I'm New To This - Here is A Little Info on my sleep study results

[ramled99]

Hello All:

I am new to the world of sleep apnea.  I had my sleep study recently, and I was diagnosed with severe sleep apnea, and proscribed a Resmed Airsense 10 CPAP machine.  I will probably get everyone's thoughts on my treatment plan and using the CPAP in a separate post.  But for now, I just want to understand the gravity of my diagnosis of "severe sleep apnea."

My sleep doctor who performed the sleep study, so far, has only had his technician perform the sleep study and the technician called me back and said I have "severe sleep apnea."  I have not yet met with my actual sleep doctor.  My appointment is in a few weeks.  I asked for the actual sleep study results to try to get more info on the severity of my OSA.  The doctor's office only sent me a snippet of the sleep study, and my doctor's email to me which states the following:


*******************************************************

You're sleep apnea is extremely severe. I copy/pasted more specific data below. CPAP is definitely the best way to treat it. You probably have gotten a Resmed CPAP which has an app you can download on your smartphone to track your nightly data. Once I see you we can try to get it synched to my account as well. The company that supplied it will also be tracking you 

Most people in your situation feel much better once treated with CPAP

Good luck!
AR

PHYSICIAN SUMMARY:
Analysis of ResMed ApneaLink Air HST recording revealed findings consistent with
severe obstructive sleep apnea, evidenced by an Apnea/hypopnea Index (AHI) of
57.4 per hour. Oxygen saturation was a baseline of 96%, with a low of 71%.
The study demonstrated nearly non-stop apneas and hypopneas with significant oxygen
desaturations.



*****************

From the sounds of this email from my sleep doctor, sounds like I have a pretty extreme case.  But can anyone on here break down this info?  How "severe" is this?  Anyone have numbers comparable to this? What do these numbers mean and what are they detecting, and how bad is it?  

After insurance processing and red tape, I finallly received my CPAP machine today and will start using it tonight. As soon as I read through the materials and try it out, I am sure I will have more questions. I have the Resmed Airsense 10 with a nasal pillow mask.  I have looked thru this forum and it seems like this particular CPAP is a good one.  I was worried about not having any say so in the CPAP machine I was prescribed.  But I will remain optimistic.  The medical device company who supplied the machine tells me that my pressure setting, based on my prescription, is set at 4-20? Not sure what that exactly means?  What exactly will the pressure be when I am actually sleeping?  Is the CPAP machine setting the pressure, minute by minute, based on how it is reading my breathing (or lack thereof)?  It seems like most folks with CPAP machines know and are told the specific pressure that they are getting in their CPAP therapy versus the CPAP continuously changing pressure throughout the night.  Any thoughts or concerns with that? 


It certainly does not surprise me that I have OSA.  I am surprised that it was labeled "severe."  I definitely do not sleep well at night due to the OSA.  But I do not have any energy issues during the day as far as I can tell.  I'm not falling asleep or sleepy during the day.  But nighttime is rough, for both me and my partner.  I have been told that there are times when I stop breathing continuously for over a minute, before choking myself awake.  Often times, I hear myself choking as I wake up.  Miserable. 

Anyway, that's my situation for now.  Any insights or advice or education would be greatly appreciated.  Again, right now, I would just like to understand how bad the results of my sleep study are, based on the info above from my sleep doctor.  But any other comments are welcomed...and appreciated.  At this point, I can and want to know the brutual realities and the optimistic points of view for treatment.  Success stories, advice, warnings, experiences, good or bad, are all welcome.  

So glad I found this board as I really have no one to talk to about this, except a frustrated partner who sleeps in a different room now because of this issue.  

I am sure my sitiation is not unique and my questions have probably already been answered somewhere in this forum. It is just a matter of locating the answers amongsts so many posts.  My apologies if my questions are redundant or have been answered, or have obvious answers.  I spent the whole day reading through post after post.  I realized that I would be reading forever, so I just decided to join and post my situation.  I will keep combing through this forum.  

I am looking forward to being educated by all on this board. 

Thanks so much.

Ramled99

[Crimson Nape]

Hi ramled99 -
Here is the sleep apnea severity index ranges:
   None/Minimal: AHI < 5 per hour
   Mild: AHI ≥ 5, but < 15 per hour
   Moderate: AHI ≥ 15, but < 30 per hour
   Severe: AHI ≥ 30 per hour

As you can see, the bar is very low to get to the severe range.   Also, an event is considered as any breathing restriction or stoppage lasting longer than 10 seconds.  It doesn't take much to have an event.

Please take a look at the Apnea Helpful Tips link, located in my signature below.  It will provide information to your new found therapy.

Welcome aboard!

[SarcasticDave94]

Hi ramled99, and welcome to Apnea Board.

