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Sleep Study Results HELP Please!
#1
Sleep Study Results HELP Please!
The Doctor said I have borderline Apnea but cannot treat. He said I would have to talk to my PCP to see why my O2 levels went below 90% when I had a hypopneas. I feel like I have something because I am always tired. I'm shock at the number of spontaneous arousals. He did say I have shallow sleep. 


Subject slept for 6.6 hours
Sleep efficiency was 82.5%: 46 seconds
Sleep onset latency was 33 minutes
Stage REM Latency: 69 minutes
Oxygen saturations: Lowest o2: 88%
                              Time Below 90%: 4.7%
                              Time below 88%


NREM / REM

Stage 1: 3.1%
Stage 2: 68.5%
Stage 3&4: 10.1%
Stage REM: 18.3%

Hypopnesas  1 @ REM AHI .9 and 3 @ non-REM AHI .6 Total AHI .7


Positional Predominance 

Back: 6..12 hrs
Front: 0 hrs
Right: 1.1 hrs
Left: 0 hrs

Events 

Arousals: Respiratory 2
               PLMs 0
               Spontaneous: 107
               Total: 109           17.8/hr

Snoring events: 0

THANK YOU!!!!
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#2
RE: Sleep Study Results HELP Please!
I think you have something going on with the spontaneous arousals.
I wish I knew more about those but I believe they can be caused by respiratory events and
are only "spontaneous" because the cause is unknown at test time.
Seems to me idiopathic would be a better word but ...

I'm sure someone will chime in soon.
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#3
RE: Sleep Study Results HELP Please!
I would try to get a referral to a sleep specialist/neurologist. IT does not look to be an SDB issue, but some other type of arousals, perhaps they can be treated with a medication or sleep hygiene training.
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#4
RE: Sleep Study Results HELP Please!
Two questions:

1) Do you know what criteria the lab used to score the hypopneas? There are two commonly used criteria. For most people it doesn't matter, but for a few people (like me) the difference between being scored under the "recommended" vs. "alternative" criteria for hypopneas can be the difference between having an AHI < 5 (no apnea) and an AHI > 20 (in my case).

2) Was the lab set up to score something called Respiratory Effort Related Arousals (RERAs)?  RERAs are NOT the same as hypopneas, but people with a lot of RERAs are said to have something called Upper Airway Resistance Syndrome (UARS) and UARS can cause a lot of the same daytime symptoms as OSA does.  However, most people with UARS don't tend to have major O2 desats---typically the RERAs in UARS are arousals that occur before the respiratory event has lasted long enough to be considered a hypopnea or involve a reduction in airflow that is not steep enough to be considered a hypopnea.
Questions about SleepyHead?  
See my Guide to SleepyHead
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#5
RE: Sleep Study Results HELP Please!
Robysue

Question for you: In the OP results it is stated that respiratory arousals =2, wouldn't that include RERA? If so I think that excludes UARS. That's why I thought it was a neurological sleep architecture problem rather than a breathing problem.
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#6
RE: Sleep Study Results HELP Please!
(06-21-2017, 12:04 AM)TASmart Wrote: Robysue

Question for you: In the OP results it is stated that respiratory arousals =2, wouldn't that include RERA? If so I think that excludes UARS. That's why I thought it was a neurological sleep architecture problem rather than a breathing problem.
Only if the lab actually scores RERAs. Not all labs score RERAs since Medicare (and many insurance companies) doesn't accept UARS as a diagnosis for justifying paying for CPAP therapy.

Likewise, if a sleep lab uses the "recommended" standard for scoring a hypopnea, then "hypopneas with arousal" that could be scored under the "alternative" standard might be considered "spontaneous" since they didn't meet that lab's criteria for scoring something as "respiratory related"
Questions about SleepyHead?  
See my Guide to SleepyHead
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#7
RE: Sleep Study Results HELP Please!
Hi sleepydwarf2014,
WELCOME! to the forum.!
Hang in there for more answers to your questions and good luck to you with getting your sleep problems figured out.
trish6hundred
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#8
RE: Sleep Study Results HELP Please!
Thank you! I'm trying to get into see my PCP now. I've tried searching the internet to find out if the spontaneous arousals are normal and I can't find anything. It's very frustrating. ?
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#9
RE: Sleep Study Results HELP Please!
Thank you, when I see my PCP I will suggest this.

I have no idea what criteria they used. The doctor was not helpful at all going over my results. I asked about the spontaneous arousals he said talk to my PCP. He was concerned about the dip in o2 and said talk to my PCP. I'm lost with this whole thing. Thank you for responding.
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#10
RE: Sleep Study Results HELP Please!
If the spontaneous arousals count as RERA's then your RDI(respiratory disturbance index) would be 17.8. This should be high enough for insurance to cover a cpap since your AHI is less than 5. I believe criteria is if the AHI is less than 5 but RDI is >15 and pt. is symptomatic then insurance would cover machine. Insurances do vary however.

For an event to be scored as hypopnea: 30% reduction in air flow, at least 10 seconds in duration and 3-4% drop in SpO2(some labs use 3%, some 4%).

RERA's would be if the event was less than 10 seconds or SpO2 didn't drop as far. There's still an arousal after event but just didn't quite meet the criteria to score as hypopnea or obstruction.

question is what exactly is a spontaneous arousal?
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