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Comment by tjohns | Hacker News Reader

Breathing and blood oxygen at a minimum, for the take-home tests. If you go into a sleep lab, they also wire you up to an EEG as well to monitor your brain activity.

They're not just looking for blood oxygen to drop. They're also looking at how many times you wake up due to airway obstructions. Even if you wake yourself up before your blood oxygen drops, waking up 50+ times/night (this would be considered "mild", btw) is not good for your brain either.

But yes, you need a sleep study to be diagnosed with sleep apnea.

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> waking up 50+ times/night (this would be considered "mild", btw)

50+ a night is mild? I thought I had it bad at 2 or 3. 50 times a night is every couple of minutes, do people who have it even worse than this actually manage to sleep at all?

> do people who have it even worse than this actually manage to sleep at all?

It's sleep as in their eyes are closed and they are somehow unconscious but they are drifting on and off between falling asleep and being knocked out. There are no recollections of the events so it seems like sleep but very bad sleep (think: more tired when waking up than when going to bed).

When I did my study they said it as >90 times an hour when sleeping on one side and something like >60 on the other. I did a pulse ox test first and the results recommended a sleep study (which was not all that conducive to a good sleep they way it's performed)

Note, you don't actually regain consciousness that often (but if you wake up every 90-120 minutes to pee, and/or snore a lot, your body is telling you something) but it does keep you from getting a deeper sleep. I hadn't dreamed in years because I'd never drop into REM state.

I used to sleep 4-6 hours a night (but rarely felt tired) now I sleep 5.5 - 7 and am much better rested.

From what I remember an apnea/hypopnia index of up to 5 is considered normal, 5-15 is mild, 15-30 is medium, and 30+ is severe. That's what I learned when I had severe sleep apnea, but it spontaneously resolved years ago so perhaps definitions have shifted. I'd be pretty shocked if 50 were "mild" now, though.

I had an AHI of ~90 at diagnosis, and I couldn't figure out why I was so damn tired all the time. My sleep was very badly disrupted, but since an apnea doesn't typically bring you all the way awake it can be hard to notice.

Outside the edit window: I just realized that I missed the mention of the timescale. The apnea/hypopnea index is measured in terms of events per hour, and my doctors never discussed it in any other terms, so I automatically interpreted those numbers as per hour.

When I had my test, mine was over 50 per hour - and that was a decade ago, so I'd likely be worse now.

Oh, goody, a test.

Let's send in as many people as profi...er possible to have that test. Probably helps to start a few print and TV campaigns to Ask Your Doctor If CPAP Is Right For You.

Then, over a few decades, let's gradually move the goalposts so that more positive tests continually maximize our shareh...healthcare values.

C'mon, think like a CEO

Except the doctors ordering and performing and evaluating these tests are not CEOs.

Exactly: https://en.wikipedia.org/wiki/Superior_orders

"Dad died of a heart attack last night, guess we'll never know why"

Health is something that is not just in the doctors purview these days. You can personally buy any number of electronic devices that monitor things like blood oxygen and how often you're waking up that will give you some idea of your sleep quality and likelihood of having apena.

Or, you can be a cynical old fart and continue accepting that dying at 60 of a heart attack is perfectly normal.

Not everything is a vast conspiracy.

I don't know about "vast conspiracy" and as a techie, I fully support testing in order to diagnose and repair.

However I just believe that the incentives are perverse and not improving, and it's begetting corruption. Doctors do not order tests out of personal concern for patient's well-being to start healing them; doctors are mandated top-down to tick boxes on a checklist and improve customer engagement.

As a techie, I also recognize how teched-up they are, and question why they need all that. I was shoved into a giant MRI and went through the whole theatrical adventure, and guess what - nobody touched that report. Nobody would read it, nobody would tell me what it meant, nobody would use it for treatment. It was hilarious. So glad it wasn't my pocketbook that time. And I had a real concern, not just a suspicion; my shoulder was bad, and fractures had already been ruled-out by a good old X-ray.

High-tech is able to supplant "safe, inexpensive and effective" by virtue of profit margins, patents, marketing, and customer perception. I've been honestly rather shocked once in a while, to see a nurse wearing a stethoscope, or checking BP by sphig.

I mean, do you realize how much of a fortune those guys are making by selling adhesive nasal strips, after we all developed a huge concern for apnea? What's that line about the American Space Pen and the Russian pencil???

>Doctors do not order tests out of personal concern for patient's well-being to start healing them

I don't order server rebuilds because out of personal concerns for a companies well-being. WTF kind of standard is this. Maybe if we had 10x as many doctors we could afford some personalism with our healthcare workers.

>High-tech is able to supplant "safe, inexpensive and effective" by virtue of profit margins, patents, marketing, and customer perception.

No, again, 40 years ago, you just would have died of your ailment, or had life long suffering. With increased insurance coverage along with increased treatment offerings more people want and are willing to get what affects them diagnosed. Meanwhile we've not increased the number of healthcare workers at the same rate, and increasing with individual workers is very difficult and expensive.

Honestly your post history is concerning. It appears everything is a vast conspiracy against you.

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