Sleep Apnea home test

[Corpsman8404]

Good morning!

So I had a sleep test done on 27Oct15.  I asked for the results of the test yesterday in "secure messaging" on myhealthevet.  I get the reply that I need to come in for the overnight test there, with all the hookups.  (I have heard from others that the "at home" test is pretty much inconclusive alot).

In my results below of the "at home" test, can anyone clarify things?  
(bolded part is mine)



Unattended portable sleep recording was conducted 10/27/15 16:00. The study was performed with airflow, resp belts x2, position sensor, snore microphone, actigraphy, and pulse oximetry. This HST was requested in further assessment of symptoms of snoring, witnessed apneas, and excessive daytime somnolence.

Respiratory rate is typically 12 - 14/min Pulse data shows ~ 58 bpm total and 71 bpm supine.
Baseline SpO2: ~94.1%
Time in bed: 7 hrs 41 min.
AHI: 2.2 overall, 0 supine (% 1.7 of time supine)
Minimum SpO2: 88%
IMPRESSION: This study does not meet criteria for a dx of sleep disordered breathing. However, events which were recorded were primarily central events. The few obstructive upper respiratory events were not positional.
RECOMMENDATIONS: 1) In further assessment, recommend an overnight diagnostic sleep study within 2 weeks. 







So, after doing a little research, I see that there are 3 types of sleep apnea:

*Obstructive sleep apnea (OSA)Obstructive sleep apnea (OSA) occurs when a patient’s upper airway closes (either partially or fully) but efforts to breathe continue.The primary causes of upper airway obstruction are:

• lack of muscle tone during sleep
• excess tissue in the upper airway
• the structure of the upper airway and jaw

OSA is the most common form of sleep apnea, affecting more than three in ten men and nearly one in five women.



*Central sleep apnea (CSA)CSA occurs when the patient’s airway is open, but respiratory effort ceases due to a decrease in his or her ventilatory drive. It is a =18.7pxcentral nervous system disorder.CSA can be caused by heart failure, or disease or injury involving the brain, such as:

• stroke
• brain tumor
• viral brain infection
• chronic respiratory disease

Patients with CSA don’t often snore, so the condition sometimes goes unnoticed.Mixed sleep apnea




*Mixed sleep apnea occurs when the patient shows signs of both OSA (where the airway is obstructed) and CSA (where no effort is made to breathe).








In seeing the above from my workup, it "states" I have more of a "primary central events", yet the definition of CSA says don't often snore.  Oh...I snore, trust me!  lol.
So what does this all mean? Is CSA more apt to be dangerous? More apt to compensation? Et cetera?
Sorry for such a long post, and I'm sure better results will come from the full on/in house testing at the facility.

[Gastone]

The New , at home sleep study is ok for an  initial or follow up SA  Evaluation and much CHEAPER than the VA or Private Over-night study. If your planning a SA SC Claim, the raters will only accept a DX based on the VA over-night results.

I was DX'd with MSA in 2011 after 3 separate Over-night Studies, spanning 3 weeks. !st was used to identify the sleep issues, all the electrodes and infra-red camera data. 2nd was used to dial in the best CPAP/Bipap settings and the 3rd addressed the Central Apnea issue. Private Sleep Clinic costs were about $30K. About 3 weeks later, an at-home overnight Pulse Ox was completed, resulting in the need for 02 being used in conjunction with my BiPap.

The Central Apnea events are neurological in nature. Basically your brain is'nt reading the build up of CO2 and forcing you to breath. It's like when you hold your breath for an extended period of time, your brain reads the buildup of CO2 and forces you to exhale and take in more air, otherwise you drown or pass out.

My Sp02 was dropping to about 87 during Central episodes. If you can get an SC, your good for a 50%. For future reference, untreated SA KILLS, be a 100% compliant user of your CPAP or BiPap. SA can cause Pulmonary Hypertension and lead to problems with your Right Ventricle (See Cor Pulmonale - Right Heart Failure). PH nexsus'd to an SC SA is a ratable secondary claim.

Semper Fi

[Vync]

I never had a sleep study at home, but did have two of them.

The first was done by the VA neurology/sleep clinic. They said they don't do home sleep studies. The room was lame, lumpy pillow, had a swedish memory foam mattress that hurt my back, I heard snoring through the wall, and the AC unit was rattling all night. No surprise the results were "inconclusive".

The second was done at the sleep center of the hospital where my wife works. The difference was day vs. night and I left in the morning with my CPAP machine configured as BIPAP.

Andy,
I grind my teeth and the VA dental clinic made me a splint/night guard to wear. I chewed through several softer materials, so they got smart and made an extra thick one from acrylic. I got mine through the VA dental clinic because I am SC for TMJ, not related to SA.

