Central Sleep Apnea Diagnosis Code

Living With and Managing Sleep Apnea

JIM: I had this problem throughout my life. Driving was always a problem, and I tried to make sure that no place I ever had to go was very far away because I knew I'd fall asleep. Carol Lynn was complaining about snoring and, more specifically, snoring and then long periods of nothing,

and then a gasp when I would, you know, start breathing again. Obviously, I wanted to enjoy my life with my children more than I felt that I was enjoying it. It's Saturday morning, and the kids are at your bed ready to do something, and I'm just like, quot;I gotta sleep, guys. I'm sorry. I can't play with you. I can't do this.quot; And I look back and I'm like, quot;This just can't be right.quot;

I had been talking to my about possibly having depression symptoms. I remember the other thing that I said to the when I went was that I no longer had any dreams. If you're not getting into REM sleep, you have no dreams. And so she's the one who then said, quot;Okay, we're gonna send you for a sleep study.quot; I spent the night there.

The amount of times that I was technically waking, and as low as my blood oxygen levels were, it was extreme. I was diagnosed with severe obstructive sleep apnea. Surgery, as it turned out, really wasn't a good option for me. The next step was that my did prescribe a CPAP machine. CPAP stands for continuous positive airway pressure.

The idea is they have to get the air pressure to your nose or your mouth or both in order to keep your airway open while you sleep. Because it wasn't comfortable for me to use, I was not using it as well as I should have been, in some cases not at all for weeks at a time. And things got worse, other symptoms appeared. I felt confused and out of it and just not right.

And I realized that I really needed to figure out a way to learn to live with this contraption. Now I'm at the point where I am consistently using it and have been for a long period of time. I definitely feel better. I'm looking forward to feeling better yet. Certainly, I have more energy to do activities with the children than I did before, and we do more.

Obstructive Sleep Apnea versus Central Sleep Apnea

Obstructive sleep apnea is when the airwaybecomes narrowed or obstructed and you're making the effort to breathe but we do notsee any flow in air movement coming from your nose or mouth. Where central sleep apnea occurswhere your brain forgets to tell your body to breathe. If we're looking at it from avery simplistic term and so we do not see the drive to breathe. So the first step isto come into the and be seen by one of our physicians in the sleep medicine .We'll go through a questionnaire and try to determine what risk factors we think you havefor sleep apnea such as obesity, snoring, daytime sleepiness and then if we think thatyou have a high risk for meeting those criteria

then we would set you up for a sleep studyeither in your home to do an overnight sleep study or in our laboratory, depending on yoursituation. The CPAP can be used to treat both conditions and, in some patients, that isenough. However, there are some patients that have more complex types of central sleep apneathat require more complicated types of machines to treat that condition. Obstructive sleepapnea actually has been linked to a lot of other problems such as high blood pressureand then, you know, difficulty functioning during the day. If it goes untreated for along period of time there's an increased risk of early heart problems and those types ofthings.

You have sleep apneawhat now

Typically what we will do after you're diagnosedwith sleep apnea is we'll bring you back for a titration study. And basically what thatdoes is those are done in the lab and our technicians or respiratory therapists willactually measure you to determine what size of mask that you need and what type of maskthat you are most comfortable with because there are multiple types. There's a type thatcovers the nose and the mouth and a and a type that covers just the nose. And withinthe types that cover the nose, there's ones that sits over the nose like a dome as wellas ones that go up in the nose almost like thick oxygen prongs. And so typically whenwe bring you back for your titration we determine

which feels most comfortable to you and thenwhat we do is we start with a low airway pressure through the machine and we continue to monitoryou to see if you have sleep apnea. If you're demonstrating sleep apnea through your studythen we continue to increase your pressure until we see those events go away and that'stypically then around the pressure that we'll prescribe for you to start using at home.But even after that you need to have regular followups with your sleep physician becauseadjustments are typically needed to optimize things. This is because sometimes people sleepa little bit differently at home then they do in the laboratory. It really depends onthe severity, in my experience, of their sleep

apnea. Typically what I see is the more severesomebody's sleep apnea, the more they notice a difference more quickly. And I've had patientsthat have said they've slept the best night of their life that they've slept in the lasttwenty years after just one night of using their CPAP. But as we know, sleep deprivationis not something that goes away overnight. And so if somebody has had significant sleepapnea and been sleep deprived from it for years, typically it can take weeks to monthsuntil somebody really starts feeling their optimum. It's important that if you're diagnosedwith obstructive sleep apnea or central sleep apnea that you do get treated because we knowthat patients that go for a long period of

time years to decades without being treateddo have an increased risk of early strokes, heart disease, those types of things. There'salso now been shown some linkages to difficulty in controlling things like blood sugar, yourblood pressure and those types of things in patients that have significant sleep apneaand aren't being treated.

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