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]

Did you ask or did he offer to complete a VA SA DBQ? The Clinician notes are good, possibly even great, but a SA DBQ completed by a Board Certified Sleep Specialist; think GOLD.

Semper Fi

[Corpsman8404]

Thanks, Gastone,

 

Ok, so I went the other day to a Private Sleep Dr, who like described above, did a IMO letter.  Picked it up today.

1) He said he was going to write "more than likely as not" but wrote this in one of the sentences. "Based on my examination and records reviewed, in my opinion it is highly probably that his sleep apnea is related to his other service related condition PTSD. This relationship has also been noted in the medical literature".  (My highlights) So, does this look ok? This "sounds" better, but we all know the VA....  

2) Also, he is going to fill out the DBQ for me (sleep apnea). --Do I really need it from him since I have the CPAP now and been diagnosed with sleep apnea from the VA? Can't hurt, right?

[TALON II FE]

GET THE DBQ!  Mention to him to use the EXACT WORDING on the DBQ and you are golden, brother.  Good Luck!

[Corpsman8404]

Roger that, Talon! Thanks! (Dr is board certified, MD, sleep specialist btw)

 

Anyone  ---> Okay...editing, for PERFECT clarification here:  When he fills out the DBQ, should he state,

"it is more likely than not that his sleep apnea is related to his other service related condition PTSD"    

"it is more likely than not that his sleep apnea is aggravated by his service connected PTSD".

 

 

Please read the above carefully and advise.  There are soooo many different things that could make a difference there in those two.  I mean it's crazy, there is "related/aggravated/service related/service connected...."  Perfect sentence? Anyone?  Thanks in advance!

 

 

Edited February 17, 2016 by Corpsman8404

[Navy4life]

9 hours ago, Corpsman8404 said:

Thanks, Gastone,

 

Ok, so I went the other day to a Private Sleep Dr, who like described above, did a IMO letter.  Picked it up today.

1) He said he was going to write "more than likely as not" but wrote this in one of the sentences. "Based on my examination and records reviewed, in my opinion it is highly probably that his sleep apnea is related to his other service related condition PTSD. This relationship has also been noted in the medical literature".  (My highlights) So, does this look ok? This "sounds" better, but we all know the VA....  

2) Also, he is going to fill out the DBQ for me (sleep apnea). --Do I really need it from him since I have the CPAP now and been diagnosed with sleep apnea from the VA? Can't hurt, right?

Corpsman8404;

Agree with Gastone 110%!!!  See my Nexus letter 

NOD doctor letter_Redacted.pdf

You want the wording "more likely than not" which is the best wording you can have.  The other option is "at least likely than not".

Get the letter changed b/c the wording "highly probably" won't cut the muster....

[smoothc100]

I had a home study done through the VA and was diagnosed with OSA and the next week I had a CPAP machine through the VA. I've never had to come in for another test or anything. The sleep doc wrote up a summary about my sleep apnea and insomnia, but refused to provide me with a DBQ and needless to say my claim was denied, without rational just says not service connected. I'm used to seeing why they are denied and not just its not service connected, but that's all I got in the denial.