Do I "really" need a CPAP-Mild sleep apnea

Hello;
I have recently been diagnosed with mild sleep apnea (AHI 8x/hour). The private (for profit) company that did my sleep study is still recommending I purchase a CPAP machine for a whopping $2500. My question is, will I still notice a difference in the morning and will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?
Thank You

I have the same question, I don't snore or have any unusual problems. I had to do a sleep test because I had an upcoming colonoscopy (66 years old) and my neck measured 13 and I have high blood pressure which is under control. After 20 days on the machine my AHI was 1.9, whatever that means. I can't stand the machine and usually throw it off early in the morning when I finally get some sleep.
I have a Nuance nasal pillow, which isn't too bad compared to the Opus I started off with. I had the sleep study at the hospital and the doctor said I needed the CPap machine.

What exactly are you being sold for $2500?

You seem to imply that profit motive is at work here. I don't think we have nearly enough detail to tell you that. If you really are suspect, take your results for a second opinion somewhere.

I don't have personal experience with low levels of apnea but I can tell you that I've seen people here thoroughly upset that their levels weren't over the threshold (5 AHI) to get a prescription and they believe apnea is ruining their lives. Also, 5 is the commonly accepted threshold, seems to be a standard in the field, so no one is bending the truth here, you are within the range.

Jazzhiker wrote:Hello;
I have recently been diagnosed with mild sleep apnea (AHI 8x/hour). The private (for profit) company that did my sleep study is still recommending I purchase a CPAP machine for a whopping $2500. My question is, will I still notice a difference in the morning and will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?
Thank You

Did the company mention the very serious usability issues with CPAP? That when looking at long term (over a year) objective (not self reported) data somewhere in the neighborhood of 50% of those who are commended to CPAP are not using it the required 4 hours per night (most of them have given up by that time)?

Did they mention that sleep studies are known to have false positive diagnosis? Honestly, a test in a lab under the financial pressure and all is not going to see how you actually sleep in your own bed at home night after night. It simply will not.

Now there may be some conditions such as hypertension which will not respond to drugs which may have your main doctor still recommending CPAP. If it works it can have wonderful effects on blood pressure. I have seen this myself.

But with just the info you have given I would tend to move toward spending the funds on a dietitian (go for at least three years!) and a personal trainer (again three years) shopping well. In other words pursue metabolic health (and yes please do study on your own!).

Jazzhiker wrote:Hello;
I have recently been diagnosed with mild sleep apnea (AHI 8x/hour). The private (for profit) company that did my sleep study is still recommending I purchase a CPAP machine for a whopping $2500. My question is, will I still notice a difference in the morning and will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?
Thank You

Big Red Flag on the $2500 tag -- tell us the make and model of the machine they want you to buy.

Is the sleep lab where you had your sleep study also the seller of the machine? If so, another Big Red Flag.

The sleep study AHI of 8 is 'officially' mild but may not tell the whole story. First, we don't sleep the same way every night, so it's possible that your one night at the sleep study may not be perfectly representative of most of your nights. Second, another aspect of severity is how long do those apnea episodes last, and how low does your blood oxygen level go? Third, even 8 events per hour can be horribly disruptive to one's sleep.

So a machine does seem to be in order, however, something smells fishy about the message you're getting about the cost of the machine.

If you want to post a copy of your sleep study and also let us know what machine is being recommended, we can give you more feedback.

Please ignore the irresponsible recommendation in the previous post -- no one should recommend a dietician and a personal trainer as an alternative to PAP therapy to someone has just been diagnosed with sleep apnea. We don't know anywhere near enough about your medical history or recent sleep study.

