Had a sleep study, anxiously awaiting diagnosis

[Matthew]

I think it's >31 days, based on my recent email with an AME.

> 31 days of what?

> 31 out of 90?

Or 75%-80% of the last 31+ days?

My machine gives a 30 and 90 day report (I think - it's been about 6 months since I had to generate one, and I've slept since then.)

It counts >4hrs of use as one day of compliance. Miss a day, or use it less than 4 hrs and you don't get credit.

The simplest compliance report is one line long: "xx/90 days usage > 4 hours."

 

[Unregistered]

Thought I'd give an update...

In my previous post, I mentioned I did have OSA, and a rate of about 90 apneas per hour. The doctor prescribed the ResMed S9 with humidifer and heated hose, which I've now been using every night the past week.

I went with a nasal pillow, a new design called the Wisp from Respironics. It seems fairly comfortable, I've at least been able to fall asleep with it on every night.

I have it set to gradually increase the pressure over the first 45 minutes. I think I've been falling asleep within about 30 minutes, although it's hard for me to tell. I was worried about only breathing through my nose at first, because I was a mouth-breather (that was confirmed during the sleep study, too) but so far it's been working out well. I had a concern about when I catch a cold and my nose stuffs up, if I should also keep a full face mask handy, but the lady at the DME said most people don't do that, they just take medication to help clear their nose up (my thing is I drink NyQuil by the bucket when I get a cold) and if they're able to breathe enough with the nasal pillow, they're fine. Otherwise, they might do without the CPAP for a couple nights until their nose improves. I guess I'll just have to play it by ear (or nose?) next time I get a cold.

I check the ResMed each morning to see the last night's results, and it's reporting under 5 apneas per hour each time I've used it. Last night was 1.1. Most I've had I think was 3.8.

I've only noticed two odd things in the past week:

After about 6 hours or so with the mask on, I wake up, usually noticing the mask is leaking a little and hissing. It's at full pressure (between 9 and 14) at that point, and I think me sleeping on my side with my nose/mask kind of pushed into the pillow moves it around a bit. That, and the full pressure, causes it to hiss sometimes. I'm not sure if that's waking me up (I doubt it) or whether it's more "I've had this thing on for 6 hours now, it's time to take it off".

I'll usually take it off at that point, and just spend the next hour or two completing the waking up process. Sometimes I might fall back asleep, or I might just lie there until I decide to get up.

I'm curious if other people have this same response, that after having it on for "x" number of hours, you take it off?

The other odd thing...when I take off the mask, the room air smells different for a few minutes. I guess after breathing nothing but filtered air for several hours, when I go back to smelling room air, I'm hyper-sensitive to smelling the dust in the room air, or whatever. It only lasts for about 5 or 10 minutes, then everything smells normal.

I have my next follow-up appointment with the sleep doctor in another 5 weeks, when I bring in the SD card and they'll evaluate the results.

So far, so good, I hope...

 

[Palmpilot]

The other odd thing...when I take off the mask, the room air smells different for a few minutes. I guess after breathing nothing but filtered air for several hours, when I go back to smelling room air, I'm hyper-sensitive to smelling the dust in the room air, or whatever. It only lasts for about 5 or 10 minutes, then everything smells normal.

I'm not a doctor, but that sounds to me like olfactory fatigue, which is the phenomenon where you can't smell an odor after your nose has been exposed to it for a while.

For colds, have you tried Cold-Eze spray? It works wonders for me. (I think Zicam is another brand of the same thing.)

 

[JimNtexas]

I think you'll find a 45 minute ramp to be too long. They set mine initially to ramp from 4 to [8-20] over 20 minutes. The 4 setting was sufficating me.

I eventually turned the ramp off and just go straight to 8. Mine stays at 8 almost all the time, when there is an event it bumps up to about 10 or 11 momentarily.

The Resmed software is pathetic. It's clearly a Windows 95 app that has been ported. It reads the plain text csv file from the card and draws some primitive graphs and tables.

It is almost impossible to get to use any time period other than the first 90 days on the card.

The FAA per night requirement is six hours, not four.

 

[Matthew]

The FAA per night requirement is six hours, not four.

I thought that might be the case, but I couldn't find the details. A lot of machines, maybe most, record the 4 hr compliance. I remember hearing some complaints about FAA being different. But I think all machines also report an avereage/night usage.

