apap and chest pain

Question:

- Hide quoted text — Show quoted text -Tom Devlin wrote: > normc <no…@socal.rr.com> wrote: >>My neurologist sleep doc has told me similarly.  Everyone doesn’t >>necessarily DIE if they don’t use their xpap for one night. > But you might _wish_ you could. <Rueful grin> > My old Aria died a couple of years ago, leaving me without a spare. I > went through three days in zombie-mode before a new insurance company > and DME got their act(s) together enough to get me a new blower. I > don’t _ever want to do that again!   > I now have a spare CPAP. > Tom

As is often the case, it is difficult (at least for me) to cover all the whys and wherefores in an email/post. The worst possible for me would be laying in bed without a pillow.  The next worse would be with a pillow.  The next worse to that would be using a foam wedge. However, the best is my recliner.  I couldn’t walk, sit at the computer, or lay in bed for three months, without severe pain, but I could position myself in the recliner so that I didn’t have any pain, could get up without having to twist, and was able to sleep I didn’t use my CPAP and felt great from a ‘quality sleep’ standpoint. None of the symptoms that I had experienced before using CPAP.  I made arrangements to use a recording pulse oximeter to see what was happening to my blood oxy sat levels, but never got around to using it. Instead, I was concerned that my need to get up every two hours to urinate was a telltale indicator of my OSA.  Sure enough, I went back to my CPAP and that problem changed to four hours.

Response:

normc <no…@socal.rr.com> wrote: >>>My neurologist sleep doc has told me similarly.  Everyone doesn’t >>>necessarily DIE if they don’t use their xpap for one night. >> But you might _wish_ you could. <Rueful grin> >> My old Aria died a couple of years ago, leaving me without a spare. I >> went through three days in zombie-mode before a new insurance company >> and DME got their act(s) together enough to get me a new blower. I >> don’t _ever want to do that again!   >As is often the case, it is difficult (at least for me) to cover all the >whys and wherefores in an email/post.

Oh sure, and your doctor was right, I didn’t die. <g> >However, the best is my recliner.  I couldn’t walk, sit at the computer, >or lay in bed for three months, without severe pain, but I could >position myself in the recliner so that I didn’t have any pain, could >get up without having to twist, and was able to sleep

I slept in the recliner while waiting for a new CPAP, it wasn’t as good as the blower, but it did seem to help. >Instead, I was concerned that my need to get up every two hours to >urinate was a telltale indicator of my OSA.  Sure enough, I went back to >my CPAP and that problem changed to four hours.

I monitor my dreams as much as anything, few dreams seem to mean that my pressure’s ok. Many dreams, especially if I wake up sweating, means that I’m due for a pressure boost. Tom

Response:

normc <no…@socal.rr.com> wrote: >My neurologist sleep doc has told me similarly.  Everyone doesn’t >necessarily DIE if they don’t use their xpap for one night.

But you might _wish_ you could. <Rueful grin> My old Aria died a couple of years ago, leaving me without a spare. I went through three days in zombie-mode before a new insurance company and DME got their act(s) together enough to get me a new blower. I don’t _ever want to do that again!   I now have a spare CPAP. Tom

Response:

Em wrote: > Hi and thanks for all the responses! i am glad to see this is still a > fantastic group of people. i remember most of y’all, you have helped me with > CPAP years before. in fact, i think Tom was the person who encouraged me to > see a sleep doctor. > i’ll try to answer the questions: > as far as not using it tonight, the doc said it was okay.

My neurologist sleep doc has told me similarly.  Everyone doesn’t necessarily DIE if they don’t use their xpap for one night. > i have already had > two PSG’s. this was bit of an experiment to see if i could tolerate apap and > to see where my pressure was at.

Were you titrated following one or both of your PSGs and resulting Dx of OSA? I was having similar problems to yours after my PSG/titration.  I told my neurologist sleep doc that I wanted to use (at home) an apap and a recording finger oximeter to see what was going on. The apap to determine if the pressure is OK and the oximeter to determine if you might be experiencing any neurological sleep interruptions (often called central apneas).  This would be indicated by pressure OK, but O2 sat low. You don’t mention an oximeter!  Did your PSGs specifically indicate whether you experienced any central apneas during your PSGs or, potentially more likely, during your titration(s)? > i had a cflex with a humidifier, and various types of masks. the end result > was, even if i did manage to get to sleep with it (which didn’t happen > often), i removed it in my sleep.

This has happened to many of us.  Some have even reported turning off the blower and not even knowing it. > tho i don’t recall ever experiencing > bronchial pain during that time. > on the first PSG, my RDI was 96 and o2 sats dropped to 74. on the second > PSG, my RDI was 11. on both sleep studies, i got the most improvement on the > lowest pressure levels (5-6), the hyopneas increased at higher levels.

Guess this sez you were titrated. This is the first time I have read of this kind of situation.  Central apneas can occur at higher pressures.  If it was me, I would be investigating your potential for CAs. Look at your PSG/titration reports and determine if anything is said about CAs.  It is important that it specifically say there were none. Some reports just don’t say anything. Even if it says none, doesn’t mean that you aren’t experiencing them as part of your problem(s). > however, after a 5 month 90 hrs/week crunch, and i am exhausted. it’s been > weeks since the crunch ended and i am still beat. i weigh about 100 lbs, so > i don’t want to lose weight. > so i went back to the sleep doc and they took a close look at the last > study, and found that, while my RDI was 11 (8 apneas and 27 hypopneas)… > the  8 apneas occured three hours into the study, back to back, and my o2 > sats dropped to 79, so i was put on cpap. so they don’t really know if i > would have ‘recovered’ my o2 sats or if the apneas would have stopped.

As indicated above, this can be determined with apap and recording finger oximeter. > so > they thought they would try me on the aPAP to see if i would be less > fatigued, they also said apap is easier to tolerate. it’s a loaner and > didn’t have a humidifier. i have to admit, the apap is MUCH easier to breath > with than a cpap or even a cflex. > also, i have a problem with air escaping out of my mouth (even with a chin > strap), my lips just don’t close tight enough to prevent the air from > escaping.

Precisely what I discovered before I went to a FFM.  You’d be amazed at how many users, AND RTs, don’t seem to understand this.  It’s the lips that need to be kept closed, not the jaw.   i have tried a FFM with the apap, but it leaks a lot. so i went > back to a nasal interface, and two times i have tried it, i am just blowing > air out of my mouth. i am really uncomfortable taping my mouth shut.

Yes, I also know this from experience.  I tried tape before my FFM (with a full beard). Which FFM are you using?  Was it fitted by a CRT/RRT or did you buy it on the web? If it was fitted…. and it leaks, then you are probably trying to make it too tight (to eliminate the leaks).  In other words, it’s not loose enough to work correctly. Loosen all the straps until the mask just stays on your face when sitting up.  Then turn on blower and lay down.  If there are any leaks, pull on the straps enough to eliminate them.  This gives you an idea of how much you will have to readjust the headgear straps to get rid of the leak(s). If you turn your head, and the mask leaks, do the same thing…. pull on the strap first to see how little/much it needs to be adjusted, and then readjust. Sounds like I had pretty much the same problems as you are having.  The only reason(s) I post here is to try to help people NOT HAVE THE SAME PROBLEMS I HAD. – Hide quoted text — Show quoted text -> anyways, thanks for info and advice, if you have more suggestions, would > love to hear it. > cheers and thanks again > "normc" <no…@socal.rr.com> wrote in message > news:G3_Cd.47852$Ew6.12712@twister.socal.rr.com… >>Em wrote: >>>not sure the correlatiion. but i am having a lot of chest pain (seems to > be >>>bronchial, center of the chest kinda pain). but geez, it burns when i > use >>>the apap.(there is no humidity on it, BTW). i was just wondering if > burning >>>chest pain is normal on cpap/apap. i only have another week to get > myselft >>>titrated on it, but i am thinking of not using it tonite *whheezzz* >>>suggestions/recommendations? >>>TIA! >>You’ll find many differing opinions here, depending on individual >>philosophies, national health plans/insurance coverage, and/or available >>funds. >>My philosophy is that if one has enough symptoms of a sleep disorder to >>require some kind of diagnostic test, then that test should be a >>complete polysomnogram (PSG).  [It is best to learn about PSGs by >>searching the web with GOOGLE.  To start off, take a look at >>http://www.suite101.com/article.cfm/sleep_apnea/57133 ]  From your post >>it would appear that you have not had a PSG.  Titration is normally >>follows a PSG to determine what the sleep disorder is.  If it turns out >>to be OSA, then a titration is done.  How was it dermined that you have > OSA? >>If the PSG doesn’t determine what the disorder is and how to treat it, >>at least you know you’ve done the most medical science can do. >>Moreover, when you do anything less than a complete PSG, you run the >>risk of not fully determining what your exiting, and, in your case, >>forthcoming, problems, might be.  Many without adequate initial testing >>have gone months trying to figure out what is wrong, feeling like crap >>(that’s crap not cpap <g>).  I went months working out the fine points >>even after having a PSG. >>To work out the fine points, I used a recording finger oximeter(to >>determine blood oxygen saturation levels, necessary to assure heart, >>brain, and other organ health) I used an autopap to make some >>determination of, what is often called, central sleep apnea (CSA)(CPAP >>pressure OK, oxygen saturation not OK). >>I’ve noted a tendency, here on ASSD, to oversimplify the overall matter >>of sleep disorder, and, in particular OSA.  So do your inquiring, >>reading, and researching carefully.  Some posts are long, well written, >>and sound like they are written by a sleep disorder specialist.  Don’t >>accept any statements without a reference that you read.  There also >>seems to be a tendency to provide links to what appears to provide >>suppot, but really don’t. >>Finally, beware the conspiracy theories.  These are the theories that >>PSGs only make money for doctors and sleep labs.  PSGs are >>state-of-the-art diagnostic tools for sleep disorders.  If you can’t get >>one, then you must do the best you can, but don’t believe that >>everything will be OK without one.  It may or it may not. >>PSGs help many, many people.  Can you get along without one?  Sure, you >>may have immediate results.  But, if you are miserable while untreated >>now, you may have to spend months more of misery. >>In the event you are unable to get a PSG now, and you still feel like >>crap, be certain that you dog your healthcare providers until you get one. >>HYH

Response:

I had a problem with feeling like I was hyperventalating when I first went on CPAP.  Took me a few minutes to get with the rhythm even using the ramp up.  Now I don’t have the problem except once in a blue moon. As for pain.  I didn’t have any.  Perhaps you should be talking it over with a Respiratory therapist. Lynne – Hide quoted text — Show quoted text -Em wrote: > not sure the correlatiion. but i am having a lot of chest pain (seems to be > bronchial, center of the chest kinda pain). but geez, it burns when i use > the apap.(there is no humidity on it, BTW). i was just wondering if burning > chest pain is normal on cpap/apap. i only have another week to get myselft > titrated on it, but i am thinking of not using it tonite *whheezzz* > suggestions/recommendations? > TIA!

Response:

Hi and thanks for all the responses! i am glad to see this is still a fantastic group of people. i remember most of y’all, you have helped me with CPAP years before. in fact, i think Tom was the person who encouraged me to see a sleep doctor. i’ll try to answer the questions: as far as not using it tonight, the doc said it was okay. i have already had two PSG’s. this was bit of an experiment to see if i could tolerate apap and to see where my pressure was at. i had a cflex with a humidifier, and various types of masks. the end result was, even if i did manage to get to sleep with it (which didn’t happen often), i removed it in my sleep. tho i don’t recall ever experiencing bronchial pain during that time. on the first PSG, my RDI was 96 and o2 sats dropped to 74. on the second PSG, my RDI was 11. on both sleep studies, i got the most improvement on the lowest pressure levels (5-6), the hyopneas increased at higher levels. however, after a 5 month 90 hrs/week crunch, and i am exhausted. it’s been weeks since the crunch ended and i am still beat. i weigh about 100 lbs, so i don’t want to lose weight. so i went back to the sleep doc and they took a close look at the last study, and found that, while my RDI was 11 (8 apneas and 27 hypopneas)… the  8 apneas occured three hours into the study, back to back, and my o2 sats dropped to 79, so i was put on cpap. so they don’t really know if i would have ‘recovered’ my o2 sats or if the apneas would have stopped. so they thought they would try me on the aPAP to see if i would be less fatigued, they also said apap is easier to tolerate. it’s a loaner and didn’t have a humidifier. i have to admit, the apap is MUCH easier to breath with than a cpap or even a cflex. also, i have a problem with air escaping out of my mouth (even with a chin strap), my lips just don’t close tight enough to prevent the air from escaping. i have tried a FFM with the apap, but it leaks a lot. so i went back to a nasal interface, and two times i have tried it, i am just blowing air out of my mouth. i am really uncomfortable taping my mouth shut. anyways, thanks for info and advice, if you have more suggestions, would love to hear it. cheers and thanks again "normc" <no…@socal.rr.com> wrote in message

news:G3_Cd.47852$Ew6.12712@twister.socal.rr.com… – Hide quoted text — Show quoted text -> Em wrote: > > not sure the correlatiion. but i am having a lot of chest pain (seems to be > > bronchial, center of the chest kinda pain). but geez, it burns when i use > > the apap.(there is no humidity on it, BTW). i was just wondering if burning > > chest pain is normal on cpap/apap. i only have another week to get myselft > > titrated on it, but i am thinking of not using it tonite *whheezzz* > > suggestions/recommendations? > > TIA! > You’ll find many differing opinions here, depending on individual > philosophies, national health plans/insurance coverage, and/or available > funds. > My philosophy is that if one has enough symptoms of a sleep disorder to > require some kind of diagnostic test, then that test should be a > complete polysomnogram (PSG).  [It is best to learn about PSGs by > searching the web with GOOGLE.  To start off, take a look at > http://www.suite101.com/article.cfm/sleep_apnea/57133 ]  From your post > it would appear that you have not had a PSG.  Titration is normally > follows a PSG to determine what the sleep disorder is.  If it turns out > to be OSA, then a titration is done.  How was it dermined that you have OSA? > If the PSG doesn’t determine what the disorder is and how to treat it, > at least you know you’ve done the most medical science can do. > Moreover, when you do anything less than a complete PSG, you run the > risk of not fully determining what your exiting, and, in your case, > forthcoming, problems, might be.  Many without adequate initial testing > have gone months trying to figure out what is wrong, feeling like crap > (that’s crap not cpap <g>).  I went months working out the fine points > even after having a PSG. > To work out the fine points, I used a recording finger oximeter(to > determine blood oxygen saturation levels, necessary to assure heart, > brain, and other organ health) I used an autopap to make some > determination of, what is often called, central sleep apnea (CSA)(CPAP > pressure OK, oxygen saturation not OK). > I’ve noted a tendency, here on ASSD, to oversimplify the overall matter > of sleep disorder, and, in particular OSA.  So do your inquiring, > reading, and researching carefully.  Some posts are long, well written, > and sound like they are written by a sleep disorder specialist.  Don’t > accept any statements without a reference that you read.  There also > seems to be a tendency to provide links to what appears to provide > suppot, but really don’t. > Finally, beware the conspiracy theories.  These are the theories that > PSGs only make money for doctors and sleep labs.  PSGs are > state-of-the-art diagnostic tools for sleep disorders.  If you can’t get > one, then you must do the best you can, but don’t believe that > everything will be OK without one.  It may or it may not. > PSGs help many, many people.  Can you get along without one?  Sure, you > may have immediate results.  But, if you are miserable while untreated > now, you may have to spend months more of misery. > In the event you are unable to get a PSG now, and you still feel like > crap, be certain that you dog your healthcare providers until you get one. > HYH

Response:

On Fri, 7 Jan 2005 17:43:15 -0000, "Frankie" <femfran…@blueyonder.co.uk> wrote: >Ditto …. >Experianced chest pain in first weeks of CPAP usage too. >Still don’t know why folks do not get supplied with a HH as a matter of >course by now. This little addition to my CPAP was the turning point of me >getting compliant and makes usage far more bearable. The dry air burns like >hell without it! >Frankie

If you buy it yourself, there is no problem whatsoever.  Any supplier will be pleased to accomodate you.  :-) If it’s from a healthcare provider, then the small matter of

Leg Weakness

Question:

I’m interested to know if anyone else has had any sort of leg weaknesses whilst having a bad sinus spell. A week ago I played football (soccer) for an hour or so with no problems at all.  A couple of days later I started to have sinus problems (the usual painful cheekbones, upper teeth and a headache) but also had very weak legs. I went to the doctors and told him of all the symptoms and he prescribed a course of anti-biotics. He didn’t seemed particularly concerned with the legs, he put it down to sinus related fatigue.  My legs have felt better as the week has gone on, but still ache first thing in the morning and feel weaker than normal. Anyone else experienced this? Thanks Chris

Response:

Chris, I think I am experiencing something very similar to what you describe.  The circumstances are slightly different though.  I have had head pressure for the last six weeks I believe due to sinuses.  What got me to the doctor was that I started experiencing leg weakness this week. I really can’t do more than walk and I’m very active.  My legs are heavy and tight.  It’s strange and very scary.  My nasal passages are not blocked, but I think my sinuses are.  I saw an ENT specialist today who sent me for a Sinus Cat-Scan.  I won’t have the results for two days.  I was wondering if you had any similar sypmtons and how long after you started antibiotics your legs and sinuses started feeling normal again. Thanks, Scott

Response:

On Mon, 22 Nov 2004 16:55:11 -0500, "Scott2" <scottleb…@hotmail.com> wrote: >Chris, I think I am experiencing something very similar to what you >describe.  The circumstances are slightly different though.  I have had >head pressure for the last six weeks I believe due to sinuses.  What got >me to the doctor was that I started experiencing leg weakness this week. >I really can’t do more than walk and I’m very active.  My legs are heavy >and tight.  It’s strange and very scary.  My nasal passages are not >blocked, but I think my sinuses are.  I saw an ENT specialist today who >sent me for a Sinus Cat-Scan.  I won’t have the results for two days.  I >was wondering if you had any similar sypmtons and how long after you >started antibiotics your legs and sinuses started feeling normal again.

Leg weaknes could indicate a neurological problem. You also need to have a complete blood workup including check for white blood call count. Certain type of anemia could cause both leg weakness and infections. That is all just one possibility……

Response:

Thanks Don.  any idea what type of neurological problems?  

Response:

On Tue, 23 Nov 2004 10:50:25 -0500, "Scott2" <scottleb…@hotmail.com> wrote: >Thanks Don.  any idea what type of neurological problems?  

