British Snoring & Sleep Apnoea Association

Hi everyone,

I was diagnosed with mild OSA yesterday.
I was basically told try to lose weight and come back in a year- this is what NICE guidelines state!

I have a few issues, the main one being regardless of having 'mild ' OSA I am still incredibly exhausted, forgetful and often have trouble concentrating.

As I understand things, regardless of NICE guidelines, apnoeas per hour do not necessarily corelate directly with the severity of 'tiredness'.

So, I'm having an average of 10 apnoeas per hour, but I did look through the charts & graphs. My initial couple of hours sleep didn't have many at all, then the next couple of hours a lot of areas where there were bursts of apnoeas. the last couple of hours sleep was kind of in between.

So, how do they work out these average figures?

My other question is, how much do other people's apnoeas vary from night to night?
The reason being, I seem to often have periods of a few days at a time when I feel even worse than normal....like a hangover really!!

Sorry to moan & ask so much but I like to be informed as much as possible.

At the end of the day, my OSA mild or not does have a serious impact on my quality of life (and my families) and I feel pretty let down after yesterday

From N.I.C.E guidelines -

CPAP is only recommended as a treatment option for adults with
mild OSAHS if:
• they have symptoms that affect their quality of life and ability to
go about their daily activities, and
• lifestyle advice and any other relevant treatment options have
been unsuccessful or are considered inappropriate

I think you fit the bill don't you ???

http://www.nice.org.uk/nicemedia/pdf/TA139Guidance.pdf

Thats your starter ,

Why did'nt you see a sleep consultant in sleep medicine ???

Demand a second opinion with overnight psg test in a sleep lab.

Fight it all the way -don't take bullshit like that like you say its the impact on your quality of life and your family .

As NM37 says, GO BACK for a second opinion and push for xPAP treatment. OK so it's great if you can lose some weight (you're not alone if you're a bit heavier than you should be!!!) but it WON'T cure your condition. Go back to your GP and enforce your case! Good luck.

How do you intend to reduce your collar size im wondering ????

My gp told me anything over a 16 is a risk of sleep apnoea .

Regards,

Thanks, that's given me a bit more confidence to push this!

I expect it's part of a 'cost improvement' program at the hospital........or probably a way of covering up the waiting list? I know how these things work in my own department so I wouldn't be surprised.

Clinical decisions are now made by the NICE flowcharts rather than by individual patients needs, and that's before the postcode comes into play!!!!

LOL the only way my collar size will get smaller is if I have my neck muscles removed Perhaps I need some kind of neck corset? Also, I have some other problems with my neck that are compressing my nerve roots & spinal cord so I'm a bit restricted on the exercise front and will be even moreso I've I have to have an op. Plus, I barely have enough energy to make it through a working day nevermind go for a jog or whatever.

OK. I need to get back to my GP. Say, I'm not happy with the outcome. Push the point that this is having a severe impact on my quality of life.

Also, as I deal with radiation, needles and other peoples blood at work, feeling spaced out could be pretty catastrophic!

Also, on a different note- something some of you guys might be interested in. A member of staff at the hospital I work at with OSA was recently sacked for nodding off on a night shift. They are taking the hospital to court for disability discrimination!!!!

PS.

What about me just buying CPAP machine to give it a go in the meantime?

There are some for sale on here. I could probably get a prescription for a mask & some advice regarding pressure etc. from the Drs. at work. Or perhaps just pay for a private consultation. Plus I know the guys that service CPAP machines.....

I'm thinking even if I push things I'll have to be re-referred etc. and it will take a while. So, getting a basic set up to see how I get on and see if things improve would give me a head start.

Any thoughts?

I can understand your frustration ... and please let us know how your colleague's court case goes ... I suspect the hospital might not let it got that far and settle out of court.

I'd advise against buying a machine privately. You need to have it set correctly for your needs - the results of a titration study - and have it checked regularly. On top of the cost of the machine you'll need a mask, a tube, a filter and possibly a humidifier. All of these need checking and the filter replacing regularly.

Much better to be in the care of a clinic for this lot. I know it seems to be an ideal shortcut (even though a costly one) but you really DO need the interaction of technicians and a sleep doc to keep your treatment at the highest level ... and to have your equipment replaced as better machines come along.

Right so you know the guys that service the cpap machines be cheeky ask them if you could errrr borrow /steal/lend one just to give you a taster im sure they could do it wink wink nudge nudge .Tell them your thinking of buying one yourself see if its possible.

If you were to buy a machine in the meantime go for a apap machine it will adjust the pressure accordingly to your needs throughout the night therefore no need to be set a constant pressure and no need for anybody to monitor the pressure . A mask would cost £80 -£120 roughly if you breathe through your mouth you would need a full face mask ,if not you could go for a nasal mask.

If you did buy a machine and later got one from the hospital you could always sell it on here you will easily get the money back you paid out .

Am i right to presume that the hospital where you work is the hospital that shafted you with the result?.
If it is i would ask for another hospital .

Im glad your getting the fighting spirit now -well done.

Regards,

Yep, machine, filters & tube should be doable!

Well, I come under a different catchment area to the hospital that I work at, so I will try to get referred to my own hospital....will save on the outrageous parking charges if nothing else.

Alsacienne, yes I understand where you are coming from. I expect I can get some off the record advice at work, a chat with the sleep techs and ask occy health to book me in with the sleep doc.

I'm still thinking of a 'try out', but will need a mask for a mouth breather!!!

That sucks. I find personally, that my tiredness makes me eat foods that aren't particularly good for me and trying to eat healthily is a problem, let alone going on a diet. Trying to do exercise sounds like a marathon when you're tired all the time, walking the dogs around the park tires me out!

Exactly headthrob!!

I know what you mean. Getting some sleep first to have enough energy to exercise might have helped!!

Hi all,

This is probably a strange question but I've been thinking of it all day.....

When using cPAP on a basic level, air under positive pressure is pumped into the mask & hence into the airways to keep them open. So......where does the air when breathing out go? Are there holes, or valves in the mask or is all breathing done through the mask & tube but under positive pressure?

Told you it was a strange question

There are one-way valves in the mask so you don't rebreathe the CO2! That's why there's a small hiss at times and a feeling of air being blown out of the mask. HOWEVER, the air you breath in (O2) has to go somewhere besides the blood stream, heart and lungs, hence 'windy moments' especially on waking!!

Oh and it's NOT a daft question .... very sensible actually!!

LOL Just wait until I tell my wife that in the future along with the snoring and a pipe and mask stuck to my face she's going to have to put up with (more!) wind

You know it means she really loves you if she stands on the windward side!!