I wouldn’t be surprised if there is a bit of apnea running around - but I had been asleep (or whatever passes for sleep, given the bedtime cocktail* (see above)) for 2.5 hours before the tech woke me to start the CPAP.
That would indicate to me that the apnea is not the cause of the insomnia - and until the insomnia is fixed, I really don’t care to make an even larger production of getting to sleep,
for the test, I did not use the antihistamines, so the fact that I ended up mouth breathing doesn’t surprise me. The tech (who was in a huge hurry to get me out the door) did tell me (I think) that I had switched to mouth breathing.
Since you are on medicaid, it might be smart to push for the surgery instead of the CPAP. When you combine their findings with the fact the you have to take an antihistamine every night, it may be enough to justify it. I would do it in a second if I could get it covered.
I have been on a CPAP for about 10 years and have no trouble with it at all. If you need one then make sure it’s an auto pressure, because they are a 100% easier to use than the set pressure ones.
While I understand both usedtobe and Senegoid’s skepticism, the criteria for diagnosis of sleep apnea is pretty clear. According to the American Academy of Sleep Medicine guidelines, a diagnosis can be made with 5 or more apnea/hypopnea + respiratory associated arousals per hour (AHI or Apnea Hypopnea Index) plus symptoms (daytime sleepiness, unrefreshing sleep, falling asleep in the middle of the day unintentionally, reports of insomnia, waking up breath holding, choking, gasping, or with a bedmate reporting loud snoring, breath pauses, or both), or greater than 15 apnea/hypopnea + respiratory-associated arousals per hour in the absence of the additional symptoms. Further, an AHI of 40 or more over the course of 2 hours is sufficient to allow a split night protocol to go into effect (essentially, hooking the sleep study participant up with a CPAP machine a few hours in, rather than merely recording the whole night), though the guidelines allow for clinical judgement to be used to do the same for AHI values between 20 and 40.
Mild apnea is defined with AHI values falling in the 5-14 range, moderate 15-30, and severe greater than 30, so if usedtobe ended up getting put on CPAP after 2.5 hours, his apnea was likely at least moderate in severity (AHI of 20-30), if not severe if they stuck to the AHI >= 40. He also mentioned he’s on four different medications for blood pressure, and hypertension is relatively common in individuals with sleep apnea, with four different antihypertensives at least suggesting, if not outright supporting, treatment resistant hypertension putting him in the high risk of sleep apnea category. Last, and certainly not least, he’s on several medication known to worsen, if not outright cause, apnea (of whatever type)–Temazepam and Morphine. The CPAP already being in the room could very well just mean that they know a significant number of patients are going to need it, so why not already have it ready to go?
Actually, putting you on CPAP 2.5 hours in (~30 minutes for sleep latency as well as the meds starting to exert their effects plus 2 hours for the split-night protocol requirements) strikes me as being dead on for the accuracy of the sleep apnea being a major cause of your insomnia. It’s potentially severe enough that it really doesn’t take you very long to stop breathing once you go to sleep, triggering a micro- or full arousal event which you interpret as having difficulty falling asleep. Your medications, in addition to potentially worsening the apnea, also raise the threshold the brainstem has to overcome to actually arouse you. The mouth breathing thing may play it’s own role in the difficulty you find in falling asleep, but it doesn’t (to my knowledge) mess with the detection of apnea/hypopnea events.
Apnea, btw, is the complete cessation of breathing, while hypopnea is characterized by abnormally shallow breathing and/or a very low respiratory rate. Both contribute to the symptoms and problems associated with a diagnosis of a sleep apnea disorder.
OK, clear up a couple of things" Medicare, not Medicaid.
The 4 antihypertensives are 2 each of Atenolol and Amlopidine (sp) - not 4 different drugs.
The drug of choice that night was Clonazepam - easier to control dosage (I use 1.5 “pills”/night).
The clonazepam is tablet, temazepam is capsule.
Yes, the tech measured my neck - 16" - no Gotcha! there.
I will google “apnea/hypopnea + respiratory associated arousals”, but how does something which develops AFTER the onset of sleep cause insomnia?.
The tech told me he might wake me to have me change positions if I didn’t do so on my own. I don’t remember any such instructions. FWIW.
OK, so, should I ever see the printout, the little O2 sensor on my finger should nosedive as soon as I lose consciousness, correct?
The bands around torso should show a flattening.
Timing: Appt was 10:00 I gave it 30:00 to get to the point of taking the cocktail and another 30:00 for them to take effect - so the 2.5 hours would have been AFTER the drugs kicked in…
And, for extra points, my eye movements should not indicate REM.
There was a nasal cannula was installed - unless there is a way to detect mouth breathing (is that what the chin electrode was about), by itself is meaningless.
I wear a full beard and my hair is past my butt - getting the wires attached was something of a challenge.
And for giggles - after the 04:58 reply to this thread, I went back to bed - and got in some dreaming. Even in a very light sleep.
Looks like, whatever the hell was going on in the shop, I was not sleeping.