02-25-2025, 01:44 PM
Help me with Sleep Study interpretation?
Long story short:
I started to sleep like crap when I was ~28yro. Now I'm 35. At 28yro I had a sleep study done with results showing no sleep apnea.
At 34yro I've requested my doc to check my testosterone. I had low testosterone symptoms (noticed mainly after I returned to the gym). The bloodwork confirmed my worries. My doctor recommended a sleep study again to verify (bad sleep = low T).
I'm not an obese guy, no belly. I had my nose broken a few times (boxing and some stupid youth street fights). I lift, can easily run 5k, or 10k but struggling. My wife told me I've been snoring and/or breathing very shallow. I sometimes wake up gasping for air with elevated heart rate. My dad has exactly the same issues (and now suffers from cardiovascular issues at 65). I wanted to take this seriously, seeing my dad's deteriorating health.
Level 3 sleep study revealed only 8 AHI. I was offered a trial with CPAP considering my bad sleep and low T. After initial titration and getting used to it, the CPAP made a big difference.
During the follow-up my doctor (real sleep MD) said that CPAP shouldn't make a huge difference with AHI 8 and recommended another sleep study (Level 1 or 2).
I went with level 2. I had to come off my CPAP for 3 days prior and I slept like crap again... Please see the results below:
SPECIAL PROCEDURES: Level ll Sleep Study (Unattended Polysomnography Testing)
SLEEP ARCHITECTURE & STAGING: Testing began at 11:22 PM and ended at 6:16 AM, for a total
recording time (TRT) of 413.6. The total sleep time (TST) was 343.5 minutes, which resulted in a sleep
efficiency (TST/TRT) of 83.1%. The sleep onset latency (SOL) was 6.6 minutes. The latency to the first
epoch of Stage R sleep was 70.5 minutes, and there were 3 Stage R sleep periods. Wake after sleep onset
(WASO) time totaled 63.5 minutes. The percentage of total sleep time in each stage was: 6.7% (Stage N1);
54.3% (Stage N2); 12.2% (Stage N3); and 26.8% (Stage R). The patient spent 53.0% of the total sleep time
in supine position. Supine stage R sleep was sampled.
CARDIO-RESPIRATORY: Intermittent soft snoring was heard. The overall apnea-hypopnea index
(AHI) was 34.1 events/hour (obstructive apneas = 0; mixed apneas = 0; hypopneas = 195; central apneas
= 0). AHI results by body position: supine position = 33.9/hr; lateral positions (right & left) = 38.2/hr;
prone position = 30.2/hr. AHI results by sleep stage: stages N1, N2, and N3 sleep (NREM) = 27.0/hr;
stage R (REM) sleep = 53.5/hr. The mean SpO2 value was 91.1%, with a minimum value of 85.0%. The
percentage of time spent asleep with oxygen saturation below 90% was (T90) was 6.1%. TcpCO2 was not
collected. The predominant cardiac rhythm was sinus, with no evidence of a clinically significant cardiac
rhythm disturbance, with the heart rate ranging from 49.0bpm to 96.0bpm during sleep, averaging 65.0
bpm.
AROUSALS: The total arousal index was 21.7 events/hour. Of these, 65 were identified as respiratory-related
arousals (11.4/hr), 0 were PLM-related arousals (0/hr), and 59 were spontaneous arousals (10.3/hr).
MOTOR MOVEMENTS: There were no periodic limb movements (PLMs) during sleep. There were a total
of 6 episodes of bruxism during sleep, for a bruxism index of 1 events/hour. Audible grinding sounds were
detected.
-------------------------------------------------------------
So it turns out that I have no obstructive apneas, but a lot of hypopneas... My sleep doc said to consider it "nearly the same thing". I asked him if there was any other treatment options for me, considering that I only get hypopneas. He said "surgery but it has high risks and often no results", "dental device that is expensive and rarely works", or to continue to use my CPAP. I will, for sure, if it ain't broken don't fix it, I have no desire to sleep like crap again...
But overall, I'd love to hear your thoughts on my results, your own experiences with hypopnea/apnea and those of you who are really into sleep study interpretation could give some more insights...