 

[Unregistered]

Thanks for the replies. I'll have to check out the Cold-Eze spray next time I get a cold. I'm good with that kind of thing as long as it doesn't have zinc in it. I remember some stories a few years ago of some people who used zinc nasal spray and lost their sense of smell.

I haven't loaded the SD card data into any software yet, but I've seen other posts here about the ResMed software being crappy. I'll probably install Sleepyhead and use that, at least for my own tracking. I don't know what my sleep doc uses - I'll find out in a few more weeks when I have my follow-up.

I think I fixed the issue of waking up after 6 hours or so and wanting to remove the nasal pillow (due to leaking/hissing) by tightening the headband a little. I think it was too loose, causing it to leak and hiss too much at the higher pressures, and it might have been waking me up too early. Last night, with the tighter fit, I slept for about 7 hours and didn't wake up until my alarm went off, so hopefully the tighter fit helped.

I'll have to try adjusting the ramp downwards. I don't think it's taking me 45 mins to fall asleep, so I'll try 30, and maybe keep going down as much as possible.

I've read various posts (some were Dr. Bruce's) about the FAA's number of hours per night. I've seen both 6 and 4 mentioned. 6 hours shouldn't be an issue, now that I've hopefully fixed the leaking/hissing mask issue, and I won't feel like waking up after only 6 hours and wanting to remove the mask.

 

[Palmpilot]

Thanks for the replies. I'll have to check out the Cold-Eze spray next time I get a cold. I'm good with that kind of thing as long as it doesn't have zinc in it. I remember some stories a few years ago of some people who used zinc nasal spray and lost their sense of smell.

It does have zinc in it. My understanding is that the problem people had with nasal use is the reason why the spray is now intended only for use in the mouth.

 

[hannanmike]

I've read various posts (some were Dr. Bruce's) about the FAA's number of hours per night. I've seen both 6 and 4 mentioned. 6 hours shouldn't be an issue, now that I've hopefully fixed the leaking/hissing mask issue, and I won't feel like waking up after only 6 hours and wanting to remove the mask.

I would like to mention two things that you need to pay attention to once your compliance to the devices has been certified -

(1) Be especially careful with regards to choosing an AME. Whether you choose Dr Bruce or anyone else, make sure you talk to them or visit them as a physician before scheduling an appointment as an official AME. If your paperwork is not in order, a wrong AME might worsen your case, and you might get entangled in lot of unnecessary delays with the FAA.

(2) Even before you talk to your AME, make sure that your sleep disorder is thoroughly taken care of. There is a wonderful free app for this. Do this -
+ Go to the app store on your smartphone (android/apple) and search for a free app called "zee appnea".
+ Run an overnight sleep breathing test just with a pair of ear-buds & microphone
+ You will get an expert analysis report within 48-hours indicating whether you have sleep apnea or not. In your case, if everything has been taken care of, it will be "Normal". Now you can be 100% confident about approaching an AME. You can also confirm with them about the completeness of your current documentation, and can even ask suggestions for a good AME in your area i.e. if you are not going to Dr Bruce.

 

[JimNtexas]

Your Resmed S9 will tell you every morning what your 'AHI' (events per hour) value is, just hit the 'info' button. IIRC it needs to be less than 5.0, but don't quote me on that.

Goto cpaptalk.com, look around, and you can get a link to the ResMed software, which you will need to have to generate your 31 day report for the FAA.

 

[gismo]

I guess. But there's nothing to prevent someone from just creating their own report in MS Word, and writing their own doctor's status report, either.

Nothing except the potential to lose all your certs, pay a big fine, and maybe get some free meals with a place to sleep if you get caught.

 

[Unregistered]

Thanks for the recent replies.

I check the "info" screen on the S9 every morning, and now it's always above 6 hours each night, and AHI is always below 5. It's usually around 2.0 now.

I solved the wanting to remove the mask early by tightening up the strap, which fixed the loose/hissing problem. Now, I don't have any tendency to want to remove the mask early. I usually start waking up about 30 mins before my alarm goes off to begin the wake-up process, and I'll go ahead and take it off then. But it's still over 6+ hours of use each night. Sometimes on weekends, I'll sleep later and get close to 8 hours of use in.