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Sleep Test Results....IDK....
#1
Well, here they are copied from the report I got yesterday. Titration test set for June 4. Any comments would be appreciated as I don't quite understand all the numbers and percentages. Thanks in advance!

Diagnosis: Obstructive sleep apnea syndrome (327.23) moderate, AHI of 22.7/hr associated with sleep fragmentation and moderate arterial oxygen dissertations.

Sleep Summary (Entire Night)

Total Time in Bed (Minutes) 427.7
Total Wake Time “ 66.0
Wake after Sleep Onset “ 36.0
Sleep Onset Latency “ 30.0
REM Onset Latency “ 70.5
Total Sleep Time “ 361.7
Sleep Efficiency 84.6%
Number of Awakenings 8

Sleep Stage Summary Normal%

Stage 1: Latency (min.) = 0.0; Time (min.) = 11.0; %TST= 3.0 7 ± 5%
Stage 2: “ “ = 3.0; “ = 70.5; 19.5 45 ± 5%
Stage 3: “ = 15.0 “ = 185.2 51.2 20 ± 15%
Stage 4 " = 0.0 0.0
REM “ = 70.5 “ = 95.0 26.3 20 ± 5%

Respiratory Disturbances
Mean
# Index Saturation Longest Time (min.)
OA 6 1.0 10.0 10.0 1.0
MA 0 0 0 0 0
CA 9 1.5 10.0 10.0 1.5
APNEA# 15 AI: 2.5

HYP 122 20.2 10.0 10.0 20.3
A+H# 137 AHI: 22.7

RERA 0 0 0 0 0
A+H+R# 137 RDI: 22.7

Oxygen Saturation Summary

Avg. SaO2 Total 90%
Avg. SaO2 REM 89%
Avg. SaO2 NREM 90%
Lowest SaO2 70%
SaO2 < 89% 83.7
%TIB SaO2 < 89% 19.6

Cardiac Summary

Mean NREM Hr: 77.9
Mean REM Hr: 78.2
Mean Wake Hr: 80.3
"Freedom is the oxygen of the soul."
Moshe Dayan
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#2
(05-15-2015, 08:54 AM)kingskid Wrote: Well, here they are copied from the report I got yesterday. Titration test set for June 4. Any comments would be appreciated as I don't quite understand all the numbers and percentages. Thanks in advance!

Diagnosis: Obstructive sleep apnea syndrome (327.23) moderate, AHI of 22.7/hr associated with sleep fragmentation and moderate arterial oxygen dissertations.

Sleep Summary (Entire Night)

Total Time in Bed (Minutes) 427.7
Total Wake Time “ 66.0
Wake after Sleep Onset “ 36.0
Sleep Onset Latency “ 30.0
REM Onset Latency “ 70.5
Total Sleep Time “ 361.7
Sleep Efficiency 84.6%
Number of Awakenings 8

Sleep Stage Summary Normal%

Stage 1: Latency (min.) = 0.0; Time (min.) = 11.0; %TST= 3.0 7 ± 5%
Stage 2: “ “ = 3.0; “ = 70.5; 19.5 45 ± 5%
Stage 3: “ = 15.0 “ = 185.2 51.2 20 ± 15%
Stage 4 " = 0.0 0.0
REM “ = 70.5 “ = 95.0 26.3 20 ± 5%

Respiratory Disturbances
Mean
# Index Saturation Longest Time (min.)
OA 6 1.0 10.0 10.0 1.0
MA 0 0 0 0 0
CA 9 1.5 10.0 10.0 1.5
APNEA# 15 AI: 2.5

HYP 122 20.2 10.0 10.0 20.3
A+H# 137 AHI: 22.7

RERA 0 0 0 0 0
A+H+R# 137 RDI: 22.7

CA is a central apnea. OA is an obstructive apnea. You had 9 and 6 events respectively. Both of these apnea result in a cessation of breathing.

Hyp stands for hypopnea. You had 122 events. These are breathing events that rouse your autonomic system thus waking you up (you might not even know). You don't however have a cessation of breathing during these events.

Many specialists now believe that having low oa and CA events but high hyp events is just as serious.
Oxygen Saturation Summary

Avg. SaO2 Total 90%
Avg. SaO2 REM 89%
Avg. SaO2 NREM 90%
Lowest SaO2 70%
SaO2 < 89% 83.7
%TIB SaO2 < 89% 19.6

SaO2 is your blood oxygen or saturation level. For most cases anything above 95 is normal. Many docs use >90 as normal as well.

Simply put the lower this percentage is the less oxygen you have in your bloodstream. I don't like that 70% nor is it good that almost 85% of your Desai times are below 89%. You clearly do need cpap.

Cardiac Summary

Mean NREM Hr: 77.9
Mean REM Hr: 78.2
Mean Wake Hr: 80.3

Your cardiac results look completely fine surprisingly. No Bradycardias or tachycardias which is good.

I hope this helps you and please ask if you have any other questions.

AHI is your apnea plus hypopnea index. This is your 22.7/hour. This is calculated as follows.

oa index of 1.0
ca index of 1.5

apnea index = 1.0+1.5=2.5 thus your ai is 2.5/hour. You had 15 total apnea events.

You had 122 hypopnea events for an hi of 20.2/hour.

You add the Ai and hi to get 22.7/hour which is your ahi.

This info will help you in the long run to understand how all of these stats are interrelated.

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#3
Thank you, Multime. I appreciate the feedback!
"Freedom is the oxygen of the soul."
Moshe Dayan
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#4
As far as sleep architecture goes, your numbers show that you are getting more SWS sleep (stage 3/4) and more REM sleep than most people. Usually, an apnea sufferer has such disturbed sleep that they are getting a low amount of both SWS and REM, and severe insufficiency in at least one. You got to sleep fast and got to deeper sleep fast. I think that is good.