I tihnk it could be any of several different types, or something else altogether. Here is one list of possible causes from Ask Jeeves and it does not even list some that I have heard of. I tihnk you had better pursue the leg weakness as an independent problem (whether it is or not) in order not to miss the true cause. I think I would start with a *good* internist… He can check thyroid level and white blood cell morphology among other things….. ============================================= # Aortic coarctation … weak legs # Autoimmune thyroid diseases … weak leg muscles B # Brain cancer … Weakness of arms or legs C # Chronic Inflammatory Demyelinating Polyneuropathy … slowly progressive weakness and sensory dysfunction of the legs and arms, weakness of the arms and legs # Classic migraine … leg weakness D # Dermatomyositis … upper leg muscle weakness, difficulty climbing stairs # Duchenne Muscular Dystrophy … difficulting climbing stairs, difficulty descending stairs G # Graves Disease … weak leg muscles # Guillain-Barre Syndrome … leg weakness H # Hereditary Spastic Paraplegia … progressive leg weakness # Hyperthyroidism … weak leg muscles I # Infant botulism food poisoning … weak muscles (esp. arm/leg/neck) M # Machado-Joseph Disease … leg weakness # Marfan syndrome … leg weakness # Migraine … leg weakness # Multiple Myeloma … leg weakness # Muscular Dystrophy … difficulting climbing stairs, difficulty descending stairs P # Panic attack … leg weakness # Panic disorder … leg weakness # Primary Lateral Sclerosis … leg weakness R # Rett’s syndrome … difficulty climbing stairs S # Spinal Muscular Atrophy … leg weakness # Spinal Muscular Atrophy type III … difficulty climbing steps # Spinal stenosis … leg weakness # Syringomyelia … leg weakness T # Thyroid disorders … weak leg muscles # Transient Ischemic Attack … leg weakness V # Varicose veins … weak leg muscles

Response:

Hello Scott As well as leg weakness I was aching all over the body, neck, arms, back and legs, plus I developed twitching muscles. My sinus symptoms were there, but only slightly more than normal, upper jaw aching, tender cheeks, a headache and a fair bit of post-nasal drip. I had two weeks of anti-biotics though I’m not sure if they really helped too much.  The aching and twiching did go away almost completely, but I have had a recurence of it again in the last week.  I am OK going for walks of 2-3 miles and I play football (soccer) once a week and again feel OK during the activity, it’s when I am ‘resting’ that the aching comes on. I’m seeing the doctor again on Tuesday.  I have seen him twice over this (I cancelled a couple of appointments as I felt better only for it to reccur). He was interested in the muscle twiching as it’s a symptom of lots of things, though he did say this can occur with tired muscles. As I am not experiencing vision, coordination or other problems linked to certain more serious illnesses I hope this is just another of the strange ways Sinusitis manifests itself. Are you seeing anything like this? or has anyone else experienced anything similar? Thanks Chris "Scott2" <scottleb…@hotmail.com> wrote in message

news:82be454160564713549d33f05f4ad2f4@localhost.talkaboutsupport.com… – Hide quoted text — Show quoted text -> Chris, I think I am experiencing something very similar to what you > describe.  The circumstances are slightly different though.  I have had > head pressure for the last six weeks I believe due to sinuses.  What got > me to the doctor was that I started experiencing leg weakness this week. > I really can’t do more than walk and I’m very active.  My legs are heavy > and tight.  It’s strange and very scary.  My nasal passages are not > blocked, but I think my sinuses are.  I saw an ENT specialist today who > sent me for a Sinus Cat-Scan.  I won’t have the results for two days.  I > was wondering if you had any similar sypmtons and how long after you > started antibiotics your legs and sinuses started feeling normal again. > Thanks, Scott

Response:

On Wed, 24 Nov 2004 12:06:13 +0000 (UTC), "Chris Duff" – Hide quoted text — Show quoted text -<c.j.d…@btinternet.com> wrote: >As well as leg weakness I was aching all over the body, neck, arms, back and >legs, plus I developed twitching muscles. >My sinus symptoms were there, but only slightly more than normal, upper jaw >aching, tender cheeks, a headache and a fair bit of post-nasal drip. >I had two weeks of anti-biotics though I’m not sure if they really helped >too much.  The aching and twiching did go away almost completely, but I have >had a recurence of it again in the last week.  I am OK going for walks of >2-3 miles and I play football (soccer) once a week and again feel OK during >the activity, it’s when I am ‘resting’ that the aching comes on. >I’m seeing the doctor again on Tuesday.  I have seen him twice over this (I >cancelled a couple of appointments as I felt better only for it to reccur). >He was interested in the muscle twiching as it’s a symptom of lots of >things, though he did say this can occur with tired muscles. >As I am not experiencing vision, coordination or other problems linked to >certain more serious illnesses I hope this is just another of the strange >ways Sinusitis manifests itself. >Are you seeing anything like this? or has anyone else experienced anything >similar?

OK twitching muscles are a likely symptom of a severe deficiency of certain vitamins and minerals, which can also cause immunodeficiency and leg weakness. Do not supplement though until you find out the cause, That was my original hypothesis more or less. If I am right on that, you have malabsorption of vitamin B12.    This is common in those over 60, or those who have Gastrointestinal disease, or vegans. Be careful not to ignore this indefinitely, it is not called pernicious anemia for nothing.  Eventually it would lead  to severe mental impairment too. What is your fasting B12 level?  Also check TSH levels. If you have not had a complete blood workup your doctor is incompetent and negligent.

Response:

Thanks for all the comments everybody.  The results of my sinus cat-scan were basically negative.  As I mentioned previously I am not congested either.  I have been put on Levaquin (an antibiotic) as a precaution.   I find the negative results on the sinus cat-scan too be bad news in that its not a simple sinus blockage causing the pressure in my head.  I was today referred to a neurologist who conducted some tests on me and found nothing wrong (although I still have the same head pressure and leg weakness for which it is still hard to walk).  I am now scheduled for an MRI tonight. Thank you everybody for your comments.  Have a great holiday.  I’ll keep you posted on the MRI results when I get back to work Monday. Scott

Response:

My doctor is obviously neither incompetent nor negligent, he send me for full blood works, plus additional tests for arthritis and everything is normal. As I’m under 40 (just!), have no gastric troubles and not a vegan, looks like it’s probably not a B12 problem. "Don Brady" <dbr…@pobox.com> wrote in message

news:cjc9q0tcnvgocq4dvqk9edoubigosgl0j3@4ax.com… – Hide quoted text — Show quoted text -> On Wed, 24 Nov 2004 12:06:13 +0000 (UTC), "Chris Duff" > <c.j.d…@btinternet.com> wrote: > >As well as leg weakness I was aching all over the body, neck, arms, back and > >legs, plus I developed twitching muscles. > >My sinus symptoms were there, but only slightly more than normal, upper jaw > >aching, tender cheeks, a headache and a fair bit of post-nasal drip. > >I had two weeks of anti-biotics though I’m not sure if they really helped > >too much.  The aching and twiching did go away almost completely, but I have > >had a recurence of it again in the last week.  I am OK going for walks of > >2-3 miles and I play football (soccer) once a week and again feel OK during > >the activity, it’s when I am ‘resting’ that the aching comes on. > >I’m seeing the doctor again on Tuesday.  I have seen him twice over this (I > >cancelled a couple of appointments as I felt better only for it to reccur). > >He was interested in the muscle twiching as it’s a symptom of lots of > >things, though he did say this can occur with tired muscles. > >As I am not experiencing vision, coordination or other problems linked to > >certain more serious illnesses I hope this is just another of the strange > >ways Sinusitis manifests itself. > >Are you seeing anything like this? or has anyone else experienced anything > >similar? > OK twitching muscles are a likely symptom of a severe deficiency of certain > vitamins and minerals, which can also cause immunodeficiency and leg weakness. > Do not supplement though until you find out the cause, > That was my original hypothesis more or less. > If I am right on that, you have malabsorption of vitamin B12.    This is common > in those over 60, or those who have Gastrointestinal disease, or vegans. > Be careful not to ignore this indefinitely, it is not called pernicious anemia > for nothing.  Eventually it would lead  to severe mental impairment too. > What is your fasting B12 level?  Also check TSH levels. > If you have not had a complete blood workup your doctor is incompetent and > negligent.

Response:

You didn’t mention what type of antibiotic you were taking. Apparently some types can result in some serious and unusual side effects. Look up Sinus Infection Leviquin in a Google search and you’ll come across some some shocking comments from patients who took it. I needed to find the "Precautions / Side Effects" for Levaquin because I recieved some free samples from my ENT but did not recieve the "standard" paper warning sheet. Apparently this is not required for "free samples". So a drug that can result in side affects ranging from (See the Following) DOES NOT REQUIRE A PRINTED WARNING! What a loophole in regulations. Where’s the FDA on this? Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Levaquin.     * More common side effects may include:       Headache, nausea, constipation, diarrhea, difficulty sleeping     * Less common or rare side effects may include:       Abdominal pain, abnormal dreams, abnormal vision, aggressiveness, agitation, anemia, angina, anxiety, asthma, bad taste, back pain, bone inflammation, blood abnormalities, blood clot, bursitis, changeable emotions, chest pain, circulatory failure, colitis, coma, confusion, coughing, decreased senses, dehydration, depression, difficulty breathing, difficulty concentrating, disorientation, disturbed sense of smell, dizziness, double vision, drowsiness, dry mouth, exaggerated sense of well-being, fainting, fever, fungal infection, gas, general feeling of unwellness, genital infection and itching, hallucination, heart attack, heart failure, high or low blood pressure, high or low blood sugar, hives, impaired thinking, impotence, indigestion, intestinal bleeding, intestinal inflammation, involuntary muscle movement, irregular heartbeat, itching, joint inflammation and pain, kidney disorders, lack of muscle coordination, liver disorders, loss of appetite, lung inflammation, muscle pain, muscle tension, muscle weakness, nervousness, nosebleed, pancreatitis, paralysis, purple or red spots on skin, rapid or slow heartbeat, rash, ringing in the ears, seizures, skin disorders, sinus or nasal inflammation, sleep disorders, speech difficulty or disorder, sweating, swelling, swollen tongue, trembling, tendon inflammation, tremor, tumor, vaginal inflammation, vertigo, vomiting, weakness, weight loss, yeast infection, yellowing of eyes and skin Why should this drug not be prescribed? If any other quinolone antibiotic

recently diagnosed sleep apnoea

Question:

Hi people I have been recently diagnosed as having sleep apnoea along with chronic sinusitis and orbital sinusitis. I have been referred to ENT and the sleep disorder clinic – the time scale bing 6 mths for the sleep clinic and 4 mths for the ENT. Can anyone give me advice to ease the problem of the sleep apnoea in the meantime – this is getting desparate as ‘work’ are monitoring my absence level (increasing due to repaet infections) and my productivity levels (dropping fast due to exhaustion) !!! TIA Adrian tssf – West Yorkshire, UK — Technical Support, BlackFlag Associates Tertiary, Society of St. Francis, Church of England. Grandfather & Civil Servant Governor, St Chad’s Aided Primary School

Response:

On Mon, 19 Jul 2004 09:56:18 +0100, Adrian Haigh-Hutchinson – Hide quoted text — Show quoted text -<kadu.fl…@zetnet.co.uk> wrote: >Hi people >I have been recently diagnosed as having sleep apnoea along with chronic >sinusitis and orbital sinusitis. >I have been referred to ENT and the sleep disorder clinic – the time >scale bing 6 mths for the sleep clinic and 4 mths for the ENT. >Can anyone give me advice to ease the problem of the sleep apnoea in >the meantime – this is getting desparate as ‘work’ are monitoring my >absence level (increasing due to repaet infections) and my productivity >levels (dropping fast due to exhaustion) !!! >TIA >Adrian tssf – West Yorkshire, UK

You *may* be able to reduce the amount and effect of apnoea events by a) making sure that you don’t sleep on your back and/or b) sleeping propped up or in a reclining chair. One method of avoiding laying on your back is to have a tennis ball sewn into the seat of your shorts/pyjamas.   Mileage may vary on this. There is not a great deal beyond this that does not involve medical intervention.   Would your GP prescribe some more effective antibiotics to at least help with the sinusitis fo rthe time being? How supportive is your employer?   Are they prepared to write to your doctor etc. in support of the necessity of your position?   Presumably these are timescales for NHS treatment.   Have you looked at alternative locations.? Have you looked at private treatment and do you have medical insurance at all?    Going this route would reduce your waiting time to weeks at the most.   Given the seriousness of the situation, I would find a way to do that if the NHS can’t be squeezed into action. Without in any way wanting to increase your burden, you mention that you have been diagnosed as having sleep apnoea.   Was this from a sleep test carried out by a specialist or is this the strong suspicion of your GP?    One thing to be aware of is that in the UK, it is a criminal offence (potentially punishable by a custodial sentence) to continue driving if you have been diagnosed with certain types of sleep disorder and they are not being treated.  You are required to inform the DVLA and your insurer.    Suffice it to say, if you have been diagnosed and have not done these things then you are in a precarious legal position.     Your comment that you are becoming exhausted is a pretty strong clue. Try out the Epworth Test (a questionnaire) and answer the questions honestly or get someone else to score you.   You can find this easily on the internet.    Anything greater than 10 and you have a problem. If it’s that the GP has referred you, then technically you are in the clear with the DVLA on sleep disorder, but if you are driving when you know that you are sleepy, then this is not a good situation as the driver in the Selby crash discovered – you can still be in trouble. However, it is possible that the driving issue could be turned around. Do you need to be able to drive for work reasons? If so, again coming back to your employer,  if this is necessary then being able to go back to the doctors etc. and say that your livelihood depends on earlier treatment may help. Assuming that you do have Obstructive Sleep Apnoea, then as you will have read, CPAP therapy is the treatment of choice in most cases. For this to work, you ideally need the sinus problem to be addressed as well.   In some cases, CPAP actually improves the situation with sinuses. .andy To email, substitute .nospam with .gl

Response:

The message <k35nf01pudtnh2hk5f5o3j7el3aeu0s…@4ax.com> from Andy Hall <an…@hall.nospam> contains these words: snip… > You *may* be able to reduce the amount and effect of apnoea events by > a) making sure that you don’t sleep on your back and/or > b) sleeping propped up or in a reclining chair.

tried raising my pillow but fell off !! am looking at using combinations of pillows. > One method of avoiding laying on your back is to have a tennis ball > sewn into the seat of your shorts/pyjamas.   Mileage may vary on this.

??? > There is not a great deal beyond this that does not involve medical > intervention.   Would your GP prescribe some more effective > antibiotics to at least help with the sinusitis fo rthe time being?

Diagnosis of sinusitis/orbital sinusitis was by A&E Eye Clinic – GP only saw me when I was off for over the 7 days self-certification !! > How supportive is your employer?   Are they prepared to write to your > doctor etc. in support of the necessity of your position?  

Have been referred to the external medical support (BMI) for investigation – they should write to Respiratory consultant who confirm diagnosis of sleep apnoea & sinus problem. > Presumably these are timescales for NHS treatment.   > Have you looked at alternative locations.?

Not yet – am checking into my medical insurance docs … > Have you looked at private treatment and do you have medical insurance > at all?    Going this route would reduce your waiting time to weeks at > the most.   Given the seriousness of the situation, I would find a way > to do that if the NHS can’t be squeezed into action.

Timescales for the sleep clinic won’t change going private as there is only 2 beds in West Yorkshire for the clinic to use for assessment and treatment. > Without in any way wanting to increase your burden, you mention that > you have been diagnosed as having sleep apnoea.   Was this from a > sleep test carried out by a specialist or is this the strong suspicion > of your GP?    One thing to be aware of is that in the UK, it is a > criminal offence (potentially punishable by a custodial sentence) to > continue driving if you have been diagnosed with certain types of > sleep disorder and they are not being treated.  You are required to > inform the DVLA and your insurer.    Suffice it to say, if you have > been diagnosed and have not done these things then you are in a > precarious legal position.    

[1] Diabetes consultant at annual review at hosptial asked me about any problems – explained about continual tiredness and falling asleep in afternoon (4pm onwards at that time), both at work and on bus home. [2] Don’t drive now as awaiting retest re diabetes (( > Your comment that you are becoming exhausted is a pretty strong clue. > Try out the Epworth Test (a questionnaire) and answer the questions > honestly or get someone else to score you.   You can find this easily > on the internet.    Anything greater than 10 and you have a problem.

Will try this. > If it’s that the GP has referred you, then technically you are in the > clear with the DVLA on sleep disorder, but if you are driving when you > know that you are sleepy, then this is not a good situation as the > driver in the Selby crash discovered – you can still be in trouble. > However, it is possible that the driving issue could be turned around. > Do you need to be able to drive for work reasons? > If so, again coming back to your employer,  if this is necessary then > being able to go back to the doctors etc. and say that your livelihood > depends on earlier treatment may help. > Assuming that you do have Obstructive Sleep Apnoea, then as you will > have read, CPAP therapy is the treatment of choice in most cases. > For this to work, you ideally need the sinus problem to be addressed > as well.   In some cases, CPAP actually improves the situation with > sinuses.

Saw Respiratory consultant on 010704 (referred to him by Diabetes consultant as he could not refer direct to sleep clinic) [1] small jaw and narrow airway – therefore will have problems with any infections re breathing during waking periods as well. [2] chronic sinusitis means that the airways restricted during recurrances of infection – increased problems re sleep apnoea Thanks Andy – I’m chasing an updated appointment for ENT (given 25 October 2004 at the moment).  January 2005 for sleep clinic (if I’m really lucky). I’ll look at the info and see how it goes – the depression is rearing it’s head again and *that* will be a major problem. adrian tssf — Technical Support, BlackFlag Associates Tertiary, Society of St. Francis, Church of England. Grandfather & Civil Servant Governor, St Chad’s Aided Primary School

Response:

On Mon, 19 Jul 2004 12:03:16 +0100, Adrian Haigh-Hutchinson – Hide quoted text — Show quoted text -<kadu.fl…@zetnet.co.uk> wrote: >The message <k35nf01pudtnh2hk5f5o3j7el3aeu0s…@4ax.com> >from Andy Hall <an…@hall.nospam> contains these words: >snip… >> You *may* be able to reduce the amount and effect of apnoea events by >> a) making sure that you don’t sleep on your back and/or >> b) sleeping propped up or in a reclining chair. >tried raising my pillow but fell off !! am looking at using combinations >of pillows. >> One method of avoiding laying on your back is to have a tennis ball >> sewn into the seat of your shorts/pyjamas.   Mileage may vary on this. >???

If you have a tennis ball under your backside, you won’t lay on your back for long, is the theory. – Hide quoted text — Show quoted text ->> There is not a great deal beyond this that does not involve medical >> intervention.   Would your GP prescribe some more effective >> antibiotics to at least help with the sinusitis fo rthe time being? >Diagnosis of sinusitis/orbital sinusitis was by A&E Eye Clinic – GP only >saw me when I was off for over the 7 days self-certification !! >> How supportive is your employer?   Are they prepared to write to your >> doctor etc. in support of the necessity of your position?   >Have been referred to the external medical support (BMI) for >investigation – they should write to Respiratory consultant who confirm >diagnosis of sleep apnoea & sinus problem. >> Presumably these are timescales for NHS treatment.   >> Have you looked at alternative locations.? >Not yet – am checking into my medical insurance docs …

Most will pay for a sleep study but if you require CPAP equipment afterwards you either have to wait for availability through NHS or you can buy one tomorrow (budget about

Is sleep apnea being over diagnosed?

Question:

- Hide quoted text — Show quoted text -Judy Simon wrote: > The real Norm wrote: >> Well…. one of the very first questions I asked here, 3-4 years ago >> was, "Has anyone ever had a PSG and not been diagnosed with apnea?"   >> Never received a response.  (I was hoping someone here knew of someone.) > Norm, I wasn’t here 3-4 years ago when you asked this question, but two > years ago I asked the same question to the technician in the sleep lab > who was hooking me up to all the monitors.  My initial suspicion also > was that everyone who walked into a sleep lab walked out with a > prescription for CPAP.  But the technician said no, not everyone who > comes to the lab is diagnosed with sleep apnea. Then in the morning when > she was disconnecting me, she said that not everyone here gets a sleep > apnea dx but that I certainly would get one > Judy

Hi Judy – Well, your input provides an answer to my question!  You know someone who knows many who had PSGs and no apnea <g>.

Response:

"elliot gainway" <elig…@hotmail.com> wrote in message news:99061578.0402100007.3498c2ca@posting.google.com… > "The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:40283158.4060601@socal.rr.com>… > > elliot gainway wrote: > > > First let me say that I am a person who can’t use cpap. I have given > > > it a 4 month try and despite several differant masks I get less sleep > > > with it than without it. That being said, with all the people I am > > > finding that are being diagnosed with it, it is starting to look like > > > more have it than don’t. Maybe they should start issuing cpaps to > > > everyone over 40. In my case, the sleep study was done only on my > > > back. In real life I sleep very little on my back. I sleep mostly on > > > my side. So was the sleep study accurate?

As was pointed out below, most likely titration with back-sleeping would cover for other positions. Other issues, like noise, leaks, and comfort can be addressed… – Hide quoted text — Show quoted text -> > OSA is generallly worse on one’s back.  If you were manually titrated on your > > back, the pressure should be adequate to cover the lesser apneas on one’s side. > >   So this is not, necesarily, your problem.  But the question is….. exactly > > what is your problem? > > Did you have a PSG in a sleep lab? > > Did a diplomated sleep doc write a PSG summary report. > > Was anything other than OSA diagnosed, such as central apnea? > > Do you have a copy of the report? > > Were you manually titrated in a sleep lab? > > Do you know what pressure you were titrated to? > > Do you know if the pressure was set to the titrated pressure? > > Describe your system and how it is set up: > >     Manufacturer and name of blower and mask > >     Where are the blower and humidifier located? > >     How do you manage your hose/tube?  Is it suspended? > > Are you aware of any mask leaks? > > Have you checked your hose for leaks? > > Have you had the blower pressure checked? > > That oughta do it for now. > Yes to all your questions. I just can’t sleep with cpap. I can’t stand > the mask on my face or anything up my nose or the noise.

