PutSleepApneatoBed

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?

Sacrofago—I empathize. You have a big problem. First, you clearly have very severe sleep apnea. (Severe is anything north of an AHI of 30.) And your treatment, sadly, isn’t working to the point of alleviating your symptoms, so that you can function.

You clearly need more help: first from your sleep lab/docs in treating your OSA more effectively and, perhaps, from other sources, because there’s a possibility of more than one thing going on. Research other sleep disorders such as Idiopathic hypersomnia restless leg syndrome, REM Behavior Disorder and narcolepsy. (Sometimes sleep disorders travel in pairs, or even threes.) ask your sleep lab. Perhaps you need an in lab study.

It IS possible to combine more than one therapy for sleep apnea. Some people use both a dental device AND a PAP machine. (Two of my friends are doing that.) Plus, there are surgical implant possibilities and surgical possibilities, generally. And don’t forget to consider such things as positional therapy, weight loss, treatment of allergies and other life-style interventions.

A friend of mine with an AHI of 120(!) recently underwent a palate expansion procedure to lower his pressure requirements to enable him stay within the air pressure range provided by his RESMED Bi-PAP. (As he aged, he was requiring more pressure than his Bi- PAP could provide.) It worked for him, and he’s been happy with the results.

Also, a residual AHI of 4.8 isn't necessarily optimal. That means that your sleep is still being disrupted almost forty times a night during an 8 hour night! I felt a huge improvement when my residual AHI went from 3.0, to 0.3 with my transition from my gen 8 to gen 10 REMED APAP machines.

The most important thing is: Don’t give up! Healthy sleep is worth the diagnostic and treatment battle! (I’d like to say “journey’, but frankly, mine was more of a “battle.”

Good Luck! And keep us posted on your progress.

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.”)

You’re not on oxygen, are you? Too much might interfere with the ventilatory drive. One way or the other talk to your doctor about this, ASAP. It sounds very frightening….

I would consult both a pulmonologist and a neurologist. The brain controls breathing and sends the message to the lungs and diaphragm to inhale. It sounds as though either that message in not being sent, or it’s not being received. Anyway, those would be my starting points. Your GP may have more ideas.

I hear you re the S9, but I would recommend that you start the process moving to get a replacement, because there is shortage of machines generally out there, and it could take you months to get a new one. And, if the old S9 curls up it’s toes and dies in the meantime, you may be without a usable machine….

We have the RESMED Airsense 10 machines. With a pressure requirement of about 12, and using the FREEDOM batteries (without humidity or heat in the hoses) we get about 13 hours per FREEDOM battery. Also, we use the pigtail connectors. So, with four batteries altogether, we get about three to four nights coverage, each. And the batteries are quite small and easy to store or transport.

I have friends here in the US who registered in the recall for a replacement machine back in early July and are just now getting the replacement, supposedly tomorrow.

The problem may be the Philips recall in the US. Philips has been so slow in replacing the machines that many people are opting to buy a RESMED out of pocket and the machines are getting very scarce.

Hi, Sierra! What was the point if getting them from Amazon? Better pricing? Faster availability? If they are too different, is it a good idea? They DO look less porous than the original….