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Home Sleep Study Interpretation - jasbur - 07-07-2021

Hi All -
I did one of those studies you order online and they ship to your house. Below is the result summary. I have not started therapy yet, but I have a Resmed AirCurve 10 Vauto.
What are your thoughts? Is it a mistake to use that machine? Should I get an APAP instead?

Interpretation
Severe Obstructive Sleep Apnea with evidence of significant Central Apnea and an AHI of 51.6.
Patient had evidence of hypoxia with an average saturation of 87% and a lowest saturation of 68%. Patient had no evidence of Cheyne-Stokes respirations and an average heart rate of 82 bpm.

RECOMMENDATIONS:
1. Auto-CPAP with CPAP related supplies and an APAP with pressures ranging from 4-20 cm and close CPAP compliance to r/o complex breathing with CPAP or Auto-BIPAP or ASV with related supplies and an IPAP with pressures ranging from 4-25 cm and a pressure support with pressures ranging from 2-8 cm.
2. Overnight oximetry on APAP to r/o hypoxia with APAP.
3. Caution with drinking, driving, or operating heavy machinery with untreated Obstructive Sleep Apnea.

RE: Home Sleep Study Interpretation - Crimson Nape - 07-07-2021

Hi jasbur!  -  Welcome

You can make the VAuto act like an APAP, so don't worry about that.   The item that I see that may be the problem, is your Clear Airways (CAs) being reported as significant.   In that case, the preferred CPAP used to treat CAs is an Auto Servo Ventilator (ASV).  

Do you have a copy of the detailed sleep test, complete with a statistical breakdown?  If so, posting a redacted copy here may help.  By redacted, I mean blocking out your name and any other personal information.

- Red

RE: Home Sleep Study Interpretation - Gideon - 07-07-2021

I would want to see the report itself, not just the summary.

First and foremost. You have a significant oxygen problem. Start with the VAuto tonight
4-25 PS=3. Mode=Auto. We will use the results as a baseline

Get a recording oximeter compatible with OSCAR,. Your O2 SATs are significant, let's make sure the VAuto corrects them, it should.

The report stayed "significant" central Apnea. That is not common. We don't know what significant means . The report suggested a variety of machines including an ASV. This is so unusual I feel you need to get an ASV. These "significant" centrals are most likely idiopathic meaning of unknown cause which again indicates the need for an ASV.

Actions,
Start the VAuto tonight.
Get an oximeter
Get the full copy of the HST report, including the graphics.
Follow-up with your doctor. Primary goal, an inland sleep study that includes an ASV titration to prove efficacy.

RE: Home Sleep Study Interpretation - jasbur - 07-07-2021

Thank you for taking the time!

I actually did 2 different tests. One with the Resmed ApneaLink and one with the NightOwl.
Hopefully these can be copied/pasted as I can't post links yet...

https://www.dropbox.com/s/moewd1sq3p0ksou/Sleep%20Study1%20.pdf?dl=0
https://www.dropbox.com/s/tvvmpkgaafccqaw/Sleep%20Study%202.pdf?dl=0

RE: Home Sleep Study Interpretation - Sleeprider - 07-07-2021

I fixed the links. The Nightowl sleep study did not differentiate between obstructive or central apnea. The Resmed Airview report shows OSA at 15.9, CSA at 6.3 and mixed apnea at 2.5. CPAP or the Vauto should certainly help to suppress and mitigate all obstructive events. There is really not other way to gauge how effective the therapy will be, or if it will increase your central events, until you try it, and work to optimize results. Some people succeed with CPAP or VPAP, and others have an increased central event with the ventilation provided by positive air pressure, and end up needing a more advanced therapy that can actually treat central events with a breath-by-breath pressure support provided by and Adaptive Servo Ventilator (ASV).

If you got the Vauto, that is the best possible therapy device for obstructive apnea and hypopnea, and has some useful features for mixed apnea. We will work with you to optimize the therapy. It may be worth getting a recording oximeter to monitor blood oxygen at night. They are not very expensive and we would hope to see considerable improvement in SpO2 with PAP therapy.

RE: Home Sleep Study Interpretation - jasbur - 07-08-2021

Hi All -
I have data from my first night. Unfortunately it's not great data, as I am on-call for work and was interrupted in the middle of sleep for awhile.
I obviously don't know much about this data but I do see that huge drop in o2 at the beginning. I'm hoping that is just a fluke.
Hopefully I can get better data tonight.

dropbox.com/s/v2wldcviw2zkr0p/Oscar%20Night%201.pdf?dl=0

RE: Home Sleep Study Interpretation - staceyburke - 07-08-2021

When posting Oscar. Use F12 button to take a screenshot and then post using the button at the bottom of the post. To put in the correct charts see my signature.

RE: Home Sleep Study Interpretation - jasbur - 07-08-2021

Thanks! I'll add a screenshot now (hopefully this post gives me enough posts to let me add a picture)   Smile
No luck, here's the dropbox location of the screenshot:
dropbox.com/s/xrags699zk6fh0o/screenshot-20210708-130627.png?dl=0

[Image: p.png?fv_content=true&size_mode=5]

RE: Home Sleep Study Interpretation - Sleeprider - 07-08-2021

Once again, linked your image. You can attach images as a new member.

You are getting pretty good results on the Vauto considering the mixed sleep apnea. Obstructive events are clearly much improved over your sleep study with only 1.5 per hour and CA events are at 3. Between 3:30 and 6:00 you had a very quiet, uneventful sleep, and then the CA kicked up a bit. It appears the low pressure of 8.0/5.0 during this time was both effective and comfortable. As events began after 6:00, pressure rose and appears to have increased the CA events. Based on this, I'd like to limit maximum IPAP pressure to 10.0. This will deliver a smaller range of pressure from 7.0/4.0 to 10.0/7.0. This should continue to be effective in controlling obstructive events, and may avoid over-ventilation which makes CA events more prevalent.

RE: Home Sleep Study Interpretation - jasbur - 07-08-2021

(07-08-2021, 12:37 PM)Sleeprider Wrote: Once again, linked your image. You can attach images as a new member.

You are getting pretty good results on the Vauto considering the mixed sleep apnea. Obstructive events are clearly much improved over your sleep study with only 1.5 per hour and CA events are at 3.  Between 3:30 and 6:00 you had a very quiet, uneventful sleep, and then the CA kicked up a bit.  It appears the low pressure of 8.0/5.0 during this time was both effective and comfortable.  As events began after 6:00, pressure rose and appears to have increased the CA events.  Based on this, I'd like to limit maximum IPAP pressure to 10.0. This will deliver a smaller range of pressure from 7.0/4.0 to 10.0/7.0.  This should continue to be effective in controlling obstructive events, and may avoid over-ventilation which makes CA events more prevalent.

Thanks for the input! I'll give the recommendations a try tonight.