Unless the pressure is high, masks can be fitted "lightly" and some are light-weight, with few straps, and are comfortable at most times. I like the ResMed Ultra Mirage and Activa (the latter is heavier, but with less leakage with movement) and the Respironics Comfort Select nose masks, but others prefer nose-pillows or full-face masks. Masks vary in vent noise levels, and CPAP machines also vary in noise. Mine are not the quietest, but sometimes I check the vent for air flow to see if the machine (Respironics RemStar Pro) is really running – it is almost inaudible. If the pressure is high, a BiPAP machine may help (or the Respironics with "C-Flex", which drops the pressure briefly upon exhaling). I run the hose behind, then over, an up-ended stiff pillow placed against the headboard to keep the hose in order (and to insulate part of it to prevent "rain-out" with use of a humidifier). I use a heated humidifier to avoid nasal drying… > The reason > for my initial post was to question whether cpap manufacturers and > sleep labs are pushing this sleep apnea as an ailment to fuel a new > money making area of health care. I know sleep apnea is a real aliment > and people really have it but after seeing how many people are being > diagnosed with it, you have to wonder if it is being pushed a little. > Also the amount of people that are put on cpap that don’t use it makes > you wonder if they needed it in the first place.

I thought I was sleeping well (except for a break in the middle, around 3-4AM), but a sleep test indicated that the more sleep I got (at the time around 9+ hours/day), the more harm I was doing (very low blood oxygen level, no REM and little deep sleep). An enlarged heart and heart-arrythmia for me (and the death of my father likely caused by the effects of OSA) convinced me of the need to use the CPAP machine "religiously". I put up with the minor problems with it to do it, and now I get about 7-hours/night of better sleep… —  David Ruether  r…@cornell.edu  http://www.ferrario.com/ruether

Response:

The real Norm wrote: > Well…. one of the very first questions I asked here, 3-4 years ago > was, "Has anyone ever had a PSG and not been diagnosed with apnea?"   > Never received a response.  (I was hoping someone here knew of someone.)

Norm, I wasn’t here 3-4 years ago when you asked this question, but two years ago I asked the same question to the technician in the sleep lab who was hooking me up to all the monitors.  My initial suspicion also was that everyone who walked into a sleep lab walked out with a prescription for CPAP.  But the technician said no, not everyone who comes to the lab is diagnosed with sleep apnea. Then in the morning when she was disconnecting me, she said that not everyone here gets a sleep apnea dx but that I certainly would get one Judy

Response:

elliot gainway wrote: > "The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:40283158.4060601@socal.rr.com>…

[cut] Ross reminded me…. here are two tests that also may ‘enforce’ the conclusion that you and your relatives all have a sleep disorder.  Ross mentioned the first one. http://www.silentpartners.org/sleep/patients/epworth.htm http://www.newtechpub.com/phantom/question/quiz.html

Response:

Count me in as another woman who was tired for years, struggling with inability to sleep through the night, depression and anxiety, whose quality of life greatly improved after being diagnosed and treated for sleep apnea.  It was a pulmonary doctor who first diagnosed my sleep apnea two years ago.  I went to him on my own because I wanted to find out if there was anything different a specialist would do to treat my asthma than my family doctor was doing.  The pulmonary doctor said I showed no signs of asthma, took me off all the asthma asthma meds except for one anti-inflammatory, and sent me for a sleep study. The problem that had kept sending me back to the family practitioner was waking up at night repeatedly, coughing.  The family doc misinterpreted this as a worsening of my asthma.  By the time I took myself to the pulmonary doctor, i was on three different asthma meds and still waking up many times a night. Neither the family doc nor I realized that I was gagging for air due to OSA- we all thought I was coughing from an asthma attack. The family doc didn’t take my tiredness as a serious symptom either- that should have been his clue that sleep apnea may be involved.  I assumed I wasn’t getting enough oxygen because of the asthma and that must have been what was making me tired, so I didn’t press the issue with him.  Anyhow, the pulmonary doctor scheduled the sleep test even though I was a woman and not overweight. The family doctor thought it was unnecessary; he didn’t think I had sleep apnea because I don’t fit the profile of the "typical" OSA patient- its a good thing my health insurance didn’t require a referral from the family doctor!  In the (nearly) two years since I am using CPAP, I sleep through everynight, never wake up coughing, and have none of the pathological tiredness that I had for years before CPAP.  The lack of sleep had also caused me to be depressed.  A year before I went to the pulmonary specialist, I had gone to a psychiatrist for depression and anxiety; the psychiatrist prescribed an anti-depressant which took care of the depression and anxiety but did nothing to help the tiredness (duh, but I didn’t know about sleep apnea yet).  Since CPAP, I have weaned off the antidepressant and have had no problems with depression and anxiety. My family doctor is starting to take sleep apnea seriously now.  It is very important that we as patients educate the doctors who do not have sleep apnea in their diagnostic radar screen. Judy – Hide quoted text — Show quoted text -Susan Wachob wrote: > Me too- For five years my psychiatrist added one anti-depressant after > another and more combinations than I can think of. Only when he couldn;t > find anything that affected my constant exhaustion and foggy head did he > finally suggest maybe it was OSA and referred me for a sleep study. > The kicker is he used to be the director of Stanford’s sleep lab! > Susan > christineu wrote: >> I would agree with Beth. I have Central Sleep apnea and mine went >> undiagnosed and of course untreated for years before I was sent to a >> sleep doctor this past fall. I think that there are a lot more people >> who have sleep apnea and don’t realize it- especially women. I can’t >> even remember how many times I complained of being tired over the year >> to different doctors and their treatment of choice after checking >> thyroid was to prescribe an antidepressant just because I was >> complaining of fatigue and I’m female. >> There is a push now to educate more doctors about sleep disorders with >> apnea probably being the most comon one. ANd with more people getting >> diagnosed other people realize they might have a problem so they talk >> to their doctors about it and end up getting diagnoised. I just wish >> more doctors would bother to ask about patients sleep habits- I was >> given sleep meds by several different doctors in the past couple of >> years when what I really needed was to see a sleep speacialist. >> I do think the medical community needs to do more to educate people >> with sleep apnea about treatment and possible medical problems they >> may have if they don’t comply with treatment. Look how much is done >> when someone is diagnosed with diabetes to educate the patient and >> their family- patients with apnea need a similar program to increase >> compliance with CPAP/BiPAP therapy.

Response:

"Ross Bernheim" <ross…@mindspring.com> wrote in message

news:1g8wvcr.3pgs9ptm7ceqN%rossber@mindspring.com… – Hide quoted text — Show quoted text -> David Ruether <r…@no-junk.cornell.edu> wrote: > > Good comments. A story: when I was a kid, it was annoying > > that my father never seemed to have any of the common ailments, > > so did not always appear to understand their effect on us – and he > > had more energy than any of us (sometimes hard to live with…;-). I do > > remember as a kid laughing with a friend who was staying overnight > > at my father’s very loud snoring, and at its abrupt stops/starts. In old > > age, I did come to appreciate his good humor and lack of complaints > > as he suffered stomach and colon cancer (and two-way incontinence), > > four heart attacks, and a four-way bypass. What got him in the end, > > though, was likely the heart failure (not the simple thing it sounds like > > if you are not familiar with it…) from the effects of sleep-apnea. In the > > process of dealing with a recent "heart event" (likely caused by SA) > > and odd neurological problems of my own, the SA that I knew > > existed (but which I had not taken seriously) was confirmed during > > a sleep-clinic stay. After "putting some things together", I now take > > OSA seriously, and have slept a total of only about 4-5 hours in > > the last six weeks without using the CPAP machine. I never felt tired > > as a result of OSA, but an enlarged heart, heart arrhythmia, thoughts > > of what would be down the line if I didn’t take care of the OSA, > > plus the possible effects of lack of REM and late-stage sleep keeps > > me on "the machine" when sleeping. I still have the neurological > > problems, alas, but searching for their cause has at least brought > > me a treatment for OSA… > The paralells can be rather frightening. Father snored but had few > ailments other than hay fever. In older age, he has had numerous > strokes, a few severe. I suspect that a stroke will do him in > eventually. > I had some of the other symptoms besides just snoring. The hypertension > and family history of strokes were a big concern, but conventional > medicine was unable to keep the blood pressure under control. When some > of the other symptoms got bad enough, I did some on-line research and > found out about sleep apnea and took one of the on-line quizes. It was > scary to recognize how much of the test questions were applicable. > I made a note to ask the primary physician, so I would not forget. He > passed me on to the HMO’s sleep specialist. Ended up being tested and > had apnea. Titrated and on CPAP for just over two years now. Haven’t > missed a night on CPAP. Some have been better than others. > Bottom line. Hypertension was gone in a few months. Interoccular > pressure at the next eye exam after a year on CPAP showed a decrease of > about 25 percent. My astigmatism has improved as well. Short term memory > which was going bad is much better. I am going from bald to thinning on > top. There are a number of other improvements as well. > Don’t give up on improvements in the neurological area. It may take some > time. The problems did not happen overnight, but took time, and any > improvements may take some time also. > Sleep well. > Ross Bernheim

Thanks for the comments. When my local neurologist suggested that the multitude of weird neurological problems that cropped up fairly abruptly in severe forms (though most had existed before, but in much more manageable and predictable forms) may be sleep-related, I had a hard time believing it. I researched it the best I could at the time on the ‘net, and asked here if anyone else had seen any symptoms similar to mine that were sleep-related, but I came up empty at first. With more experience with this, and with finding more on the ‘net in the "nether regions" of research, I’m now beginning to believe he was right – there can be some VERY weird effects related to sleep-disorders! (Mebbe the "village idiots o’ yore" were just sleep-deprived – but I now have a FAR greater appreciation for their plight…!;-) Episodic jerks/jitters, unexpected loss of muscle strength, loss of muscle-control, "freezing", and loss of speech control (various forms, all unpleasant and disturbing), all often many times a day, has put more than a little "crimp" in normal activities for almost four months now. A possible drug solution did seem to help with some of the types of problems, but I could not tolerate it (depression and "stupid" and confused feelings appeared at low dossage) – and I was "climbing the walls" for many days while getting off it. If use of CPAP gear is the answer, I hope it does not take years to improve things noticeably (the coming year’s income is already likely gone due to when I need to book work for it – which is now, and kinda hard to do in my present condition…). Ah, well… Thanks, again, for your comments. —  David Ruether  r…@cornell.edu  http://www.ferrario.com/ruether

Response:

- Hide quoted text — Show quoted text -David Ruether <r…@no-junk.cornell.edu> wrote: > Good comments. A story: when I was a kid, it was annoying > that my father never seemed to have any of the common ailments, > so did not always appear to understand their effect on us – and he > had more energy than any of us (sometimes hard to live with…;-). I do > remember as a kid laughing with a friend who was staying overnight > at my father’s very loud snoring, and at its abrupt stops/starts. In old > age, I did come to appreciate his good humor and lack of complaints > as he suffered stomach and colon cancer (and two-way incontinence), > four heart attacks, and a four-way bypass. What got him in the end, > though, was likely the heart failure (not the simple thing it sounds like > if you are not familiar with it…) from the effects of sleep-apnea. In the > process of dealing with a recent "heart event" (likely caused by SA) > and odd neurological problems of my own, the SA that I knew > existed (but which I had not taken seriously) was confirmed during > a sleep-clinic stay. After "putting some things together", I now take > OSA seriously, and have slept a total of only about 4-5 hours in > the last six weeks without using the CPAP machine. I never felt tired > as a result of OSA, but an enlarged heart, heart arrhythmia, thoughts > of what would be down the line if I didn’t take care of the OSA, > plus the possible effects of lack of REM and late-stage sleep keeps > me on "the machine" when sleeping. I still have the neurological > problems, alas, but searching for their cause has at least brought > me a treatment for OSA…

The paralells can be rather frightening. Father snored but had few ailments other than hay fever. In older age, he has had numerous strokes, a few severe. I suspect that a stroke will do him in eventually. I had some of the other symptoms besides just snoring. The hypertension and family history of strokes were a big concern, but conventional medicine was unable to keep the blood pressure under control. When some of the other symptoms got bad enough, I did some on-line research and found out about sleep apnea and took one of the on-line quizes. It was scary to recognize how much of the test questions were applicable. I made a note to ask the primary physician, so I would not forget. He passed me on to the HMO’s sleep specialist. Ended up being tested and had apnea. Titrated and on CPAP for just over two years now. Haven’t missed a night on CPAP. Some have been better than others. Bottom line. Hypertension was gone in a few months. Interoccular pressure at the next eye exam after a year on CPAP showed a decrease of about 25 percent. My astigmatism has improved as well. Short term memory which was going bad is much better. I am going from bald to thinning on top. There are a number of other improvements as well. Don’t give up on improvements in the neurological area. It may take some time. The problems did not happen overnight, but took time, and any improvements may take some time also. Sleep well. Ross Bernheim

Response:

I would agree with Beth. I have Central Sleep apnea and mine went undiagnosed and of course untreated for years before I was sent to a sleep doctor this past fall. I think that there are a lot more people who have sleep apnea and don’t realize it- especially women. I can’t even remember how many times I complained of being tired over the year to different doctors and their treatment of choice after checking thyroid was to prescribe an antidepressant just because I was complaining of fatigue and I’m female. There is a push now to educate more doctors about sleep disorders with apnea probably being the most comon one. ANd with more people getting diagnosed other people realize they might have a problem so they talk to their doctors about it and end up getting diagnoised. I just wish more doctors would bother to ask about patients sleep habits- I was given sleep meds by several different doctors in the past couple of years when what I really needed was to see a sleep speacialist. I do think the medical community needs to do more to educate people with sleep apnea about treatment and possible medical problems they may have if they don’t comply with treatment. Look how much is done when someone is diagnosed with diabetes to educate the patient and their family- patients with apnea need a similar program to increase compliance with CPAP/BiPAP therapy.

Response:

The real Norm wrote: > Similarly, I like to buy cars that others don’t have, but every time I do, I > discover that everyone has bought one also.  <LOL>  That is, I never notice them > until I buy one.

And I though that only happened to me

Response:

Great info Tal and all! saw an article today in a magazine at the office. ‘10 illnesses doctors miss’ or some such… (was printed in bold letters on the cover of the magazine, so i took a quick look). sleep apnea was one of the 10 listed. anyways, WRT being ‘being over diagnosed’, i also think it is under diagnosed. tho the only way one will know is to do the sleep study, IMHO. hope all is well. take care y’all =) "Tal" <goer…@hotmail.com> wrote in message

news:c07lbq$13hjhb$1@ID-148111.news.uni-berlin.de… – Hide quoted text — Show quoted text -> > I went to a family function this weekend and started talking to many > > related and non related family members about my recent diagnosis of > > sleep apnea. I was stunned by how many had also been  diagnosed with > > sleep apnea. Most are not blood related to me so no heredity could be > > coming into play here. The amount at this get together would be way > > over the estimated aveage of people who have sleep apnea. Could the > > numbers be really that high and does everyone have some degree of > > apnea sometime in their life or is it the new fad diagnosis. It seemed > > like, if your are middle age or older and have few extra pounds, they > > are checking for and finding sleep apnea. Most of the family members I > > talked to don’t use their cpap because they find it uncomfortable and > > hard to get used to. The fact that so many had been diagnosed and > > prescribed cpap therapy has me very curious. > I don’t think it’s being over diagnosed, i believe it’s still being UNDER > diagnosed…… i think lifestyle MAY play some part in the higher number of > people being diagnosed in a few ways – 1. bad diet and lack of excercise > means more of us are carrying more weight than is healthy.  2.  people are > less willing to put up with feeling like crud than they used to.  Then > here’s also the fact that more doctors are becoming aware of what sleep > apnea is etc….. this is still a relatively newly discovered disorder in > the big scheme of things. > Apnea has always been a problem……it was just more hidden in years past. > Increased ability to detect the cause of this problem has increased the > numbers diagnosed – where before, people who were feeling constantly tired > were just told to get over it, now more people are trying to find out WHY > and then how to fix it. > I wouldn’t be suprised if in the years to come – as more people are > diagnosed and then treated (of course, the treated is the hard part, as you > noted, many people don’t realise the risks and don’t bother with treatment > because it takes a little more effort than they’d like) I believe we’ll find > that there may be a reduction in the amount of heart problems etc observed > in such individuals. > There are very strict guidelines for diagnosing apnea…..it’s not a really > fuzzy line like that you see with some other highly diagnosed conditions > these days.  I guess my point is, if you’re diagnosed wtih apnea through a > sleep study, there’s no doubting you actually have it and can benefit from > treatment. > of course, this is just my rambling thoughts on the matter > — > Beth in Australia > (I am not a medical professional and anything stated in my posts is my > opinion only unless specified otherwise) > =================== > FAQ for alt.support.sleep-disorder can be found here > http://talhost.net/sleep > Newsgroup Archives http://talhost.net/sleep/archives.htm > this site is a work in progress – feel free to submit info/articles

Response:

- Hide quoted text — Show quoted text -paula wrote: > First I would say that you must be living in an area where doctors maybe more > familiar with sleep disorders then elsewhere. I find that enormously refreshing. > To me there is no doubt that with the increasing weight problems people have > that more and more people will be dx with sleep apnea. Although we can never be > certain ( my 45 lb weight loss didn’t even touch my pressure needed) those will > probably the same people who might lose the apnea once losing weight. And, they > make it so much the harder for those who have non weight related apnea because > it will become know that it is "just a weight issue". OK off that soap box. > Next, are those people nuts?? Have we as a society become so used to modern > medicine with its quick fixes that they feel by trying a bit it should be easy > whatever the treatment? having a mask on your face is something very strange and > might take many months of trials and nifty tricks to get used to. it certainly > is not like taking an aspirin for most people. > In regard also to future problem. Let me tell you that since knowing about > apnea, I now know that my grandma ( dad’s mother) did not really die of a stroke > but the result of apnea. Nor did my dad die of a stroke, he had apnea also. Both > there lives was like mine; losing energy and life interest slowly but surely. I > am now being treated; maybe I still die at age 58 but slowly I am getting a life > again; something they didn’t. sure if the people are younger they don’t see what > will happen later on. One of the things that happens when one educates oneself > on their health is knowledge, and knowledge comes with responsibility. Imagine > how you would feel once around 50 and getting a stroke. By then it is to late. > Welcome to the worlds of "nobody said it was easy but where there is a will > there is a way; perseverance is not always a bad thing. > something else I wanted to say in regard to "so many dx "  Guess you never has a > child? or truly involved with the pregnancy? Ask any woman what happens when she > is pregnant. It SEEMS that the whole world is pregnant. You all of a sudden are > very aware of all the others while they have been around all the time; you just > didn’t notice. Wouldn’t that happen with apnea also? You think it is rare > because you never hear about it but start taking and you find the ones having > it.

Very well stated, especially the part about being pregnant. Similarly, I like to buy cars that others don’t have, but every time I do, I discover that everyone has bought one also.  <LOL>  That is, I never notice them until I buy one.

Response:

- Hide quoted text — Show quoted text -elliot gainway wrote: > "The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:40283158.4060601@socal.rr.com>… >>elliot gainway wrote: >>>First let me say that I am a person who can’t use cpap. I have given >>>it a 4 month try and despite several differant masks I get less sleep >>>with it than without it. That being said, with all the people I am >>>finding that are being diagnosed with it, it is starting to look like >>>more have it than don’t. Maybe they should start issuing cpaps to >>>everyone over 40. In my case, the sleep study was done only on my >>>back. In real life I sleep very little on my back. I sleep mostly on >>>my side. So was the sleep study accurate? >>OSA is generallly worse on one’s back.  If you were manually titrated on your >>back, the pressure should be adequate to cover the lesser apneas on one’s side. >>  So this is not, necesarily, your problem.  But the question is….. exactly >>what is your problem? >>Did you have a PSG in a sleep lab? >>Did a diplomated sleep doc write a PSG summary report. >>Was anything other than OSA diagnosed, such as central apnea? >>Do you have a copy of the report? >>Were you manually titrated in a sleep lab? >>Do you know what pressure you were titrated to? >>Do you know if the pressure was set to the titrated pressure? >>Describe your system and how it is set up: >>    Manufacturer and name of blower and mask >>    Where are the blower and humidifier located? >>    How do you manage your hose/tube?  Is it suspended? >>Are you aware of any mask leaks? >>Have you checked your hose for leaks? >>Have you had the blower pressure checked? >>That oughta do it for now. > Yes to all your questions. I just can’t sleep with cpap. I can’t stand > the mask on my face or anything up my nose or the noise.

