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.

[Corpsman8404]

Thanks, goaltender.  The above is the overnight sleep clinic study with all the probes.  I'll see if I can get the graph data, too.

[goaltender]

Wow, if that was done at the VA hospital, they have VERY LITTLE info to give you compared to my reports done at the VA contracted hospital. None the less, keep up with their reports/ your result numbers.

If I can be of help, let me know. I spent all of 2015 and most of my energy on this topic and I am glad I did. Bugged the hell out of them I did.......lol.

 

[Buck52]

 here ya go Andman this is a good read and it may help ya buddy

http://www.hadit.com/entitlement-to-service-connection-for-sleep-apnea-to-include-as-secondary-to-ptsd-granted/

 

...................Buck

 

[Buck52]

I think for VA Purposes the AHI is 5  anything over AHI 5 or higher is consider SA /OSA

[Corpsman8404]

 here ya go Andman this is a good read and it may help ya buddy

http://www.hadit.com/entitlement-to-service-connection-for-sleep-apnea-to-include-as-secondary-to-ptsd-granted/

 

...................Buck

 

Good info, thanks Buck!

Edited January 3, 2016 by Corpsman8404

[Corpsman8404]

So, after getting those results above from VA official Sleep Study, I spoke with the VA Sleep doctor on Feb 2nd:

See below:

I didn't even get the chance to give it to the Sleep Dr.  He was SET on explaining how his theory of sleep apnea is based on sympathetic parasympathetic issues and quoted an Albuquerque study from 2001, and a rat study that showed even if you do stuff to them they can have sleep issues, and when we are asleep we may hear a noise like a siren and think it's an emergency and wake up...et cetera. This was loong before I even began discussing the correlation between PTSD and sleep apnea that I wanted to begin with him. I don't disagree with all that, but he was adamant to the extreme about his theory and that he "would some day be vindicated" by science. Very smart Dr, and I learned alot about other issues with the brain and sleep.  

When I began my conversation on research I had, he stated he wouldn't look at it. He was unaware of the US National Library of Medicine/National Institutes of Health/Journal of sleep medicine information and other info that I had researched.  Likewise, as the conversation went on, very respectfully between the two of us, he stated he was told the other day not to spend time with vets on this issue (deeply), and that he understood my thoughts and such, but it was a "waste of time" and this discussion was keeping him from helping other vets.  Uh...That's where I nicely stated that this is the VA, and aren't you helping vets like me?   He then began to give me the "look, I DO care about vets and I find that insulting" speech, to which I stated "yes Sir, I saw you here past 8pm on the night I had my sleep study, I certainly do believe you are passionate and caring about vets and your research into your beliefs on sleep apnea, you are very well versed and I have learned alot from you on this conversation". 

I then made my case and he listened and was impressed.  I mentioned the cases won, the research that DOES show a relation, and that I was not asking for a "caused by" but a discussion on the "aggravation".  I then stated that if the VA believes there is no relation between PTSD and sleep apnea as secondary to it, then why is there an option when you make a claim in the VA system to select it.  This stunned him...He actually didn't know this, and stated he would certainly look at it. Now, I know we all know that they are separate entities, and I am preaching to the choir when I say it's preposterous that they don't know this and that soooo many claims could be DONE, and time, money, appeals, and backpay saving the VA/Govt money if this could be approved the first time. 

He also stated he doesn't make the decisions.  I told him "I understand that, but I would argue that actually, in a way, you do make a decision when you put your notes about my visit in your system for the RATERS to see. (I am being totally professional all this time and so is he). "The raters will go by that, and deny."  He paused and "hmmmmed". He got it, for a brief second..... 

I politely thanked him for his time, and he said I could send him my research info to his email. Sure, he's probably going to keep his ideas and his research that is VERY convincing as HIS proof of what causes SA, which is fine. But I'm amazed that the BIBLE (sleep) that his profession is based on states the correlation/connection, and he is unaware.  I get the feeling (and I understand) that they all are extremely busy and that they do not focus on that aspect for vets.  I get it.  But again, preaching to the choir, you wouldn't continue being so busy in the long run if the damn system was correctly DONE RIGHT. 

In the end, we laughed and we both agreed how passionate we both were on our research.   

I had spent hours typing up a draft nexus for him to look at, but there was certainly no use in offering it to him.  I left there very professionally, but I was drained from being nice and attentive and not wanting to choke slam this SOB.  

 

 

 

Fast forward to TODAY.  The battle continues! 

Did research, typed up a draft letter, and took my records to this PRIVATE board certified sleep doctor (pulmonologist) . I was mentioning how I had been told at the VA that there was no correlation et cetera, and he began saying "oh there is", and mentioning medical research and literature showing the ties.  He stated he just did this for a vet a few weeks ago.  I began describing how the Raters require specific verbage such as "at least as likely" and the Doctor was typing up my letter and stated he was putting in "more than likely", as he did for the other vet.  He was genuinely concerned and stated he couldn't believe the hoops we had to jump through and pretty much was describing all the things needed in the "nexus" letter as he was typing it up and speaking to me. I mentioned that I could send him the research I had from the American Academy of Sleep Medicine, and he stated he had already known about those studies and tons of other data on the subject of PTSD/Sleep Apnea and that he was going to mention that in his write up for me.

Is this a guarantee of a connection/50% compensation? NOPE.  But I certainly am thankful that he is going to put pretty much everything in a nexus letter needed, and even better than "as least as likely as not" he is putting "more than likely as not".  Picking up the letter early next week, and I will post it here and ask for any "changes" that you guys recommend. I actually got emotional in the office with him, as he was extremely helpful and then his nurse came in his office afterwards and stated, "we are going to help you, and anything you need you do not hesitate to call me." So again, the day couldn't have been better.  Like I said, this isn't a guarantee for getting the raters/examiners to agree, but it surely does feel good.

This hill, taken...on the next objective.

Edited February 11, 2016 by Corpsman8404