Sierra

Have you tried a nasal pillow mask? If so what caused you to go to a full face mask?

I would recommend downloading SleepyHead and finding out what is happening during the night. When your AHI varies from 1 to 17 something not good must be happening. Perhaps your machine setup requires some fine tuning.

I also did a bit of quick internet research on the availability of the service in Ontario. For whatever reason Ontario seems to be behind in the home diagnosis of sleep apnea. Two very credible companies, ResMed, and Phillips both make home sleep study equipment, but from what I can see, you may be able to get a lab to do the test, but OHIP will not accept it as a diagnosis for sleep apnea and you still have to go through the in clinic sleep over test.

Starting in 2017 it appears Ontario has decided to conduct a trial of a new home diagnosis technology called BresoDX which is some kind of collaboration between an Ontario company and a university. They claim to be doing 3000 trials of the equipment in the 2017-2019 period of time. If you were to contact the BresoDX company which is in Toronto, they may be able to direct you to a clinic that is using the equipment and would include you in the trial. The problem however is that since it is a trial, they may want you to do both the at home test and in clinic test so they can compare the results -- double bad! Here is a link:

BresoDX

It seems strange that Ontario has decided to ignore proven technology and essentially not offer it. Perhaps your new government will change things and bring Ontario back into the mainstream. The one good thing is that Ontario is one of the few provinces that provide coverage for the CPAP equipment. I believe they pay 75% of the cost providing you buy it at one of their approved outlets.

I had a look at my sleep report. Total apnea events include obstructive, central, unclassified, and hypopnea. They totaled 268 for my night. Time in bed was 7.22 hours. That resulted in an AHI of 268/7.22 or 37.1. However, I suspect I never really slept more than about half that time in bed, so if one was to only consider sleep time, AHI could have been double what was reported. In other words a sleep study may under report the real apnea frequency by a significant amount depending on sleep time. Normally one does not have apnea events when awake.

The other thing to consider is that some sleep studies report another type of event called a RERA (Respiratory Effort Related Arousal). When that gets added into the mix the total is then called an RDI instead of a AHI. So, you may see that on your report. Medicare and most states in the US will not diagnose sleep apnea based on RDI, only AHI. Most insurance companies follow in line with that. But, some insurance companies will diagnose and cover apnea costs if AHI is <5, but RDI is >5. A higher RDI may have been what influenced the doctor to push you over the 5 for AHI so you would not have an insurance problem.

Biguglygremlin's comments reminded me that my wife had a power adapter fail on her. It caused the machine to turn off multiple times during the night. It turned out to be an intermittent connection in one of the molded plugs. I eventually figured it out by wiggling each plug connection until I found the one that caused the power to the machine to go off. The ResMed supplier immediately shipped a replacement to us.

With the report you may be able to calculate for yourself what your AHI is. It should be the total number of central apnea, obstructive apnea, and hypopnea events divided by the number of hours you slept.

I have used the ResMed AirFit P10 nasal pillow mask for about 6 months now, and have not replaced the insert, but I probably should. It still seems to be working well for me. I just clean it with vinegar, then dish soap and water.

The best thing you can do is download SleepyHead and look at your results. See my previous post. The purpose is to figure out what type of apnea events are occurring, and at what pressure. It could be as simple as a maximum pressure that is too low. Or it could be a more complex issue with central apnea possibly being made worse with pressure that is too high. If you want to post a SleepyHead Daily detail screenshot here, I would certainly give you my thoughts. Keep in mind that I am not a medical professional, but I am quite familiar with SleepyHead, and highly recommend using it.

So far I have not had a cold bad enough to not use mouth tape and the nasal pillow mask. I have a ResMed full face F20 mask but hate it. I suppose I might use it if I really had to. I find if I can get my nose clear before I go to bed, it stays that way with the nasal mask. At times I will use Otrivin nasal spray, but most often just blow my nose.

I don't keep an official record, but unofficially I would say that the worst sleep I ever got in my life was the night I did my home sleep study. I was dead set against using a CPAP and was really anxious about "failing" the test. My wife started CPAP about 3 years earlier and I really did not want to go down that road. While I thought I never slept, they told me it was enough for a diagnosis. I recall the machine I used was the Phillips Alice NightOne. It has a built in system that evaluates the test and the data, so they know when you return it if the data is good enough or not. And I did "fail" the test with an AHI of about 34 - Severe Apnea!

And, I will warn you that the second worst sleep of my life was the first night on the CPAP as a trial. It did not go well, and I was prepared at several points to throw the whole machine out the window. But, I did manage to keep it on all night. That was 6 months ago, and I can say that I have used the CPAP every night since averaging about 8 hours a night. I now look forward to sleeping with it, as it does give me a more restful sleep despite the initial pain of it all -- most of which was in my head as I was so against having to use one.

You may want to do a little research on apnea while you are waiting for a diagnosis. It is of two basic types, the more common obstructive apena where your airway blocks air flow, and central apnea where the body just decides not to breathe. CPAP treats obstructive well, but central not so well. The point is that when you get your diagnosis if it is positive, be sure to ask for your breakdown of central vs obstructive events and what impact that would have on a choice of a machine. Also demand a written report of your sleep test results and diagnosis. If you end up buying anything out of your own pocket for equipment, you need a prescription.

You also may want to do a bit of research on machines as you may want have some influence on what you get. There are dumb brick machines that collect no data and usually have only one fixed pressure. I would try to avoid them. The newest machines collect data which can be displayed in a software program called SleepyHead, and automatically adjust your pressure. The two best machines for basic obstructive apnea in my opinion are:

1. ResMed AirSense 10 AutoSet For Her

2. Phillips Respironics DreamStation Auto

Both will work, and both collect data and are compatible with SleepyHead, but the ResMed has a few additional features that the DreamStation does not.

Hope that helps some,