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Confusing Sleep Study Results
#1
Confusing Sleep Study Results
I wake with headaches and migraines ALL THE TIME. It's always one step forward two steps back. I recently went on BP medicine and that really helped but lately they are back again. I noticed my BP is up in the morning when I wake with a headache even worse.

I had a sleep study 5 years ago and was told I didn't have sleep apnea. My neurologist noticed that I barely fell asleep (which I had mentioned to the person administering the test at the time) and ordered a new one.

So this time most of my results are borderline. My Apnea and Hypopnea per hour are 12.5 which is "mild" per my understanding.

I just got my results online and haven't talked to my sleep doctor yet.

However my number for Apnea and Hypopnea per hour during REM sleep is 45.3. My lowest SpO2% Rem sleep time is 82%. So from what I am interepreting I am suffocating during my REM sleep. This would explain why I sometimes wake up during the night headache free, go back to sleep and wake up with a horrible migraine a couple of hours later.

My Desaturation per hour>=4%  is 11.6%. I don't know what this is? Is this how low my oxygen level is getting?

Will I get prescribed a cpap?

I am so scared I won't but this not getting enough oxygen during REM sleep has to be a problem.
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#2
RE: Confusing Sleep Study Results
Request your detailed diagnostic test results. Redact the personal info. Scan it into your PC then post it here as an attachment. In case they tell you you're not permitted to have a copy, tell them HIPAA law says yes you can. No isn't an acceptable answer on this one.

We need as much data as possible to help you. You mention that SpO2 is low during REM. OK you need a recording pulse oximeter like a Wellue ring or Contec CMS50F and the free PAP report tool OSCAR. OSCAR will show you a lot of data when you get a PAP.

If all else fails in getting a PAP via insurance, you may have to buy one on your own. One place is our supplier list such as Supplier #2 that has new and gently used PAPs. The supplier list isn't an endorsement, but notation that forum members have had good purchase experience and seem to be fairly good bet.

You want to focus on ResMed branded PAPs, they're best of the bunch and the most comfortable and successful at treating Apnea with less fuss than Respironics. Your minimum choice is a ResMed AutoSet or AutoSet for her. If an actual BPAP is necessary you'll need a VAuto. Specialized therapy needs above that are available if needed. But I'm going to point you to the brand ResMed only.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Confusing Sleep Study Results
I really can not give you advice on your data BUT I will on the Cpap you should get when prescribed. A ResMed S10 Autoset or autoset for her. Do not accept a dreamstation, the supplier gets them cheaper than the ResMed and it will not be as good therapy. 

You need to ask the Dr to specifically prescribe the machine, and not just a ResMed S10 because there are many different models. It like buying a Ford (F150, Lincoln, tractor) you get the idea.  ResMed S10 autoset only!
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Confusing Sleep Study Results
Your AHI is mild bordering moderate (15) and AHI in rem is severe so something they should consider treating.

Your lowest SPO2 is not horrible especially if it was only momentary as most are. The key for oxygen levels is to look at the chart and see if you are sustaining low oxygen levels, average SPO2 and time below 90% are better indicators if you have that info available. Your ODI (oxygen desaturation index) is not a percent, it is the number of desaturations per hour and it correlates to your AHI which makes sense.

It would be worth looking into bruxism to see if you have other symptoms (muscle tone, tightness etc), it might be the cause of your headaches although it can be related to (perhaps caused by but more likely worsened by) sleep apnea.

You need to talk to your doctor about CPAP. CPAP treatment is recommended for cases of moderate apnea or in minor cases that are symptomatic. If you have typical symptoms of apnea (tiredness etc) then that along with the headaches is reason to ask to try CPAP (if your doctor doesn't recommend it), having high AHI in rem is also another reason to ask to try CPAP as rem is an important aspect of sleep. As Stacey mentioned try to get a Resmed Autoset.
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#5
RE: Confusing Sleep Study Results
This may not apply to you, but for me, the cause of 98% of my headaches (all day "cluster" headaches) was sleep disordered breathing.  Once I got treatment for apnea, my headaches subsided a bit.  My headaches have nearly vanished after using a ResMed VAuto Bilevel machine.

