singingkeys

The in-lab study also does an EKG equivalent that checks your heart rate, if I remember correctly. Mine dips down to like 40-something and I have mild to possibly moderate sleep apnea. I'm in pretty good shape otherwise, not overweight, don't fit any of the sleep apnea parameters of the typical patient and doctors tend to be a bit shocked. It doesn't help that I'm 36 and look like I'm in my upper teens to lower 20's, so they automatically assume that I couldn't have it because I'm "younger" outwardly.

You could alternatively get yourself an SPO2 monitor (pulse oximeter - I bought mine online for like $80) and it checks your blood oxygen level and also heart rate for the whole night. Just slides on one finger and is worn like a wrist watch.

Alright, I've had two sleep studies in the past. One in-lab where I slept 2.75 hours, had about 50 unclassified breathing events hypopneas/apneas all thrown together. This could have been higher because I didn't sleep much that night. I've read that getting less sleep can actually make sleep apnea even worse than it normally would be. 4.7 AHI with 18 RDI. Snoring was noted by the sleep tech. Previous sleep doc wouldn't give me CPAP.

Second study was a home study that I requested myself. Snoring was noted, but no audio that I was aware of was on the equipment, so unsure how they determined that. 5.2 AHI.

ENT doc was willing to give APAP based on my home study results, but didn't know much about the equipment. She said they use American Home Patient and that they'd call me within a couple of weeks from AHP. They never did, so I called them back after over 2 weeks. It took forever to get them on the phone (hold recordings saying the agents were all busy) and when I did, they couldn't tell me the full cost. Instead, they told me that it was $40 a month co-pay and I don't even have insurance listed. I told them I was buying it directly without insurance. So then AHP told me to call DME Suppy and give them the info/order and "if they need a prescription, have them call American Home Patient to get it."   This is ridiculous.

So I'm going to seek a ResMed Air Sense 10 Auto. Some suggested the For Her version due to the lighter setting. Doubt they'll approve it because they'll say, "That's the women's machine" and may not know the difference.

ResMed P10 nasal pillow mask.

What else will I need? Heated hose? Extra filters? Doesn't look like they have the P10 mask , so may have to get that elsewhere. Will I need a prescription for the mask itself?

What other things do I need to put in the order?

A particular issue is my tongue. I get a deeply scalloped/crenated tongue with teeth marks all the way around. This is quite devastating and has been since I was a kid. These HURT so bad some days and make little pieces of the tongue stick off the side and/or cause canker sores that last for days because certain teeth marks are so deep. As you can see, it is all the way around both sides, the front and also the top edges of the tongue and extending back a considerable amount on top of the tongue. Seems like a medical condition. GP doc didn't know. Sleep doc said it is a classic sign of sleep apnea, but sometimes my marks stay deep and last all day and into the night before it is time for bed again. That makes me wonder if a night mouth guard would solve the problem completely. Some days the tongue is swollen and looks larger with these teeth marks. Other days it looks smaller and has no marks at all. I'm confused. Everyone else is confused. ENT doc seemed confused about it, as well. Logic tells me that if my tongue is enlarged or I'm thrusting at night to keep the tongue from blocking my throat, pushing it forward and therefore causing teeth marks would be expected. But I'm not sleeping all day. They should go away when I'm up during the day and they don't. Is this a medical problem other than sleep apnea-related stuff? My lips are also exceptionally red and my face is a bit flush red on days when I don't sleep very well, but blood pressure is normal on those days. Other days I look fine.

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Previous in-lab study before with 4.7 AHI and 50 breathing events. Snoring was detected. Got 2.75 hours of sleep. No sleep apnea was mentioned because it was just below the threshold. Recently had a home sleep study that I requested myself via mail-order that showed 5.3 AHI, detected snoring and some pretty long apnea events (one was about 80+ seconds) and heart rate dropped down to 49 beats per minute at a low point during the night. Couldn't get the sleep doc to give me a prescription to try APAP. I went to my ENT doc Friday and I'll get a call from their supplier in a week or two and they're going to work with me to get an APAP. So going to try for the ResMed AIr Sense 10 Auto and P10 nasal mask.

Curiously, the ENT doc said that some people have a 10 AHI and don't feel too much in regards to being tired. Others can have a 5 and theirs hits much harder to the point where they're virtually falling on their face tired all of the time. She did not recommend surgery for other stuff, said it hurts a lot and is dangerous. She previously did my turbinate reduction and deviated septum surgery, so it definitely isn't my nose/sinuses. We have the CT and MRI scans showing my sinus/throat and such. Must be either the adenoids, throat or the tongue causing my apneas. She said if the CPAP works, then keep at it and stay with that and don't bother with surgery. If it doesn't work, then she said we'll start looking at neurology-related stuff. What's she talking about with that?

I should also note that it feels like I wake up 5 or 10 times every 10 minutes sometimes, and that's when I'm laying on my stomach with my head to the side. Usually the worst apneas are supposed to happen on the back. My tongue usually feels incredibly swollen during this time and may be the culprit.

GP says they don't treat sleep apnea.