[Andyman73]

 

Andy,
I grind my teeth and the VA dental clinic made me a splint/night guard to wear. I chewed through several softer materials, so they got smart and made an extra thick one from acrylic. I got mine through the VA dental clinic because I am SC for TMJ, not related to SA.

Vynce, I have tried to be aware of what my teeth and tongue were doing as I was relaxing to fall asleep, and I noticed that I put my tongue between my teeth, but don't bite down on it, as if I was subconciously doing that to keep from clenching or grinding. But during awake time, totally different experience.  I will be filing for "jaw pain", very soon.  I have half a dozen STR entries from Dr. and DDO trying to diagnose my painful jaw(TMJ) condition, that spanned over most of my 6 year enlistment.

[Notorious Kelly]

I'd recommend sleep lab over home due to more sophisticated equipment and technician can make changes to see what your best settings are.

re: grinding/bruxism- I didn't realize how important this was until repeated trips to dentist for broken teeth. They can do custom mouth guard for around $500 (VA won't pay for those) but I just get the $20 ones at Walgreens that you boil and set yourself; you might have to try more than one brand for what fits your mouth.

[Corpsman8404]

Andyman73--Oh yes, EXTREME wear and tear on teeth/bruxism. I have loud cracking every once in awhile of left side of jaw as well (TMJ joint). It actually feels better when I can get it to "snap" if I have had pain in the jaw all day.  When I move my bottom teeth/jaw to the right my jaw shakes spasms like it's weak or something? Wake up with headaches, jaw pain. 

USMC_VET--I believe you had stated you were also trying to secondary your SA to PTSD, correct?  Let me know how that goes. I am trying to find the best avenue to do that, as well.

 

Thanks everyone for the good info, I'm hopeful the overnight lab test in December that I have scheduled will provide a clearer picture.  Either way, I'm tired of feeling like crap during the day for years now, and napping at lunch every day.

[Andyman73]

Good morning!

So I had a sleep test done on 27Oct15.  I asked for the results of the test yesterday in "secure messaging" on myhealthevet.  I get the reply that I need to come in for the overnight test there, with all the hookups.  (I have heard from others that the "at home" test is pretty much inconclusive alot).

In my results below of the "at home" test, can anyone clarify things?  
(bolded part is mine)



Unattended portable sleep recording was conducted 10/27/15 16:00. The study was performed with airflow, resp belts x2, position sensor, snore microphone, actigraphy, and pulse oximetry. This HST was requested in further assessment of symptoms of snoring, witnessed apneas, and excessive daytime somnolence.

Respiratory rate is typically 12 - 14/min Pulse data shows ~ 58 bpm total and 71 bpm supine.
Baseline SpO2: ~94.1%
Time in bed: 7 hrs 41 min.
AHI: 2.2 overall, 0 supine (% 1.7 of time supine)
Minimum SpO2: 88%
IMPRESSION: This study does not meet criteria for a dx of sleep disordered breathing. However, events which were recorded were primarily central events. The few obstructive upper respiratory events were not positional.
RECOMMENDATIONS: 1) In further assessment, recommend an overnight diagnostic sleep study within 2 weeks. 


Corpsman,

Ok, I am going to try to compare my ratings to yours, just for sh!#s and giggles;

No respiratory rate noted.  Mean SpO2 of 93.4 for diagnostic part of study, w/min saturation of 76.0 and mean value of 93.2 for same period. O2 saturation was below 89% for 28.5 minutes of the time spend asleep.

AI of 19.8 per hour of sleep. HI of 42.8/hr.  The overall AHI was 62.5 events/hr.  AHI breakdown is as follows; supine 71.5/hr, right-side AHI N/A/hr, left side AHI 49.1/hr and prone N/A/hr.  During this time there was 1 respiratory effort related arousal and 2 snoring arousals. The total repiratory disturbance index with arousals was 63.9 events/hr.

Heart rate peaked at 98 bpm, average during sleep was 70.5 and highest for same was 91. bpm.  But during the treatment part of the study, the bpm peaked at 104, average during sleep was 75.3, with highest for same period was 93.

Strangely there were no recorded periodic limb movements.

Initial diagnostic portion indicated severe degree of OSA with AHI of 63.

Longest duration of CSA event was 10 seconds, and OSA was 48.7 seconds.

My SaO2 mean during wakeful sleep was 94.5, with min of 73. And same for during REM sleep was mean of 93.2 and min of 76.

My sleep efficiency before treatment was 85.6, and during treatment was 86.6%(huge increase!). Pretreatment supine was 78 minutes, and during treatment, supine was 0 minutes.  I had 16 awakenings before treatment and 10 during treatment.

So there ya go, in a nutshell.

Andyman