2 ms·

Respectfully... how do you work in the field, while being so wrong? Oxygen desaturation correlates with long-term metabolic outcomes, but correlates very poorl

Respectfully... how do you work in the field, while being so wrong? Oxygen desaturation correlates with long-term metabolic outcomes, but correlates very poorly to day-to-day symptoms. The actual primary cause of symptoms in SDB is microarousals resulting from increased respiratory effort, and sleep studies using 3%-or-arousal criteria report MUCH higher OSA rates than the commonly used hypoxia+reduction in flow criteria, while also having a much higher correlation with symptoms(>60% vs ~17% for AHI), and the problem is not over, but under- diagnosis since people with relatively few apneas(e.g. UARS patients) are rarely diagnosed correctly. Also, (optimally) healthy people DO breathe 100% of the time during sleep- breathing during sleep is controlled by a different system while awake, and is extremely regular during NREM sleep, with REM merely introducing noise to breath amplitude. Any and all pauses in breathing are caused by sleep disruption. The only reason why it seems like apnea-based criteria are oversensitive is because obese, older men often DON'T wake up from airway collapse and may be fine at 5, 10, or even 15 AHI. For everyone else, it's possible to have debilitating symptoms at 4 because the actual Respiratory Disturbance Index is 20+. Goddammit man. People like you are why so many go their entire lives unable to find treatment. If you're working in the field, educate yourself about it. Ugh.

reverendsteveii 1y ago
This, precisely. An apneic event is defined as 10 seconds of pause in your breathing (https://www.sleepfoundation.org/sleep-apnea/ahi https://www.sleepfoundation.org/sleep-apnea/ahi). Go ahead and hold your breath for a slow count of 10 (set a timer or do the mississippis or alligators or locomotives or whatever other 4 syllable phrase you need to do in order to make it a real, honest 10 seconds. it's long enough to be noticeably uncomfortable). You don't casually do that during the day. Sleep apnea is defined as you doing that 10-15 times per hour, and your sleep study also measures microarousals to correlate (source: I built the damn things for a living a few years back). Also they do monitor o2 sat in children at least, cyanosis is one of the ways they diagnose apnea in children. Way too many professionals in the field thinking that they're the first person to think about something when literally millions of people think about this same thing all day every day.

reverendsteveii 1y ago

This, precisely. An apneic event is defined as 10 seconds of pause in your breathing (https://www.sleepfoundation.org/sleep-apnea/ahi https://www.sleepfoundation.org/sleep-apnea/ahi). Go ahead and hold your breath for a slow count of 10 (set a timer or do the mississippis or alligators or locomotives or whatever other 4 syllable phrase you need to do in order to make it a real, honest 10 seconds. it's long enough to be noticeably uncomfortable). You don't casually do that during the day. Sleep apnea is defined as you doing that 10-15 times per hour, and your sleep study also measures microarousals to correlate (source: I built the damn things for a living a few years back). Also they do monitor o2 sat in children at least, cyanosis is one of the ways they diagnose apnea in children. Way too many professionals in the field thinking that they're the first person to think about something when literally millions of people think about this same thing all day every day.