PutSleepApneatoBed

In the US the standard used to be 5. But now it is 15, unless there is at least one comorbidity, in which case it reverts to 5. The insurers are being “penny wise, and pound foolish”. Actually, I suspect the insurers think that the expensive fallout of under-treatment will occur on Medicare’s watch, not theirs.

Hi, BUG!

The dreaming connection is that, in my case at least, my AHI was far higher in REM than non REM. (My Sleep Tech, Laura, has advised that that is quite common). Upon initial diagnosis, my overall AHI was 19, but in REM (when I could still get into REM) it was 83.

So here’s the theory: If you stop remembering your dreams, it’s possible that you have stopped dreaming, because you can no longer maintain REM sleep.
This happened to me at about puberty (the voice box descends in both genders blocking the airway.) But when I asked my Dad if he remembered his dreams he said”no”. (Mom, on the other hand) lived at least three other lives at night.)

Many years later, when I diagnosed my own OSA, I diagnosed Dad’s, but by then it was too late for him to handle the headgear (strokes) or remember when he awoke in the middle of the night why he was wearing a mask on his face(multi-infarct dementia.)

In retrospect, Mom dodged OSA, notwithstanding that her brother and father had bad cases (not formally diagnosed, but in retrospect I recognize clear symptoms) because as a young child she had her tonsils and adenoids removed enlarging her airway.

Mom is still with us, living independently in her own home at 94, but due to vision problems she has given up the car keys. And she still has an active dream life she tells me.

Are you using a CPAP or an APAP? What were your AHIs during REM and non REM on your original, diagnostic sleep study? And what is your pressure setting (CPAP) or pressure setting range (APAP)? Finally, are you dreaming? Did you dream when you felt better? Did you dream before initial treatment?

Are you using a CPAP or an APAP? What were your AHIs during REM and non REM on your original, diagnostic sleep study? And what is your pressure setting (CPAP) or pressure setting range (APAP)? Finally, are you dreaming? Did you dream when you felt better? Did you dream before initial treatment?

If a machine turns off under those circumstances, shouldn’t be an alarm? I’ve set up an alarm for situations where the power to the machine shuts down, e.g. during a power outage. My RESMED Airsense 10 for Her has an auto on feature, such that when you start breathing into the mask, it automatically turns on.

If that feature is enabled, does your machine still shut off? I HATE the idea of the machine shutting off while I’m wearing the mask —so much so that I sprang for a standby generator and backup (Freedom) batteries that I can use inline as an uninterruptible power source.

My nomination for additional functionality for the next generation of machines is an alarm feature for power outages/machine shutdowns.

I don’t really know anything about the breathing technique you referenced.

However, I DO know this much: using AHI and O2 desats to diagnose, and particularly to determine, from a definitional standpoint, whether a patient “has” SA, has been very unsatisfactory for all of the following reasons:

1) The AHI definition requires breathing cessation of at least 10 seconds duration combined with a desat of 4%.
Many people will be symptomatic even with shorter apneas and less desaturation. In particular, many women and children will not be diagnosed under those standards, or will be sicker and more at risk than their AHI categorization would indicate, because they typically have shorter duration apneas and lower desaturation rates. So they will show up with RERAS rather than apneas and hyponeas. And then insurers won’t pay for a machine for them.

2) The AHI is reported as an average, but may vary greatly throughout the night. E.g.it may be FAR higher during REM than non-REM sleep. In some cases apneas may meet the definitional standards only during REM sleep

3) the AHI, taken alone, doesn't rally tell you much, clinically speaking.

As a result there is currently research underway to study the effects on the heart during sleep apnea events.

;

I THOUGHT my Sleep Apnea (solely obstructive) at an overall AHI of 19 was within the range that could be treated with a dental appliance. So, I paid $2000 (this was several years ago) out of pocket for one to use when traveling. Then I went to Berlin for a week and used the dental device the whole time. By the end of that week I was a zombie.

If, like most people, your apnea is much worse in REM than in non-REM sleep, your overall AHI number may, unfortunately, be rather misleading. While your overall number may be within the dental device range, what about your AHI during REM? I couldn’t maintain REM sleep using the dental device because it couldn't remotely handle my AHI of 83 during REM.

So, I used the dental device for that week and never used it again. There are reasons why PAP tis considered the “Gold Standard” of Sleep apnea treatment.

Of course, a dental device or even a CPAP or APAP is unlikely to be able to do much for centrals. For that you usually need a VPAP. From what I hear, treating centrals is quite tricky. It may be a good idea to seek out a doc who specializes in that.

My late series Gen 10 Airsense for Her machine has an auto-on feature: as soon as I breathe into the mask it goes on. Prevents you from putting on the mask and then possibly falling asleep without the machine being on. Also, the machine automatically goes off when you remove the mask. Doesn’t yours do that?

What is the Prewarm feature?

Welcome, Jason!

Successful Sleep Apnea treatment can often be more of a journey than a destination. What machine do you have? Are the ramping and expiratory assist features set up properly? Properly implemented, they may both help you adjust..

It DOES sound like a bad electrical connection combined, perhaps, with age.
Did you happen to check the manufacturer’s recommended replacement schedule? I doubt that it is nearly as long as a year…..probably more like six months, but that should be checked.

However, it sounds as though, at more than three years of age, yours was probably well overdue for retirement.

I try to be vigilant wrt replacement schedules, because as plastics age, they can breakdown and emit volatile organic compounds, and other toxic or carcinogenic substances. I don’t want to be breathing those long term.

And our PAP peripherals and accessories are mostly plastic and get daily eight hour use in an environment of heat and humidity. Hence, the recommended replacement schedules. Of course, there is also the possibility of the buildup of biofilms or other infection control issues.

So, although the hose or mask may LOOK like new long after the recommended time for replacement, it may be a better idea to try to stick more closely to the recommended replacement cycles.

I’m going to try taping the mask/hose connection.