Hello and welcome. There is so much more to consider than just the number. I'm guessing you went in for testing because you were symptomatic. If your sleep apnea was enough to cause symptoms, you'd likely benefit from addressing it in some way. Please do yourself a favor and get a copy of your report. Here's some things to look for as you make treatment decisions. Whatever decision you make, fortunately the information is available to make it with knowledge.
- Were they able to capture a significant time in REM while supine? That is the worst case scenario for some people. If that is not reflected in your testing time, your results may not be fully representative of your condition. Sometimes people don't sleep enough or have enough of the different stages and positions to get a full picture of their problem.
- Arousals matter. How many of your relatively few apneas per hour are causing arousals and fracturing your sleep? A few that all cause arousal can be more disruptive to the solidarity of your sleep than a greater number that don't cause arousal.
- What was the duration of your events? Does a low event count mean you were sleeping fine in between or that your events were longer in duration? Long events are particularly concerning.
- What do your oxygen levels look like - lots of fluctuation or low levels?
- What did your report say about limb movements? If there were a lot of them not related to respiratory effort your potential apnea count may have been obscured by the movements.
- Was there a significant difference in your events between side sleeping or supine? Some people have positional apnea and can control it by taking measures to stay off the back.
Good luck!

My original S9 Autoset was billed at over $2600.
They were paid a rental fee by the insurance of about $125/mo which they were satisfied with. They never asked me for a dime.
Prices quoted by DMEs are not always what they actually get.

Jazzhiker wrote:will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?

When I started cpap in July of 2011 I was taking 20MG of Vasotec in the morning and 20MG at supper, I know take 5MG in the morning and 5MG at supper. I really think I can get off of BP medicine altogether the next time I see my Doctor. I'm still the same weight that I started cpap, so the only difference is this wonderful machine I sleep with every night,I've gotten to where I can't sleep well with out it. I've also gotten to where I feel like a whole new person compared to what I was before.

If you don't have insurance coverage for it, the worst (most expensive) place
to buy cpap equipment is just down the street (local DME).
Shop online, as many of us did.

Jazzhiker wrote:Hello;
I have recently been diagnosed with mild sleep apnea (AHI 8x/hour). The private (for profit) company that did my sleep study is still recommending I purchase a CPAP machine for a whopping $2500. My question is, will I still notice a difference in the morning and will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?
Thank You

I have never heard of a "NOT-for-profit" company that did sleep studies. Are you kidding?
That amount of money is about par for machines w/humidifier being submitted to insurance companies. About nine years ago, it was also in that ballpark......maybe a little less. If you purchase the equipment out-of-pocket from an online/Internet seller it'll be much less.

"Only 8 X an hour"? Just because it's considered "mild", doesn't mean diddly squat. They could have caught it near the beginning and if left untreated for longer periods, it could take a heavy toll on your health. You should be thankful and not blow that off.

And, yes, CPAP therapy has been known to bring down blood pressure.


Den

.

Here are links to two popular machines, and they are way less than $2,500 if bought online thru our host's, cpap.com:

https://www.cpap.com/customize.php?PNum=4068&PAID=0

https://www.cpap.com/customize.php?PNum=3151&PAID=0

This should give you an idea of the cost of great, full data, auto machines. (Note that both of these links come up without humidifier included in the pricing, just scroll down to the humidifier & add to get accurate price. I just wanted to show you the average pricing for these machines & I couldn't get the humidifier pricing to come up in the link.) Things you want are FULL DATA & AUTO. These are both important part of helping you manage your own therapy. Another important part of helping you with therapy is this great forum, which you have found. Everyone here will help as much as each of us can. Its already been posted for you to get the report of your sleep study. I'd say even if you have mild apnea, treatment is still needed, apnea without treatment can lead to many major health problems, just as heart disease, diabetes, strokes & many other bad things you don't want. Hope this info helps !

Jen

carrly wrote:I have the same question, I don't snore or have any unusual problems. I had to do a sleep test because I had an upcoming colonoscopy (66 years old) and my neck measured 13 and I have high blood pressure which is under control. After 20 days on the machine my AHI was 1.9, whatever that means. I can't stand the machine and usually throw it off early in the morning when I finally get some sleep.
I have a Nuance nasal pillow, which isn't too bad compared to the Opus I started off with. I had the sleep study at the hospital and the doctor said I needed the CPap machine.

