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Sleep Study Results
#21
(02-07-2014, 06:30 PM)retired_guy Wrote: I'm thinking "manufacturing defect" here. Maybe we should be recalled?

We are all defective and we all get recalled. Dielaughing

PaytonA
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#22
my first sleep study, I had 50+ per hour. Actual "sleep" about two hours. Second sleep study, no apneas. Confusing.
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#23
(02-10-2014, 12:25 AM)victor hegemony Wrote: my first sleep study, I had 50+ per hour. Actual "sleep" about two hours. Second sleep study, no apneas. Confusing.

I found that the sleep study data doesn't accurately record when I'm asleep, and therefore the averages got leveled by the fact that it took me 2.5 hours to fall asleep, I had 3-4 awake periods of 30-60 minutes, and I was awake for about an hour before I got out of bed and said "I'm done!" (My point is that there is little to no OSA and CSA when I'm not sleeping.)

When I finally received the official report, it said I was asleep in 15 minutes! WHAT?!!!
It also said that I slept for about 7.5 hours. WHAT?!!!

Therefore, if there were few or no apneas for the first 2.5 hours and same with last hour, why is that data factored in the averages? The should give patients a mini-clicker that you keep clicking every 10 minutes to tell them: "hey, I'm awake here, even though my eyes are closed and I'm quietly breathing".

The other thing I'm perplexed with is that Encore and SleepyHead show that I have an ongoing daily Central Apnea Index of about 5-9. However, the with-machine 2nd (awful) sleep study data showed a low Central Apnea Index of 2.0 but instead showed a Hypopnea index of 7.0. Who's more accurate I wonder?
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#24
My first sleep study determined AHI = 85.2 on my back and 8.5 on my side. I also learned that about 40% of the events were central apnea. The second study included a CPAP and showed a reduced AHI = 15.0 with nearly all the events being central apnea. The third sleep study used a ResMed ASV and was total torture: it took 6.6 hours latency REM sleep while the technician adjusted the machine. I seemed to be fighting the machine all the way with AHI's varying between 25 and 35, before the final settings brought it down to 4.8. My sleep doc is concerned that ASV might not be the way to go since central apnea sometimes goes away after a few months on CPAP and I had such an awful experience in the sleep lab. I want to get rid of my dumb brick and at least be able to store AHI type data. I am using the PR REMstar Plus with C-flex and wonder if I would be better off with the REMstar Pro or REMstar Auto while I see if I can avoid ASV. Any experience with these machines or other thoughts?
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#25
(04-07-2014, 05:50 PM)WakeUpTime Wrote: The other thing I'm perplexed with is that Encore and SleepyHead show that I have an ongoing daily Central Apnea Index of about 5-9. However, the with-machine 2nd (awful) sleep study data showed a low Central Apnea Index of 2.0 but instead showed a Hypopnea index of 7.0. Who's more accurate I wonder?

Our CAI fluctuates daily.

Your machine is probably reporting accurately your current CAI, and the rate at which you had Central Apneas during your titration probably simply happened to be lower than your new normal.

If you have insurance coverage, I suggest asking for an Auto-ASV titration. (A titration where the machine is given a range for EPAP and a range for Pressure Support.) If you have obstructive apneas (as you do) I think your doc can (and should) specify a minimum EPAP which is the same as your current minimum EPAP setting.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#26
(04-12-2014, 04:24 PM)natdenkin Wrote: My sleep doc is concerned that ASV might not be the way to go since central apnea sometimes goes away after a few months on CPAP and I had such an awful experience in the sleep lab. I want to get rid of my dumb brick and at least be able to store AHI type data. I am using the PR REMstar Plus with C-flex and wonder if I would be better off with the REMstar Pro or REMstar Auto while I see if I can avoid ASV. Any experience with these machines or other thoughts?

See if you can get your doc to order a new titration study using an AVAPS machine, or just ask for a prescription for an AVAPS machine as a trial. An AVAPS (Alveoli Volume Assured Pressure Support) machine is a type of ASV machine which tends to adjust more gradually, and you may find one far more tolerable. If the doc won't write a prescription for an AVAPS machine, I suggest you trial a PRS1 BiPAP autoSV Advanced with heated hose. It may be more tolerable than the ResMed model.

At very least, I suggest asking for a PRS1 BiPAP Auto or an S9 VPAP Auto if you want to try standard Auto BiPAP therapy to see if the CAI lowers enough during the initial months of therapy. These are premium machines with more features and more likelihood of success, in my view.

Actually, my best recommendation would be to try ASV for a while and see if you can adapt to it. Simply lowering the Max Pressure Support temporarily (while you get used to ASV therapy) may be your ticket to sleep bliss. But make sure they give you a new model ASV, with heated hose and self-adjusting EPAP pressure within a range (in addition to self-adjusting Pressure Support within a range, which is the minimum definition of an ASV machine). Try both PRS1 and ResMed if necessary.

Take care,
--- Vaughn



Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#27
(02-06-2014, 09:38 PM)me50 Wrote: I am curious about what members' sleep study showed as far as how many events they had per hour.

My initial sleep study 3 years ago showed 44 per hour while sleeping on my back.

During my sleep study (about 4 months ago), I was fortunate enough to sleep pretty well. The sleep study summary report indicated an AHI of 36. After working on CPAP for a bit, I suspected that my OSA was quite positional. I requested the actual data, and the results were a little shocking. The supine AHI was 58.8, the non-supine was 3: a ratio of almost 20!! For some reason, the Sleep specialist did not include this data in the summary report. Now that I am taking steps to avoid back-sleeping, the AHI is averaging less than 2! Three cheers for data-capable machines and software to display the results!

As I have 2 sisters also on CPAP therapy, I expect there is a significant genetic influence involved.
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#28
(04-12-2014, 08:15 PM)vsheline Wrote:
(04-12-2014, 04:24 PM)natdenkin Wrote: My sleep doc is concerned that ASV might not be the way to go since central apnea sometimes goes away after a few months on CPAP and I had such an awful experience in the sleep lab....

See if you can get your doc to order a new titration study using an AVAPS machine, or just ask for a prescription for an AVAPS machine as a trial....

If the doc won't write a prescription for an AVAPS machine, I suggest you trial a PRS1 BiPAP autoSV Advanced with heated hose. It may be more tolerable than the ResMed model.

At very least, I suggest asking for a PRS1 BiPAP Auto or an S9 VPAP Auto if you want to try standard Auto BiPAP therapy...

Actually, my best recommendation would be to try ASV for a while and see if you can adapt to it....
Take care,
--- Vaughn

Thanks Vaughn for your thoughtful suggestions. I think I need more time with ASV than I can get in a sleep lab. I noticed that during the day, I sometimes stop breathing and wonder if that is like sleep onset central apnea... I will discuss your suggested with my sleep doc! Thanks again,
nat
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#29
(02-07-2014, 04:58 AM)me50 Wrote: those are pretty low numbers so it goes to show us all that even though the numbers are on the lower side, it can still have a great affect on our sleep quality and quality of life.

me50, I had 87 events per hour during my sleep study. If my AHI is above say 2 per hour I start to feel stressed and out of it the next day. I'm definitely sleepy and stressed all day when the previous night's stats show that I have around 3-4 AHI events per hour. (The stress/sleepiness with an AHI of 3-4 may also be in part due to sleeping less than 7 hours per night, since an AHI of 5 or below is considered normal)
Not your ordinary Moe Schmoe
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