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Home Sleep Study - Help understanding results
Home Sleep Study - Help understanding results
Hi all,

EDIT: Just an FYI on the O2 data, the pulse fell off my I finger and so there was not reading for the last 2 hours of the study.

I've been browsing these forums looking for some indications about the results of my sleep study. I am a 30-year-old male, overweight but not obese and am 185cm tall.

For as long as I can remember I have been waking up multiple times (>10) a night for brief periods before falling back asleep. This happens every night as well. I have no issues falling back asleep but the number of times I am waking up during the night seems excessive and might be interrupting my sleep. I find myself going to bed at waking up at the same time (on average 8 hours a night) and struggle to wake up and am not at all refreshed. I feel it's getting worse and worse and my memory and fatigue are hitting all time highs.

The awakening are not caused by any bowel or toilet issues, but I do move A LOT in my sleep as well. I don't do drugs or drink alcohol but I drink coffee (about 2 cups a day) but don't drink after 2pm. I do have a history of snoring and my father has been diagnosed with sleep apnea.

So I got organised at did an overnight sleep study at home and these are the results:


Here are the graphs of the sleep study:


And a detailed summary of the report:


The doctors report noted the following:

Quote:The patient states that he slept about the same time as usual. The patient was studied for a period of 394.7 minutes with a sleep efficiency of 95%. Sleep was not fragmented, the arousal index was normal. The duration of  of REM sleep was normal, The duration of slow wave sleep was reduced. There was mild obstructive sleep apnoea, the AHI was 12.1 per hour. There was occasional snoring during sleep. There was no hypoxaemia during sleep. Periodic limb movements were noted. The ECG was sinus rhythm.

1. Mild obstructive sleep apnoea with occasional snoring.
2. Mild periodic limb movements during sleep.

And this is the technician's report:

Quote:Respiratory Events: Hypopnoeas were noted intermittently during the study, particularly during REM
sleep. The overall AHI was 12.1 events per hour, increasing to 27 events per hour during REM sleep.

Arousal index was normal at 18.9 per hour.

Loud snoring was noted, particularly during REM sleep.

Limbs: Several short clusters of PLMs were noted. Clinical correlation is recommended.

What I am unsure about is that the doctor didn't really acknowledge the high AHI in the REM stages of sleep and I believe that 27 is significant enough to be of concern. This would also align with why my memory and retention is quite bad. The doctor also mentioned that it was "occasional" snoring however from the report, it existed for about 44% of my sleep....

I was hoping someone could break down some of those numbers are just confirm if there is any cause for concern or whether I'm a likely candidate for a sleep apnoea machine? I'm also not sure if sleep apnoea is genetic.

Thank you very much if you're still reading up until this point! As you would all probably know, it is a frustrating problem and is such a hidden beast and I just want more than anything to wake up refreshed and ready for the day.

Thank you Smile
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RE: Home Sleep Study - Help understanding results
Welcome to Apnea Board. Your home sleep study seems to be complete with an EEG to determine sleep stage, which is pretty sophisticated for a HST. Your overall AHI is just over 12/hour with REM being notably higher and considerable snoring, especially when supine. Most event are obstructive hypopnea with significant duration, followed by obstructive apnea. There were 3-central events of shorter duration and only in REM. It's not uncommon for those to be breath-holds in REM or to follow recovery breathing, however we don't have that detail. The hypnogram shows numerous brief arousals during the night, many showing fully awake. Your doctor has diagnosed mild obstructive sleep apnea, but it is sufficient to justify CPAP therapy, particularly if you have comorbid complaints of fatigue, sleepiness, complaints from your bed partner for snoring, etc.

Since CPAP and other therapeutic mitigation was not discussed in your post, I'll do it here. The pattern of clustered snoring suggests you might benefit from sleep position modification. Back sleeping is clearly implicated here, and we often refer to positional apnea as being more related to chin-tucking than anything else as described here. http://www.apneaboard.com/wiki/index.php...onal_Apnea The solution is to avoid sleep positions, pillows etc that allow the chin to drop towards the chest and obstruct the airway. Many members here do use soft cervical collars, even with CPAP. Your events are in all sleep positions, and higher in REM on your left and right side, so CPAP is going to be a good solution. My recommendation is an auto CPAP and specifically the Resmed Airsense 10 Autoset which uses a form of exhale pressure relief that is like bilevel therapy (different inhale and exhale pressure), which is especially effective in comfortably treating hypopnea. The Resmed Autoset is more proactive to treat events compared to a Philips, which is reactive and comes to the game too late to prevent the hypopnea events. Using an Auto CPAP allows you to self-titrate and optimize for your needs without another expensive clinical test, and i think ends up being better more comfortable therapy. These machines come with full data so you can see the results and make changes to improve as needed together with your doctor and of course this forum is a good source. The next step is to discuss therapeutic options with your doctor, but express a strong preference for self-titration using the Resmed Airsense 10 Autoset. You have a choice, and you should make yours clear very early.
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RE: Home Sleep Study - Help understanding results
Looks like a Nox A1 PSG or similar study (it's a Noxturnal generated report). I had a similar study and have the complete raw data - it's interesting to look back at as a baseline.

What has the doctor recommended here? That doesn't seem to be any directive here as to next steps (or have you left that out?).

I see PLM is noted (although the numbers aren't that high) - do you have RLS symptoms as well?
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RE: Home Sleep Study - Help understanding results
Hi and thanks for the reply!

Quote:The hypnogram shows numerous brief arousals during the night, many showing fully awake.

This has been the main issue for myself. It's the frequent awakenings where I am fully conscious, it just can't be good for my health long term. I am able to get back to sleep quickly after these so I at least have the going for me.

Thanks for the suggestion regarding the use of soft cervical collars, I'll definitely be checking them out. As for the CPAP machine, my father uses Resmed and says that they're very effective so I'll have a look into them Smile
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RE: Home Sleep Study - Help understanding results
The doctor recommended I try a Mandibular Splint mouthguard. I have tried but have not found it effective in the sense that I am still waking up during the night and am not feeling refreshed in the morning despite getting >7 hours a night. I need to book an appointment to go back and see the specialist but I am thinking I will need a sleep apnea machine.

What I am concerned about the most is the 27/hour AHI during REM sleep. Hopefully a sleep apnea machine can help!!

Quote:I see PLM is noted (although the numbers aren't that high) - do you have RLS symptoms as well?

I've never been diagnosed with RLS but I'm fairly certain I have a mild form of it. It is difficult to get to sleep sometimes because of the "feeling" I have to move my leg. I normally get around this by using an icepack on my foot! 

Do you think this might be causing the frequent awakenings?
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RE: Home Sleep Study - Help understanding results
your doctor is unlikely to tell you your rls/plm are significant but my experience is that it's enough to mess with your sleep & possibly your pap treatment.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
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