There have been others who have posted here who admit to phobias about not being able to tolerate anything on the face, even before CPAP.  Is is just the CPAP for you. > The reason > for my initial post was to question whether cpap manufacturers and > sleep labs are pushing this sleep apnea as an ailment to fuel a new > money making area of health care.

That would have to be a helluva large conspiracy.  Can’t imagine how you could come up with that kind of conspiracy theory, unless you are paranoid <grin>. Attitude has a lot to do with compliance.  And anyone, who has been properly diagnosed with OSA and properly titrated, can check it themselves at home with a recording finger oximeter.  Sleep with it and without CPAP for a couple nights and see what happens to your blood oxygen saturation levels.  If they stick around 98, you don’t have apnea.  If they don’t, you probably do.  Then do it some more while using your CPAP and see what happens. > I know sleep apnea is a real aliment > and people really have it but after seeing how many people are being > diagnosed with it, you have to wonder if it is being pushed a little.

I doubt it. > Also the amount of people that are put on cpap that don’t use it makes > you wonder if they needed it in the first place.

Hey… if you feel great the morning after, without CPAP, you probably don’t need it.  Why did you and all your relatives go to the sleep lab in the first place? – Hide quoted text — Show quoted text ->>>I don’t know. >>>The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:4027DC1A.70802@socal.rr.com>… >>>>elliot gainway wrote: >>>>>I went to a family function this weekend and started talking to many >>>>>related and non related family members about my recent diagnosis of >>>>>sleep apnea. I was stunned by how many had also been  diagnosed with >>>>>sleep apnea. Most are not blood related to me so no heredity could be >>>>>coming into play here. The amount at this get together would be way >>>>>over the estimated aveage of people who have sleep apnea. Could the >>>>>numbers be really that high and does everyone have some degree of >>>>>apnea sometime in their life or is it the new fad diagnosis. It seemed >>>>>like, if your are middle age or older and have few extra pounds, they >>>>>are checking for and finding sleep apnea. Most of the family members I >>>>>talked to don’t use their cpap because they find it uncomfortable and >>>>>hard to get used to. The fact that so many had been diagnosed and >>>>>prescribed cpap therapy has me very curious. >>>>Well…. one of the very first questions I asked here, 3-4 years ago was, "Has >>>>anyone ever had a PSG and not been diagnosed with apnea?"  Never received a >>>>response.  (I was hoping someone here knew of someone.) >>>>I couldn’t believe that I had it, even after having a laboratory PSG evaluated >>>>by a neurologist diplomated sleep doc.  But, as I took the time to learn, I >>>>began to realize that I DID. >>>>I have six acquaintances (5 men, 1 woman) all, but one, of which were diagnosed >>>>with sleep apnea, long before I was.  Not a one of them knows diddly sh*t about >>>>sleep apnea.  And they don’t seem to be able to muster the strength (physical >>>>and mental) to  learn.  They think their computers are for sending jokes only. >>>>Not a one has ever read any posts here. >>>>One is a retired orthopedist.  He doesn’t know a cpap from a bipap.  He just >>>>knows he feels better and is compliant. >>>>The woman is married to one of the men.  When I was diagnosed, they were >>>>non-compliant.  So, as I learned, I told them what I had learned about enlarged >>>>hearts and strokes.  They ignored everything I said. >>>>Then he had a stroke.  She was quick to tell me it wasn’t from OSA, but they are >>>>both very compliant now. >>>>I spent 2-3 hours with another of the men, who was having all kinds of newbie >>>>problems.  He is in his mid-7o’s.  He just couldn’t seem to understand.  He >>>>decided he no longer had OSA and totally stopped using cpap. >>>>So, that’s a personal slant on your question.  But there is also a testing and >>>>diagnosis slant.  Were the people, at this get-together, properly tested and >>>>diagnosed and, then, supported?  Did they all have lab polysomnograms for >>>>diagnostic purposes?  Did they get a second PSG while being manually titrated? >>>>Were they all tested at home? >>>>Be sure and read every word of Beth’s and David’s responses.

Response:

First I would say that you must be living in an area where doctors maybe more familiar with sleep disorders then elsewhere. I find that enormously refreshing. To me there is no doubt that with the increasing weight problems people have that more and more people will be dx with sleep apnea. Although we can never be certain ( my 45 lb weight loss didn’t even touch my pressure needed) those will probably the same people who might lose the apnea once losing weight. And, they make it so much the harder for those who have non weight related apnea because it will become know that it is "just a weight issue". OK off that soap box. Next, are those people nuts?? Have we as a society become so used to modern medicine with its quick fixes that they feel by trying a bit it should be easy whatever the treatment? having a mask on your face is something very strange and might take many months of trials and nifty tricks to get used to. it certainly is not like taking an aspirin for most people. In regard also to future problem. Let me tell you that since knowing about apnea, I now know that my grandma ( dad’s mother) did not really die of a stroke but the result of apnea. Nor did my dad die of a stroke, he had apnea also. Both there lives was like mine; losing energy and life interest slowly but surely. I am now being treated; maybe I still die at age 58 but slowly I am getting a life again; something they didn’t. sure if the people are younger they don’t see what will happen later on. One of the things that happens when one educates oneself on their health is knowledge, and knowledge comes with responsibility. Imagine how you would feel once around 50 and getting a stroke. By then it is to late. Welcome to the worlds of "nobody said it was easy but where there is a will there is a way; perseverance is not always a bad thing. something else I wanted to say in regard to "so many dx "  Guess you never has a child? or truly involved with the pregnancy? Ask any woman what happens when she is pregnant. It SEEMS that the whole world is pregnant. You all of a sudden are very aware of all the others while they have been around all the time; you just didn’t notice. Wouldn’t that happen with apnea also? You think it is rare because you never hear about it but start taking and you find the ones having it.

Response:

"The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:40283158.4060601@socal.rr.com>… – Hide quoted text — Show quoted text -> elliot gainway wrote: > > First let me say that I am a person who can’t use cpap. I have given > > it a 4 month try and despite several differant masks I get less sleep > > with it than without it. That being said, with all the people I am > > finding that are being diagnosed with it, it is starting to look like > > more have it than don’t. Maybe they should start issuing cpaps to > > everyone over 40. In my case, the sleep study was done only on my > > back. In real life I sleep very little on my back. I sleep mostly on > > my side. So was the sleep study accurate? > OSA is generallly worse on one’s back.  If you were manually titrated on your > back, the pressure should be adequate to cover the lesser apneas on one’s side. >   So this is not, necesarily, your problem.  But the question is….. exactly > what is your problem? > Did you have a PSG in a sleep lab? > Did a diplomated sleep doc write a PSG summary report. > Was anything other than OSA diagnosed, such as central apnea? > Do you have a copy of the report? > Were you manually titrated in a sleep lab? > Do you know what pressure you were titrated to? > Do you know if the pressure was set to the titrated pressure? > Describe your system and how it is set up: >     Manufacturer and name of blower and mask >     Where are the blower and humidifier located? >     How do you manage your hose/tube?  Is it suspended? > Are you aware of any mask leaks? > Have you checked your hose for leaks? > Have you had the blower pressure checked? > That oughta do it for now.

Yes to all your questions. I just can’t sleep with cpap. I can’t stand the mask on my face or anything up my nose or the noise. The reason for my initial post was to question whether cpap manufacturers and sleep labs are pushing this sleep apnea as an ailment to fuel a new money making area of health care. I know sleep apnea is a real aliment and people really have it but after seeing how many people are being diagnosed with it, you have to wonder if it is being pushed a little. Also the amount of people that are put on cpap that don’t use it makes you wonder if they needed it in the first place. – Hide quoted text — Show quoted text -> > I don’t know. > > The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:4027DC1A.70802@socal.rr.com>… > >>elliot gainway wrote: > >>>I went to a family function this weekend and started talking to many > >>>related and non related family members about my recent diagnosis of > >>>sleep apnea. I was stunned by how many had also been  diagnosed with > >>>sleep apnea. Most are not blood related to me so no heredity could be > >>>coming into play here. The amount at this get together would be way > >>>over the estimated aveage of people who have sleep apnea. Could the > >>>numbers be really that high and does everyone have some degree of > >>>apnea sometime in their life or is it the new fad diagnosis. It seemed > >>>like, if your are middle age or older and have few extra pounds, they > >>>are checking for and finding sleep apnea. Most of the family members I > >>>talked to don’t use their cpap because they find it uncomfortable and > >>>hard to get used to. The fact that so many had been diagnosed and > >>>prescribed cpap therapy has me very curious. > >>Well…. one of the very first questions I asked here, 3-4 years ago was, "Has > >>anyone ever had a PSG and not been diagnosed with apnea?"  Never received a > >>response.  (I was hoping someone here knew of someone.) > >>I couldn’t believe that I had it, even after having a laboratory PSG evaluated > >>by a neurologist diplomated sleep doc.  But, as I took the time to learn, I > >>began to realize that I DID. > >>I have six acquaintances (5 men, 1 woman) all, but one, of which were diagnosed > >>with sleep apnea, long before I was.  Not a one of them knows diddly sh*t about > >>sleep apnea.  And they don’t seem to be able to muster the strength (physical > >>and mental) to  learn.  They think their computers are for sending jokes only. > >>Not a one has ever read any posts here. > >>One is a retired orthopedist.  He doesn’t know a cpap from a bipap.  He just > >>knows he feels better and is compliant. > >>The woman is married to one of the men.  When I was diagnosed, they were > >>non-compliant.  So, as I learned, I told them what I had learned about enlarged > >>hearts and strokes.  They ignored everything I said. > >>Then he had a stroke.  She was quick to tell me it wasn’t from OSA, but they are > >>both very compliant now. > >>I spent 2-3 hours with another of the men, who was having all kinds of newbie > >>problems.  He is in his mid-7o’s.  He just couldn’t seem to understand.  He > >>decided he no longer had OSA and totally stopped using cpap. > >>So, that’s a personal slant on your question.  But there is also a testing and > >>diagnosis slant.  Were the people, at this get-together, properly tested and > >>diagnosed and, then, supported?  Did they all have lab polysomnograms for > >>diagnostic purposes?  Did they get a second PSG while being manually titrated? > >>Were they all tested at home? > >>Be sure and read every word of Beth’s and David’s responses.

Response:

"Tal" <goer…@hotmail.com> wrote in message

news:c07lbq$13hjhb$1@ID-148111.news.uni-berlin.de… – Hide quoted text — Show quoted text -> > I went to a family function this weekend and started talking to many > > related and non related family members about my recent diagnosis of > > sleep apnea. I was stunned by how many had also been  diagnosed with > > sleep apnea. Most are not blood related to me so no heredity could be > > coming into play here. The amount at this get together would be way > > over the estimated aveage of people who have sleep apnea. Could the > > numbers be really that high and does everyone have some degree of > > apnea sometime in their life or is it the new fad diagnosis. It seemed > > like, if your are middle age or older and have few extra pounds, they > > are checking for and finding sleep apnea. Most of the family members I > > talked to don’t use their cpap because they find it uncomfortable and > > hard to get used to. The fact that so many had been diagnosed and > > prescribed cpap therapy has me very curious. > I don’t think it’s being over diagnosed, i believe it’s still being UNDER > diagnosed…… i think lifestyle MAY play some part in the higher number of > people being diagnosed in a few ways – 1. bad diet and lack of excercise > means more of us are carrying more weight than is healthy.  2.  people are > less willing to put up with feeling like crud than they used to.  Then > here’s also the fact that more doctors are becoming aware of what sleep > apnea is etc….. this is still a relatively newly discovered disorder in > the big scheme of things. > Apnea has always been a problem……it was just more hidden in years past. > Increased ability to detect the cause of this problem has increased the > numbers diagnosed – where before, people who were feeling constantly tired > were just told to get over it, now more people are trying to find out WHY > and then how to fix it. > I wouldn’t be suprised if in the years to come – as more people are > diagnosed and then treated (of course, the treated is the hard part, as you > noted, many people don’t realise the risks and don’t bother with treatment > because it takes a little more effort than they’d like) I believe we’ll find > that there may be a reduction in the amount of heart problems etc observed > in such individuals. > There are very strict guidelines for diagnosing apnea…..it’s not a really > fuzzy line like that you see with some other highly diagnosed conditions > these days.  I guess my point is, if you’re diagnosed wtih apnea through a > sleep study, there’s no doubting you actually have it and can benefit from > treatment. > of course, this is just my rambling thoughts on the matter > — > Beth in Australia [...] > http://talhost.net/sleep

Good comments. A story: when I was a kid, it was annoying that my father never seemed to have any of the common ailments, so did not always appear to understand their effect on us – and he had more energy than any of us (sometimes hard to live with…;-). I do remember as a kid laughing with a friend who was staying overnight at my father’s very loud snoring, and at its abrupt stops/starts. In old age, I did come to appreciate his good humor and lack of complaints as he suffered stomach and colon cancer (and two-way incontinence), four heart attacks, and a four-way bypass. What got him in the end, though, was likely the heart failure (not the simple thing it sounds like if you are not familiar with it…) from the effects of sleep-apnea. In the process of dealing with a recent "heart event" (likely caused by SA) and odd neurological problems of my own, the SA that I knew existed (but which I had not taken seriously) was confirmed during a sleep-clinic stay. After "putting some things together", I now take OSA seriously, and have slept a total of only about 4-5 hours in the last six weeks without using the CPAP machine. I never felt tired as a result of OSA, but an enlarged heart, heart arrhythmia, thoughts of what would be down the line if I didn’t take care of the OSA, plus the possible effects of lack of REM and late-stage sleep keeps me on "the machine" when sleeping. I still have the neurological problems, alas, but searching for their cause has at least brought me a treatment for OSA… —  David Ruether  r…@cornell.edu  http://www.ferrario.com/ruether

Response:

On Mon, 09 Feb 2004 19:13:20 GMT, The real Norm wrote: >Well…. one of the very first questions I asked here, 3-4 years ago was, "Has >anyone ever had a PSG and not been diagnosed with apnea?"  Never received a >response.  (I was hoping someone here knew of someone.)

I had a co-worker who had a PSG which showed very mild OSA… not severe enough for CPAP. I do suspect that the prescreening questions tend to filter out a lot of people.

Response:

On Tue, 10 Feb 2004 10:13:22 +1100, Terry Collins wrote: >Their is a "paper" floating around geneaological circles that says >everyone in England is probably related to Princess Diana.

Given what I’ve run into, I suspect everyone who has ancestors in England is related to Eleanor of Castile.

Response:

Me too- For five years my psychiatrist added one anti-depressant after another and more combinations than I can think of. Only when he couldn;t find anything that affected my constant exhaustion and foggy head did he finally suggest maybe it was OSA and referred me for a sleep study. The kicker is he used to be the director of Stanford’s sleep lab! Susan – Hide quoted text — Show quoted text -christineu wrote: > I would agree with Beth. I have Central Sleep apnea and mine went undiagnosed and of course untreated for years before I was sent to a sleep doctor this past fall. I think that there are a lot more people who have sleep apnea and don’t realize it- especially women. I can’t even remember how many times I complained of being tired over the year to different doctors and their treatment of choice after checking thyroid was to prescribe an antidepressant just because I was complaining of fatigue and I’m female. > There is a push now to educate more doctors about sleep disorders with apnea probably being the most comon one. ANd with more people getting diagnosed other people realize they might have a problem so they talk to their doctors about it and end up getting diagnoised. I just wish more doctors would bother to ask about patients sleep habits- I was given sleep meds by several different doctors in the past couple of years when what I really needed was to see a sleep speacialist. > I do think the medical community needs to do more to educate people with sleep apnea about treatment and possible medical problems they may have if they don’t comply with treatment. Look how much is done when someone is diagnosed with diabetes to educate the patient and their family- patients with apnea need a similar program to increase compliance with CPAP/BiPAP therapy.

Response:

elliot gainway wrote: > First let me say that I am a person who can’t use cpap. I have given > it a 4 month try and despite several differant masks I get less sleep > with it than without it. That being said, with all the people I am > finding that are being diagnosed with it, it is starting to look like > more have it than don’t. Maybe they should start issuing cpaps to > everyone over 40. In my case, the sleep study was done only on my > back. In real life I sleep very little on my back. I sleep mostly on > my side. So was the sleep study accurate?

OSA is generallly worse on one’s back.  If you were manually titrated on your back, the pressure should be adequate to cover the lesser apneas on one’s side.   So this is not, necesarily, your problem.  But the question is….. exactly what is your problem? Did you have a PSG in a sleep lab? Did a diplomated sleep doc write a PSG summary report. Was anything other than OSA diagnosed, such as central apnea? Do you have a copy of the report? Were you manually titrated in a sleep lab? Do you know what pressure you were titrated to? Do you know if the pressure was set to the titrated pressure? Describe your system and how it is set up:     Manufacturer and name of blower and mask     Where are the blower and humidifier located?     How do you manage your hose/tube?  Is it suspended? Are you aware of any mask leaks? Have you checked your hose for leaks? Have you had the blower pressure checked? That oughta do it for now. – Hide quoted text — Show quoted text -> I don’t know. > The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:4027DC1A.70802@socal.rr.com>… >>elliot gainway wrote: >>>I went to a family function this weekend and started talking to many >>>related and non related family members about my recent diagnosis of >>>sleep apnea. I was stunned by how many had also been  diagnosed with >>>sleep apnea. Most are not blood related to me so no heredity could be >>>coming into play here. The amount at this get together would be way >>>over the estimated aveage of people who have sleep apnea. Could the >>>numbers be really that high and does everyone have some degree of >>>apnea sometime in their life or is it the new fad diagnosis. It seemed >>>like, if your are middle age or older and have few extra pounds, they >>>are checking for and finding sleep apnea. Most of the family members I >>>talked to don’t use their cpap because they find it uncomfortable and >>>hard to get used to. The fact that so many had been diagnosed and >>>prescribed cpap therapy has me very curious. >>Well…. one of the very first questions I asked here, 3-4 years ago was, "Has >>anyone ever had a PSG and not been diagnosed with apnea?"  Never received a >>response.  (I was hoping someone here knew of someone.) >>I couldn’t believe that I had it, even after having a laboratory PSG evaluated >>by a neurologist diplomated sleep doc.  But, as I took the time to learn, I >>began to realize that I DID. >>I have six acquaintances (5 men, 1 woman) all, but one, of which were diagnosed >>with sleep apnea, long before I was.  Not a one of them knows diddly sh*t about >>sleep apnea.  And they don’t seem to be able to muster the strength (physical >>and mental) to  learn.  They think their computers are for sending jokes only. >>Not a one has ever read any posts here. >>One is a retired orthopedist.  He doesn’t know a cpap from a bipap.  He just >>knows he feels better and is compliant. >>The woman is married to one of the men.  When I was diagnosed, they were >>non-compliant.  So, as I learned, I told them what I had learned about enlarged >>hearts and strokes.  They ignored everything I said. >>Then he had a stroke.  She was quick to tell me it wasn’t from OSA, but they are >>both very compliant now. >>I spent 2-3 hours with another of the men, who was having all kinds of newbie >>problems.  He is in his mid-7o’s.  He just couldn’t seem to understand.  He >>decided he no longer had OSA and totally stopped using cpap. >>So, that’s a personal slant on your question.  But there is also a testing and >>diagnosis slant.  Were the people, at this get-together, properly tested and >>diagnosed and, then, supported?  Did they all have lab polysomnograms for >>diagnostic purposes?  Did they get a second PSG while being manually titrated? >>Were they all tested at home? >>Be sure and read every word of Beth’s and David’s responses.

