sleeptech

Nice summary Sierra. I agree about the So Clean as well - just a rip-off. I've never really understood why people think they catch a respiratory infection by using CPAP when they are breathing EXACTLY the same air they would be breathing without it. And the same pathogens.

Oxygen too high to recommend CPAP? That's just bizarre. Is that the ENT's perspective or is it an official rule that they must abide by? If they're worth the money they're being paid, they should know that just because your oxygen saturation doesn't drop below 90% doesn't mean that you can't have severe OSA that will threaten your health (an eventually your life).

If he was going to ask for an in lab study any way, why did he do the home studies? It does seem like a waste of time and money. And If he wants you to do an in lab study with a CPAP, why not do a manual titration? I am coming across this sort of thing increasingly - expensive home studies followed by an in lab study which renders the home study rather pointless. Of course, where I am the in lab study is free, which makes the home study seem especially wasteful.

"some of their sales stuff claims it fits 93% of patients."

lol. Yeah, sure. 93% of the patients they tested it on perhaps. They always say that.

It means your oxygen saturation probably started at something like 97% and, when you had an obstructive event, it dropped by only a few percent to no lower than 93%. This means that your events only cause a small drop in oxygen. This is not unusual. Unfortunately this does not mean that they don't do you damage because they still place your heart an other organs under stress, so it is still worth getting treated. And, as Biguglygremlin mentioned above, it will only get worse over time. In order to be counted as an obstructive apnoea or hypopnoea, each event has to cause either a drop in oxygen saturation of at least 3%, or a change in your brain activity. So you can have severe OSA, which is causing your body a lot of damage, but your oxygen level may never drop below 90%. I hope that helps.

While I know nothing about haematology, I can tell you that such a test is not an approved way for testing for sleep apnoea. If it were reliable I would be surprised if I had not heard of it, because thousands of doctors and researchers all over the world have been looking for such a test for years. It sounds a little risky to not perform a sleep study on the basis of an untested... er... test.

The bruise will almost certainly be due to you mask being too tight at the top. It is quite possible, especially with the F20, that you need it that tight to stop it leaking into your eyes. If this is so, a new mask maybe in order. Perhaps an Amara View or a DreamWear full face?

A BiPAP ST is not a crude ASV. They are 2 different (although related) devices with 2 different purposes. Putting it simply, BiPAP ST (and other similar modes of BiPAP) are used to help someone breathe more, increasing their oxygen levels and decreasing their CO2. However, if your CO2 is not elevated this can send it too low and induce or exacerbate Cheyne Stokes Respiration. This is where ASV comes in. ASV is used to even out respiration without increasing ventilation, thus removing central events without causing problems due to CO2 levels being too low. BiPAP ST helps someone breathe more but ASV helps them breathe more evenly without making them breathe more. It is more complicated than that in reality, but that is the gist, and treatment is (or should be) tailored to the patient's needs.

I agree that the Epworth Sleepiness Scale was misused in this case. It was designed to track CHANGES in perceived sleepiness over time. It was never meant to be an objective measure of sleepiness at any given moment. A One-off result is, as you say, far to objective to have meaning, and should not be used to determine whether someone is disqualified from driving. I'm told that Dr who instituted use of the Epworth gets very upset about how people misuse his Sleepiness Scale.

Have you had a study with CPAP to make sure it works? It's be nice to be sure the treatment is effective before committing to it. Aside from that I'd strongly consider buying my own machine if I were you. You will save a lot of money. Especially when you have support of a helpful doc.