OK, I've been studying and have what may be an obvious question but since we're dealing with medicine and insurance - well, we all know they way things are done don't always make sense. Also, I could easily be mistaken in the facts as I understand them or be drawing faulty conclusions from them. I'd appreciate someone setting me straight.
Fact: Women with OSA are less likely to be diagnosed (for many reasons.)
Fact: According to the studies I've read, women have the same health risks at a lower AHI then men do at a higher one.
Fact: According to the studies I've read, women have more frequent, less severe respiratory events AND those events tend to be more concentrated in REM sleep.
Fact: The longest period of REM sleep tends to be the last one, just before awakening for the day.
Fact: Sleep studies average the number of qualifying events per hour of sleep to achieve AHI.
Fact: During a split night sleep study, only the first half of the night is conducted under natural breathing then the second half is conducted with CPAP.
Question: During a woman's split night sleep study, how (if at all) is the AHI formula corrected for the facts that a- a woman can have the same health risks at a lower AHI as a man at a higher one and b- the greater concentration of respratory events would be expected to occur in the second half of the night for a woman?
My guess: She would go in for a sleep study. If the first half of the night does show OSA, then it is conducted as a split night sleep study and CPAP is added for the second half of the night. Since her OSA is probably most severe in the second half of the night, the correct settings can be determines during that time.
If the first half of the night does NOT show enough events to warrant a diagnosis of OSA, the sleep study continues without CPAP for the entire night. If the number of later events raise the AHI to the threshold of waranting a diagnosis of OSA then a SECOND full night sleep study is scheduled to try her on CPAP.
I'm asking because sleep studies are expensive and I'd prefer to do it just once but I also fear being misdiagnosed. If the events contributing to my overall AHI are concentrated in the second half of sleep and I don't have enough of a problem in the first half of the night to be taken seriously, what happens?
I have recorded myself sleeping and noticed that I mostly have regular, rhythmic snoring most of the night, but the last 2 - 3 hours or so, I really sound like I'm struggling for air, choking, and snorting.
You know how your car makes a funny noise so you bring it to the shop and say, "What's this weird thing going on with my car?" and the car doesn't make that noise for the mechanic?
And he says, "There's nothing wrong with you car. You're just paranoid".
Could that happen to me in a sleep study?