Sleep Study Results - Advice on Next Steps

[Sully1234]

Based on my results (images attached) my ENT doesn't want to do anything and thinks my fatigue/brain fog are caused by something else.

I'm at a loss as I thought it would be much worse. I was absolutely convinced my apnea was much worse but apparently results are "normal"...

Open to any advice or other recommendations of what to look into.

 

[EnhancedFatGrappler]

I'm just a fat meathead that abuses gear, so take it with a huge grain of salt:

2.8 AHI really is low. Oximetry looks good, snoring doesn't seem to be bad. My AHI was over 20, my snoring and obstruction was so bad, they stopped the test lol. For me, the CPAP was a godsend. I just don't see how it would help you, it just doesn't look like you got sleep apnea.

But your HR is really high. 89 BPM during sleep is not good. I'd book an appointment with a cardiologist, seems like you are just too amped up to really get good sleep.

Paging Dr. @bbxtreme

 

[Swifto]

Based on my results (images attached) my ENT doesn't want to do anything and thinks my fatigue/brain fog are caused by something else.

I'm at a loss as I thought it would be much worse. I was absolutely convinced my apnea was much worse but apparently results are "normal"...

Open to any advice or other recommendations of what to look into.

Am I reading this right... Your highest HR during sleep was 184?

Is there any oxygen related readings?

Your HR is probably elevated due to not getting in enough oxygen.

 

[bbxtreme]

I'm just a fat meathead that abuses gear, so take it with a huge grain of salt:

2.8 AHI really is low. Oximetry looks good, snoring doesn't seem to be bad. My AHI was over 20, my snoring and obstruction was so bad, they stopped the test lol. For me, the CPAP was a godsend. I just don't see how it would help you, it just doesn't look like you got sleep apnea.

But your HR is really high. 89 BPM during sleep is not good. I'd book an appointment with a cardiologist, seems like you are just too amped up to really get good sleep.

Paging Dr. @bbxtreme

Sorry I’m just not on here as much lately.

I would like to see bloodwork and cardiovascular testing. There’s not enough oxygen being made. This could be anything from CKD to being overweight to an iron deficiency etc.

I’d get bloodwork and follow up with a cardiologist at minimum.

 

[specter]

Am I reading this right... Your highest HR during sleep was 184?

Is there any oxygen related readings?

Your HR is probably elevated due to not getting in enough oxygen.

Yeah that looks insane..

 

[Sully1234]

Am I reading this right... Your highest HR during sleep was 184?

Is there any oxygen related readings?

Your HR is probably elevated due to not getting in enough oxygen.

Yes, 184 bpm. Last sleep study was similar - HR of 180 BPM during sleep. Although on that one I stopped breathing for over 60 seconds.

I have a custom fit mouth piece that locks my jaw 6mm forward. So it appears to have reduced the events per hour which was 5-10.

Oximetry table on the second page "SS SC 2".

 

[Sully1234]

Sorry I’m just not on here as much lately.

I would like to see bloodwork and cardiovascular testing. There’s not enough oxygen being made. This could be anything from CKD to being overweight to an iron deficiency etc.

I’d get bloodwork and follow up with a cardiologist at minimum.

Nothing to apologize for, I appreciate the input. I got an iron panel this morning through ULTA Labs.

Waiting on call back from Doctor to schedule Cardiology appointment.

By CKD I assume you mean Chronic Kidney Disease (not cyclical ketogenic diet)?

Other than Iron what blood work would you order?

And I assume the cardiovascular testing would need to be ordered from a physician.

 

[bbxtreme]

Nothing to apologize for, I appreciate the input. I got an iron panel this morning through ULTA Labs.

Waiting on call back from Doctor to schedule Cardiology appointment.

By CKD I assume you mean Chronic Kidney Disease (not cyclical ketogenic diet)?

Other than Iron what blood work would you order?

And I assume the cardiovascular testing would need to be ordered from a physician.

Kidney disease. So would check eGFR and Cystatin c.

