Sleep apnea

[juice2012]

Well, I just got diagnosed with sleep apnea.

Here is my background thread:
http://forums.steroid.com/showthread...ions-about-TRT.

Here are my results:

Clinical Background:
27 year-old patient is here for an Attended Diagnostic
Polysomnography.

PROCEDURE:
This attended polysomnogram montage using Compumedics Profusion 3
Software included recorded video, 6 EEG electrodes for frontal,
central, and occipital monopolar recordings, 2 EOG electrodes,
ECG, and chin EMG electrodes, snoring microphone, thermistor,
airflow pressure, thoracic, and abdominal respiratory effort,
pulse oximetry, leg movement, body sleeping position, and body
movement. The 30 sec. epochs were scored according to The AASM
Manual for the Scoring of Sleep and Associated Events: Rules,
Terminology and Technical Specifications (2007).

SLEEP SCORING DATA:
Lights Out / On (clock times): 21:42:10 / 05:20:41
Total Recording Time (TRT) (min): 459.5
Total Sleep Time (TST) (min): 370.5
Sleep Efficiency: 80.8%
Sleep Latency (min): 17.0
Stage REM Latency (min): 101.5
Wake after sleep onset (WASO) (min): 71.0

Stage N1 Sleep (min, % of TST): 21.0 (5.7%)
Stage N2 Sleep (min, % of TST): 212.5 (57.4%)
Stage N3 Sleep (min, % of TST): 87.0 (23.5%)
Stage R Sleep (min, % of TST): 50.0 (13.5%)
Supine Sleep (min): 161.0
Arousals (index, #): 34.0 (210)

RESPIRATORY ANALYSIS: (index = #/hr)
Apnea/Hypopnea Index (AHI): 1.9
NREM AHI: 1.3
REM AHI: 6.0
Non-Supine AHI: 1.1
Supine AHI: 3.0

Respiratory Disturbance Index (RDI): 16.0
NREM RDI: 14.0
REM RDI: 28.8

Apneas (index, #): 0.2 (1)
Obstructive Apneas (index, #): 0.0 (0)
Mixed Apneas (index, #): 0.0 (0)
Central Apneas (index, #): 0.2 (1)
Hypopneas (index, #): 1.8 (11)
RERAs (index, #): 14.1 (87)

Mean Awake SpO2: 96%
Mean Sleep SpO2: 95%
Minimum Sleep SpO2: 91%
Sleep Time with SpO2 < 88% (min, % of TST): 0.0 (0.0%)

Cheyne Stokes breathing: No
Snoring: Yes

CARDIAC ANALYSIS:
Mean Awake HR: 62
Mean Sleep HR: 63

Bradycardia: No
Asystole: No
Sinus tachycardia: No
Narrow Complex Tachycardia: No
Wide Complex Tachycardia: No
Atrial Fibrillation: No
Other: None

LIMB MOVEMENT ANALYSIS:
Periodic Limb Movements of sleep (PLMS) (index, #): 8.1 (50)
PLMS with arousals (index, #): 1.0 (6)

OTHER ABNORMALITIES:
No other unusual body movements were demonstrated and no seizure
activity was noted.

CLINICAL INTERPRETATION:
1. Polysomnographic findings are consistent with moderate
obstructive sleep disordered breathing with evidence of upper
airway resistance syndrome (UARS). The overall RDI was 16.0
events per hour of sleep and the lowest oxygen saturation was 91
%.
2. Snoring was present per technician's notes.
3. Periodic limb movements of sleep did not appear significant.
4. The most efficacious treatment modality for sleep apnea is
continuous positive airway pressure (CPAP) and surgical treatment
modalities are alternative options. An oral appliance may be
effective treatment in mild cases. Non-specific treatment
options include weight loss of at least 10% of body weight (if
overweight), avoidance of supine posture (i.e. side-sleeping or
elevation of the head 30 degrees is preferred), and avoidance of
sleep deprivation, alcohol and nicotine.

Next week I was about to go back to my PCP and start TRT, how does this new diagnosis change things? Should I wait to see how using a CPAP works out before I start TRT?

[juice2012]

Here is something interesting I just read on Wikipedia:

Women suffer typically less frequently and to a lesser degree than do men, owing partially to physiology, but possibly also to differential levels of progesterone.

[juice2012]

After re-reading the diagnosis it looks like I don't have apnea but some other thing called "Upper airway resistance syndrome".

http://en.wikipedia.org/wiki/Upper_a...tance_syndrome

There is question in the medical community as to not only the existence of this syndrome, but whether it should be classified as a separate syndrome or part of the larger group Sleep-disordered Breathing (SDB). This unfortunately has led to a poor understanding of the illness by the medical community at large as well as a consequential lack of acceptance by medical facilities and health insurers.

[xtitan1]

Sorry to hear you have both these issues going on (sleep apnea and low testosterone).

Whether you think you have OSA or buy into UARS and think you have that, the treatment is the same. CPAP therapy. What would suck is if you believed you had UARS but could not get prescribed CPAP therapy because your AHI wasn't high enough. You fortunately don't have that problem. Definitely get started on the CPAP therapy. Usually your Doc will order a second lab, called a titration study, to determine the appropriate pressure for your CPAP machine. Basically they inch it up during the night as long as it makes you sleep more soundly, until you start getting hypopneas again. Then they inch back down to that sweet spot and that's what they prescribe long-term for your CPAP machine at home. Make sure if you have any reservations about the mask/headgear that you demand to try something else, even if it takes 10 tries! It won't cost you any money and you will be much more likely to stay compliant with the machine if your mask is perfect. Try out the Swift FX, which I and many others use (it's a nasal pillow mask), but if you don't like it, keep trying new ones!

I'm going to leave the question about its effect on testosterone to the experts.

If your testosterone comes up either from the CPAP therapy or if you decide to do TRT, you will probably lose some weight and that might be enough to cure the Sleep Apnea/UARS and allow you to stop using the machine. That is something, of course, you need to figure out with your doctor's help.