Response:

First let me say that I am a person who can’t use cpap. I have given it a 4 month try and despite several differant masks I get less sleep with it than without it. That being said, with all the people I am finding that are being diagnosed with it, it is starting to look like more have it than don’t. Maybe they should start issuing cpaps to everyone over 40. In my case, the sleep study was done only on my back. In real life I sleep very little on my back. I sleep mostly on my side. So was the sleep study accurate? I don’t know. The real Norm" <"The real Norm"@socal.rr.com> wrote in message <news:4027DC1A.70802@socal.rr.com>… – Hide quoted text — Show quoted text -> elliot gainway wrote: > > I went to a family function this weekend and started talking to many > > related and non related family members about my recent diagnosis of > > sleep apnea. I was stunned by how many had also been  diagnosed with > > sleep apnea. Most are not blood related to me so no heredity could be > > coming into play here. The amount at this get together would be way > > over the estimated aveage of people who have sleep apnea. Could the > > numbers be really that high and does everyone have some degree of > > apnea sometime in their life or is it the new fad diagnosis. It seemed > > like, if your are middle age or older and have few extra pounds, they > > are checking for and finding sleep apnea. Most of the family members I > > talked to don’t use their cpap because they find it uncomfortable and > > hard to get used to. The fact that so many had been diagnosed and > > prescribed cpap therapy has me very curious. > Well…. one of the very first questions I asked here, 3-4 years ago was, "Has > anyone ever had a PSG and not been diagnosed with apnea?"  Never received a > response.  (I was hoping someone here knew of someone.) > I couldn’t believe that I had it, even after having a laboratory PSG evaluated > by a neurologist diplomated sleep doc.  But, as I took the time to learn, I > began to realize that I DID. > I have six acquaintances (5 men, 1 woman) all, but one, of which were diagnosed > with sleep apnea, long before I was.  Not a one of them knows diddly sh*t about > sleep apnea.  And they don’t seem to be able to muster the strength (physical > and mental) to  learn.  They think their computers are for sending jokes only. > Not a one has ever read any posts here. > One is a retired orthopedist.  He doesn’t know a cpap from a bipap.  He just > knows he feels better and is compliant. > The woman is married to one of the men.  When I was diagnosed, they were > non-compliant.  So, as I learned, I told them what I had learned about enlarged > hearts and strokes.  They ignored everything I said. > Then he had a stroke.  She was quick to tell me it wasn’t from OSA, but they are > both very compliant now. > I spent 2-3 hours with another of the men, who was having all kinds of newbie > problems.  He is in his mid-7o’s.  He just couldn’t seem to understand.  He > decided he no longer had OSA and totally stopped using cpap. > So, that’s a personal slant on your question.  But there is also a testing and > diagnosis slant.  Were the people, at this get-together, properly tested and > diagnosed and, then, supported?  Did they all have lab polysomnograms for > diagnostic purposes?  Did they get a second PSG while being manually titrated? > Were they all tested at home? > Be sure and read every word of Beth’s and David’s responses.

Response:

elliot gainway wrote: > I went to a family function this weekend and started talking to many > related and non related family members about my recent diagnosis of > sleep apnea. I was stunned by how many had also been  diagnosed with > sleep apnea. Most are not blood related to me so no heredity could be > coming into play here. The amount at this get together would be way > over the estimated aveage of people who have sleep apnea. Could the > numbers be really that high and does everyone have some degree of > apnea sometime in their life or is it the new fad diagnosis. It seemed > like, if your are middle age or older and have few extra pounds, they > are checking for and finding sleep apnea. Most of the family members I > talked to don’t use their cpap because they find it uncomfortable and > hard to get used to. The fact that so many had been diagnosed and > prescribed cpap therapy has me very curious.

Well…. one of the very first questions I asked here, 3-4 years ago was, "Has anyone ever had a PSG and not been diagnosed with apnea?"  Never received a response.  (I was hoping someone here knew of someone.) I couldn’t believe that I had it, even after having a laboratory PSG evaluated by a neurologist diplomated sleep doc.  But, as I took the time to learn, I began to realize that I DID. I have six acquaintances (5 men, 1 woman) all, but one, of which were diagnosed with sleep apnea, long before I was.  Not a one of them knows diddly sh*t about sleep apnea.  And they don’t seem to be able to muster the strength (physical and mental) to  learn.  They think their computers are for sending jokes only. Not a one has ever read any posts here. One is a retired orthopedist.  He doesn’t know a cpap from a bipap.  He just knows he feels better and is compliant. The woman is married to one of the men.  When I was diagnosed, they were non-compliant.  So, as I learned, I told them what I had learned about enlarged hearts and strokes.  They ignored everything I said. Then he had a stroke.  She was quick to tell me it wasn’t from OSA, but they are both very compliant now. I spent 2-3 hours with another of the men, who was having all kinds of newbie problems.  He is in his mid-7o’s.  He just couldn’t seem to understand.  He decided he no longer had OSA and totally stopped using cpap. So, that’s a personal slant on your question.  But there is also a testing and diagnosis slant.  Were the people, at this get-together, properly tested and diagnosed and, then, supported?  Did they all have lab polysomnograms for diagnostic purposes?  Did they get a second PSG while being manually titrated? Were they all tested at home? Be sure and read every word of Beth’s and David’s responses.

Response:

elliot gainway wrote: > I went to a family function this weekend and started talking to many > related and non related family members about my recent diagnosis of > sleep apnea. I was stunned by how many had also been  diagnosed with > sleep apnea. Most are not blood related to me so no heredity could be > coming into play here.

You might have to chase these families way back to be absolutely sure. Sleep aponea can have genetic factors, so it source could have been in a Middle Ages village somewhere and it could have arisen independently in different places. Their is a "paper" floating around geneaological circles that says everyone in England is probably related to Princess Diana. Probably shows up now because work is becoming more and more sedentary. Look at the very small percentage now employed in agriculture and the small and decreasing percentage now employed in manufacturing. So people can now spend almost 100% of their life without doing any strenuous work. In fact strenuous work is frowned upon and shunned.

Response:

I went to a family function this weekend and started talking to many related and non related family members about my recent diagnosis of sleep apnea. I was stunned by how many had also been  diagnosed with sleep apnea. Most are not blood related to me so no heredity could be coming into play here. The amount at this get together would be way over the estimated aveage of people who have sleep apnea. Could the numbers be really that high and does everyone have some degree of apnea sometime in their life or is it the new fad diagnosis. It seemed like, if your are middle age or older and have few extra pounds, they are checking for and finding sleep apnea. Most of the family members I talked to don’t use their cpap because they find it uncomfortable and hard to get used to. The fact that so many had been diagnosed and prescribed cpap therapy has me very curious.

Response:

> I went to a family function this weekend and started talking to many > related and non related family members about my recent diagnosis of > sleep apnea. I was stunned by how many had also been  diagnosed with > sleep apnea. Most are not blood related to me so no heredity could be > coming into play here. The amount at this get together would be way > over the estimated aveage of people who have sleep apnea. Could the > numbers be really that high and does everyone have some degree of > apnea sometime in their life or is it the new fad diagnosis. It seemed > like, if your are middle age or older and have few extra pounds, they > are checking for and finding sleep apnea. Most of the family members I > talked to don’t use their cpap because they find it uncomfortable and > hard to get used to. The fact that so many had been diagnosed and > prescribed cpap therapy has me very curious.

I don’t think it’s being over diagnosed, i believe it’s still being UNDER diagnosed…… i think lifestyle MAY play some part in the higher number of people being diagnosed in a few ways – 1. bad diet and lack of excercise means more of us are carrying more weight than is healthy.  2.  people are less willing to put up with feeling like crud than they used to.  Then here’s also the fact that more doctors are becoming aware of what sleep apnea is etc….. this is still a relatively newly discovered disorder in the big scheme of things. Apnea has always been a problem……it was just more hidden in years past. Increased ability to detect the cause of this problem has increased the numbers diagnosed – where before, people who were feeling constantly tired were just told to get over it, now more people are trying to find out WHY and then how to fix it. I wouldn’t be suprised if in the years to come – as more people are diagnosed and then treated (of course, the treated is the hard part, as you noted, many people don’t realise the risks and don’t bother with treatment because it takes a little more effort than they’d like) I believe we’ll find that there may be a reduction in the amount of heart problems etc observed in such individuals. There are very strict guidelines for diagnosing apnea…..it’s not a really fuzzy line like that you see with some other highly diagnosed conditions these days.  I guess my point is, if you’re diagnosed wtih apnea through a sleep study, there’s no doubting you actually have it and can benefit from treatment. of course, this is just my rambling thoughts on the matter — Beth in Australia (I am not a medical professional and anything stated in my posts is my opinion only unless specified otherwise) =================== FAQ for alt.support.sleep-disorder can be found here http://talhost.net/sleep Newsgroup Archives http://talhost.net/sleep/archives.htm this site is a work in progress – feel free to submit info/articles

Response:

RemStar Auto Smart Card – What Type of Media?

Question:

On Fri, 3 Oct 2003 22:50:19 -0400, "Jim McGowan" <jcmcgowanATcomcastDOTnet> wrote: >I’ve been reading a lot on the apaps, Norm, including NIH studies, and I’ve >yet to come across anything resembling a statement like that.  Is that an >opinion?  Or does he claim it as empirical fact?

There is plenty of research based evidence to demonstrate improved compliance with the use of aPAP as opposed to CPAP and nothing to suggest anything deleterious. >Also, please remember that most xPAP scrips are written for people whose >insurance companies won’t supply aPAPs unless proven to be medically >necessary.  Hence, most scrips are for CPAPs.  HMO economics!

The price delta between the two is getting smaller and smaller.  Here in the UK it’s down to 15% or so.   I suspect that before long aPAPs will become the norm since they can typically be set to fixed pressure anyway, and economies of scale will make it more sensible for manufacturers to produce larger volumes of a smaller range of machine types. – Hide quoted text — Show quoted text ->> He went on to say that he cautions all of his patients to not experiement >with >> changing pressures, particularly these two people, who have had so many >> problems, leading to use of apap.  So, obviously, I think, their problems >were >> not financial ones, but medical ones. >First, that’s not obvious at all.  Presumption on your part. >Second, I don’t experiment with changing pressures.  And I don’t intend to >with the aPAP.  If worst comes to worst, and the software indicates that my >aPAP is varying outside of acceptable limits, I can set is to work as a >CPAP, but still get the benefit of  reviewing the software and seeing if I >am having events at that pressure, or if my mask is leaking.

Exactly.   If I look at my own data, on some nights there are a small number of individual central events which I am told are perfectly normal for anybody (OSA or not).    These do not correspond to occasions where the machine has ramped up the pressure to handle obstructive periods.   Mask leak, as you say, is also reported. I did find that it was necessary to adjust the minimum pressure up from 4 to 6cmH2O.    This was necessary to provide sufficient flow while going to sleep and represented anyway the minimum requirement during the night. >My sleep doc is also a board-certified and "diplomated" neurologist who has >specialized in sleep disorders his entire career.  When I mentioned the >dangers of central apnea to him he agreed that it is a concern when pressure >is to high. But he qualified that statement by saying CPAPs set to high over >an extended period are more of a concern.  

Precisely.   People’s needs do change over long periods and from night to night. >AutoPAPs would only spike for >very short intervals and are not a concern to him.

On mine (Autoset Spirit) the pressure is wound up quickly where required and is sloped off over about 20 minutes if there is no further apnoea or hypopnoea.   If there is, then the pressure either increases again or tails off over a longer period. >  He said he would be more >concerned if the AutoPAP dropped too low to stop apneas without the patient >knowing.  When I mentioned that the software would point this out and >remedial action could be taken, he agreed. He said that no one ever really >looks at the data on the Smart Cards, though.  I told him that he knew I >would, and he agreed (He knows me!). I also asked if he directs patients >with machines that have SmartCards to bring them in to him on any regular >basis he said no.  Duh.

One of the aspects of this is that it is necessary to understnad statistical methods and look at the data over a period of time. There are variations for given patients from night to night.   >I tend to agree that this is not the proper way to confirm diagnosis of a >sleep disorder, but I suspect that this is economically driven by insurance >companies.  As far as malpractice, this "diplomated" neurologist has a law >degree, too?  Probably, Norm, that he was just expressing his disdain for >that method of diagnosis.

Possibly, although the technology is improving all the time.    The risk is of false negative diagnosis, but there is no reason in principle why additional instrumentation could not be added to such portable equipment to augment finger oximetry. >It’s in my original post, Norm.  the founder of the sleep disorder center I >go to, my neurologist’s "boss" so to speak, simply doesn’t like them.  When >I pressed for more detail, my doc told me they "tried a few" a few years ago >and the top doc didn’t like the pressure fluctuations and sent them back to >the manufacturer.  

"Didn’t like".    That’s really scientific isn’t it?   >Hasn’t considered them since.  Of course I know that he >doesn’t like or use cell phones, and can’t figure out why all folks don’t >"retire" at sundown and rise at dawn, like he did growing up on his family >farm.  Norm, he’s well past normal retirement age and is very old-fashioned >and conservative in his ways.

… and therefore should no longer be practicing (he should get it right ) >And…..of course, while this wasn’t >mentioned, if AutoPAPs with close software monitoring can "auto-titrate" >patients, he may not be able to keep his ten bed facility at capacity!

Now we have the real reason. >Norm, He is a diplomated sleep doc also.  He apparently is not free to offer >me that help as long as the center is run by its founder, who just doesn’t >want to use AutoPAPs.  And treatment of sleep apnea itself is a very >complicated issue.  Yet you use that technology, not knowing at all if your >pressure is the optimal pressure for stopping your events without supplying >too much pressure.  Most people don’t have apneic events all night long that >are stopped by the same exact pressure.  Your pressure is set so that it’s >high enough to overcome all events, but that means that it is almost certain >to be more pressure than you need at times.  Like you said, it’s >complicated!

Exactly.   Not to mention the effect over a period of time. >Very presumptuous and pompous response, Norm.  And your advice is accurate >and beneficial for me?  Well of course, if you say so!  I’ve read your posts >in here for close to four years, Norm, and I’ve seen your views turn around >180 degress at times, as you learned or studied something more.  Makes you >wrong about as much as you’re right. Of course that goes with all of us. >Does that mean that you "don’t know much about…sleep disorders, OSA, or >apap, and.." have "..no concern" about your reputation and/or liability"? >Would that be a generalization?  All or nothing statement?

Precisely.    If you look at any of the scientific research in this area it is interesting to note that researchers who use statistically significant numbers of patients present their results with the correct statistical qualifiers of their results and draw conclusions from those if it is possible to do so.     Yet those (often in sleep clinics) who present data using small samples (I’ve seen as few as 5) present there "findings" with much more apparent authority (aka dogma).    Of course this is totally bogus and is pseudo-science attempting to support a view already held. >I have all the money I need to be properly treated.  However I demand a >significant input into the treatment I receive.  And I never gamble.  

Likewise.    I have had no difficulty in asking for and getting the data and input to treatment that a require.    I am fortunate in having a clinician who is not living in the dark ages.    Sadly there are a majority that still are. .andy To email, substitute .nospam with .gl

Response:

Jim McGowan <jcmcgowanATcomcastDOTnet> wrote: > > He also said he considered it to be medical malpractice for Kaiser to > treat > > their patients with sleep-disorder symptoms, by sending them home with an > > autopap and finger oximeter.  IMHO, this is particularly so when they have > labs > > at some of their hospitals, but have several month waiting lists. > I tend to agree that this is not the proper way to confirm diagnosis of a > sleep disorder, but I suspect that this is economically driven by insurance > companies.  As far as malpractice, this "diplomated" neurologist has a law > degree, too?  Probably, Norm, that he was just expressing his disdain for > that method of diagnosis.

My friend who goes to Kaiser was sent home with a polysomnograph recorder and sensors. She ’slept’ with it on overnight. This was taken back to Kaiser to have the data downloaded and read to diagnose her apnea. The autopap was sent home with her overnight only after diagnosis to determine the pressure required for CPAP. I belonged to another HMO and had my testing done the same way by an indipendent lab. The lab is booked solid for months for this type of testing. I got in a bit sooner by putting myself on the list to be called if there was a cancellation. This is not the ideal way to do it, but for many is more than adaquate. If there are problems, a more thorough test overnight in a lab can be arranged. Perfect is the enemy of good enough. I would rather have this procedure than have a much longer wait to get a ‘perfect’ test done. Also, given the limited capacity of lab beds, how many would go untested and untreated for how long? Ross Bernheim

Response:

Hi Norm!  Haven’t been here in a while, but I see you’re still very active here.  Some responses/explanations to your concerns inserted below: "NormC" <no…@socal.rr.com> rambled along in message news:3F7DF44D.3080101@socal.rr.com… [snipped where appropriate] > Earlier in the week, my wife and I had a chance to talk with him for 50 minutes. > He’s been diplomated for ~13 years and has been with Pacific Sleep Medicine all > that time. > He says that apaps do not work for most people, because the brain does not > expect changing conditions.  The brain works better without such changes. I > know this leaves a lot of questions, but it’s a starting place, keeping in mind > that he is a neurologist.

I’ve been reading a lot on the apaps, Norm, including NIH studies, and I’ve yet to come across anything resembling a statement like that.  Is that an opinion?  Or does he claim it as empirical fact? > It is interesting to note that two, and only two, of his patients use apaps. I > asked if he had written the script for them.  He said yes. I asked him why, and > he reponded, "Because they seem to work with those two people."

Also, please remember that most xPAP scrips are written for people whose insurance companies won’t supply aPAPs unless proven to be medically necessary.  Hence, most scrips are for CPAPs.  HMO economics! > He went on to say that he cautions all of his patients to not experiement with > changing pressures, particularly these two people, who have had so many > problems, leading to use of apap.  So, obviously, I think, their problems were > not financial ones, but medical ones.

First, that’s not obvious at all.  Presumption on your part. Second, I don’t experiment with changing pressures.  And I don’t intend to with the aPAP.  If worst comes to worst, and the software indicates that my aPAP is varying outside of acceptable limits, I can set is to work as a CPAP, but still get the benefit of  reviewing the software and seeing if I am having events at that pressure, or if my mask is leaking. > One of the problems that could occur are central apenas.  I might mention that > he has never used the term ‘central apnea’, even when I tried an autopap and > finger oximeter to try to dianose my continuing problems, and my O2 dropped to > low levels, while my pressure remained at the laboratory, manually titrated > level.  Instead he uses the term "neurological sleep disorder". > When I went on to talk about this subject (central apnea and neurological sleep > disorder), he started using the term "intermittent breathing".  I googled this > term and found more than I wanted to read about it.

My sleep doc is also a board-certified and "diplomated" neurologist who has specialized in sleep disorders his entire career.  When I mentioned the dangers of central apnea to him he agreed that it is a concern when pressure is to high. But he qualified that statement by saying CPAPs set to high over an extended period are more of a concern.  AutoPAPs would only spike for very short intervals and are not a concern to him.  He said he would be more concerned if the AutoPAP dropped too low to stop apneas without the patient knowing.  When I mentioned that the software would point this out and remedial action could be taken, he agreed. He said that no one ever really looks at the data on the Smart Cards, though.  I told him that he knew I would, and he agreed (He knows me!). I also asked if he directs patients with machines that have SmartCards to bring them in to him on any regular basis he said no.  Duh. Of course if you read otherwise in Google, well, then all his education is out the window! > He also said he considered it to be medical malpractice for Kaiser to treat > their patients with sleep-disorder symptoms, by sending them home with an > autopap and finger oximeter.  IMHO, this is particularly so when they have labs > at some of their hospitals, but have several month waiting lists.

I tend to agree that this is not the proper way to confirm diagnosis of a sleep disorder, but I suspect that this is economically driven by insurance companies.  As far as malpractice, this "diplomated" neurologist has a law degree, too?  Probably, Norm, that he was just expressing his disdain for that method of diagnosis. > > They’d much > > prefer I just keep shelling out for retitrations whenever they require > > (which is averaging once yearly!). > I don’t understand this.  Why once a year?  Since you are paying for it, why do > you do it once a year?  I could understand getting a PSG every year, but not > another titration, unless there was some specific reason to do so. > I have had a number of problems that have been worked out without returning to > the lab, for three years.  I just another PSG a couple weeks ago.

Not actually once a year.  Perhaps I didn’t state that as clearly as I will now.  I’ve had a total of five polysomnograms in the four years since my diagnosis: the original test, the follow-up titration, and then three titrations since.  Reasons? The first two are obvious: confirm OSA, then find the optimal pressure setting to control it.  Twice more because I was still symptomatic even on the pressure determined by titration. Once because of three back surgeries in three weeks (First one planned; next two because of an "oops" during the first one), I lost 28 pounds and didn’t require as much pressure.  I’ve averaged one a year, but not one every year. > Have you ever asked them why they don’t want to prescribe autopaps?