Severe sleep apnea is an untreated AHI of 30 and above; yours is 57.4 untreated. "I stop breathing continuously for over a minute, before choking myself awake" is an indicator or how severe your situation is. No breathing over a minute is pretty much an indication you have an apnea situation obviously. No need to panic or anything like that though. It's good that you've gotten the sleep study taken care of.

I'd offer to you some "homework" to prepare yourself on the future CPAP usage you'll need to embrace. Please read the Beginner Guide from my signature below. It addresses questions and topics any CPAP user can benefit from. Take care and post data here, as it's best practice to keep your postings in one place (unless they branch off onto other topics) via SleepyHead after you get your machine.

[Walla Walla]

Your settings are the default settings the machine comes with. I recommend when you get things figured out to raise the minimum pressure up to 6cm. Most people have a hard time breathing with the pressure as low as 4cm. You can go to the private files section for members and request the clinic manual for the air sense 10. It'll describe all the clinic settings to you. Also recommend you download sleepyhead the link is below. Once you get a few days on the machine upload a chart here and we can help get your pressures dialed in.

[ramled99]

Wow.  Thanks everyone! This is all very helpful.  I will be sure to constantly check in.

[Melman]

Welcome to the forum. You have been  given good advice.  I will add one thing. It will be best if you put your followup posts i this same thread. That makes it easier for us to follow.

[ramled99]

Does anyone know what this part of the my doctor's report on the sleep study means:  "Oxygen saturation was a baseline of 96%, with a low of 71%. The study demonstrated nearly non-stop apneas and hypopneas with significant oxygen desaturations"  

Are these numbers bad? If so, how bad.  I guess it doesn't matter to some extent.  I know I have OSA, but i am just curious at what the data precisely means in terms of severity.

[jaswilliams]

It doesn’t really matter how bad the OSA is but yours is considered severe the treatment is the same a CPAP machine to hold open your collapsing airways. The pressure requirements are either a guess or tested using what’s known as a titration study which is an overnight study in a sleep centre where different pressures are used to test what pressure treats your apnea. Or a home titration can be used where your prescription is for an Auto Machine with a range of pressures we would recommend a pressure range of 6-20 initially however often the machines are set with their default range of 4-20, many people find a pressure 4 to be too low and complain of a feeling of suffication.


And Welcome to the forum we can help you treat your Apnea keep checking in and when you get your machine download sleepyhead so you can view the detailed data of your treatment.

[ShaunBlake]

Does anyone know what this part of the my doctor's report on the sleep study means:  "Oxygen saturation was a baseline of 96%, with a low of 71%. The study demonstrated nearly non-stop apneas and hypopneas with significant oxygen desaturations"  

Are these numbers bad? If so, how bad.  I guess it doesn't matter to some extent.  I know I have OSA, but i am just curious at what the data precisely means in terms of severity.

That was the part of your post that troubled me most -- probably because PAP didn't resolve all my issues and I also use supplementary oxygen. However, the titration in your sleep study must have shown that your low O2 sat was caused by your OAs; if you breathe, you get plenty of O2. In my case, I had to have a second study with a BiPAP to see if a PAP would suffice but my low sat wasn't caused by OAs (prolly due to my mild COPD).

I'm puzzled as well why the doctor prescribed such low numbers for your pressure. That is determined in your sleep study and it appears that although your OAs are severe and long (sheesh! I can't even hold a thought for a minute, much less my breath!) they can be easily overcome.

Be sure that EPR is enabled (that's expiratory pressure relief, a great feature of your unit, and will help you exhale if your pressure is real high).

You probably will find the machine easy to use and quickly get comfortable with it; it's quiet, and the way it handles the pressure range is pretty gentle (it senses how you're responding, and doesn't hit you with 20 bars (well, not bars, but the full 20) all the time, so you should't experience the "blowout" we used to get on in the olden days.

Looking forward to your progress reports and hopefully lots of successful ones.

[Ron AKA]

I think most of your questions have been answered. To put things in perspective my wife was diagnosed as Severe at 77, and I was Severe at 37. You are right in the middle  -- so Mid Severe! The critical question you should ask before you get locked into a machine is what % of those 57 events per hour (AHI) are central apnea events. You have been prescribed a good machine and in fact it is the same one I got, and I paid for it myself. I was not forced to take it. Same mask too, assuming it is a ResMed AirFit P10. My wife uses a very similar machine (ResMed S9 - the prior version of A10). However despite starting at an AHI of 77 she can easily get down to an AHI of 1.0 On the other hand, despite starting at 37, I have all kinds of trouble getting down to 3.0. The difference is that I have a lot higher level of central events (CA's), and a standard auto CPAP does not really work on central apneas. So that is the basic question you should ask. What is my % of CA events? Is a standard auto CPAP going to work well for me?