u/elkbark

I went in for a totally routine doctor visit and casually mentioned that I snore a bit. I honestly expected the conversation to end with “lose a few pounds and sleep on your side, buddy.” Instead, my doctor suggested an at-home sleep study “just to check.”

Well… shit.

The home study came back with:

AHI 77.6
oxygen down to 70%
about 74% of events classified as central/mixed apnea instead of straightforward obstructive apnea

Meanwhile, I feel… basically fine?

No excessive daytime sleepiness. Blood pressure is normal to low. Good exercise tolerance. I hike/camp regularly at altitude in Colorado and generally feel functional and healthy. Honestly the biggest stress so far has been navigating the medical admin circus itself.

One wrinkle that may matter: I live at about 7,800 ft elevation and regularly sleep/camp around 9–10k ft. From what I’m reading, altitude can apparently contribute to central apnea / periodic breathing in some people.

At this point I’m trying to push for a proper in-lab split-night polysomnography + titration study instead of just blindly getting thrown onto auto-CPAP. My understanding is:

CPAP/APAP is usually for classic obstructive apnea
ASV may be more appropriate if the central apnea component is truly dominant
home studies are not always great at accurately classifying central vs obstructive events

Curious if anybody here has had:

severe home-study results that changed significantly on full PSG
altitude-related central apnea
experience with ASV vs CPAP
or generally similar “you should feel terrible but somehow don’t” situations

Also curious whether people think an altitude lab is worth pursuing in my case versus a normal Denver-area lab.

Trying to approach this rationally without either ignoring it or turning into a full-time sleep apnea hypochondriac. Appreciate any thoughts from people who’ve been down this road.

Picked up an 18.2 lb Costco Prime packer Thursday afternoon and decided it was time for my first real overnight brisket run. Trimmed and dry brined it Friday morning, then hit it with coarse pepper, garlic powder, onion powder, minced onion, and paprika before putting it on the smoker Friday night around 9:45 at 225 with competition blend pellets and a cherry smoke tube. Fat side up on a rack over a sheet pan to catch the apocalypse underneath.

Meanwhile the “simple side of beans” escalated completely out of control. Started with Bush’s Original and Maple Bacon beans, then added bacon, hot dogs, brisket trimmings, onions, jalapeños, garlic powder, chili powder, a tiny bit of cayenne, bourbon, and a little vinegar before smoking them overnight under the brisket. Somewhere around 1:30 AM I realized the beans might actually become the main event.

The brisket smoked until Saturday morning and stalled around 156 with the bark looking exactly where I wanted it, so I wrapped in butcher paper and foil and finished it in the oven at 250. Pulled around 200–202 depending on probe location, let it vent, then held it for a long rest.

Cherry smoke on beef is absolutely staying in the rotation. The color and flavor were unreal. Pretty damn happy with how this one turned out.

Surprise....Apnea...

Brisket and Beans