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Re: Re: Re: Diagnosis after Oximetry test

Posted by writermd on May 18, 2002 at 07:53:11:

In Reply to: Re: Re: Diagnosis after Oximetry test posted by Enigneer on May 17, 2002 at 14:43:52:

First, if you do try the dental appliance (a mandibular advancement splint, they're usually called)--which works by pulling your jaw forward and theoretically opening your airway more--be *sure* not just to use it an assume it works. In my case, it seems to have been either ineffective or, possibly, even worsened my apena. That is unusual, though. But in any case, don't just take the thing home and sleep with it. Get the doc to let you use the pulse oximeter again for several nights and see if it improves with the appliance.

Also, it can be a slow process to get the mouthpiece "working" right because many people cannot tolerate the mouthpiece at the optimal setting right away. For me, it took, literally, several months to build up to the "appropriate" level (the thing pulls your jaw forward, stretches muscle and tendon, and that takes time). AND the damn thing can hurt terribly. I used to take aspirin before going to bed just so the pain would ease enough that I could fall asleep. I ultimately stopped even experimenting with the mouthpiece because it was too painful to tolerate. Also, the good ones are *not* cheap and are in fact more expensive than CPAP: mine was a custom job, from a dentist who specializes in apnea, and it cost $2,000--you can get a new CPAP, and certainly a used one, for much cheaper than that; you can even get an autoCPAP for much cheapter than that.

Finally, a question: when you say you go through long periods--15 or 20 minutes--with O2 sat at 82%, are you saying that during the 15-20 minutes you have multiple brief *episodes* (say 20-40 seconds each) of 82%, along with the baseline in the 90s, or are you saying that for 15-20 minutes your O2 saturation is consistently near 82%? Those are very different things. Let us know what you've got so someone can comment.

But either way, 82% is nothing to sneeze at, and you should definitely persue this thing aggressively. In a young person like yourself, it probably won't cause any irreparable harm in the short run, but over time it can cause memory loss and (horrors) probelms with your erection, which may be to some extent become permanent, and eventually you can give yourself a heart attack or develop heart failure. Don't mean to freak you out, as all those things take time and you'd probably manage to stay healtny for years still, given that your a young person, even without treatment (although you'd feel very tired, etc.)--but this is serious stuff and will in the long run quite possibly caus you real harm. That said, don't rush into any illconsidered treatments. Take it one step at a time, and certainly, at least to start, get yourself on CPAP ASAP.

Finally (again), if you really can't get on CPAP for a few months, due to long waiting times at the clinic, then my suggestion is to (a) push for an earlier date and repeatedly call them to see if there have been cancellations and tell them you can come in last minute, (b) if you can't get one, then talk to your doctor about getting oxygen at night, till you get other treatment inplace. Not intended as medical advice, but there do seem to be a number of studies in the medical literature that show that nocturnal oxygen can eliminate episodes of hypoxemia (low O2 levels) fairly effectively even if they don't stop the apneas themselves. In fact, I'll post some of these right now, in a new post in forum 93.


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