My "apnea score" was less than yours, but I had what was termed micro-arousals which prevented me from entering deeper stages of sleep.  Consequently, I never felt refreshed and had splitting headaches day and night.  Sometimes I would wake up with a headache.  Thankfully those days are over.  I feel so much better now, and it is from being treated using the optimal settings (for me) on my PAP machine.  

Get a copy of your detailed sleep tests and results.  With that we may be able to offer some recommendations.  As noted by others, please redact any personal information, and attach the data to your post.
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#6
RE: Confusing Sleep Study Results
My results just appeared on MyChart this Saturday. This is what is out there. Should there be more for me to look at?

The reason I am so concerned is that I just recently started having super severe headaches again and noticed that in the morning my BP had shot up again. I just went on BP medicine within the last year and it was a miracle in terms of reducing my headaches.

I wake up during the night several times without a headache or a very bit of mild pain and then I'll wake up with excrutiating pain. So when I started having headaches again mild at first then worsening I finally remembered to take my BP in the morning and it had shot up again while on the medicine. I haven't gained weight or experienced a noticeable change in health.

I tried sleeping with my head more propped up last night and was very uncomfortable and sore this morning and did not sleep well (I have arthritis) but I had a headache this morning instead of a migraine.

My test results look ok (I think) except for the things I mentioned on page 3 and 4.

pages 4 and 5


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#7
RE: Confusing Sleep Study Results
Thank you for sharing your story. I have a feeling this has been my problem for years. Explains some of the strange dreams where I can't breath too.

I feel like I've lost years of my life to headaches.

I wish I had followed up more 5 years ago when I had my first sleep study. When my neurologist looked at it he was surprised at how horrible my "sleep" was.

wow! I had never heard of a Wellue ring until yesterday when I found it online and already bookmarked it with the intent to buy it if I don't get a cpap and maybe if I do.

I'm glad to hear I'm on the right track.
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#8
RE: Confusing Sleep Study Results
I have a bite guard. I was wearing it during the test. I wear it every night. I generally do not find myself biting down on the bite guard.

My teeth have been straightened. They are not being worn down from biting or chewing.
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#9
RE: Confusing Sleep Study Results
So how does that work exactly? Do I get my doctor to prescribe the CPAP and then if insurance turns it down get one from one of these suppliers?

If I get one from the doctor I've supposed to have another sleep study to fit and adjust the device. How would I even do that if I don't get one through my doctor? I am in the US.
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#10
RE: Confusing Sleep Study Results
(06-13-2021, 09:43 PM)vmarshmellow Wrote: So how does that work exactly? Do I get my doctor to prescribe the CPAP and then if insurance turns it down get one from one of these suppliers?

If I get one from the doctor I've supposed to have another sleep study to fit and adjust the device. How would I even do that if I don't get one through my doctor? I am in the US.

If you get diagnosed with Apnea, doc needs to write a script for the machine, typically a CPAP. I think I've seen where you may be diagnosed as having mild Apnea. More on this in a bit.

Insurance will approve payment or not before PAP is issued, so you'd know either way soon enough. If declined, you can get doc to script a PAP with the stipulation you're buying one without insurance. In that case you contact Supplier #2 or others and get it shipped after calling, as I'd suggest if supplier 2 AKA second wind. They can tell you exact hours and price.

Stats in the test result of note:

83 Arousals at 12.5 per hour
12.5 is the total Apnea and Hypopnea per hour
45.3 is the Apnea and Hypopnea per hour in REM sleep
0 Central Apnea total, 3 each Obstructive and Mixed (sleep time)
SpO2 dropped to 82% in sleep and/or REM
Longest Apnea event 14 seconds

If I've got it correct, your diagnosis will be mild Apnea at 12.5, or if my math is right, an event roughly every 4.8 minutes. Seems like enough. You don't have any Central events but there's 3 Mixed and ditto for Obstructive so you're likely to be dealing with almost only Hypopnea, a 50-80% blockage instead of 80-100% full Obstructive Apnea. Still an issue though.

If my thoughts about this are accurate, you're getting a CPAP script. I'd suggest the ResMed AutoSet or AutoSet For Her.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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