Fill iron panel and ferritin, HSCRP and your basic metabolic panel, lipids and CBC.

Any cardiology testing will have to be done through a cardiologist. I personally wouldn’t put too much stock in a CT calcium score and would skip straight to a Heart Flow or Cleerly test which uses a CT angiogram to show you hard and soft plaque. If you don’t have those in network under insurance I would push for a PET scan.

 

[specter]

Yes, 184 bpm. Last sleep study was similar - HR of 180 BPM during sleep. Although on that one I stopped breathing for over 60 seconds.

I have a custom fit mouth piece that locks my jaw 6mm forward. So it appears to have reduced the events per hour which was 5-10.

Oximetry table on the second page "SS SC 2".

Dude you should not have a peak pulse of 184 during sleep.. i had spikes up to 100 and it made me wake up, 184 would give me a full blown panic attack..

 

[Reload]

I have/had Afib RVR and even my HR didn't get that high. Could you possibly be having panic attacks in your sleep? PTSD?

 

[Reload]

Question for those familiar with CPAP/APAP...is there any harm in using a CPAP w/o being diagnosed with OSA or CSA?

 

[danieltx]

Question for those familiar with CPAP/APAP...is there any harm in using a CPAP w/o being diagnosed with OSA or CSA?

No. Plenty of guys who have never been diagnosed but suspect it get them off Craigslist or similar market places and set up up without ever seeing a doctor.

 

[Reload]

No. Plenty of guys who have never been diagnosed but suspect it get them off Craigslist or similar market places and set up up without ever seeing a doctor.

That's good to know. The actual machine is the only thing that requires a Dr's prescription correct? The hoses and attachments, head gear etc. do not?

 

[danieltx]

That's good to know. The actual machine is the only thing that requires a Dr's prescription correct? The hoses and attachments, head gear etc. do not?

Correct, you can buy all the accessories online. There are also stores like The CPAP Shop that will provide you the prescription so you can buy the machine. Once you get one search online for 'provider mode' which will let you get to the areas to adjust air pressure, humidity level, etc. You literally don't need a doctor for any of it.

 

[heavyhitter]

Dude you should not have a peak pulse of 184 during sleep.. i had spikes up to 100 and it made me wake up, 184 would give me a full blown panic attack..

Maximum human heart rate is usually calculated as 220-your age. I don’t know the OP’s age…but he’s got to be right at max heart rate or even higher at 184bpm

 

[Sully1234]

Maximum human heart rate is usually calculated as 220-your age. I don’t know the OP’s age…but he’s got to be right at max heart rate or even higher at 184bpm

220 - 34 = 186

 

[Sully1234]

Kidney disease. So would check eGFR and Cystatin c.

Fill iron panel and ferritin, HSCRP and your basic metabolic panel, lipids and CBC.

Any cardiology testing will have to be done through a cardiologist. I personally wouldn’t put too much stock in a CT calcium score and would skip straight to a Heart Flow or Cleerly test which uses a CT angiogram to show you hard and soft plaque. If you don’t have those in network under insurance I would push for a PET scan.

Iron came back pretty good as far as I can tell... Guess I'll just have to wait for the cardiologist and other bloods.

IRON, TOTAL - 116 (50 - 180)
IRON BINDING CAPACITY - 382 (250 - 425)
% SATURATION - 30% (20 - 48 %)
FERRITIN - 136 (38 - 380)

 

[Sully1234]

Dude you should not have a peak pulse of 184 during sleep.. i had spikes up to 100 and it made me wake up, 184 would give me a full blown panic attack..

Yeah, I mean I knew something was off but didnt think it was that bad lol. Definitely don't feel good after waking up.

 

[heavyhitter]

Yeah, I mean I knew something was off but didnt think it was that bad lol. Definitely don't feel good after waking up.

As an example…..my heart rate doesn’t reach 184 when running a mile at a 7 minute mile pace

 

[Sully1234]

As an example…..my heart rate doesn’t reach 184 when running a mile at a 7 minute mile pace

I think I only recall getting mine that high doing hill sprints.