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[Diagnosis] Recent result
#1
Recent result
Hi,

Firstly an apology - UK-based so will probably revert to British English!

One of my best friends and former uni-housemate Pet0r has recently recommended both a sleep apnoea test and discussing the results on here. I am nowhere near as up to speed on the condition as he is (as in, I'm a complete beginner) and only received my results today, but very interested in finding out more about the condition and it sounds like you guys are very well qualified to provide some feedback on possible next steps!

Attached are my results and below is the Sleep Technician's Summary;

This is an overnight Detailed In-Home Sleep Test on a 30-year old male, BMI 31.6 (WHO classification obese class 1) and Epworth Sleepiness Score (ESS) 5/24 (a score >10/24 is considered abnormal). The patient presents with features of obstructive sleep apnoea/hypopnea syndrome (OSAHS), with main complaints including snoring, gasping/choking episodes, occasional clouded memory and sinus problems. Reported medical history includes asthma. Current medication: Fostair and Ventolin. He is a never smoker and drinks 1 unit of alcohol per week. The patient's partner reports heavy snoring (7/10), has witnessed apnoeas and his energy levels are rated as 7/10. This study shows an AHI (number of apnoeas+hypopnoeas per hour in bed) of 18.2/hr (increased in the supine position – 42/hr). The ODI (oxygen desaturation index – number of drops in oxygen saturation <4% per hour in bed) was 12.3/hr, with a minimum SpO2 of 85%. Mean SpO2 was 95%. In summary, this is an abnormal study in a symptomatic, overweight male. The AHI was 18.2/hr suggestive of moderate OSAHS (SIGN73 guidelines). Respiratory events were predominantly observed in the supine position. A positional training device to prevent sleeping from supine may be appropriate. If symptoms persist a trial of CPAP.

I would just add that my wife has managed to make me default to sleeping on my side, but I do miss sleeping on my back. Let me know if you have any other questions!

Thanks in advance,
Nick


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#2
RE: Recent result
Have you been prescribed a machine?
I would recommend the ResMed s10 airsense auto. Once you get one you can download Oscar from the top of this site. It is totally free.

There is little to say except you need to be on pap therapy, the sooner the better.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#3
RE: Recent result
I didn't see the area that states the apnea events in number or type. Did you happen to see that information? If event type isn't listed, there's important info missing. This would help us define what machine is best for you. Even so, like most new users, it may be best if you consider a CPAP such as the ResMed AirSense 10 AutoSet. I believe it's best in its class of CPAP/APAP machines. It includes a setting called EPR that will drop pressure to allow easier exhales, and it's for therapy and comfort enhancements.

If it turns out you'd need a BPAP/bilevel to add more Pressure Support than 3 cmH20, then the ResMed AirCurve 10 VAuto is top in its class.

Also it's suggested you get OSCAR to see your own sleep data after using PAP therapy. It is free, and can be posted here as attachments to give us info on how to direct your therapy settings to make it optimized for you specifically. And the top banner has "CPAP Setup Manuals" so you can get your copy of the manual for the machine you end up with. Good luck and welcome to Apnea Board.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Recent result
RDI: 25 (RERAs 6.8)
AHI: 18.2
ODI: 12.3 (Oxygen Desats)
CAI: 1.4 (Central Apneas, pAHIc)

What does this mean, That you toss in your sleep, you are not exclusively on your side. 
On your back every 1.3 minutes on average it's like getting an elbow in your ribs.
On your side every 5-6 minutes
The 25 RDI is the critical number.  This means that you have a lot of Flow Limits.  For this reason Pressure Support or EPR is an important feature, Flex is NOT.  Since it is extremely unlikely that you will be offered a BiLevel you want specifically a ResMed AirSense 10 AutoSet or the AutoSet for Her variant (Has an additional Mode) to treat your apnea.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Recent result
Thanks for all the replies, and the speed as well!

Not yet been prescribed a machine Stacey but 3 independent people consistently recommending the same machine sounds like quite the endorsement. I will do some reading up on it.

Dave - I have shared all I received, apart from the translation into more accessible language. Pet0r has bought the same machine and already lauded its effectiveness and I like the fact that it can drop pressure for exhales. Thanks also bonjour, useful feedback.
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#6
RE: Recent result
That's OK. bonjour spotted the info and gave great directions. We'll get you onto great therapy ASAP.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Recent result
N1ck depending which NHS trust your with you may get a Resmed or a Philips machine I guess your local hospital will stick with one brand. We tend to recommend the Resmed brand here but the Philips can also be set to provide good treatment but often requires a higher minimum pressure. I ended up buying my own machine from Resmed online but you can get a better deal purchasing from Supplier #2 but import duties of about 20% plus a handling charge will be due
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#8
RE: Recent result
Thanks Jas - I thought about going via the NHS but given the resounding recommendation of the Resmed AirSense 10 AutoSet CPAP I have decided just to buy myself, along with an F30 facemask. I'll install OSCAR too once I've received it, will post back soon. Thanks again all for your input, greatly appreciated.
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#9
RE: Recent result
Hi,

Attached are the first couple of nights of readings from OSCAR. The AHI 12 was my first night on the 13th - not the greatest night sleep but definitely better last night. Let me know if you have any recommendations!

Thanks,
Nick


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#10
RE: Recent result
What I'm seeing is elevated CA events that make up most of your AHI. This may be lessened by avoidance by turning down EPR to 1 or off. Then see how the therapy data reads along with telling us how you feel. You can see these CA are typical in that there's an inconsistent consistency to them, in other words the CA are up or down randomly per night. Given the sleep data, I'd say these CA may be a treatment emergent variety.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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