Your oxygen desaturations do not seem dire. The percentage of time you had SaO2<89% was 19.6%, and the average SaO2 during that time was 83.9%.

Your results are just what you could have expected, with the report you have made that you breathe very shallow. Also the presence of CAs suggest to me that the shallowness and the breathing halts you had previously observed are not related to partial or full obstruction, but somehow a central nervous system driven issue. This is further supported by the results of the study indicating there is no RERA (respiratory effort related arousals), where you are trying to breathe and encounter respiratory path resistance.

Will CPAP be an effective treatment? Doubtful. More likely, if machine is the answer, it will be a more advanced "adaptive servo-ventilator" type.

It does look like your physical condition is not dire, and you can stand taking your time finding the right treatment options.

Good luck.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#5
(05-16-2015, 09:44 AM)quiescence at last Wrote: As far as sleep architecture goes, your numbers show that you are getting more SWS sleep (stage 3/4) and more REM sleep than most people. Usually, an apnea sufferer has such disturbed sleep that they are getting a low amount of both SWS and REM, and severe insufficiency in at least one. You got to sleep fast and got to deeper sleep fast. I think that is good.

Your oxygen desaturations do not seem dire. The percentage of time you had SaO2<89% was 19.6%, and the average SaO2 during that time was 83.9%.

Your results are just what you could have expected, with the report you have made that you breathe very shallow. Also the presence of CAs suggest to me that the shallowness and the breathing halts you had previously observed are not related to partial or full obstruction, but somehow a central nervous system driven issue. This is further supported by the results of the study indicating there is no RERA (respiratory effort related arousals), where you are trying to breathe and encounter respiratory path resistance.

Will CPAP be an effective treatment? Doubtful. More likely, if machine is the answer, it will be a more advanced "adaptive servo-ventilator" type.

It does look like your physical condition is not dire, and you can stand taking your time finding the right treatment options.

Good luck.

QAL

Thank you quiescence for your response. I don't know if the titration test on Jun 4 will show if the CPAP is what I need or something more advanced, as you mentioned. Guess I'll just have to wait and see...
"Freedom is the oxygen of the soul."
Moshe Dayan
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#6
Insurance usually works in increments -- "they" think it's cost effective; it is seldom cost effective.
So, likely you will have to fail on CPAP, then BiPAP, to get to Auto ASV.
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#7
(05-16-2015, 11:00 AM)justMongo Wrote: Insurance usually works in increments -- "they" think it's cost effective; it is seldom cost effective.
So, likely you will have to fail on CPAP, then BiPAP, to get to Auto ASV.

Thanks, justMongo. Actually, I'd prefer incremental testing with dif machines, because I am one who's happy with the least amount of any medical intervention. I'd be most happy with a pretty pink S9 autoset for her with P10 nasal pillows!Wink
"Freedom is the oxygen of the soul."
Moshe Dayan
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#8
(05-16-2015, 12:29 PM)kingskid Wrote: I'd be most happy with a pretty pink S9 autoset for her with P10 nasal pillows!Wink

Priscilla, What I think is your June 4 titration will demonstrate that a modest cpap pressure of 8-11 will be just the thing for you to knock down those hypops and make you a happier camperer. And yes, the pretty pink S9 Autoset for her, or even better an Airsense 10 Autoset for her would be a fine idea.

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#9
(05-16-2015, 12:57 PM)retired_guy Wrote:
(05-16-2015, 12:29 PM)kingskid Wrote: I'd be most happy with a pretty pink S9 autoset for her with P10 nasal pillows!Wink

Priscilla, What I think is your June 4 titration will demonstrate that a modest cpap pressure of 8-11 will be just the thing for you to knock down those hypops and make you a happier camperer. And yes, the pretty pink S9 Autoset for her, or even better an Airsense 10 Autoset for her would be a fine idea.

Okay, retired guy, you can call me Priscilla Bigwink. I will be sure to post my titration results and we'll see how close you come to 8-11. After reading so many posts here, I decided it'd be good to see a pulmonologist. When I asked my PCP if he knew of any breathing exercises I could do to strengthen my breathing, he said they probably wouldn't help because SA is primarily from the neck up. However, if a person has a really low SAO2 level like 70, seems to make sense to see a pulmonologist. I like the idea of having a support team, especially if the family doctor is not a sleep specialist. I found a board-certified dr. in my PCP's group who is certified in sleep medicine, pulmonary disease and internal medicine, so will ask my PCP for a referral. Since the sleep dr. is at the Colorado Springs sleep center, he may want me to do another sleep test, so we'll see.

BTW, I've been vacillating big time between the S9 and the AirSense 10, should an autoset be appropriate. Have read many reviews of both machines, and maybe it'll come down to which machine (with both having a ClimateLine hose) consumes the most amps. Will go for the lower one because of my power situation.
"Freedom is the oxygen of the soul."
Moshe Dayan
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#10
If you have any breathing issues whatsoever, a pulmonologist would be a good thing for you. Especially since you live on cloud number 9, just above Pike's Peak. Breathing exercises can definitely be a good thing, SA or not. So if not a pulmonologist, perhaps a good respiratory therapist would be a fine idea.

I would pick up one of the little finger oximeters too. Not necessarily the recording kind, although for occasional overnight checking they're great. Just the little finger ones that sell for not many bucks. It would be interesting to see if you keep your O2 at 90+ during the day when you're out planting your summer crops.
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