New member here - Love the site already - Need some advice
As someone who participate in a few different entertainment and sports forums, I have to say that this board is a godsend! Whoever created it, thank you very much. It is nice to talk with other people diagnosed with Sleep Apnea. Well here is my story:
About three months ago I went to my doctor for a routine checkup. We got to talking about my weight (i'm 5'8 and 300 pounds) and we talked about me joining a gym. I explained that I barely have enough energy to work and keep up my home. He asked me how I have been sleeping and I told him I feel like I haven't had a good nights rest in years. He sent me for a sleep study. He said that apnea and weight gain can go together and if you have apnea, and we treat it, you will be more likely to lose weight.
At the sleep study, they hooked me up to what seemed like a 1,000 wires and told me to go to sleep. She said she would wake me and fit me for a mask if I had it and it was severe enough. I had a hard time falling asleep, but when I finally did the lady burst into my room and said I had sleep severe sleep apnea. She gave me the mask and left. By nature, I worry a lot. Not knowing anything about sleep apnea my heart was racing. I started asking questions "how did I get to this point?" "I can't believe I have gotten so fat that I now need this to sleep" "How will me fiance look at me having to wear this to bed every night". Anyway, long story short, it took me hours to fall back asleep. It appeared when they first fit me for the mask that they had the pressure so high that it was causing me to swallow air cause I started burping. I asked her to turn it down as I was afraid that it would start coming out the other end if this keeps up, and she wouldn't want to deal with that.
I FINALLY fell asleep for what seemed to be about 30 minutes when she came in and said that time was up. She recommended that I participate in another sleep study. Even though I have insurance, it still cost me a decent amount so I said I would look into it and left.
I will copy and paste the results of my sleep study at the end of my long boring story. I was given a Phillips Respironics REMstar with a system one heated humidifier. I have a full face mask ResMed Mirage Quattro. They had set it to 6 cm H20. I tried using the system, but I would wake up gasping for air. It felt like there just wasn't enough air coming into my mask and it was making things worse. I threw all the CPAP crap back in the bag and said, "*Screw* it"
Fast forward to yesterday- I spoke to a close friend that almost died because of his undiagnosed sleep apnea. His brain basically fell asleep while he was awake and driving. He drove into a six lane intersection. Luckily they survived but that story was enough to scare me into taking this more seriously.
I found out how to change the pressure (thanks to this website) so I changed it to 7.0 I made it through the night but had to get up to urinate four times which I have been told is a symptom of apnea.
Since I was diagnosed- I have found that if I sleep on my back (without the CPAP machine) and use a bunch of pillows I sleep a little better, dream better, and have to get up to urinate only once.
I guess I am a little concerned. Do you think I need to up my pressure even more? Do you think I was still having apnea episodes and that is why I had to get up so many times last night? Did changing the pressure make my apnea worse? I have read about a lot of experiences on this forum and a bunch of people had peaceful restful sleep their first night. I want that so bad!
I guess I am looking for some advice. Obviously, I will be calling the doctor to arrange to have another sleep study done. I usually will have to wait about 45 days to get in for a sleep study so I am looking for some tips to help me survive and maybe even have a good nights rest prior to the sleep study. Here are the results of my sleep study:
Sleep history: The patient is a 31 year old male with a history of snoring,
choking/gasping while asleep, excessive daytime sleepiness and daytime
fatigue. A split-night polysomnogram study was performed. A medium ResMed
Quattro Fx full face mask was used during the titration portion of the study.
Past medical history: GERD
Sleep procedure: PSG w/CPAP or Bilevel PAP 4 or > addtl param PC (95811)
Procedure: The study was attended continuously by a sleep technologist. The
monitored parameters included: left (E1-M2) and right (E2-M1) EOG, frontal
(F3-M2 & F4-M1), central (C3-M2 & C4-M1) and occipital (O1-M2 & O2-M1) EEG,
mental and submental EMG, left and right anterior tibialis EMG, single ECG
waveform, snoring, continuous airflow with thermistor, nasal pressure
transducer, and PAP Interface, chest and abdominal effort, oxygen saturation,
EtCO2, and body position via video monitoring.