It’s in my original post, Norm.  the founder of the sleep disorder center I go to, my neurologist’s "boss" so to speak, simply doesn’t like them.  When I pressed for more detail, my doc told me they "tried a few" a few years ago and the top doc didn’t like the pressure fluctuations and sent them back to the manufacturer.  Hasn’t considered them since.  Of course I know that he doesn’t like or use cell phones, and can’t figure out why all folks don’t "retire" at sundown and rise at dawn, like he did growing up on his family farm.  Norm, he’s well past normal retirement age and is very old-fashioned and conservative in his ways.  And…..of course, while this wasn’t mentioned, if AutoPAPs with close software monitoring can "auto-titrate" patients, he may not be able to keep his ten bed facility at capacity! > > Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the > > auto-adjust feature turns out to be not as reliable as they’d like, I could > > avoid the continual re-tites by setting a tight range right around where my > > CPAP is set and then monitor the software for events, leaks, etc. > As long as you understand the potential hazards of doing this, do it.  But I > would be concerned, about not having a diplomated sleep doc helping you to see > if you might be one of the few that apap helps.  It’s a very complicated issue, >   The medical community knows less about the brain than any other organ of

the body. Norm, He is a diplomated sleep doc also.  He apparently is not free to offer me that help as long as the center is run by its founder, who just doesn’t want to use AutoPAPs.  And treatment of sleep apnea itself is a very complicated issue.  Yet you use that technology, not knowing at all if your pressure is the optimal pressure for stopping your events without supplying too much pressure.  Most people don’t have apneic events all night long that are stopped by the same exact pressure.  Your pressure is set so that it’s high enough to overcome all events, but that means that it is almost certain to be more pressure than you need at times.  Like you said, it’s complicated! > > I’ll have to find a way to get an Rx elsewhere, I guess. > The best way to do that is find a doctor who doesn’t know much about the brain, > sleep-disorders, OSA, or apap, and has no concern about his reputation and/or > liability.

Very presumptuous and pompous response, Norm.  And your advice is accurate and beneficial for me?  Well of course, if you say so!  I’ve read your posts in here for close to four years, Norm, and I’ve seen your views turn around 180 degress at times, as you learned or studied something more.  Makes you wrong about as much as you’re right. Of course that goes with all of us. Does that mean that you "don’t know much about…sleep disorders, OSA, or apap, and.." have "..no concern" about your reputation and/or liability"? Would that be a generalization?  All or nothing statement? > The one good thing about doing this is that if you have any severe problems, you > can sue him for malpractice.

Ahh, sarcasm….gets you by all the time Norm, if you don’t happen to agree. One of the things I like about you! > Bottom line:  If you really don’t have the money to be properly treated, do it. >   If you want to save money to spend elsewhere, then you might want to consider > whether it’s worth the gamble.

I have all the money I need to be properly treated.  However I demand a significant input into the treatment I receive.  And I never gamble.  Can you say the same, Norm?  Truthfully?  :-) Best regards, Jim McGowan

Response:

- Hide quoted text — Show quoted text -In article <3F7DF44D.3080…@socal.rr.com>, NormC wrote: > Jim McGowan wrote: >> Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the >> auto-adjust feature turns out to be not as reliable as they’d like, I could >> avoid the continual re-tites by setting a tight range right around where my >> CPAP is set and then monitor the software for events, leaks, etc. > As long as you understand the potential hazards of doing this, do it.  But I > would be concerned, about not having a diplomated sleep doc helping you to see > if you might be one of the few that apap helps.  It’s a very complicated issue, >   The medical community knows less about the brain than any other organ of the body. >> I’ll have to find a way to get an Rx elsewhere, I guess. > The best way to do that is find a doctor who doesn’t know much about the brain, > sleep-disorders, OSA, or apap, and has no concern about his reputation and/or > liability. > The one good thing about doing this is that if you have any severe problems, you > can sue him for malpractice.

Prescribing an autopap is "malpractice"?  That’s a rather extreme view. I wouldn’t be so quick to assume the general medical community is wrong about prescribing autopaps.

Response:

- Hide quoted text — Show quoted text -On Fri, 03 Oct 2003 22:11:55 GMT, NormC <no…@socal.rr.com> wrote: >Jim McGowan wrote: >> Thanks for the info, Thumper and Charles! >> I did find out that the Smart Card is basically a SmartMedia card, but with >> a proprietary algorhythm embedded which makes it readable only by the >> Respironics reader. >> Just thought I’d try to save a little $ if I could. >> As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the >> founder of the sleep center here "just doesn’t like them". >Ditto for my neurologist diplomated sleep doc.  Don’t know about the rest of his >organization http://www.pacificsleepmedicine.com/ >Earlier in the week, my wife and I had a chance to talk with him for 50 minutes. >  One of the things we talked about was apaps and their use.  I didn’t take >notes, but I can remember a couple things he said, that may be of interest. >This is in addition to other things he’s told me and that I’ve posted in the past. >He’s been diplomated for ~13 years and has been with Pacific Sleep Medicine all >that time.  He teaches sleep medicine at UCLA.  One of his students was the >doctor who is the head of the London, England hospital containing a 3-bed sleep >clinic. >He says that apaps do not work for most people, because the brain does not >expect changing conditions.

Unfortunately he is either wrong or being misleading, because a) they do and b) I could reference at least one eminent neurologist and another equally eminent pulmonologist who would say the opposite. > The brain works better without such changes.  I >know this leaves a lot of questions, but it’s a starting place, keeping in mind >that he is a neurologist. >It is interesting to note that two, and only two, of his patients use apaps. I >asked if he had written the script for them.  He said yes. I asked him why, and >he reponded, "Because they seem to work with those two people."

That’s a somewhat thin explanation. >He went on to say that he cautions all of his patients to not experiement with >changing pressures, particularly these two people, who have had so many >problems, leading to use of apap.  So, obviously, I think, their problems were >not financial ones, but medical ones.

Hmmmm….. >One of the problems that could occur are central apenas.

Possibly in the case of excessive pressure.   However, for most people there will be sleeping positions where the pressure requirement is less. There are also diurnal pressure change requirements as well as those resulting from weight change in some patients.   Logically, a fixed pressure machine is going to be producing excessive pressure for some of the time, so if that it considered to be acceptable treatment without central apnoea risk, it does not make sense to suggest that an automatically adjusting machine which adjusts to meet pressure requirements will be more likely to induce central apnoeas. I have never found any papers supporting this from real research with a statistically significant number of patients in blind trials; only hearsay from those with a commercial clinical interest. They probably went to the same medical school as those still advocating ritual genital mutilation of infant boys and attempt to justify a position based on hearsay and common practice rather than sound scientific evidence. > I might mention that >he has never used the term ‘central apnea’, even when I tried an autopap and >finger oximeter to try to dianose my continuing problems, and my O2 dropped to >low levels, while my pressure remained at the laboratory, manually titrated >level.  Instead he uses the term "neurological sleep disorder". >When I went on to talk about this subject (central apnea and neurological sleep >disorder), he started using the term "intermittent breathing".  I googled this >term and found more than I wanted to read about it. >He also said he considered it to be medical malpractice for Kaiser to treat >their patients with sleep-disorder symptoms, by sending them home with an >autopap and finger oximeter.

Possibly, and of course there is no commercial interest either way? > IMHO, this is particularly so when they have labs >at some of their hospitals, but have several month waiting lists. >> They’d much >> prefer I just keep shelling out for retitrations whenever they require >> (which is averaging once yearly!). >I don’t understand this.  Why once a year?  Since you are paying for it, why do >you do it once a year?  I could understand getting a PSG every year, but not >another titration, unless there was some specific reason to do so.

Weight changes and numerous other factors, not to mention a nice revenue stream for the clinic……. >I have had a number of problems that have been worked out without returning to >the lab, for three years.  I just another PSG a couple weeks ago. >Have you ever asked them why they don’t want to prescribe autopaps?

I think that that is self evident.   Repeat visits to retitrate patients and adjust a fixed machine aids profitability of clinics. >> Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the >> auto-adjust feature turns out to be not as reliable as they’d like, I could >> avoid the continual re-tites by setting a tight range right around where my >> CPAP is set and then monitor the software for events, leaks, etc. >As long as you understand the potential hazards of doing this, do it.  But I >would be concerned, about not having a diplomated sleep doc helping you to see >if you might be one of the few that apap helps.

This appears to be one area where your clinician is behind the rest of the world.  There is plenty of research and government guideline supporting APAP use… http://www.guideline.gov/summary/summary.aspx?doc_id=3181 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… http://ajrccm.atsjournals.org/cgi/content/short/200201-022OCv1 >  It’s a very complicated issue, >  The medical community knows less about the brain than any other organ of the body. >> I’ll have to find a way to get an Rx elsewhere, I guess. >The best way to do that is find a doctor who doesn’t know much about the brain, >sleep-disorders, OSA, or apap, and has no concern about his reputation and/or >liability. >The one good thing about doing this is that if you have any severe problems, you >can sue him for malpractice.

Great idea.  It never ceases to amaze me how in most U.S. cities the largest letter section in Yellow Pages is ‘A’ for attorney. >Bottom line:  If you really don’t have the money to be properly treated, do it. >  If you want to save money to spend elsewhere, then you might want to consider >whether it’s worth the gamble.

Probably less of a gamble than getting involved with medical practice that is not keeping up with current trends….. >HTH

.andy To email, substitute .nospam with .gl

Response:

- Hide quoted text — Show quoted text -In article <Np2cnRaE0LYdP-aiXTW…@comcast.com>, Jim McGowan wrote: > As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the > founder of the sleep center here "just doesn’t like them".  They’d much > prefer I just keep shelling out for retitrations whenever they require > (which is averaging once yearly!). > Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the > auto-adjust feature turns out to be not as reliable as they’d like, I could > avoid the continual re-tites by setting a tight range right around where my > CPAP is set and then monitor the software for events, leaks, etc. > I’ll have to find a way to get an Rx elsewhere, I guess. > Thanks again, > Jim McGowan

I got an autopap prescription from my primary doctor after my sleep doc was stubborn about it.  I asked my primary doctor for one when I was seeing him about something else.  He already had copies of my titration report.

Response:

Jim McGowan wrote: > Thanks for the info, Thumper and Charles! > I did find out that the Smart Card is basically a SmartMedia card, but with > a proprietary algorhythm embedded which makes it readable only by the > Respironics reader. > Just thought I’d try to save a little $ if I could. > As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the > founder of the sleep center here "just doesn’t like them".

Ditto for my neurologist diplomated sleep doc.  Don’t know about the rest of his organization http://www.pacificsleepmedicine.com/ Earlier in the week, my wife and I had a chance to talk with him for 50 minutes.   One of the things we talked about was apaps and their use.  I didn’t take notes, but I can remember a couple things he said, that may be of interest. This is in addition to other things he’s told me and that I’ve posted in the past. He’s been diplomated for ~13 years and has been with Pacific Sleep Medicine all that time.  He teaches sleep medicine at UCLA.  One of his students was the doctor who is the head of the London, England hospital containing a 3-bed sleep clinic. He says that apaps do not work for most people, because the brain does not expect changing conditions.  The brain works better without such changes.  I know this leaves a lot of questions, but it’s a starting place, keeping in mind that he is a neurologist. It is interesting to note that two, and only two, of his patients use apaps. I asked if he had written the script for them.  He said yes. I asked him why, and he reponded, "Because they seem to work with those two people." He went on to say that he cautions all of his patients to not experiement with changing pressures, particularly these two people, who have had so many problems, leading to use of apap.  So, obviously, I think, their problems were not financial ones, but medical ones. One of the problems that could occur are central apenas.  I might mention that he has never used the term ‘central apnea’, even when I tried an autopap and finger oximeter to try to dianose my continuing problems, and my O2 dropped to low levels, while my pressure remained at the laboratory, manually titrated level.  Instead he uses the term "neurological sleep disorder". When I went on to talk about this subject (central apnea and neurological sleep disorder), he started using the term "intermittent breathing".  I googled this term and found more than I wanted to read about it. He also said he considered it to be medical malpractice for Kaiser to treat their patients with sleep-disorder symptoms, by sending them home with an autopap and finger oximeter.  IMHO, this is particularly so when they have labs at some of their hospitals, but have several month waiting lists. > They’d much > prefer I just keep shelling out for retitrations whenever they require > (which is averaging once yearly!).

I don’t understand this.  Why once a year?  Since you are paying for it, why do you do it once a year?  I could understand getting a PSG every year, but not another titration, unless there was some specific reason to do so. I have had a number of problems that have been worked out without returning to the lab, for three years.  I just another PSG a couple weeks ago. Have you ever asked them why they don’t want to prescribe autopaps? > Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the > auto-adjust feature turns out to be not as reliable as they’d like, I could > avoid the continual re-tites by setting a tight range right around where my > CPAP is set and then monitor the software for events, leaks, etc.

As long as you understand the potential hazards of doing this, do it.  But I would be concerned, about not having a diplomated sleep doc helping you to see if you might be one of the few that apap helps.  It’s a very complicated issue,   The medical community knows less about the brain than any other organ of the body. > I’ll have to find a way to get an Rx elsewhere, I guess.

The best way to do that is find a doctor who doesn’t know much about the brain, sleep-disorders, OSA, or apap, and has no concern about his reputation and/or liability. The one good thing about doing this is that if you have any severe problems, you can sue him for malpractice. Bottom line:  If you really don’t have the money to be properly treated, do it.   If you want to save money to spend elsewhere, then you might want to consider whether it’s worth the gamble. HTH – Hide quoted text — Show quoted text -> Thanks again, > Jim McGowan > "Charles Perrin" <c.l.perrin…@att.net> wrote in message > news:62uhnv0iqsbkftf5l6iubl2fe0nfbo3jdn@4ax.com… >>On 29 Sep 2003 07:52:16 -0700, Jim McGowan wrote: >>>I’m about to buy a RemStar Auto and the software. >>>Does anyone here know if: >>>1) The Smart Card is a SmartMedia card? >>After looking at a picture of the RemStar Smart Card, it’s exactly >>what they say: A Smart Card (ISO 7816 compliant). >>SmartMedia has a LOT more pins on it than a Smart Card. Smart Cards >>use the familiar credit card form factor. >>Other examples of Smart Cards that are out there are American Express >>Blue and Target Visa. >>>2) It’s readable by a standard SmartMedia reader? >>The real question is: "Is it readable by an Amex Blue or a Target Visa >>reader?" >>You can get those free if you sign up for the credit card, which >>undoubtedly beats Respironics’ prices. >>– >>Offshore a CEO: buy an ADR!

Response:

On 29 Sep 2003 07:52:16 -0700, Jim McGowan wrote: >I’m about to buy a RemStar Auto and the software. >Does anyone here know if: >1) The Smart Card is a SmartMedia card?

After looking at a picture of the RemStar Smart Card, it’s exactly what they say: A Smart Card (ISO 7816 compliant). SmartMedia has a LOT more pins on it than a Smart Card. Smart Cards use the familiar credit card form factor. Other examples of Smart Cards that are out there are American Express Blue and Target Visa. >2) It’s readable by a standard SmartMedia reader?

The real question is: "Is it readable by an Amex Blue or a Target Visa reader?" You can get those free if you sign up for the credit card, which undoubtedly beats Respironics’ prices. — Offshore a CEO: buy an ADR!

Response:

Thanks for the info, Thumper and Charles! I did find out that the Smart Card is basically a SmartMedia card, but with a proprietary algorhythm embedded which makes it readable only by the Respironics reader. Just thought I’d try to save a little $ if I could. As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the founder of the sleep center here "just doesn’t like them".  They’d much prefer I just keep shelling out for retitrations whenever they require (which is averaging once yearly!). Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the auto-adjust feature turns out to be not as reliable as they’d like, I could avoid the continual re-tites by setting a tight range right around where my CPAP is set and then monitor the software for events, leaks, etc. I’ll have to find a way to get an Rx elsewhere, I guess. Thanks again, Jim McGowan "Charles Perrin" <c.l.perrin…@att.net> wrote in message

news:62uhnv0iqsbkftf5l6iubl2fe0nfbo3jdn@4ax.com… – Hide quoted text — Show quoted text -> On 29 Sep 2003 07:52:16 -0700, Jim McGowan wrote: > >I’m about to buy a RemStar Auto and the software. > >Does anyone here know if: > >1) The Smart Card is a SmartMedia card? > After looking at a picture of the RemStar Smart Card, it’s exactly > what they say: A Smart Card (ISO 7816 compliant). > SmartMedia has a LOT more pins on it than a Smart Card. Smart Cards > use the familiar credit card form factor. > Other examples of Smart Cards that are out there are American Express > Blue and Target Visa. > >2) It’s readable by a standard SmartMedia reader? > The real question is: "Is it readable by an Amex Blue or a Target Visa > reader?" > You can get those free if you sign up for the credit card, which > undoubtedly beats Respironics’ prices. > — > Offshore a CEO: buy an ADR!

Response:

On Wed, 1 Oct 2003 23:58:47 -0400, "Jim McGowan" <jcmcgowanATcomcastDOTnet> wrote: >Thanks for the info, Thumper and Charles! >I did find out that the Smart Card is basically a SmartMedia card, but with >a proprietary algorhythm embedded which makes it readable only by the >Respironics reader. >Just thought I’d try to save a little $ if I could. >As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the >founder of the sleep center here "just doesn’t like them".  They’d much >prefer I just keep shelling out for retitrations whenever they require >(which is averaging once yearly!).

I bet they would.    This really is a con.   According to my consultant, there are people for whom regular manual titration and fixed pressure equipment is indicated, but for the vast majority, automatic equipment is very effective.  He also indicated that the sleep study results followed by a few days aPAP treatment are able to determine which patients require treatment each way. >Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the >auto-adjust feature turns out to be not as reliable as they’d like, I could >avoid the continual re-tites by setting a tight range right around where my >CPAP is set and then monitor the software for events, leaks, etc.