My big concern is the events where I stop breathing completely. One of them was 85 seconds, which is a pretty long apnea. I remember a couple of weeks ago before I did the sleep study, I woke up and did a big gasp for air. My entire body from head to toe was tingling all over and I figured it was from lack of oxygen. No idea how long it was. This very morning, I woke up 2 minutes before my alarm clock was going to go off. I was laying for sure on my stomach with my head turned to the side. I gasped awake, so this apparently happens when I'm also on my stomach and possibly on my side. Home study results seemed to indicate that I had less issues on my side and stomach than on my back, which seems normal for obstructive apnea. Seems quite abnormal for me to gasp awake like that while on my stomach, however. That can't be my tongue falling back. Could be the soft palate/adenoids. Doesn't seem likely at all that it is anything in my sinuses since surgery took care of that.

I do feel like when I lay down, my airway seems a little more constricted than normal for some reason. I do know that my sinus cavities were clear when the ENT doc had me do a CT scan. The swollen turbinates were corrected and so was the deviated septum, so those aren't an issue and I still notice that I breathe much more easily than before the surgery. So I suspect either my tongue falling back, the tissue/soft palate/adenoids.

My tongue looks "larger" sometimes because I think it swells up some when it is pressed into the teeth and irritated all night. Other times during the day, no teeth marks and it looks smaller and more normal to me.

My primary care doc office refused a CPAP prescription, but I have read that primary care docs can write prescriptions for CPAP. They claimed they don't treat sleep apnea. The sleep doctor that I went to before seemed quite incompetent. What are my chances for my ENT doc to write me a prescription for a ResMed Air Sense Auto?

I had a in-lab sleep study in early 2018. My results with private info removed:

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4.7 AHI. 18.1 RDI. 40.3% sleep efficiency noted. 41 snoring episodes and 14.86/hour snoring index. I only slept about 2.75 hours and they kind of botched everything by starting my study late (was one of the last people to get electrodes placed) and such. 6.5 total minutes of REM sleep during nearly 3 hours. Doc said the 0.3 below 5.0 AHI meant I didn't have sleep apnea. Told me to come back again for an in-lab study again in 6 months to "see if it was any worse" than that time. He joked around that it was "a good thing that I had an active job, because you'd be going to sleep at your desk if you had an office job." I do fall asleep and pop away with hypnogogic jerks a ridiculous amount of times at home, on the bus, while riding as a passenger in a car, etc.

Did a home sleep study on 4/6/2019.

PATIENT INFORMATION: This 36-year-old Male was referred for a type 3 portable sleep study. With sleep complaints of: Witnessed apnea, excessive daytime sleepiness, insomnia, gasping/choking. The patient is 68.0 in and weight was 157.0 lb, which represented a BMI of23.87. The patient has an Epworth score of 21/24 and a STOP BANG score of, STOP score of 2 and a BANG score of 1.

SLEEP TIME AND EFFICIENCY: The sleep study recording began at 02:08:53 AM and ended at 08:55:12 AM. Total recording time was 406.3 minutes. The total sleep time was 348.0 minutes. The sleep efficiency was 85.6 percent. The patient spent 232.9 minutes supine, and spent 115.1 minutes non-supine. The patient’s own estimate of sleep time was 6.50 hours.

RESPIRATORY DATA: The AHI in this report is indexed to sleep time based on actigraphy. The AASM defines this as REI. The AHI on this type 3 Home Sleep Study may understate the AHI determined on a type 1 or 2 study, since EEG is not monitored resulting in the inability to score non-desaturating hypopneas.

Based on 3% Calculation: The AHI3% calculation of 5.3 per hour of recording time was based on a total of 23 scored apneas and 2 scored hypopneas with 3% desaturations. Supine AHI3%:4.9 per hour. Non-supine AHI3%: 2.6 per hour.

Based on 4% Calculation: The AHI4% calculation of 5.3 per hour of recording time was based on a total of 23 scored apneas and 2 scored hypopneas with 4% desaturations. Supine AHI4%: 4.9 per hour. Non-supine AHI4%: 2.6 per hour.

Oxygen Summary: Patient's baseline O2 saturation was 98.1 %. The patient spent 0.0 minutes at an oxygen saturation less than 90%, and 0.0 minutes less than 85%. The desaturation index was 1.4 events per hour sleep time. The lowest saturation was 91.0 %. SNORING: The percent of the study time spent snoring was 88.5 %. The Snoring Count was 6931 . The Snoring Index was 1195.0 . PULSE RATE REVIEW: The mean heart rate was 65 beats per minute. The rate ranged from a low of 46 to a high of 95 beats per minute. DIAGNOSIS:

1. Mild Obstructive Sleep Apnea G47.33 This is likely a significant underestimation of the severity of Obstructive Sleep Apnea, because of the limitations of the Home Sleep Study
2. History suggests Severe Daytime Hypersomnia. This may be related to the Obstructive Sleep Apnea TREATMENT PLAN RECOMMENDATIONS: For accurate assessment of patient's sleep-disordered breathing, we recommend that they have an in-lab overnight SPLIT NIGHT STUDY. Recommend ENT evaluation if the Patient has symptons of nasal obstruction.

