta cells and leads to DM2. And I awoke every night after 3.5 hours of sleep, unable to stay asleep or get back to sleep, because in REM, my body had to choose between sleeping and breathing. Fortunately for me, it chose breathing. Some people aren’t so lucky.
Some people desaturate very badly and suffer life threatening consequences from the hypoxia. Other people suffer more from the sleep fragmentation and respiratory arousals. There are many different subtypes of Sleep Apnea and many co-morbidities.
Congratulations on getting diagnosed. Most people suffering from sleep apnea remain undiagnosed, and will have a miserable quality of life. and many will die prematurely, never knowing what was wrong, or having had a chance to treat it. You have the chance to beat that rap.
Treatment IS worthwhile. Hang in there and fight for your health and well being!
My "insomnia" of thirty years standing was "cured" by successful sleep apnea treatment. I used to fall asleep BEFORE my head hit the pillow, but wake up exactly 3.5 hours later every night, unable to get back to sleep for several hours. but after about three hours, I felt like someone had hit a reset button and I was again able to sleep (for another 3.5 hours.)
It turned out that during REM sleep (when I could sustain it) I was obstructing 83 times an hour, and 3.5 hours into the night is the time when you cycle into the first major period of REM sleep. Net/net. I didn't have "insomnia", at all.
Nor was I "depressed" (another misdiagnosis.)
I had OSA, but because I didn't fit the stereotype of a middle-aged obese male, (being young, thin and female at the time), I didn't get diagnosed until I self-diagnosed at 56. in the meantime, of course, I incurred the usual OSA co-morbidities, notably weight gain, profound exhaustion and, last, but not least, DM2. (Beta cells are very susceptible to hypoxia.)
what I thought of as the "reset button", was the fact that after a while, my body was able to get back into Stage 1 sleep, rather than trying to return directly to REM. When your body has to choose between sleeping and breathing, it will pick breathing every time.
With my old gen 8 RESMED machine I had a residual AHI of 3.0. When I upgraded to the Gen 10 Airsense for Her, it decreased to a residual AHI of under 0.3 and I noticed a significant improvement in how I felt. Notwithstanding that under 5.0 is considered the goal.
Since my problem is that I desat pretty drastically, even a few apneas during the night can make me feel miserable the next day. So, don't look only at your residual AHI numbers, but also consider your O2 desat levels. To do that you will need an overnight recording oximeter, but they are available online.
Net/net, for those who DO desat badly, if may be important to get the residual AHIs down as low as possible.
Getting your OSA diagnosed and treated is still a hit or miss proposition. 80 to 90 percent of the people who suffer from it have no idea they have it.
Consider yourself one of the lucky ones. You've been diagnosed and are apparently in fairly successful treatment. I, along with many other people was diagnosed with insomnia for thirty years, when the real problem was that I obstructing 83 times an hour during REM sleep. This runs in families, so keep an eye out for undiagnosed family members.
Another important consideration is the degree to which you desaturate. Desaturation levels are a measure of the degree to which your blood O2 levels fall below normal. you want to be 90 or better, but truly normal numbers are above 95.
You won't find that data in your machine reports, of course, but it should show up in your sleep study reports. Apneas and hypopneas will interrupt your sleep. But low desats can do organ damage. Beta cells in the panaceas are sensitive to low oxygen levels, as is the brain. I used to regularly defat below 60, although my AHI was only 19. trouble was during REM sleep my AHI was 83. and the apneas could last a while.
So, not to make things too complicated, you want to know your AHI during both REM and non-REM sleep, because when the two are averaged, you lose an important part of the picture.
Re power failures, it very much depends on where you live. In my area in CT, the electrical infrastructure is ancient, fragile and less reliable than in many third world countries. At least once in every two weeks, I used to come home to the clocks blinking at me....now most reset themselves, but I can usually tell the power’s been out.
And if you desat badly, as I do, non use CAN be life threatening. Accordingly, I go to great efforts to assure generator and or battery backups. I also will NOT Sleep without PAP for ANY reason, including an overnight PSG, and my partner has orders to not let me fall asleep without my mask —-and I do the same for him.
Remember what happened to sup. Ct. Justice Scalia? Apparently, while away from home at a meeting, he fell asleep in his hotel without his mask on....tragic, untimely, unnecessary end.
I also know of someone who, against her better judgment, allowed herself to be talked into a PSG without PAP. During the study she went into a fib, and by noon the next day, she had a major stroke.
Now, if only I could get my only sibling, who suffers from DM2 and had a CABG several years ago, to use his &$$# machine......
This issue is largely an obsolete red herring. It used to arise regularly on the ASAA and other SA websites, but largely faded with the advent of fully self-adjusting APAP machines. Now that APAPs or better are the norm, and current algorithms are effective and quick acting, fiddling with the limits shouldn’t be necessary, except in very rare instances.
The real problem, as others have opined, is Misdiagnosis, non diagnosis, and non compliance. A lot of insomnia is unrecognized SA. Ditto DM2 and PCOS. That’s where the patient advocacy and effort needs to be spent—Unless we want our children and grandchildren to continue to suffer the hell of life blighting mis and non diagnosis that we have suffered......and yet, almost forty years after the advent of a safe, effective,relatively inexpensive and noninvasive treatment innthe form of PAP, the dial has not moved on diagnosis....WHY? WHY? WHY????
Could you have been experiencing a momentary power outage? Just a flicker, such that the machine shut down and then immediately restarted in ramp up mode? Or possibly a voltage fluctuation? I ask, because in my area, we struggle with very unreliable power (old grid infrastructure)
If that's then problem, two possible fixes might be to eliminate the lower ramp setting, provided you can tolerate that, and/or invest in an uninterruptible power source, like those used for computer backup support.
Don’t get discouraged. It takes a while to recover from a life time of untreated sleep apnea. It took me three to four years of fully compliant PAP treatment to largely recover my cognitive function and eliminate my PVCs. But if you are using the machine every time you sleep, and minimizing your residual AHI, you should get there....but consider that you are essentially rebuilding and repairing your brain. Healing it will take time. But using the machine each and every time you sleep is the key.
When this has happened to me, it has been due to a mask leak, which drove my APAP to ramp up the pressure,
With the result that I would awake, trying to exhale against what felt like a hurricane.
After turning off the machine, it would revert to normal functioning.
That was a RESMED gen 8. I’ve had no trouble with my Gen10.