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Results of latest sleep study are in, questioning a few things.
#1
Results of latest sleep study are in, questioning a few things.
Had my latest sleep study back in september i believe. Results came back today and there are a few things i would like to share hoping to understand it a little better.


My AHI was (of course) perfect that night, only 0.5!

Here are the sleep stages:

Total Time in SPT %/TST 
N1: 31,0 min 6,9 % 
N2: 270,0 min 60,1 % 
N3: 53,5 min 11,9 % 
REM: 95,0 min 21,1 %

AHI: 0.5
RDI: 0.8
Hypoapneas: 4
Position related: yes
Average saturation: 97.6%
Lowest saturation: 92%
Snoring: 0%

Leg movements
PLMI: 18,0 /h 
Arousals in TST: 125 
Major Body Movement in TST: 4

Bruxism: 5,7 min

APSG with APAP pressure between 5 and 13 cmH2O. High pressure without an obvious cause between 3:30 am and 4:30 am in N2 sleep resulting in arousals and frequent bruxism.
Some little deep sleep, enough REM sleep.
A lot of fast activity.
Bruxism 5.7 min.
AHI: 0.5/hr, saturation 97.6% below 90%= 0. No snoring.
PLMI: 18/hr especially in the early part of the night. Lots of arousals(125).
Regular rhythmic leg movements during the day (awake).

(sorry for the bad translation)

Conclusion:
With APSG with CPAP little deep sleep and sufficient REM sleep. No disruptors of breathing, but high alternating pressures during the night. On the IRLS and HSDQ, the patient scores high on RLS complaints, PLMI 18.0/h.

So my AHI was perfect but yet there are so many arousals, like the last time, good ahi but 150 arousals + a 197bpm heart rate. Since my AHI can't be the cause of it i wonder what is?

My RLS is getting better thanks to my neurlogist who prescribed me some iron tablets, ferritin level in my brain was low. 

Every sleep study shows ''lots of fast activity'', do they mean brain activity? If so, it's possibly related to my ADHD?

A saturation level of 92% seems a little weird with an AHI of 0.5. But when first diagnosed my saturation level was 57% so maybe it's just something that's normal for me. 

Neurologist also changed the machine's pressure from 5-13.5 cmH2O to 8 cmH2O because i was having many central apneas. Hopefully things will change now.




Thanks
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#2
RE: Results of latest sleep study are in, questioning a few things.
57% sats?

Why aren't you dead?
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#3
RE: Results of latest sleep study are in, questioning a few things.
(11-16-2021, 09:39 PM)StevesSp Wrote: 57% sats?

Why aren't you dead?

Too short to do some real damage maybe?

Lung dr called it a record.   Grin
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#4
RE: Results of latest sleep study are in, questioning a few things.
my experience, for what it's worth.

I believe my adhd, rls/plm and the central component of my apnea are neurologically related.

even though you feel your rls is improved, you're still having sleeping plm. while frequent arousals/awakenings can have many causes, plm is your most obvious potential culprit. I don't understand why sleep docs seem to ignore plm but 18 plm/hr is bound to be ruinous to sleep.

in my experience, the resmed apap responds to plm as to flow limitations, by raising pressure. this is ineffective against our respiratory response to plm and is in fact quite disturbing in itself. plus it tends to cause leaks and aerophagia which will wake you. and, as you probably know, apap will not treat your centrals (breath-holding ca may be a consequence of plm).

with no help from the 'system' I've moved on to asv and vauto, the former to better address centrals, the latter because it has greater flexibility to limit disturbing max pressure, runaway pressure and pressure swings caused by flow limitations and our respiratory response to plm. each modality has advantages and disadvantages and both are significantly better than apap in the presence of plm.

between ropinirole and a $30 usd transcutaneous electrical nerve stimulation unit, my sleeping plm is much reduced and my sleep significantly, but not entirely, less fragmented. while I used to wake up in minutes, rarely reaching an hour of uninterrupted sleep, I'm now averaging about 1.5 to 2.5 hours at a stretch. ongoing arousals seem to be associated with disordered breathing (a floppy palate issue I suspect) and lip leaks. in addition, I have to assume I need to more-rigorously attend to sleep hygiene factors.

one more thought. if you're taking stimulants for adhd and/or sleep deprivation, consider that by definition they're antithetical to sleep. as long as we take them, we can't be sure they're not inhibiting sleep.

I haven't given up hope that someday I'll sleep through the night so please keep us informed about your own progress.

just don't let them minimize/ignore the negative effect plm has on sleep!
  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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