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Needing some opinions...
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Post Needing some opinions... 
My son has complained about being tired for years. I mean, he wakes up tired and is never rested. He plays sports, but we have a good family schedule where we actually sit down to eat dinner together every night and he's in bed by 9pm.  He's had blood test after blood test, but they can't find anything. And, he seems so healthy. Finally, we found a pediatrician who said it must be sleep apnea. We went for a sleep study and they goofed. He only slept 2 hours and had 7 obstructions, but they measured it by the 8 hours he should have slept. So, we had a second sleep study. Because my friend knew the doctor, she set it up so that my son got the cpap with the second study. So, we never had second sleep study w/o the cpap to verify the diagnosis.  He HATES the cpap. I don't know how you guys like it, but did it make a difference in your lives right away??  Did you eventually get used to it??  Is that contour pllow for $60 worth it??  He's had it two weeks and he claims to feel the same. Though, when he's half asleep he moves the cpap up to his forehead!!  I'm just wondering if any of you have dealt with this yourselves and if you have any insight to lend me. It is so hard to know what to do, as I'm not the one whose tired and achy. I just want my son to feel better!!
Thank you to anyone who has time to reply!!


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Yacob-
The guidelines for diagnosing and treating obstructive sleep apnea in children is somewhat different than the guidelines for adults and I am not expert on apnea in children.
I do have some ideas which may or may not be of help.

First, if you do not have copies of your son's two sleep studies, I would suggest that you request copies of these, preferably full copies (which will include some charts and graphs) and not just the summary. Review them and go over them with your son's sleep doctor.

As far as your son's first sleep study goes, 2 hours is not a lot of sleep to form a conclusion upon but I have read of adults having as little as 90 minutes of sleep and still getting a diagnosis. The severity of apnea is measured by the apnea-hypopnea index (or AHI) which is the number of apnea events (complete stoppages of breathing) plus the number of hypopnea events (significant reductions in air intake) divided by the number of hours of sleep. Looking at the results you mention, I am not completely sure that what you refer to as "obstructions" are only apnea events or apnea and hypopnea events both. Even if it refers to apnea and hypopnea events both, 7 events in 2 hours of sleep results in an AHI of 3.5. Although this AHI would be considered normal in an adult, I recall another parent having been told (by her daughter's sleep specialist) that an AHI over 1 was considered as needing treatment for a child.

The other thing you should be able to get from your son's first sleep study is an idea of how his apnea is affecting him in terms of the extent to which his blood oxygen level declines, the number of arousals he has, and how it affects his ability to get enough deep (stage II/IV or delta) sleep and REM sleep. These 2 stages of sleep are the most important for your well-being.

As far as the second study goes, was it a split study (where he started without CPAP and then had the CPAP put on later) or was it only on CPAP? The part with the CPAP (whether this is the full night or only the second part of the night) is done to determine the most appropriate pressure for your son's CPAP. The report on this may show the difference that CPAP made in your son's blood oxygen level and in his amount of deep sleep and/or REM sleep (however these stages of sleep may not show up as being improved with the CPAP because of difficulties getting used to the CPAP and because it takes a while for the body to bounce back from too little RERM sleep and/or too little deep sleep).

Many people have trouble adjusting to CPAP and we have had many people report that they removed their masks in the middle of the night without being aware of it.  Other people take to it within a few days. Likewise the benefits of CPAP seem to come very quickly for some and for others they may feel better only gradually. This is an area where patience and persistance pays off.

There are some tips that might be helpful in terms of adjusting the mask, in getting used to the mask and in using the equipment that might be helpful. Can you tell us how old your son is, what type of mask he uses, what type of CPAP machine he uses, and what his prescribed pressure is? These details might help provide more useful tips.

The remaining question I have is whether your son has had a tonsillectomy and adenoidectomy and/or whether his doctor discussed this as a possible treatment option. I ask this because it was my understanding that with children with sleep apnea that this type of surgery was usually recommended over CPAP as being the first thing to try.

I hope this will be of some help. Do keep us posted on how your son is doing.

Best wishes,
Bill

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