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[Diagnosis] Round 2 Sleep Test
#1
Round 2 Sleep Test
Hi All,

I did a Round 2 Sleep Test recently with AHI 13.1.  I was able to sleep very well during my Round 2 Sleep Test in the sleep lab and i am convince with my Second Round Sleep Test result than my first sleep test which i hardly slept.  My first sleep test AHI index was 21.57 six month ago.  During the 6 months period, i was put on the CPAP machine, the CA index was really high, average about 20.  However, now the second sleep test the diagnosis is mild.  Hence, my doctor's opinion is to go for my CPAP Holidays for a period of time and to observe my conditions.

What do you guys thinks?  Shall i off CPAP despite i do have OSA to manage.  I don't really have much symptoms and don't really feel extremely refresh after using the CPAP machine.  In fact, i don't see myself feeling any different with CPAP versus without CPAP.  

I appreciate your sharing of your thought.
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#2
RE: Round 2 Sleep Test
Did you have supine REM in the first study? Do you ALWAYS sleep on your side?
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#3
RE: Round 2 Sleep Test
A 65.5 second obstructive apnea is hard to believe.

I mean, like REALLY hard to believe.

Especially if your lowest sat (which one assume it belongs to that apnea) is only 88%.
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#4
RE: Round 2 Sleep Test
(03-25-2022, 11:06 AM)Rubicon Wrote: Did you have supine REM in the first study?  Do you ALWAYS sleep on your side?

My First Study Supine REM Yes because i couldn't sleep.  I was literally staring at the ceiling counting sheeps!  I usually sleep on my sides especially on my right.  i have a slipped disc on my lower back hence i dont prefer to sleep in supine position.
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#5
RE: Round 2 Sleep Test
(03-25-2022, 11:08 AM)Rubicon Wrote: A 65.5 second obstructive apnea is hard to believe.

I mean, like REALLY hard to believe.

Especially if your lowest sat (which one assume it belongs to that apnea) is only 88%.

I was also thinking the 65.5 second OA was crazy.  My oximetry summary was okay.  Min Sp02 during TIB:88%, Min Sp02 during TST: 88%, Min Sp02 w/Respiratory event: 88%.  Average Sp02 (TIB): 97%, Average Sp02 (REM): 98%, Average Sp02 (NREM): 97%
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#6
RE: Round 2 Sleep Test
What's even crazier is the 133 second hypopnea on the first study. Which I would argue is impossible because baseline is defined as the previous 2 minutes before an event. Therefore, the 2+ minute "hypopnea" is actually the baseline!

But I guess that's somewhat academic...

Given the results of your downloads I can see why you don't feel better. Your sleep with CPAP is as bad as without!

If you're looking for opinions, since you have an AHI which should probably be treated, IIWM I'd do CPAP desensitization. Fixed CPAP at 5 cmH2O, which should treat some events, prevent most leaks and allow you (hopefully) to sleep. Don't worry about that stupid number.
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#7
RE: Round 2 Sleep Test
(03-25-2022, 12:07 PM)Rubicon Wrote: What's even crazier is the 133 second hypopnea on the first study.  Which I would argue is impossible because baseline is defined as the previous 2 minutes before an event.  Therefore, the 2+ minute "hypopnea" is actually the baseline!

But I guess that's somewhat academic...

Given the results of your downloads I can see why you don't feel better.  Your sleep with CPAP is as bad as without!

If you're looking for opinions, since you have an AHI which should probably be treated, IIWM I'd do CPAP desensitization.  Fixed CPAP at 5 cmH2O, which should treat some events, prevent most leaks and allow you (hopefully) to sleep.  Don't worry about that stupid number.


Thanks for your recommendation.  My sleep was okay last night.  It did showed some improvement of numbers on my cpap report.  It does balance my OA and CA to a lower index.  Previously it was a kind of a havoc when the technician set me at Fixed CPAP at 12 ERP 3.  I felt like give me a break, i literally had the feeling of counting my inhalation and exhalation during the sleep all time!  Auto at 8 ERP at 0 also did not worked for me after a few days, I felt no different with and without the machine in that setting.
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#8
RE: Round 2 Sleep Test
Where are the other pages of that report? You can see at the bottom it says page 1 of 6 and lots of details are unknown from that summary page like the prevalence of central apnea.

Taking a look at your original thread central apnea was your biggest issue. Taking a look at your original sleep study it indicated that you had more central apnea than obstructive apnea before trying CPAP. Your central apnea is not all treatment emergent and I imagine your details for this second sleep study would indicate central apnea was present once again.

This recent data at 5 cm pressure didn't aggravate your central apnea as bad but it shows signs of obvious obstructive apnea and flow restrictions. Your AHI in first study was 21 and in second study was 13.5, both of which are significant enough that treatment is recommended if you have any symptoms related to apnea (tired, unrefreshing sleep etc).

It seems obvious that you have both central and obstructive sleep apnea and this machine is not capable of treating the central apnea and in fact aggravates it once the machine starts treating your obstructive apnea. Rather than discontinuing CPAP your doctor should consider treating your central apnea... A basic APAP like yours is not capable of doing so and you require ASV.
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#9
RE: Round 2 Sleep Test
(03-26-2022, 07:34 PM)Geer1 Wrote: Where are the other pages of that report? You can see at the bottom it says page 1 of 6 and lots of details are unknown from that summary page like the prevalence of central apnea.

Taking a look at your original thread central apnea was your biggest issue. Taking a look at your original sleep study it indicated that you had more central apnea than obstructive apnea before trying CPAP. Your central apnea is not all treatment emergent and I imagine your details for this second sleep study would indicate central apnea was present once again.  

This recent data at 5 cm pressure didn't aggravate your central apnea as bad but it shows signs of obvious obstructive apnea and flow restrictions. Your AHI in first study was 21 and in second study was 13.5, both of which are significant enough that treatment is recommended if you have any symptoms related to apnea (tired, unrefreshing sleep etc).

It seems obvious that you have both central and obstructive sleep apnea and this machine is not capable of treating the central apnea and in fact aggravates it once the machine starts treating your obstructive apnea. Rather than discontinuing CPAP your doctor should consider treating your central apnea... A basic APAP like yours is not capable of doing so and you require ASV.
I asked for the ASV but the doctor said it was not necessary and i have no obvious symptoms.  ASV in Singapore are for very severe patients.


Attached Files
.pdf   Sleep 2.pdf (Size: 239.41 KB / Downloads: 10)
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#10
RE: Round 2 Sleep Test
A few centrals and mixed apnea in that as expected. A little odd how breathing was good most of the night and then real bad for about an hour. Goes to show how your apnea fluctuates and some nights could be noticeably worse than others.

If you have no symptoms why did you originally get a sleep study done? If you truly have no symptoms then sure try going without PAP but I am guessing you do have symptoms hence why you are asking for help.

If doctor isn't interested in trying ASV and you don't feel your sleep quality is adequate you might need to purchase your own machine however possible. Unfortunately lots of people end up having to do that due to incompetent doctors/healthcare systems.
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