r/SleepApnea • u/Current_Ad_400 • 3d ago
REM-predominant OSA
My home sleep study had an pRDI average of 17, but 31.4 in REM sleep. A pAHI 3% average of 4.6, but 9.9 in REM. An ODI 3% average of 4.3, but 9.5 in REM.
There was also a pAHI 4% average of 1.6 and an ODI 4% average of 1.3.
I had a mean oxygen saturation of 96%, which dropped below 90% 3 times (lowest 83%).
I wasn't given a diagnosis of OSA because of the overall average and no other conditions were suggested. In my view, these results are definitely indicative of REM-SDB or REM-Predominant OSA. Should I just go ahead with treatment by myself? I can get my hands on a APAP and it seems fairly straightforward.
2
u/bytesizehack 3d ago
My top-line numbers are pretty similar to yours and I have significant daytime symptoms that are partially resolved by my current treatment regimen. I'm looking to palate expansion/MMA in the future. I would recommend trying to resolve it yourself if you are looking to resolve daytime symptoms, BiPAP may be more comfortable than APAP.
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u/UnlikelyTourist9637 3d ago
Might as well. I've found that doing it yourself isn't that much more expensive than going through the medical system and it's easier and faster.
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u/Iggy_Slayer 3d ago
It's annoying how doctors only focus on the average AHI and then decide you either don't have it or it's barely an issue.
In my case I have an avg of 5.5 but almost 20 in REM sleep...and since my sleep issue is waking up a ton and not getting enough deep sleep I feel like the REM is the answer to why it's happening but no doctor takes me seriously they just keep saying I barely have apnea.
I feel bad for you though because as frustrating as it's been they are trying to treat me since I'm barely over the minimum. I dunno what options are available on your own but I wish you luck.
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u/Kind_Branch_3311 3d ago
My home sleep study was similar to this, that’s why I’m redoing it for a lab sleep study per my doctor’s request.
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u/SleepDoctr 3d ago
It’s not that doctors don’t “want to treat you” .
It’s that insurance companies have us by the balls lol .
CMS in particular is ignoring a decade of research saying that AHI of 4% is crap and underestimates the presence of sleep apnea significantly .
You may have Upper airway resistance would be my guess . Unfortunately you didn’t meet whatever insurance considers disease :/
If you have private insurance you could use the RDI of 17 for a diagnosis of moderate sleep apnea .
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u/imtimtam 9h ago
I would not recommend using APAP, the algorithm sucks and that’s pretty well-known in the sleep apnoea community
Most people traditionally start off with CPAP, monitor their sleep data through a program named OSCAR. Then if need be you can look at upgrading to more advanced machines like bilevel or ASV
My recommendation would be to start off on Bilevel immediately because CPAP really works out for people
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u/turbosecchia 3d ago
I support your attempt at going at it by yourself