Sierra

When I was using a full nose and mouth mask I was plagued with mask leaks near the bridge of my nose. The air leaks irritated and dried my eyes out. And it would also wake me up. I have given up for now on the full face mask and gone back to a nasal cushion mask. It still does leak occasionally, but at least the leaks don't go into my eyes.

I don't believe the at home ResMed device uses EEG. I saw no mention of it in the product datasheet. My Phillips Alice NightOne setup certainly did not. My thoughts are that this test probably did include the time not sleeping and while sitting up. Positional data was probably messed up in the sitting position, and since most people don't have apnea while awake, the overall AHI is probably underestimated.

It looks like you may have until the end of 2018 to make a claim. Best to call them now. See this link:

Narval CC

So I am taking this to mean you have no opportunity to do a free trial of the machine? That certainly makes it more difficult.

As for a prescription the way it works in Canada is that your doctor gets the sleep test report. If it indicates apnea and they believe a CPAP is suitable, the doctor just signs it and it becomes a prescription. I would think it is similar in the US, and the doctor involved is obligated to provide you a prescription even if they don't sell you the machine. Kind of like a prescription for a medication.

As for a machine, your issue is essentially hypopnea and not apnea. Not all machines detect and treat hypopnea as well as full obstructive apnea. I think the best auto CPAP on the market is the ResMed AirSense 10 AutoSet. From testing it does treat hypopnea well, and it is good at reporting hypopnea, obstructive apnea, central apnea, snoring, flow limitation, and other variables. It is compatible with SleepyHead so you can take the SD card from the machine and read it with SleepyHead to get your detailed results.

I see that CPAP.com offers a 30 day free return policy. So I guess one could buy the machine, try it, view the results on SleepyHead, and then decide if an APAP is really necessary, and if you can tolerate it.

Here is a link to the machine at CPAP.com. I would suggest the "For Her" version even if you are male. It has an optional extra program that you can try to see if it works better than the standard program. Unlike places in Canada, this outlet does not seem to offer packages. This appears to be just for the machine standard hose, and no mask. Most will want a heated hose for comfort, and that is an extra $40. A basic mask would be the ResMed AirFit P10, and it is $100. It comes with a fit pack which means it includes the small medium and large inserts, and you use the one that fits you the best. But, I would look around. In Canada you can get the machine, heated hose, and mask for about $900 CDN ($660 US). There may be better prices in the US. But perhaps at CPAP.com you are paying extra for the 30 day ability to return and get your money back. In any case here is the link:

ResMed AirSense 10 AutoSet For Her

Based on the data you provided the diagnosis of "Mild Obstructive Sleep Apnea" would seem about right. The home sleep test is considered suitable for straightforward cases of quite probable sleep apnea in the absence of other cardio pulmonary issues. Your case is not so obvious based on the test. The rating system used for AHI is:

None/Minimal: AHI < 5 per hour

Mild: AHI ≥ 5, but < 15 per hour

Moderate: AHI ≥ 15, but < 30 per hour

Severe: AHI ≥ 30 per hour

Your oxygen desaturation is kind of on the borderline to normal too. See this link for a bit more of an explanation.

In my amateur non medical opinion, the cost no object obvious alternative would be to get a full sleep in the lab test done. That probably will be more invasive than the home sleep test, and if you are paying out of your pocket it can be in the thousands of dollars, depending on your insurance and where you are located. And, at the end of the day the results may come back exactly the same but with more detail.

If that is not feasible then there are three options I can think of:

1. If there are no sleep issues to deal with, do nothing. Up to an AHI of 5 is considered normal. You are close to that, and not having any full apneas (zero air flow), only flow restrictions. If it is an option, weight loss may improve the situation.
2. Dental devices can be considered with mild apnea, but they tend to be expensive. You could talk to your dentist about it. There is one dentist that checks in here and may comment. I also believe there are "boil and bite" dental devices you get at a drug store, but that is probably a last resort. No experience with them, but some report they help.
3. Buy or do a trial on a APAP and see what it does for you. If you get a good APAP that is compatible with SleepyHead you will get much better data on your apnea than you got from your sleep test.

Where are you located and have you been given prices for an APAP? It may seem rash, but in Canada at least you can get a good APAP for $900 CDN or so. In the US about the same, or perhaps a little more. Also in Canada when you have had a home sleep test the labs at least in our province, will give you a free trial of an APAP to see if you tolerate it. That would be the very best way to go if that is an option. In fact that is what I did. I did the free trial and then took the equipment back because they wanted a ridiculous price for it ($2400), and bought my own from an on line company for the $900.

Hope that helps some. If you can fill in a little more detail on what your options and costs are for a machine, I can probably make a few more suggestions.

Back in March or so, I had a home sleep study done with the Philips Alice NightOne system. The Phillips system looks very similar to the ResMed setup and I would say records all the same things. The test report looks very similar. Remember that besides nasal flow there is a respiratory effort sensor based on tension in the belt around your chest. That is an indicator of your breathing. And if you have an apnea there should be a reduction in oxygen saturation which is being measured also. So there are three independent measures of breathing flow, effort, and oxygen. I also breathe through my mouth, and now that I have a CPAP I know I open my mouth in my sleep based on leak data.

My sleep test was a horrible experience and I would have sworn that I got close to zero sleep. But, the device monitors data quality and gives a quality signal in the morning that indicated the test was valid. Who can argue with a computer? In any event it came up with an AHI rating of about 34 which puts me just into the severe range. Now that I have a CPAP and frequently analyze my own data using SleepyHead, I can easily see that I do in fact suffer from obstructive apnea, central apnea, hypopnea, and snoring. It takes about 12 cm of pressure to normalize the obstructive apnea and eliminate the snoring. Central apnea is not reduced with pressure, and my hypopnea seems to be mainly an incomplete central apnea cycle, so it is not reduced so much either. I now have no question that the home sleep study report was reasonably accurate for me, but I sure did wonder at the time.

That said your concern about validity and accuracy is a fair one to question them about. Also for sure you should ask for a copy of the sleep study report. It should look like the example shown on page 4 of the product brochure at the link below.

ApneaLink Product Brochure

If you post the critical details from your report (AHI, OA, CA, hypopnea), you can get some feedback on what it means, and what implications it might have on a need for a machine, any things to watch out for.

The Mayo Clinic review of the system is probably as objective as you are going to find. On a quick read, it sounds like it may work in some people, but it is not a sure thing.

Pillar Procedure - Mayo Clinic

An AHI of 6 is on the borderline of not requiring any treatment. What is the breakdown of events that compose the AHI?

Thanks for the tip. I did a full scan of my computer and there were no detections of a virus.

Here is a similar link. Hopefully it is not blocked by your virus scan software. Silicone seems to be quite safe from ozone. Stainless steel is probably fine too. Other plastics, elastic polymers in the headgear, and electrical connections on a heated hose more undetermined.

Material Compatibility with Ozone

It is not surprising that the CPAP manufacturers don't endorse the use of SoClean. It uses ozone which is a very corrosive gas. See this list of of susceptible certain materials are to ozone. They obviously want to isolate themselves from any damages which may be done to the CPAP equipment.

Material Compatibility with Ozone