great vid, explains why things like antihistamines drowsiness can result in less sensitivity or how ptsd can result in more sensitivity. This seems like an area where a lot of folks fall through the cracks due to how insurance has a myopic aggregate view of ahi
This is really valuable and interesting discussion, it deserves more attention. I'm sure tons of people are frustrated with "decent" sleep study results that don't accurately reflect how much sleep they're really losing, just because they don't conform to the parameters of a perfect "AHI" event!
Thank you for your constant supply of videos on the sleep apnea topics. I wish I was still able to access the NHS and try to come and see you and/or your colleagues. I live in the Czech Republic now and having been to see my doctor was eventually given a tape to wear for two nights. They just happened to be good nights but that was enough for them to tell me everything was fine. I feel awful a lot of the time and I know the sleep disturbances are to blame. Anyway once again thank you for the valuable information. I am educating myself, thanks to you.
I'm sorry - I agree there is a lot of night to night variation which can exclude or viciously include patients. if patients tell me that they think that the test was not representative of their normal sleep then I just keep repeating it until we get a better picture. I'm moving to 3 day sleep study as standard for my patients in the future.
Love your videos! Can you do a video on the magnitude of benefit from tirzepatide (Zepbound) which just got approved in the USA IN December 2024 for OSA?
We assume that everyone is the same. We need to, for initial ease of study, but it is a problem. We're always trying to make people meet what we deem to be "normal". I loved the idea I read in a novel in which it stated that, as cavemen, we had different jobs; we were hard-wired for the different jobs in life. So, there were the hunters - possibly those with ADHD, the night watch - those with trouble sleeping, etc. I'm wondering about those of us with chronic low levels of vitamin D. Anyway, I love listening to you wondering about your patients. I used to wonder about my students the same way. It's great to know you care so much about your patients and not just your area of expertise.
Thank you for this good explanation Dr. Vik. I think that in the end the solution is to focus on using the correct sensors to have a perfect and detailed polysomnography, and analyze it by hand; thus not relying on the software which uses an algorythm to do a diagnostic...
I agree! at the moment the sleep study automated programs say that everyone has sleep apnoea, and the automated CPAP sensors say everyone is okay. These are marketing tactics that we need to move away from.
ur video gave me insight that i may have uars, not sleep apnea. also isnt not waking up on time worse. it can soon spiral into not waking up at all and death. i also noticed something...on days i eat well and "happy" foods my sleep apnea is less or non existing. on days i diet and eat foods im not happy with it is worse.
So......people getting a home sleep study done, with an ahi of 5, but with spo2 drops down to as low as 79%. What is the medical name/condition- for that behavior? 🤔
I@@JeanPierreWhite Yes, if the ahi number gets all the attention, then a low number could lead to this person not getting offered treatment. But such low spo2 drops, certainly isn't healthy? 🤔😉
@@JeanPierreWhite sorry but that is not correct at all. The official criteria from the AASM to have Obstructive Sleep Apnea Hypopnea Syndrome is that the AHI is equal or above 5. So any doctor must diagnose and treat you as a patient with this illness…
The AASM only uses SpO2 desaturation to diagnose hypoapneas inside OSAHS, but it is very strange that you have those big oxygen drops and having few apneas and hypoapneas. Take into account that a home sleep study is not very precise, but anyway, you already are eligible for being diagnosed as an OSAHS patient.
Cheers, Mr. Veer! Love your AI-generated profile picture! I’ve got both sleep apnea and UARS (confirmed by my OSCAR airflow data and DISE results). Funny thing is, I seem to have a pretty decent CO2 tolerance-I can hold my breath for ages, up to 2 minutes without much fuss. Makes me wonder if that sort of thing stays the same when sleeping. Two ENTs reckon a septoplasty and turbinate reduction could help, as they think my nasal issues are making my throat airway narrower. I hope I will have a chance to consult with you or your MDT in the future.
I thought I would give AI a go at this one. People I'm sure are sick of my face on every thumbnail. if you have sleep apnoea, then you are getting trained into holding your breath every night. I think it swings the other way when you start getting deep desaturations. i'm sorry i didn't go into that much detail. that is why people with sleep apnoea get raise EPO.
Interesting, explained well. I wonder if one can increase their arousal threshold (be less sensitive to these arousals) ? Seems like it could potentially help in some cases ? Perhaps less overall disturbances/awakenings. In any case, would treatment (or pressure titration) change/vary depending on one's arousals threshold ? Thanks
I guess my body was highly tolerant of carbon dioxide. The longest period of not breathing I saw, when I videoed myself, was 35 seconds. My untreated AHI was 62.5. I was breathing less than half the time.
great vid, explains why things like antihistamines drowsiness can result in less sensitivity or how ptsd can result in more sensitivity. This seems like an area where a lot of folks fall through the cracks due to how insurance has a myopic aggregate view of ahi
I have to admit I hadn't thought about the PTSD thing - it's a good thought though! I wish I had more time to look into all of this. thank you.
