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3% vs 4% Hypopnea Scoring
#1
3% vs 4% Hypopnea Scoring
Hi All!

I was recently just recently diagnosed with OSA as a 25 year old, skinny male. I am trying to learn as much as I can. I have an AHI of 9 and an RDI of 11. I had an O2 nadir of 85 percent and was at 88 percent for about 5 minutes. 

My study used a 4% drop to score hypopneas. How big can the difference potentially be if it was scored with the 3% rule? Obviously, it will vary from person to person and it's probably somewhat difficult to extrapolate. Just want to get an idea if a different choice in scoring could've led to an AHI of 15 or more, which is moderate SA.

Regardless, amazing how diagnoses can hinge on something as subjective as a specific scoring choice.

Appreciate any and all responses!
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#2
RE: 3% vs 4% Hypopnea Scoring
Thank you for posting that.  What kind of sleep study did you have?  Home sleep study or polysomnography?  Using the 3% drop instead of 4% drop would make the test more sensitive (higher AHI #'s, etc.).  5 minutes below 88% qualifies a person for supplemental oxygen (you are very closet to this).  

If you could, upload the sleep study with all personal information redacted and we can take a look at it also.  Are you planning on getting a machine?  What kind?
Download OSCAR
OSCAR Chart Organization
Attaching Files

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. 

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.  
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#3
RE: 3% vs 4% Hypopnea Scoring
            Thanks for your reply! I had a PSG done. I will attach the full study. Really appreciate you taking a look. 


I do need to keep an eye on oxygen which is why I recently bought a monitor. If I was at 88 percent for 5 minutes in 5 hours of sleep, I'd imagine I'd be at 8 minutes during 8 hours of sleep (give or take - I know you can't extrapolate perfectly). Thanks again for taking a look.


Attached Files Thumbnail(s)
   
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#4
RE: 3% vs 4% Hypopnea Scoring
Thank you for posting those.  I am sorry.  I tried to increase my screen from 100% up to 500%, but still couldn't read your PSG.  Also, I tried using my magnifier app., but I couldn't read it.  

The basic things are:  1.  What % of your total apneas were OA's?  What % of your total apneas were H's?  What percent of your total apneas were CA's?  I could kind of make out your SPO2 chart.  You did have some significant drops.  2.  What does the summary say?  3.  Anything unusual that they talked about in the PSG?
Download OSCAR
OSCAR Chart Organization
Attaching Files

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. 

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.  
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#5
RE: 3% vs 4% Hypopnea Scoring
The charts you posted I think are thumbnail and not the full resolution. Basicly they are unreadable.

Your profile says you have an AS11, post your daily charts from that.

A now O2 Sat, any value, simply means to look deeper, nothing more. Your nearly 5 minutes at or below 88% means a lot more.
As Jay stated that means that without CPAP you nearly qualify for supplemental oxygen overnight. So that IS a big deal. While any CPAP use will typically increase your oxygen SATs, you will need to measure it to be sure.

Typically using a standard of 3% desats vs 4% will increase the amount of measured apnea. How much of a difference this makes would vary considerably by individual and their specific apnea. I would expect less variance from an individual with lower AHI, higher.
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#6
RE: 3% vs 4% Hypopnea Scoring
            Hi Jay/Gideon,

Apologies - attached here. I was out of town for the day yesterday and couldn't get to it. I am getting my AS11 soon (I hope so anyway - insurance approval process has been less than ideal) and thus have not used it yet.

All the data I have about my sleep is in the above 3 screenshots. Again, thank you guys very much for taking a look!

I am taking care of the PLMD. I took ropinirole for a week - couldn't really tolerate it + I am not a fan of the large chance of augmentation.
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#7
RE: 3% vs 4% Hypopnea Scoring
Thank you for reposting those.  Wow.  You had a lot of arousals during your sleep.  Hopefully getting your PLMD treated and getting optimized with your new AS11 will help you sleep much better in the future.
Download OSCAR
OSCAR Chart Organization
Attaching Files

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. 

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.  
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#8
RE: 3% vs 4% Hypopnea Scoring
Yeah. It's no wonder I don't ever feel very good, LOL. Appreciate the kind words.
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