From the machine data I find that I need a maximum pressure of 12-13 cmH2O, although that is for short term peaks which might happen 3-4 times per night. The median is normally around 7-8 and 95th percentile 10-11.    The minimum is set to 6. However, these figures do vary quite a bit from night to night, and seem to be influenced by sleeping position among other factors. It is possible to set the machine (Resmed Spirit) to cPAP mode as well, but considering the variations in required pressure, this would not make sense. >I’ll have to find a way to get an Rx elsewhere, I guess. >Thanks again, >Jim McGowan

.andy To email, substitute .nospam with .gl

Response:

Thanks for the info, Andy.  I think I’m entitled to make the decision on aPAP.  It’s not like he’s restricted by insurance coverage rules since I’m buying.  I already know from my previous titrations that I have more and varying length events in different positions.  His response is to always try to go to sleep on my right side! And Carl, that’s a really great idea.  I think I’ll ask my primary doc if he’ll write me a scrip. Thanks much, Jim McGowan "Andy Hall" <an…@hall.nospam> wrote in message

news:cginnvk7ip2kh6hcjvvh2nkbo0felu63sv@4ax.com… – Hide quoted text — Show quoted text -> On Wed, 1 Oct 2003 23:58:47 -0400, "Jim McGowan" > <jcmcgowanATcomcastDOTnet> wrote: > >Thanks for the info, Thumper and Charles! > >I did find out that the Smart Card is basically a SmartMedia card, but with > >a proprietary algorhythm embedded which makes it readable only by the > >Respironics reader. > >Just thought I’d try to save a little $ if I could. > >As it turns out, my sleep doc doesn’t want to prescribe the autoPAP – the > >founder of the sleep center here "just doesn’t like them".  They’d much > >prefer I just keep shelling out for retitrations whenever they require > >(which is averaging once yearly!). > I bet they would.    This really is a con.   According to my > consultant, there are people for whom regular manual titration and > fixed pressure equipment is indicated, but for the vast majority, > automatic equipment is very effective.  He also indicated that the > sleep study results followed by a few days aPAP treatment are able to > determine which patients require treatment each way. > >Since I’m paying on my own, I’d much rather use the autoPAP.  Even if the > >auto-adjust feature turns out to be not as reliable as they’d like, I could > >avoid the continual re-tites by setting a tight range right around where my > >CPAP is set and then monitor the software for events, leaks, etc. > From the machine data I find that I need a maximum pressure of 12-13 > cmH2O, although that is for short term peaks which might happen 3-4 > times per night. The median is normally around 7-8 and 95th percentile > 10-11.    The minimum is set to 6. > However, these figures do vary quite a bit from night to night, and > seem to be influenced by sleeping position among other factors. > It is possible to set the machine (Resmed Spirit) to cPAP mode as > well, but considering the variations in required pressure, this would > not make sense. > >I’ll have to find a way to get an Rx elsewhere, I guess. > >Thanks again, > >Jim McGowan > .andy > To email, substitute .nospam with .gl

Response:

Hi all! Long time since I’ve been here. I’m about to buy a RemStar Auto and the software. Does anyone here know what type of media the SmartCard is?  Before I shell out $ for the Respironics Reader, I want to know if the card can be read in a standard media reader.  I have readers already for SmartMedia (SM), Compact Flash (CF), Secure Digital (SD), MultiMedia Card (MMC), and Memory Stick. A call to Respironics brought me a litany of "I don’t know"s.  I finally got a tech to say it’s a SmartMedia card, he believes. Does anyone here know if: 1) The Smart Card is a SmartMedia card? 2) It’s readable by a standard SmartMedia reader? Thanks in advance for all help! Jim McGowan

Response:

Jim, The card is proprietary and although I tried to do the same, could not find a generic alternative.  I have the reader and software for my RemstarAuto and am very happy with both.  The reporting is incredible, but the bad thing is, the software transfers the data to your computer, leaving the card empty.  So if your Dr wants to read the card, it will be incomplete.  I’ve found it easiest just to bring a hard copy of the report.  It would be nice if you had the option to just read the card instead of reading and erasing. However, you might want to try to buy the reader through cpapman whom I believe gives you a copy of the software for free. ( at least some have claimed this). Give it a shot.  Good luck. "Jim McGowan" <jcmcgo…@comcast.net> wrote in message

news:9aad8fc.0309290652.64e0bddc@posting.google.com… – Hide quoted text — Show quoted text -> Hi all! > Long time since I’ve been here. > I’m about to buy a RemStar Auto and the software. > Does anyone here know what type of media the SmartCard is?  Before I > shell out $ for the Respironics Reader, I want to know if the card can > be read in a standard media reader.  I have readers already for > SmartMedia (SM), Compact Flash (CF), Secure Digital (SD), MultiMedia > Card (MMC), and Memory Stick. > A call to Respironics brought me a litany of "I don’t know"s.  I > finally got a tech to say it’s a SmartMedia card, he believes. > Does anyone here know if: > 1) The Smart Card is a SmartMedia card? > 2) It’s readable by a standard SmartMedia reader? > Thanks in advance for all help! > Jim McGowan

Response:

Questions to Ask

Question:

"Charles Perrin" <c.l.perrin…@att.net> wrote in message

news:2hr9gvgc7hs6v76jmunefpomt9qirrhgen@4ax.com… – Hide quoted text — Show quoted text -> On Thu, 3 Jul 2003 19:39:42 -0400, "Terry Stone" > <tstone8…@comcast.net> wrote: > >I am Terry and I had my study a week ago. I was told by next week my > >doctor will have the results of the study. What should I ask him about the > >study? What are the major areas of concern? > Well, #1 is definitely #1… but the other ones may actually have > different priorities: > #1 – AHI (number of breathing disturbances per hour). > #2 – Lowest level of oxygen saturation > #3 – Amount of PLMS (leg movement) > #4 – Percentage of Stage 3/4 (deep) sleep > #5 – Percentage of REM (usually dreaming) sleep

You could ask him to go over the results and explain all the measurements but it would probably work out best to request a copy of the study summary and conclusion to take with you. It takes a while to understand what the measurements are and what they mean. You can do that here looking through the archives. *If* you are diagnosed with OSA and the doc is going to prescribe CPAP try your best to ensure that he also prescribes the heated humidifier that will work with your machine. In the mean time you might browse looking at the various masks/interfaces. Sites like www.cpapman.com carry all of the common ones with tips and descriptions. Then if you go for a machine and to be fitted for a mask/interface you will have some idea what to expect and know what’s available if you have options. -Quick

Response:

Terry Please note that Anna’s advice is assuming you have OSA and therefore you will need CPAP…. As Norm points out, there are over 40 sleep disorders. Guess your questions will depend on which disorder the study indicates you have. Check out the links on Tal’s website – maybe this will be of some help for you. http://www.talhost.net/sleep/sleepstudy.htm Good luck for your appointment. Kit — To reply replace nospam with kamuzz "Anna LeBlanc" <lebla…@qwest.net> wrote in message

news:BB2AD2C1.E22F%leblancr@qwest.net… – Hide quoted text — Show quoted text -> in article chqdnXfVK8ldI5miU-K…@comcast.com, Terry Stone at > tstone8…@comcast.net wrote on 7/3/2003 4:39 PM: > > Hi, > > I am Terry and I had my study a week ago. I was told by next week my > > doctor will have the results of the study. What should I ask him about the > > study? What are the major areas of concern? > > Thanks > Terry, > In addition to all the medical questions that have been suggested, I > recommend you ask how the fitting for machine and mask will work. What you > want is the greatest range of options to find a mask that fits your face and > suits your own sensibility about CPAP. We had a poster recently whose doctor > prescribed a particular mask. Therefore when she met with the DME (Durable > medical equipment supplier), the folks who could have tried a number of > different types of interfaces for fit, they were limited to the one the > doctor specified. At least that’s what they told her. So when you meet with > your doctor tell him/her you would like to have the greatest number of > options. If you live in an area with choices express that you would like to > work with the DME that has the best reputation for patient service. > Also ask if he will prescribe a machine with a heated humidifier. Not > everyone benefits from one, but a lot of us do. It puts water vapor into the > air you breath, and can make it a lot more comfortable for your nasal > passages. I live in Arizona where the humiditity is generally low, so I > really value having that extra moisture. > Some researchers report that having a heated humidifier increases what they > call "compliance." That means that you overcome obstacles and use your > treatment as directed. Your doctor should be interested in increasing your > compliance. Your insurance  will be. I am looking at buying Long Term Care > Insurance. The guidelines say that if I have Sleep Apnea, and have been > using CPAP for less than 6 months, I am a greater risk than if I have been > treated for more than 6 months. This is entirely a matter of compliance. > If you travel a lot there are some models of CPAP that are a lot more > compact. These are options that you can’t get without your doctor’s > prescription. > Anna

Response:

Thanks to all for your thoughts and questions. NormC I had a full night polysonogram. Terry

Response:

in article chqdnXfVK8ldI5miU-K…@comcast.com, Terry Stone at tstone8…@comcast.net wrote on 7/3/2003 4:39 PM: > Hi, > I am Terry and I had my study a week ago. I was told by next week my > doctor will have the results of the study. What should I ask him about the > study? What are the major areas of concern? > Thanks

Terry, In addition to all the medical questions that have been suggested, I recommend you ask how the fitting for machine and mask will work. What you want is the greatest range of options to find a mask that fits your face and suits your own sensibility about CPAP. We had a poster recently whose doctor prescribed a particular mask. Therefore when she met with the DME (Durable medical equipment supplier), the folks who could have tried a number of different types of interfaces for fit, they were limited to the one the doctor specified. At least that’s what they told her. So when you meet with your doctor tell him/her you would like to have the greatest number of options. If you live in an area with choices express that you would like to work with the DME that has the best reputation for patient service. Also ask if he will prescribe a machine with a heated humidifier. Not everyone benefits from one, but a lot of us do. It puts water vapor into the air you breath, and can make it a lot more comfortable for your nasal passages. I live in Arizona where the humiditity is generally low, so I really value having that extra moisture. Some researchers report that having a heated humidifier increases what they call "compliance." That means that you overcome obstacles and use your treatment as directed. Your doctor should be interested in increasing your compliance. Your insurance  will be. I am looking at buying Long Term Care Insurance. The guidelines say that if I have Sleep Apnea, and have been using CPAP for less than 6 months, I am a greater risk than if I have been treated for more than 6 months. This is entirely a matter of compliance. If you travel a lot there are some models of CPAP that are a lot more compact. These are options that you can’t get without your doctor’s prescription. Anna

Response:

Hi,   I am Terry and I had my study a week ago. I was told by next week my doctor will have the results of the study. What should I ask him about the study? What are the major areas of concern? Thanks

Response:

0) If you have proposed treatment, what is it? Please explain. 1) What is my AHI (aka RDI) and does it merit treatment?     If the answer is > 5.0 and no, challenge this. 2) What is my nadir O2 sat when not on treatment. If it is too low (Norm, chime in here as you are the most recent O2 sat guru!) and the doc offers no treatment, challenge this. 3) If Apneas are present and many are central, insist upon ‘BiPAP ST’ treatment. This is fairly rare. 4) If you get no results from 0-3, ask doc specifically in plain English ‘what is wrong and how do we fix it?’ Do not leave the doc until you get an answer. If doc refuses to answer, file complaint with your insurer and all available medical certification agences. Consider finding an attorney. regards, eric pearson db2e…@nospammindspring.com On Thu, 3 Jul 2003 19:39:42 -0400, "Terry Stone" – Hide quoted text — Show quoted text -<tstone8…@comcast.net> wrote: >Hi, >  I am Terry and I had my study a week ago. I was told by next week my >doctor will have the results of the study. What should I ask him about the >study? What are the major areas of concern? >Thanks

Response:

On Thu, 3 Jul 2003 19:39:42 -0400, "Terry Stone" <tstone8…@comcast.net> wrote: >I am Terry and I had my study a week ago. I was told by next week my >doctor will have the results of the study. What should I ask him about the >study? What are the major areas of concern?

Well, #1 is definitely #1… but the other ones may actually have different priorities: #1 – AHI (number of breathing disturbances per hour). #2 – Lowest level of oxygen saturation #3 – Amount of PLMS (leg movement) #4 – Percentage of Stage 3/4 (deep) sleep #5 – Percentage of REM (usually dreaming) sleep

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Terry Stone wrote: > Hi, >   I am Terry and I had my study a week ago. I was told by next week my > doctor will have the results of the study. What should I ask him about the > study?

This is difficult to answer, because there are more than 40 sleep disorders.  Has anyone given you any clues as to which one, or more, you might have? In addition, it depends on what you define as a sleep study.  Did you have a full night’s polysomnogram?  A full night of titration? An evalation report, of your PSG and titration, should have been written by a diplomated sleep doctor.  In addition there should be traces/curves/charts of specific important parameters. So the absolutely most important thing you should ask him is, "Where is my copy of the (1) PSG evaluation and (2) titration study?" If everything goes well for you, you may not need them, but if it doesn’t, you will have to take your healthcare into your own hands, like many of us, with sleep disorders, have had to do. Many (most?) of us have had to make use of a diplomated sleep doc.  What doctor are you meeting with?  Your GP/PCP or a diplomated sleep doctor who evaluated your PSG and titration? > What are the major areas of concern?

IMHO, the major areas of concern are whether you had any central apneas (which are not readily treatable), what your blood oxygen saturation was before you fell asleep, and a profile of your oxy sats while you slept, especially the amount of time you spent at the lowest saturation. Eric and Charlie have provided some specific suggestions that I totally agree with. HTH – Hide quoted text — Show quoted text -> Thanks

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how strong can T become

Question:

"Mantorok" <cosmicma…@msn.com> wrote in part: >its not that I can’t live with the degree that I have >now, its just that I cant stand it at night sometimes…..

Then experiment with different kinds of partial masking at night while you sleep. — Jim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere’s? See http://groups.yahoo.com/group/MenieresDG

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If you stand by a railroad track when the train comes by and you still hear it. Thats bad. Like mine when it is going at it.  Lee

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Snaiiiiiiiiiiiiiiiip > I’ mjust wondering.. I’ve been telling here lately my T is become worse > although I don’t really know, maybe i’m just ain a dip again because > sometimes the pitch is higher, or the direction changes (left or right ear > more).. but it has always characterized it as the following:

Snaiiiiip Mine varies, It is at times about as noisy as a chainsaw and other times not more noisy that having a 30-06 fired on my ear. The point is this. It is louder than some and not as loud as others. I get bummed sometimes and other times I am fine too. I look at life and at the problems others have and suddenly, I am lucky compared to what some people have to deal with. I will tell you something, I have been around the world more than once, I have been rich, I have been so poor I have had to look through the couch to find enough money to buy Mac and cheese. "T" sucks no doubt, it could be oh so much worse. That does not make it easier when in the middle of the s**t but this too will pass. Heroes are people who overcome adversity, not those people who have avoided it. Robin

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"Robin" <rpatrickjm[remove]@attbi.com> wrote in news:oTI8a.338476$vm2.256958@rwcrnsc54: > Heroes are people who overcome adversity, not those people who have > avoided it.

Bullseye   Toan

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Well one of the thinks is that even if i’m tieing myself in a knot at night, i will not take sleeping drugs… and I know when I’m going to try and get treatment (first PET scan and MRI scans) that i know it won’t go away and i stand tall to that, its not that I can’t live with the degree that I have now, its just that I cant stand it at night sometimes….. "Robin" <rpatrickjm[remove]@attbi.com> wrote in message

news:oTI8a.338476$vm2.256958@rwcrnsc54… – Hide quoted text — Show quoted text -> Snaiiiiiiiiiiiiiiiip > > I’ mjust wondering.. I’ve been telling here lately my T is become worse > > although I don’t really know, maybe i’m just ain a dip again because > > sometimes the pitch is higher, or the direction changes (left or right ear > > more).. but it has always characterized it as the following: > Snaiiiiip > Mine varies, It is at times about as noisy as a chainsaw and other times not > more noisy that having a 30-06 fired on my ear. > The point is this. It is louder than some and not as loud as others. > I get bummed sometimes and other times I am fine too. > I look at life and at the problems others have and suddenly, I am lucky > compared to what some people have to deal with. > I will tell you something, I have been around the world more than once, I > have been rich, I have been so poor I have had to look through the couch to > find enough money to buy Mac and cheese. "T" sucks no doubt, it could be oh > so much worse. That does not make it easier when in the middle of the s**t > but this too will pass. > Heroes are people who overcome adversity, not those people who have avoided > it. > Robin

Response:

On Mon, 03 Mar 2003 14:58:59 GMT, Tonyjeffs <iraq[remove]@tonyjeffs.com> wrote: >> Heroes are people who overcome adversity, not those people who have >> avoided it. >Bullseye  

Then I fear that England has no heroes left as the population uniformly is avoiding its moral obligation Martin Aquinas Borders…Language,..Culture…QUICK! Support the troops. Islam is not the religion of peace we are told it is Islam’s history is one of brutal conquest Islam is involved in 20 of 22 wars today Islam [much of it] is currently preaching hatred and terrorism against Christians Islam must undergo a reformation, as it is not compatable with the western nation state, or be asked to leave

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I do understand, Gut it out. It will become as normal for you as the furnace kicking on at night. It just takes time. Be patient with yourself. You are all you have. Robin "Mantorok" <cosmicma…@msn.com> wrote in message

news:N9M8a.1641$Dl1.202569903@hestia.telenet-ops.be… – Hide quoted text — Show quoted text -> Well one of the thinks is that even if i’m tieing myself in a knot at night, > i will not take sleeping drugs… and I know when I’m going to try and get > treatment (first PET scan and MRI scans) that i know it won’t go away and i > stand tall to that, its not that I can’t live with the degree that I have > now, its just that I cant stand it at night sometimes….. > "Robin" <rpatrickjm[remove]@attbi.com> wrote in message > news:oTI8a.338476$vm2.256958@rwcrnsc54… > > Snaiiiiiiiiiiiiiiiip > > > I’ mjust wondering.. I’ve been telling here lately my T is become worse > > > although I don’t really know, maybe i’m just ain a dip again because > > > sometimes the pitch is higher, or the direction changes (left or right > ear > > > more).. but it has always characterized it as the following: > > Snaiiiiip > > Mine varies, It is at times about as noisy as a chainsaw and other times > not > > more noisy that having a 30-06 fired on my ear. > > The point is this. It is louder than some and not as loud as others. > > I get bummed sometimes and other times I am fine too. > > I look at life and at the problems others have and suddenly, I am lucky > > compared to what some people have to deal with. > > I will tell you something, I have been around the world more than once, I > > have been rich, I have been so poor I have had to look through the couch > to > > find enough money to buy Mac and cheese. "T" sucks no doubt, it could be > oh > > so much worse. That does not make it easier when in the middle of the s**t > > but this too will pass. > > Heroes are people who overcome adversity, not those people who have > avoided > > it. > > Robin

Response:

Hello, I’ mjust wondering.. I’ve been telling here lately my T is become worse although I don’t really know, maybe i’m just ain a dip again because sometimes the pitch is higher, or the direction changes (left or right ear more).. but it has always characterized it as the following: I can hear it in my room with window closed I can hear it in my room with an open window, but only the very high (i think around 10.000hz) part of it its totally masked  when i sit at my PC (unless i’ve been in very quite surroundings all day, then I hear a slight high pitch ringing in my right ear) It’s totally masked on the street).. I’ve heard people say here that it sounds at loud as someone who yells in his ear, are you serious? I think i’d be at the end of my life or taking heavy valium to sleep then… After 3 years I thought I’ve had overcome my being afraid of T, but I guess it’s not quite over yet… When I have problems sleeping There are 2 types of sleep disorders that I get (well I’m talking about feelings at night really).. One night I can be sad of just wanting to sleep because when I think of the beautiful days ahead I cant cope with the idea of having to sleep untill 11 am or 12 pm while its goin to be a beautiful day, or when there are people meeting up with me or when I have to do a task early in the morning.. that stresses me and makes me sad and then I really cant sleep anymore Another thing I might feel is that I’m angry and full of self pitty of not having wore ear plugs when playing in bands or with my headphone on.. but usually that feeling makes me feel bored easily and I can fall asleep after 15 to 30 minutes  (sometimes more if I didn’t do much that day)… I’m just bragging about on this ng, bear with me.. it givesmme courage to just wirte out stuff like that so I can also keep some kind of tracking to what I can do to live with my T.. although some might be saying that I’m lucky, I dont really know if my T is loud or silent, its just there and I preceive it as an intrusion…

Response:

Meaning of "vivid dreams?"

Question:

Hello, I have recently been diagnosed w/ sleep apnea.  I was originally sent to the sleep clinic by a neurologist after complaining about migraine headaches and lousy sleep. In a very brief report from the sleep lab, I was told that I had sleep apnea, and poor sleep.  The report recommended CPAP titration — I go back next week.  After some thought and some reading on the subject, I decided that sleep was my primary problem, and migraines secondary, so I have scheduled an appointment with a sleep specialist, but that appointment won’t take place for a month. In the meantime, I have some questions about my report, and I thought that some of you might have some answers (all I have is this summary). 1)  The report notes that I told the tech about "vivid dreams."  I talked about a lot of things.  Why is this worth singling out? 2)  The report said that I had a "reduced efficiency" of 68%.  What does this mean? 3)  What is "overall RDI?"  Mine was 64.8 4)  I did not get into deep sleep in the sleep lab — I had a really bad night of sleep.  Is sleep apnea usually worse in sleep stages 3 & 4? The good news is that they told me that it was worse on my back and that I have trained myself to sleep on my side by strapping a softball to my back.  I have slept very well for the past week or so, and I feel much more rested already.