This is really valuable and interesting discussion, it deserves more attention. I'm sure tons of people are frustrated with "decent" sleep study results that don't accurately reflect how much sleep they're really losing, just because they don't conform to the parameters of a perfect "AHI" event!
Thank you for your constant supply of videos on the sleep apnea topics. I wish I was still able to access the NHS and try to come and see you and/or your colleagues. I live in the Czech Republic now and having been to see my doctor was eventually given a tape to wear for two nights. They just happened to be good nights but that was enough for them to tell me everything was fine. I feel awful a lot of the time and I know the sleep disturbances are to blame. Anyway once again thank you for the valuable information. I am educating myself, thanks to you.
I'm sorry - I agree there is a lot of night to night variation which can exclude or viciously include patients. if patients tell me that they think that the test was not representative of their normal sleep then I just keep repeating it until we get a better picture. I'm moving to 3 day sleep study as standard for my patients in the future.
Thank you for the video, I learned new things and will be more prepared when I see a sleep study doctor.
Love your videos! Can you do a video on the magnitude of benefit from tirzepatide (Zepbound) which just got approved in the USA IN December 2024 for OSA?
We assume that everyone is the same. We need to, for initial ease of study, but it is a problem. We're always trying to make people meet what we deem to be "normal". I loved the idea I read in a novel in which it stated that, as cavemen, we had different jobs; we were hard-wired for the different jobs in life. So, there were the hunters - possibly those with ADHD, the night watch - those with trouble sleeping, etc. I'm wondering about those of us with chronic low levels of vitamin D. Anyway, I love listening to you wondering about your patients. I used to wonder about my students the same way. It's great to know you care so much about your patients and not just your area of expertise.
Thank you for this good explanation Dr. Vik. I think that in the end the solution is to focus on using the correct sensors to have a perfect and detailed polysomnography, and analyze it by hand; thus not relying on the software which uses an algorythm to do a diagnostic...
I agree! at the moment the sleep study automated programs say that everyone has sleep apnoea, and the automated CPAP sensors say everyone is okay. These are marketing tactics that we need to move away from.
ur video gave me insight that i may have uars, not sleep apnea. also isnt not waking up on time worse. it can soon spiral into not waking up at all and death. i also noticed something...on days i eat well and "happy" foods my sleep apnea is less or non existing. on days i diet and eat foods im not happy with it is worse.
So......people getting a home sleep study done, with an ahi of 5, but with spo2 drops down to as low as 79%.
What is the medical name/condition- for that behavior? 🤔
AHI of 5 is unlikely to get a diagnosis or sleep apnea. 15 is typically the threshold for untreated sleep apnea.
I@@JeanPierreWhite Yes, if the ahi number gets all the attention, then a low number could lead to this person not getting offered treatment.
But such low spo2 drops, certainly isn't healthy? 🤔😉
@@JeanPierreWhite sorry but that is not correct at all.
The official criteria from the AASM to have Obstructive Sleep Apnea Hypopnea Syndrome is that the AHI is equal or above 5.
So any doctor must diagnose and treat you as a patient with this illness…
The AASM only uses SpO2 desaturation to diagnose hypoapneas inside OSAHS, but it is very strange that you have those big oxygen drops and having few apneas and hypoapneas.
Take into account that a home sleep study is not very precise, but anyway, you already are eligible for being diagnosed as an OSAHS patient.
Cheers, Mr. Veer! Love your AI-generated profile picture!
I’ve got both sleep apnea and UARS (confirmed by my OSCAR airflow data and DISE results). Funny thing is, I seem to have a pretty decent CO2 tolerance-I can hold my breath for ages, up to 2 minutes without much fuss. Makes me wonder if that sort of thing stays the same when sleeping.
Two ENTs reckon a septoplasty and turbinate reduction could help, as they think my nasal issues are making my throat airway narrower. I hope I will have a chance to consult with you or your MDT in the future.
I thought I would give AI a go at this one. People I'm sure are sick of my face on every thumbnail. if you have sleep apnoea, then you are getting trained into holding your breath every night. I think it swings the other way when you start getting deep desaturations. i'm sorry i didn't go into that much detail. that is why people with sleep apnoea get raise EPO.
Your face is quite reassuring to me, doctor!😊
Interesting, explained well. I wonder if one can increase their arousal threshold (be less sensitive to these arousals) ? Seems like it could potentially help in some cases ? Perhaps less overall disturbances/awakenings. In any case, would treatment (or pressure titration) change/vary depending on one's arousals threshold ?
Thanks
I guess my body was highly tolerant of carbon dioxide. The longest period of not breathing I saw, when I videoed myself, was 35 seconds. My untreated AHI was 62.5. I was breathing less than half the time.
Interesting!
Glad you think so!
@VikVeerENTSurgeon my world is so osa + uars so I would be! 😁
@@VikVeerENTSurgeon have you read? pmc.ncbi.nlm.nih.gov/articles/PMC5863160/
Dr veer, it’s funny you say you’ll get into trouble if you talk about UARS… nonsense! And I will fight anyone who will put you in trouble👊🥊😂😂😂😂
i use a mask works great