Longest Obstructive Apnea duration was 85 seconds. Mean Apnea duration was 34 seconds. Longest hypopnea was 29 seconds and mean was 23 seconds. My AHI seems to cut in half when I'm on my side and possibly my stomach. Sleep efficiency was listed as 85.6%.

SNORE SUMMARY SNORE Count: 6931
SNORE Index: 1195.0 SNORE Supine Count: 4602
SNORE Supine Index: 1185.6 SNORE Non-Supine Count: 2329
SNORE Non-Supine Index 1214.1 Percent of sleep time snoring: 88.5

PULSE RATE SUMMARY Mean Heart Rate 65(bpm) Minimum Heart Rate 46(bpm) Maximum Heart Rate 95(bpm)

My heart rate dropped to 46bpm and at one point I stopped breathing for 85 SECONDS?? Yikes.

Sleep doc from the first study is giving me the run-around. Wants me to come back to get CPAP prescription because I "haven't seen him in a long time." Prescription request for an APAP denied until a visit, which they can't do for months (backed up). Asked my PCP doctor if they could write a prescription and they won't. Next I'm going to ask my ENT that did the surgery. Yeah, I had the study last year in like March of 2018. Had turbinate reduction/deviated septum surgery in July 2018 and took a few months to heal all the way. My airways in my nose were too small. I breathe much better now, but it seems like when I lie down on a bed, I instantly feel like I don't breathe as well. My snore numbers look off the charts.

APAP? Seek some kind of ablation surgery? How do I figure out which makes me snore? I wake up with teeth marks on my tongue that are very deep, sometimes deep enough to turn into canker sores. My tongue looks swollen some mornings. My lips tend to be bright red (not chapped, more like blood pressure related) and yet I don't have high blood pressure in general when I check it during those times. Face looks flush red during the day. Blood pressure usually shows a little low like 110/70 when it feels like it is high in my hands and face and those areas will feel hot.

Was going to try ResMed Air Sense 10 Auto probably with P20 mask and upgraded supports for the mask (people said it is flimsy). Why would I snore that much? Should I seek another solution?

I don't usually have this happen, but I woke up this morning gasping for air. This was a heavier experience than normal and I think just once. I was laying on my stomach with my head turned to the left side (a very common position for me). When I took a breath of air, it was like I had not taken one for a while. Also, my entire body felt tingly all over. I suspect that this was due to low oxygen. Does anyone know how long I might have stopped breathing for that to happen? I should get my home sleep study kit within days. This is the first time that I know of that this has happened with the tingling.

I'm now puzzled because many nights of using a personal SPO2 monitor showed no drops below about 93%. An in-lab sleep study that only resulted in less than 3 hours of sleep showed 6.5 minutes total REM time during that. REM AHI was 9.2. RDI was 18.1. No drops in blood oxygen levels noted in the in-lab study.

Sleep staging from in-lab study:

N1 44 minutes

N2 86.5 minutes

N3 28.5 minutes

REM: 6.5 minutes.

Looks like my sleep cycle is all whacked out, as well. Not overweight. 5'8, about 155 pounds. Very muscular and athletic. Only a 15" neck size. They just verified all of that on the forms for the home study. I do not fit the stereotype for sleep apnea, but it looks like more and more symptoms are coming up. That's pretty scary to wake up feeling tingly all over. How common is it?

Just curious what other people's symptoms are. For me, it is the non-restorative sleep...I feel like I basically just went to bed like an hour ago, even after up to 8-10 hours of sleep. Other odd symptoms, I can't seem to match with other people's experiences. Throughout the day, there are times when I feel like my lungs want to "lazy breathe" and after the exhale, it is like I'm too tired to inhale against and simply don't want to because it feels like so much work. I do and my body does it naturally, but sometimes I feel like I also have to "remind" my body to. It may simply be because I'm just really tired.

During the day on days when I don't go to bed early enough and get like 4-6 hours of what would be sleep (probably ends up being half or a little more of actual sleep)...I feel like a "pressure" feeling in my face. My blood pressure does not register as high, but my face will be moderately flushed red at certain times of the day. My lips will also tend to be a bright reddish color every morning (as if really chapped) if I don't sleep well...I presume this is blood pressure high only in certain particular areas causing it? If I sleep longer on the weekend when I don't have to work, they aren't. But overall, the blood pressure itself is not high when taken via a test. At night, as soon as I lie down and put my head on the back of the pillow, I tend to feel this pressure on the back of my head like someone is forcing the back of my head into the pillow. I also feel the pressure in my face. If I bend over to pick something up, I feel that it increases in my face.

Feeling "jumpy/jittery" throughout the day in general. I know that I have high RERA's/RDI, but no actual O2 desaturization.

What are yours?

So basically RERA's may not be technically detected by some of these home sleep studies?

My only concern with the home sleep kit is that it may not detect specific RERA's, which I apparently have a lot of without oxygen drops.