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[Diagnosis] Trying to understand my report...
#1
Question 
Can someone please help me to further understand my Sleep Study report? Under "Hyponea with 3% desaturation (AASM)" one of the columns says this:

Apnea + Hyp
===========
Count: 117
Index: 16.3
Mean Duration: 30.1
Longest Event: 114.9
REM Count: 48
Non-REM Count: 69
REM Index: 47.2
Non-REM Index: 11.2

I understand the Indexes, but what does the "Mean Duration" and the "Longest Event" mean? Does that mean I stopped breathing for over 114 seconds???

There are lots of other acroyms on the report - "RERA, RDI, CSM, WASO" - is there anything else I should be looking at?

Thanks for your help!
-Ailu
Reformed CPAP Outlaw
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#2
The way you have it listed, it's both Apneas ans Hypopneas combined. The Mean Duration is the value in the middle of all recorded events. The Longest Event is the longest recorded event. This could be a 115 second hypopnea, which is very slow breathing.

Here is a link to the acronyms:
Sleep Disorder Glossary:
http://sleepyhead.sourceforge.net/wiki/i...p/Glossary
Statistics prove that people who have more birthdays live longer.
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#3
Thanks Sgearhart!

In the table, for Longest Event it has:

Central Apnea: 10.4
Obs Apnea: 64.8
Mxd Apnea: 41.8
Total Apnea: 64.8
Cen. Hyp: 92.6
Obs Hyp: 114.9
Mxd Hyp: 55.9
Total Hyp: 114.9
Apnea + Hyp: 114.9
Obs. A+H: 114.9
Cen. A+H: 92.6
RDI: 114.9

Does that info help? Thanks!
-Ailu
Reformed CPAP Outlaw
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#4
Ailu, does your report contain a recommendation? Looks like you have complex apnea that might move you towards an adaptiive servo ventilator (ASV) rather than CPAP or bilevel. Are you scheduled for a titration study?
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#5
(06-09-2015, 10:17 AM)Ailu Wrote: ...Central Apnea: 10.4
Obs Apnea: 64.8
Mxd Apnea: 41.8
Total Apnea: 64.8
Cen. Hyp: 92.6
Obs Hyp: 114.9
Mxd Hyp: 55.9
Total Hyp: 114.9
Apnea + Hyp: 114.9
Obs. A+H: 114.9
Cen. A+H: 92.6
RDI: 114.9...

This just underlines how complex all of this is, even though it all seems pretty clear. It also seems pretty clear that it really is a complex issue.

Us lay folk understand the different kind of events, and your xPAP can distinguish between them, somewhat, but a full study such as this example seems to indicate that they are not always distinct types of events, and that an event can have mixed characteristics (something an xPAP doesn't seem to be able to do or to report).

Lots of blurred lines here, which is what we have the sleep docs for. Its easy to forget that this is more complex than we are continually led to believe by a dumbed-down single number every morning as our indicator (AHI).

As for the alphabet soup, Google is your friend. So is the acquired data on this forum on record. The level of motivation is key here, and much more important than random factoids from us will ever be. Brick wall? Back to the sleep doc. I guess we could talk about the Continuous Shuffling Machine they have out in Vegas, but that probably is the wrong answer. Wake After Sleep Onset? Probably a little closer to the mark.

The classic philosophical question "if a tree falls in the forest..." should be changed to "if a patient gets a sleep study, and no one is there to parse the data and make an informed recommendation, was it really worth the $3700?".

The sleep doc should have all the answers. And he should give them to you.

A question I like to ask my sleep doc as I write the check is "if I have a question about any of this, who will be available to answer it?" (this may also be a leading question, leading into a number of follow-up questions). If there is a pregnant pause, or his name is not among those in his response, well, time for a new sleep doc.
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#6
(06-09-2015, 09:39 AM)Ailu Wrote: Can someone please help me to further understand my Sleep Study report? Under "Hyponea with 3% desaturation (AASM)" one of the columns says this:

Apnea + Hyp
===========
Count: 117
Index: 16.3
Mean Duration: 30.1
Longest Event: 114.9
REM Count: 48
Non-REM Count: 69
REM Index: 47.2
Non-REM Index: 11.2

I understand the Indexes, but what does the "Mean Duration" and the "Longest Event" mean? Does that mean I stopped breathing for over 114 seconds???

There are lots of other acroyms on the report - "RERA, RDI, CSM, WASO" - is there anything else I should be looking at?

Thanks for your help!

Is there other data not under the heading of "Hypop with 3% desat"?
I'm wondering if the technician highlighted the data for hypop only.

There should be other data like total hours asleep, in REM, etc. Units help too.

However, your sleep doc is the best person to answer. The "AASM" refers to American Academy of Sleep Medicine. i.e. using their definitions.

You did not stop breathing for 114 seconds. You had a hypopnea for that long. Think of it as very shallow or partially obstructed breathing that is insufficient to adequately oxygenate you. Hence the Column of "3% Desat ". They used a 3% drop in O2 as a marker of an event significant enough to take note of and measure.

Most of your events occur during REM sleep (normal).

The doc will likely have you back in for a titration trial where they will attach you to a PAP machine and figure out what pressures will work on you during the various phases of sleep and your body position.
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#7
Thanks guys! I finally had time to anonymize & scan my report. I've attached it below. Any observations regarding it are greatly appreciated!
-Ailu
Reformed CPAP Outlaw
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