Thank you!!!
I started to sleep like crap when I was ~28yro. Now I'm 35. At 28yro I had a sleep study done with results showing no sleep apnea.
At 34yro I've requested my doc to check my testosterone. I had low testosterone symptoms (noticed mainly after I returned to the gym). The bloodwork confirmed my worries. My doctor recommended a sleep study again to verify (bad sleep = low T).
I'm not an obese guy, no belly. I had my nose broken a few times (boxing and some stupid youth street fights). I lift, can easily run 5k, or 10k but struggling. My wife told me I've been snoring and/or breathing very shallow. I sometimes wake up gasping for air with elevated heart rate. My dad has exactly the same issues (and now suffers from cardiovascular issues at 65). I wanted to take this seriously, seeing my dad's deteriorating health.
Level 3 sleep study revealed only 8 AHI. I was offered a trial with CPAP considering my bad sleep and low T. After initial titration and getting used to it, the CPAP made a big difference.
During the follow-up my doctor (real sleep MD) said that CPAP shouldn't make a huge difference with AHI 8 and recommended another sleep study (Level 1 or 2).
I went with level 2. I had to come off my CPAP for 3 days prior and I slept like crap again... Please see the results below:
SPECIAL PROCEDURES: Level ll Sleep Study (Unattended Polysomnography Testing)
SLEEP ARCHITECTURE & STAGING: Testing began at 11:22 PM and ended at 6:16 AM, for a total
recording time (TRT) of 413.6. The total sleep time (TST) was 343.5 minutes, which resulted in a sleep
efficiency (TST/TRT) of 83.1%. The sleep onset latency (SOL) was 6.6 minutes. The latency to the first
epoch of Stage R sleep was 70.5 minutes, and there were 3 Stage R sleep periods. Wake after sleep onset
(WASO) time totaled 63.5 minutes. The percentage of total sleep time in each stage was: 6.7% (Stage N1);
54.3% (Stage N2); 12.2% (Stage N3); and 26.8% (Stage R). The patient spent 53.0% of the total sleep time
in supine position. Supine stage R sleep was sampled.
CARDIO-RESPIRATORY: Intermittent soft snoring was heard. The overall apnea-hypopnea index
(AHI) was 34.1 events/hour (obstructive apneas = 0; mixed apneas = 0; hypopneas = 195; central apneas
= 0). AHI results by body position: supine position = 33.9/hr; lateral positions (right & left) = 38.2/hr;
prone position = 30.2/hr. AHI results by sleep stage: stages N1, N2, and N3 sleep (NREM) = 27.0/hr;
stage R (REM) sleep = 53.5/hr. The mean SpO2 value was 91.1%, with a minimum value of 85.0%. The
percentage of time spent asleep with oxygen saturation below 90% was (T90) was 6.1%. TcpCO2 was not
collected. The predominant cardiac rhythm was sinus, with no evidence of a clinically significant cardiac
rhythm disturbance, with the heart rate ranging from 49.0bpm to 96.0bpm during sleep, averaging 65.0
bpm.
AROUSALS: The total arousal index was 21.7 events/hour. Of these, 65 were identified as respiratory-related
arousals (11.4/hr), 0 were PLM-related arousals (0/hr), and 59 were spontaneous arousals (10.3/hr).
MOTOR MOVEMENTS: There were no periodic limb movements (PLMs) during sleep. There were a total
of 6 episodes of bruxism during sleep, for a bruxism index of 1 events/hour. Audible grinding sounds were
detected.
-------------------------------------------------------------
So it turns out that I have no obstructive apneas, but a lot of hypopneas... My sleep doc said to consider it "nearly the same thing". I asked him if there was any other treatment options for me, considering that I only get hypopneas. He said "surgery but it has high risks and often no results", "dental device that is expensive and rarely works", or to continue to use my CPAP. I will, for sure, if it ain't broken don't fix it, I have no desire to sleep like crap again...
But overall, I'd love to hear your thoughts on my results, your own experiences with hypopnea/apnea and those of you who are really into sleep study interpretation could give some more insights...
Thank you!!!