That's really dumb! At your age, you should take this therapy more seriously.
And, if you don't know what the "AHI" means, you'd better start studying up on this therapy.

Den

.

carrly wrote:I have the same question, I don't snore or have any unusual problems. I had to do a sleep test because I had an upcoming colonoscopy (66 years old) and my neck measured 13 and I have high blood pressure which is under control. After 20 days on the machine my AHI was 1.9, whatever that means. I can't stand the machine and usually throw it off early in the morning when I finally get some sleep.
I have a Nuance nasal pillow, which isn't too bad compared to the Opus I started off with. I had the sleep study at the hospital and the doctor said I needed the CPap machine.

A recent study[1] found that beyond the obstruction that CPAP is able to treat there may be nonanatomic features that play an important role in 56% of patients with OSA.

The features that they looked at were:

A. hi respiratory control loop gain (a tendency to loose good control of breathing)
B. low arousal threshold
C. minimal genioglossus (tongue) muscle responsiveness

CPAP tends to exacerbate “A” as the pressure tend to be a plus factor for respiratory control loop gain.

CPAP has, in my opinion, high levels of noise, vibration, fast pressure changes, and initial back pressures upon the start of exhale which all tend to result in excessive arousals due to “B”.

The tongue is heavy and tends to swell due to allergic response and for many other reasons. While I do believe that the pressure of CPAP helps shrink the tongue I also think that there comes a point where it is not enough. I have found my own tongue to apparently change in size in terms of how much room it takes up with my mouth closed. I would guess this is common.

“A” seems to be helped by getting vitamin D3 levels above 50 (see The Vitamin D Counsel for information regarding the proper assay). I have found that it is directly related to the stress levels in my life. I have found it helpful to pursue good metabolic health (eat well move well) and that long term exercise is helpful if it contains a bit of good aerobics appropriate for my fitness level.

“B” seems to be most helped by long term exercise. Not high level just “keep it moving” until good and tired by the end of the day. But not too much.

“C” seems to be helped by the pursuit of good metabolic health and anti-inflammatory foods. I believe that all with OSA should be assigned a dietitian and personal trainer for at least three years.

Ask your doctor to find out what is really causing your problems and what can be done about that!!

[1] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman "Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets", American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004. doi: 10.1164/rccm.201303-0448OC

Jazzhiker wrote:Hello;
I have recently been diagnosed with mild sleep apnea (AHI 8x/hour). The private (for profit) company that did my sleep study is still recommending I purchase a CPAP machine for a whopping $2500. My question is, will I still notice a difference in the morning and will a CPAP bring down my elevated BP even if my AHI is only 8 X an hour ?
Thank You

So basically you stop breathing 8 times an hour for at least 10 seconds. Do you know what your O2 levels drop too? Because it doesn't sound much but it is an average which means you could be fine for most of the night except for the 20 minutes when you are dreaming and you stop breathing 20 times and at least once for over 60 seconds...... Or you could be having only 8 and they are all at lest 40 seconds long with your O2 levels dropping dramatically.

Yes it could bring down your BP, you might not notice a difference right away or you might. And without insurance, buying from a brick and mortar store yes that is about the right price. Online it will be about half that much.

My mom had a *treated* ahi of 3.4 which sounded good. But when I checked the data, I found events that were over a minute long. Each person is different, so you need to get the summary that shows your graphs, oxygen desaturations, etc.

Keep in mind that sleep apnea is sleep disruption and oxygen deprivation. I used to have normal blood pressure, then high blood pressure, then high blood pressure even with 3 medications. At 39, I was told I was at high risk of stroke. I finally got on cpap and my blood pressure is normal as long as I keep using the cpap. If I skip half a night, my blood pressure shoots back up.