Hypopnea definition: The nasal pressure signal excursions (or those of the
alternative hypopnea sensor) drop by =50% of baseline. The duration of this
drop occurs for a period lasting at least 10 seconds. There is a =3%
desaturation from pre-event baseline or the event is associated with an
arousal. At least 90% of the event?s duration must meet the amplitude
reduction criteria for hypopnea.
The study started at 22:50:46 and ended at 06:23:10. Total sleep time was 221
minutes resulting in a sleep efficiency of 51.4% (TRT = 430 m). There were 12
awakenings with a total time awake after sleep onset of 168.5 minutes. The
sleep latency was 38.0 minutes and the REM latency was 161 minutes. The
patient spent 64.5% of sleep time in the supine position. The sleep stage
percentages were 14.9% stage N1, 75.1% stage N2, 0.5% stage N3 and 9.5% REM
sleep. There were 174 arousals, resulting in an arousal index of 47.2. There
were 87 stage shifts.
BASELINE RESPIRATORY DATA:
Snoring was noted. There were 154 respiratory events consisting of 2 apneas
(2 obstructive, 0 mixed, and 0 central) and 152 hypopneas. The patient spent
40.8% of baseline sleep time in the supine position. The apnea-hypopnea index
was 69.7. The back index was 108.9. The offback index was 42.8. The REM index
was 80.0. The non-REM index was 68.4 and the arousal index was 69.7. The mean
oxygen saturation during the first part the study was 94.0%, with a minimum
oxygen saturation of 88.0%. The patient spent 5.9% of sleep time with an
oxygen saturation below 90%. The maximum end-tidal CO2 was 45 mmHg.
REM-Time REM-Index NREM-Time NREM-Index Total-Time Total-Index
Supine 0.0 m -- 54.0 m 108.9 54.0 m 108.9
Off-Supine 15.0 m 80.0 63.5 m 34.0 78.5 m 42.8
Total 15.0 m 80.0 117.5 m 68.4 132.5 m 69.7
POSITIVE AIRWAY PRESSURE THERAPY:
During the second part of the study, CPAP titration was initiated at 02:45:16
and ended at 06:05:57. The patient did have difficulty falling back asleep.
Snoring was eliminated at a CPAP setting of 5 cmH2O. The mean oxygen
saturation during the second part of the study was 96.0%, with a minimum
oxygen saturation of 93.0%. There were 23 stage shifts.
IP EP TST REM %Sup Apn Hyp Tot SupIdx AHI RAHI ArIdx Nadr Mean SaO2
5 5 09 m 0 m 100.0% 0 5 5 31.6 31.6 0.0 37.9 93.0% 96.0%
6 6 23 m 0 m 100.0% 0 1 1 2.6 2.6 0.0 10.2 96.0% 96.0%
7 7 23 m 6 m 100.0% 0 8 8 20.4 20.4 20.0 17.9 93.0% 96.0%
8 8 32 m 0 m 100.0% 0 0 0 0.0 0.0 0.0 0.0 95.0% 95.0%
9 9 00 m 0 m 0.0% 0 0 0 0.0 0.0 0.0 0.0 -- --
LIMB MOVEMENT DATA:
There were 0 periodic limb movements during sleep, resulting in a PLM-index
The average heart rate during sleep was 65 beats per minute, with a range of
56 to 83. During wake, the heart rate ranged from 57 to 104 beats per minute.
Obstructive Sleep Apnea Syndrome [327.23]
1. Severe obstructive sleep apnea syndrome. Respiratory events were
associated with oxygen desaturations (nadir of 88% on room air).
2. Due to prolonged wakefulness, titration time was relatively short. At a
CPAP setting of 6 cmH2O, the apnea-hypopnea and the arousal indices were
normalized. At this setting, supine sleep was recorded, snoring was
eliminated and the oxygen saturation was maintained above 95%. However at
this setting, there was no REM sleep recorded. Of note the only setting of 7
cmH20 recorded REM sleep but it did not normalize the AHI.
3. Abnormal sleep architecture likely due to respiratory events, PAP
titration and first night effect.
CPAP 6 cmH20 with humidification for habituation. A dedicated overnight PAP
titration study should be considered.
(This post was last modified: 08-26-2012 09:58 AM by biglar831.)