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]

Your expert Clinicians statement will do the trick. He opines that he believes your SC was a major causative factor either causing or worsening your SA, your good to go.

Just don't set on the Evidence, get it into the VA ASAP.

VA Sleep Dr's all seem to be reluctant to complete the Vet Requested SA DBQ. Time to start Bxxxxing about their failure to follow VA Regs, in writing. Your MHV Secure Msg has a section for "Reports of Excellence." I'd use it to complain about the DBQ Refusal. Everybody at the VA, answers to someone, right.

Semper Fi

[Corpsman8404]

Took it to that sleep private dr this am and having it changed to more likely than not.

At the VA now and my PCP after a good conversation, agreed to make a statement in notes about IU and I explained the wording needed for that.  

[TALON II FE]

7 hours ago, Corpsman8404 said:

Took it to that sleep private dr this am and having it changed to more likely than not.

At the VA now and my PCP after a good conversation, agreed to make a statement in notes about IU and I explained the wording needed for that.  

Sweet, looks like things are all moving in the right direction for you!

[Navy4life]

Corpsman;

Did you get the letter changed?

[Corpsman8404]

Yes Navy4life 

 

Update

1)Took the letter back to the private Dr. and had him change the wording. GREAT staff, as well!!!
From:
"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"
To:
"Based on my examination and records reviewed, in my opinion it is more than likely than not that his sleep apnea is related to and aggravated by his other service related condition PTSD"

-----So, we shall see. God forbid the raters now get stupid with, "more than likely than not" instead of "AS not"!     Deeeerp!



2) The private Dr also did a DBQ for me!



3) On a side note, met with my PCP while at the VA today, and she stated that she would put the "cannot work" info in my progress notes, and for me to bring something of a draft since I explained the EXACT types of words needed "gainful, cannot sustain, any work, et cetera". She said she understood what I needed and would also put in her own info from her time with me, and such. Also spoke with my PTSD counselor (LCSW) who stated she couldn't write that kind of wording but would make a strong case from my treatment/classes time with her for not any work. So not the same as the PCP, but more ammo...

Edited February 18, 2016 by Corpsman8404

[Navy4life]

Thats great to hear Corpsman!  I agree with you on the dang wording and what should be in the Nexus Letter.  I had my doctor simply put "After a review of the pertinent records, it is my professional opinion that it is more than likely that XXXXXX (contention) are a direct result of her numerous falls and accidents during her military service." He also stated XXXXX has no other known risk factors that ma have precipitated her current condition.

Looks like you got good peeps to help you out too!  

I just sent my letter and additional document to my DAV rep today via FedEx to have it put into my file so the DRO can review it prior to our hearing in two weeks!

Edited February 18, 2016 by Navy4life