Response:

<< 1)  The report notes that I told the tech about "vivid dreams."  I talked about a lot of things.  Why is this worth singling out?>> Can be an indication of sleep disorders of various types. Some of us dreamt a lot pre-treatment, some of us never dreamed.  It does indicate that you are getting into REM sleep. <<2)  The report said that I had a "reduced efficiency" of 68%.  What does this mean?>> Not sure exactly what that means. Ask your doc. <<3)  What is "overall RDI?"  Mine was 64.8>> Respiratory Distress Index.  It is usually the most important single measurement of apneas and hypopneas and indicates you were stopping breathing for 10 seconds or more 64 times an hour, or more than once a minute.  In general any index over about 40 is considered "severe" sleep apnea. You might also want to look for your Oxygen Saturation or O2Sat.  Normal is 98% and anything below 95% is a strong sign of a problem <<4)  I did not get into deep sleep in the sleep lab — I had a really bad night of sleep.  Is sleep apnea usually worse in sleep stages 3 & 4?>> The thing about sleep apnea is that you NEVER get to stages 3 and 4!  The fact that you did not have any deep sleep is a principal result of your apnea!  I also did not think I slept well during my study, but they are normally able to get plenty of data even if you don’t feel you slept well. CPAP is a wonderful thing and I predict that, like many of us, you will find that it makes a major difference in your health and lifestyle!  It can be a bit hard to adjust to but it is well worth making the effort! Keep us informed about your progress by posting here. Mike posted and emailed

Response:

Thanks for the response. The report noted that I had no significant oxygen desaturations.  Which I guess is a good thing, but not so good when it comes to getting my insurance company to pay for the CPAP.  But my doc thinks that there are other ways of getting them to pay. I have my CPAP titration next week, and will keep you posted…. "MercedMike" <mercedm…@aol.com> wrote in message

news:20030228181338.02067.00000205@mb-mq.aol.com… – Hide quoted text — Show quoted text -> << 1)  The report notes that I told the tech about "vivid dreams."  I > talked about a lot of things.  Why is this worth singling out?>> > Can be an indication of sleep disorders of various types. Some of us dreamt a > lot pre-treatment, some of us never dreamed.  It does indicate that you are > getting into REM sleep. > <<2)  The report said that I had a "reduced efficiency" of 68%.  What > does this mean?>> > Not sure exactly what that means. Ask your doc. > <<3)  What is "overall RDI?"  Mine was 64.8>> > Respiratory Distress Index.  It is usually the most important single > measurement of apneas and hypopneas and indicates you were stopping breathing > for 10 seconds or more 64 times an hour, or more than once a minute.  In > general any index over about 40 is considered "severe" sleep apnea. > You might also want to look for your Oxygen Saturation or O2Sat.  Normal is 98% > and anything below 95% is a strong sign of a problem > <<4)  I did not get into deep sleep in the sleep lab — I had a really > bad night of sleep.  Is sleep apnea usually worse in sleep stages 3 & > 4?>> > The thing about sleep apnea is that you NEVER get to stages 3 and 4!  The fact > that you did not have any deep sleep is a principal result of your apnea! I > also did not think I slept well during my study, but they are normally able to > get plenty of data even if you don’t feel you slept well. > CPAP is a wonderful thing and I predict that, like many of us, you will find > that it makes a major difference in your health and lifestyle!  It can be a bit > hard to adjust to but it is well worth making the effort! > Keep us informed about your progress by posting here. > Mike > posted and emailed

Response:

> The thing about sleep apnea is that you NEVER get to stages 3 and 4!  The fact > that you did not have any deep sleep is a principal result of your apnea! I > also did not think I slept well during my study, but they are normally able to > get plenty of data even if you don’t feel you slept well.

nooooooooooooooooooo……… people without apnea can experience lack of stage .3+4 sleep…and ppl with apnea can quite easily HAVE deep sleep… in some people, true, the apnea can reduce the amount of deep sleep, but i think most people with apnea have at least some deep sleep – apnea tends to be worse during deep sleep stages — Beth in Australia =================== FAQ for alt.support.sleep-disorder can be found here http://www.anchorweb.com.au/sleepdisorders this site is a work in progress – feel free to submit info/articles

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"Tal" <beth…@hotmail.com> wrote in message <news:b3qku5$1ov2s6$1@ID-148111.news.dfncis.de>… > nooooooooooooooooooo……… people without apnea can experience lack of > stage .3+4 sleep…and ppl with apnea can quite easily HAVE deep sleep… > in some people, true, the apnea can reduce the amount of deep sleep, but i > think most people with apnea have at least some deep sleep – apnea tends to > be worse during deep sleep stages

Based on my own experience, I think you’re right, Tal — I think I get some stage 3&4 sleep — not enough of it and it is constantly interrupted.  In any event, I did not get any deep sleep during my visit to the sleep lab. Your comment summons a follow-up question for the group: if my RDI score is so high, indicating a "severe" case of sleep apnea, why did I experience no significant O2 desaturations?  Is it because I never got into deep sleep?

Response:

- Hide quoted text — Show quoted text -Grumpstone wrote: > "Tal" <beth…@hotmail.com> wrote in message <news:b3qku5$1ov2s6$1@ID-148111.news.dfncis.de>… > > nooooooooooooooooooo……… people without apnea can experience lack of > > stage .3+4 sleep…and ppl with apnea can quite easily HAVE deep sleep… > > in some people, true, the apnea can reduce the amount of deep sleep, but i > > think most people with apnea have at least some deep sleep – apnea tends to > > be worse during deep sleep stages > Based on my own experience, I think you’re right, Tal — I think I get > some stage 3&4 sleep — not enough of it and it is constantly > interrupted.  In any event, I did not get any deep sleep during my > visit to the sleep lab. > Your comment summons a follow-up question for the group: if my RDI > score is so high, indicating a "severe" case of sleep apnea, why did I > experience no significant O2 desaturations?  Is it because I never got > into deep sleep?

Great question!   My shot in the dark:  Perhaps the duration of the apneas are not great enough to reduce the oxy sat levels.

Response:

"NormC" <no…@socal.rr.com> wrote in message

news:3E610984.7C6DC79E@socal.rr.com… > Grumpstone wrote: > > "Tal" <beth…@hotmail.com> wrote in message

<news:b3qku5$1ov2s6$1@ID-148111.news.dfncis.de>… > > > nooooooooooooooooooo……… people without apnea can experience lack of > > > stage .3+4 sleep…and ppl with apnea can quite easily HAVE deep sleep… > > > in some people, true, the apnea can reduce the amount of deep sleep, but i > > > think most people with apnea have at least some deep sleep – apnea tends to > > > be worse during deep sleep stages > > Based on my own experience, I think you’re right, Tal — I think I get > > some stage 3&4 sleep — not enough of it and it is constantly > > interrupted.  In any event, I did not get any deep sleep during my > > visit to the sleep lab.

I’m with Beth on this one! I’m guesiing but I think we might make it into and even thru stage 3 and 4 and then start having trouble after (or approaching) the first REM cycle. http://faculty.washington.edu/chudler/sleep.html REM paralyses pretty much everything but the involunatery muscles (heart, lungs, etc.). Means tongue which is a big old muscle relaxes and may stay relaxed blocking air. > > Your comment summons a follow-up question for the group: if my RDI > > score is so high, indicating a "severe" case of sleep apnea, why did I > > experience no significant O2 desaturations?  Is it because I never got > > into deep sleep? > Great question! > My shot in the dark:  Perhaps the duration of the apneas are not great enough to > reduce the oxy sat levels.

Good answer, that’s my first thought also! Also, central apnea can show less O2 desat than obstructive (got central on the brain, pun intended ) Mike

Response:

> Your comment summons a follow-up question for the group: if my RDI > score is so high, indicating a "severe" case of sleep apnea, why did I > experience no significant O2 desaturations?  Is it because I never got > into deep sleep?

I’d guess that it’s likely that the duration of each of your apnea events was short enough that it didn’t affect your oxygen levels……the longer the apnea event, the more your O2 levels are likely to drop.  Thinking about your theory of deep sleep – it is indeed possible (in theory) that while in deep sleep, it takes you longer to wake out of an apnea event, meaning the O2 levels are more likely to drop. — Beth in Australia =================== FAQ for alt.support.sleep-disorder can be found here http://www.anchorweb.com.au/sleepdisorders this site is a work in progress – feel free to submit info/articles

Response:

"Tal" <beth…@hotmail.com> wrote in message <news:b3t53i$1ppbfe$1@ID-148111.news.dfncis.de>… > > Your comment summons a follow-up question for the group: if my RDI > > score is so high, indicating a "severe" case of sleep apnea, why did I > > experience no significant O2 desaturations?  Is it because I never got > > into deep sleep? > I’d guess that it’s likely that the duration of each of your apnea events > was short enough that it didn’t affect your oxygen levels……the longer > the apnea event, the more your O2 levels are likely to drop.  Thinking about > your theory of deep sleep – it is indeed possible (in theory) that while in > deep sleep, it takes you longer to wake out of an apnea event, meaning the > O2 levels are more likely to drop.

Hi Tal, I don’t know if you are reading this but … I think you’re right.  I went in for my CPAP trial, and the tech (same person as last time, and she is experienced) showed me some of the charts.  There were hundreds of apneas/hypopneas…the charts did not show duration, but she thought they were probably short — they had to be as there were so many over the course of a single night.  Also significant was the fact that I am young and in good shape.  The apneas also correlated perfectly with frequent arousals. Anyway, it took a while to get to sleep with the CPAP.  I tolerated it well, and when I finally did fall asleep, I experienced a true rarity: stages 3 & 4.  The tech said that I will have to wait 3-4 weeks for it!  Argh!

Response:

- Hide quoted text — Show quoted text -NormC <no…@socal.rr.com> wrote in message <news:3E610984.7C6DC79E@socal.rr.com>… > Grumpstone wrote: > > "Tal" <beth…@hotmail.com> wrote in message <news:b3qku5$1ov2s6$1@ID-148111.news.dfncis.de>… > > > nooooooooooooooooooo……… people without apnea can experience lack of > > > stage .3+4 sleep…and ppl with apnea can quite easily HAVE deep sleep… > > > in some people, true, the apnea can reduce the amount of deep sleep, but i > > > think most people with apnea have at least some deep sleep – apnea tends to > > > be worse during deep sleep stages > > Based on my own experience, I think you’re right, Tal — I think I get > > some stage 3&4 sleep — not enough of it and it is constantly > > interrupted.  In any event, I did not get any deep sleep during my > > visit to the sleep lab. > > Your comment summons a follow-up question for the group: if my RDI > > score is so high, indicating a "severe" case of sleep apnea, why did I > > experience no significant O2 desaturations?  Is it because I never got > > into deep sleep? > Great question!   > My shot in the dark:  Perhaps the duration of the apneas are not great enough to > reduce the oxy sat levels.

Norm, Based on my CPAP trial I think you’re right — see my response to Tal below. Thanks!

Response:

> Anyway, it took a while to get to sleep with the CPAP.  I tolerated it > well, and when I finally did fall asleep, I experienced a true rarity: > stages 3 & 4.  The tech said that I will have to wait 3-4 weeks for > it!  Argh!

ahh, great tht you got some deep sleep while on CPAP – I hope the benefit is seen even more when you’re sleeping with it every night Good luck…and be sure to bring any issues that crop up to us so we can help you out wtih them. — Beth in Australia =================== FAQ for alt.support.sleep-disorder can be found here http://www.anchorweb.com.au/sleepdisorders this site is a work in progress – feel free to submit info/articles

Response:

- Hide quoted text — Show quoted text -Grumpstone wrote: > "Tal" <beth…@hotmail.com> wrote in message <news:b3t53i$1ppbfe$1@ID-148111.news.dfncis.de>… > > > Your comment summons a follow-up question for the group: if my RDI > > > score is so high, indicating a "severe" case of sleep apnea, why did I > > > experience no significant O2 desaturations?  Is it because I never got > > > into deep sleep? > > I’d guess that it’s likely that the duration of each of your apnea events > > was short enough that it didn’t affect your oxygen levels……the longer > > the apnea event, the more your O2 levels are likely to drop.  Thinking about > > your theory of deep sleep – it is indeed possible (in theory) that while in > > deep sleep, it takes you longer to wake out of an apnea event, meaning the > > O2 levels are more likely to drop. > Hi Tal, > I don’t know if you are reading this but … I think you’re right.  I > went in for my CPAP trial, and the tech (same person as last time, and > she is experienced) showed me some of the charts.  There were hundreds > of apneas/hypopneas…the charts did not show duration, but she > thought they were probably short — they had to be as there were so > many over the course of a single night.  Also significant was the fact > that I am young and in good shape.  The apneas also correlated > perfectly with frequent arousals. > Anyway, it took a while to get to sleep with the CPAP.  I tolerated it > well, and when I finally did fall asleep, I experienced a true rarity: > stages 3 & 4.  The tech said that I will have to wait 3-4 weeks for > it!  Argh!

Why 3-4 weeks?

Response:

That’s what I was wondering.  Well, for some reason I have to await the results of the (second) sleep study to get the prescription.  I was told that that should take about two weeks, but the best case is 1 week.  Then I have to wait for an appointment with the DME company…. I’ve been complaining to doctors for 15 years about poor sleep.  You’d think I could wait a week or two, but now that I know what the solution is, the wait is killing me! "NormC" <no…@socal.rr.com> wrote in message

news:3E66E69C.9A66BE2A@socal.rr.com… > Grumpstone wrote: > > "Tal" <beth…@hotmail.com> wrote in message

<news:b3t53i$1ppbfe$1@ID-148111.news.dfncis.de>… – Hide quoted text — Show quoted text -> > > > Your comment summons a follow-up question for the group: if my RDI > > > > score is so high, indicating a "severe" case of sleep apnea, why did I > > > > experience no significant O2 desaturations?  Is it because I never got > > > > into deep sleep? > > > I’d guess that it’s likely that the duration of each of your apnea events > > > was short enough that it didn’t affect your oxygen levels……the longer > > > the apnea event, the more your O2 levels are likely to drop.  Thinking about > > > your theory of deep sleep – it is indeed possible (in theory) that while in > > > deep sleep, it takes you longer to wake out of an apnea event, meaning the > > > O2 levels are more likely to drop. > > Hi Tal, > > I don’t know if you are reading this but … I think you’re right.  I > > went in for my CPAP trial, and the tech (same person as last time, and > > she is experienced) showed me some of the charts.  There were hundreds > > of apneas/hypopneas…the charts did not show duration, but she > > thought they were probably short — they had to be as there were so > > many over the course of a single night.  Also significant was the fact > > that I am young and in good shape.  The apneas also correlated > > perfectly with frequent arousals. > > Anyway, it took a while to get to sleep with the CPAP.  I tolerated it > > well, and when I finally did fall asleep, I experienced a true rarity: > > stages 3 & 4.  The tech said that I will have to wait 3-4 weeks for > > it!  Argh! > Why 3-4 weeks?

Response:

NormC, thanks again for your follow-up.  I am bouncing between posting on google and an nntp server, so things may appear disjointed, time-wise…. No, I have not seen my PSG report.  I called my neurologist about the CPAP prescription.  The reason I have to wait for the prescription is that I did not meet the insurance criteria for a CPAP after my first night in the lab (probably b/c my O2 desats were minimal).  They did diagnose poor sleep secondary to sleep apnea (RDI = 65).  I don’t know if my apnea is "serious," but it seems to cause about 60 arousals a minute, if I recall my conversation with the sleep lab technician correctly.  It really prevents me from getting proper sleep. I went in for a CPAP titration, and will hopefully meet insurance criteria this time.  But I have to wait for the sleep study report, which takes about two weeks. In the meantime, I have scheduled my first visit with a sleep specialist early next week (I was sent to the sleep lab by a neurologist treating headaches).  Because I will be seeing the same md who reads the sleep study, I may actually be able to walk away with a prescription.  I plan to ask for a copy of my PSG report as well, and I will post the results here. I do not know if I will get to pick my own DME.  The lab tech recommended what she thought was a good one, and FWIW thought that my insurance company was good at paying for these things…. Take care.

Response:

Grumpstone wrote: > That’s what I was wondering.  Well, for some reason I have to await the > results of the (second) sleep study to get the prescription.  I was told > that that should take about two weeks, but the best case is 1 week.  

FWIW, and for your use, my sleep lab guarantees (in writing – see http://www.sleepmedservices.com/ ) a diplomated sleep doc report in 72 hours (3 days).  And they did so for one PSG and two titrations. > Then I > have to wait for an appointment with the DME company….

What kind of insurance do you have?  Do you get to pick your own DME? > I’ve been complaining to doctors for 15 years about poor sleep.  You’d think > I could wait a week or two,

IMHO, after 15 years, you shouldn’t have to wait at all. Have you ever posted your PSG report?  It would be interesting to see if it looks like your apnea is ’serious’. Have you ever had an echocardiogram?  Did it indicate you had an enlarged heart, a typical occurrence for those with apnea.  The longer the apnea is untreated, the more enlarged the heart can become. Perhaps you can use some of the above to speed things up. – Hide quoted text — Show quoted text -> but now that I know what the solution is, the > wait is killing me! > "NormC" <no…@socal.rr.com> wrote in message > news:3E66E69C.9A66BE2A@socal.rr.com… > > Grumpstone wrote: > > > "Tal" <beth…@hotmail.com> wrote in message > <news:b3t53i$1ppbfe$1@ID-148111.news.dfncis.de>… > > > > > Your comment summons a follow-up question for the group: if my RDI > > > > > score is so high, indicating a "severe" case of sleep apnea, why did > I > > > > > experience no significant O2 desaturations?  Is it because I never > got > > > > > into deep sleep? > > > > I’d guess that it’s likely that the duration of each of your apnea > events > > > > was short enough that it didn’t affect your oxygen levels……the > longer > > > > the apnea event, the more your O2 levels are likely to drop.  Thinking > about > > > > your theory of deep sleep – it is indeed possible (in theory) that > while in > > > > deep sleep, it takes you longer to wake out of an apnea event, meaning > the > > > > O2 levels are more likely to drop. > > > Hi Tal, > > > I don’t know if you are reading this but … I think you’re right.  I > > > went in for my CPAP trial, and the tech (same person as last time, and > > > she is experienced) showed me some of the charts.  There were hundreds > > > of apneas/hypopneas…the charts did not show duration, but she > > > thought they were probably short — they had to be as there were so > > > many over the course of a single night.  Also significant was the fact > > > that I am young and in good shape.  The apneas also correlated > > > perfectly with frequent arousals. > > > Anyway, it took a while to get to sleep with the CPAP.  I tolerated it > > > well, and when I finally did fall asleep, I experienced a true rarity: > > > stages 3 & 4.  The tech said that I will have to wait 3-4 weeks for > > > it!  Argh! > > Why 3-4 weeks?

Response:

What kinds of sleep disorder are there?

Question:

Hi, I’m doing an assignment on sleeping disorders. Could someone tell me some types of sleeping disorders and a littler information about them? Any help would be much appreciated. Thanks, Mojo.

Response:

Do a search on www.google.com using sleep disorders as your search words. For example here is one site I found http://www.neurologychannel.com/sleepdisorders/types.shtml Then use google on each individual sleep disorder and you’ll have enough info even Joe Biden wouldn’t get into trouble ) Mike "Mojo" <m…@mrstump.com> wrote in message

news:a6a1e18c.0206301737.1505150f@posting.google.com… – Hide quoted text — Show quoted text -> Hi, > I’m doing an assignment on sleeping disorders. Could someone tell me > some types of sleeping disorders and a littler information about them? > Any help would be much appreciated. > Thanks, > Mojo.

Response:

Scoop0901 read article <uhvdccccj1p…@corp.supernews.com>, dated Sun, 30 Jun 2002 21:51:36 -0500, that "Lori&Mike" said: >Do a search on www.google.com using sleep disorders as your search words. For >example here >is one site I found http://www.neurologychannel.com/sleepdisorders/types.shtml >Then use >google on each individual sleep disorder and you’ll have enough info even Joe >Biden wouldn’t >get into trouble ) Mike

Actually, there is a better source.  It is the International Classification of Sleep Disorders, and lists 88, in all.  The list can be accessed at: http://www.uni-marburg.de/sleep/enn/database/asdadefs/welcome.htm -dave |          Dave Jackson (Scoop0901) * Philadelphia, PA.         | |     ~~eFax: 253-423-7208~~  *  mailto:sco…@newsguy.com      | |              "What the mind of man can conceive               | |         and believe, it can achieve." – Napolean Hill         |

Response:

http://www.span.com.au/apnea/links.html some of the links on this page will help "Mojo" <m…@mrstump.com> wrote in message

news:a6a1e18c.0206301737.1505150f@posting.google.com… – Hide quoted text — Show quoted text -> Hi, > I’m doing an assignment on sleeping disorders. Could someone tell me > some types of sleeping disorders and a littler information about them? > Any help would be much appreciated. > Thanks, > Mojo.

Response:

sleepdisorder

Question:

I wonder what the causes are of a sleepdisorder, greetings celine

Response:

that’s an extreemly broad question.  There are many types of sleep disorders with many types of causes! – Hide quoted text — Show quoted text -> I wonder what the causes are of a sleepdisorder, > greetings > celine

Response: