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overnight sleep study results--newbie here
#1
overnight sleep study results--newbie here
I’m Maybe you all Geniuses can make sense of all of this. I’e been on cpap a couple of months. My first study was wearing a ring and I had 56 or so episodes an hour of not breathing. From this overnight study, I guess it’s best to stay around pressure of 6. I love EPR at 3 for a short ramp.  Are my centrals disturbing? 

I tried to attach photo files of charts from study, but if not viewable maybe one can look at them in a Google doc here:
https://docs.google.com/document/d/1jfVX...sp=sharing


FINDINGS: Please refer to the attached summary for additional quantitative information.
DIAGNOSIS: Obstructive sleep apnea syndrome
IMPRESSION: A full night PAP titration polysomnogram was completed. PAP was initiated at a setting of 4cm H20 and increased from this setting. Best results were seen at a pressure of 6cm H20, where near-complete resolution of sleep apnea was observed. REM stage sleep was observed at this pressure. Cardiac bigeminy was noted.
RECOMMENDATIONS:
1. Initiate CPAP using a properly adjusted large ResMed AirTouch F20 mask, or fit to patient comfort, at a pressure of 6cm H2O with heated humidification.
2. Close clinical follow-up to ensure proper comfort and usage of PAP is paramount.
3. May consider nocturnal pulse oximetry once compliant on PAP to assess for the need of supplemental oxygen.
4. May consider consultation with otiaryngiogy for airway assessment and possible surgical options for improvement. May consider dental consult for possible mandibular device.
5. Counsel patient on risks of driving or operating heavy machinery when tired as well as the hazards of using alcohol or sedatives at bedtime.
========
SLEEP CONTINUITY AND SLEEP ARCHITECTURE: Lights off was at 23:54: and lights on 05:55: (6.0 hours in bed). Total sleep time was 253.5 minutes (30.0% supine; 69.0% lateral; 0.0% prone, 13.0% REM sleep), with a decreased sleep efficiency at 70.0%. Sleep latency was decreased at 4.0 minutes. REM sleep latency was normal at 73.5 minutes. Of the total sleep time, the percentage of stage N1 sleep was 11.0%, stage N2 sleep was 75.9%, stage N3 sleep was 0.0%, and REM sleep was 13.0%. There were 4 Stage R periods observed on this study night, 22 awakenings (i.e. transitions to Stage W from any sleep stage), and 81.0 total stage transitions. Wake after sleep onset (WASO) time accounted for 104 minutes.
AROUSAL: There were 43 arousals in total, for an arousal index of 10.2 arousals/hour. Of these, 25 were identified as respiratory-related arousals (5.9/hr), 0 were PLM-related arousals (0.0/hr), and 17 were nonspecific arousals (4.0/hr)
RESPIRATORY MONITORING: Based on CMS criteria (using a 4% oxygen desaturation rule for scoring hypopneas), there were 16 apneas (5 obstructive; 10 central; 1 mixed), and 44 hypopneas. Apnea index was 3.8. Hypopnea index was 10.4. The apnea-hypopnea index was 14.2 overall (28.4 supine, 5.6 non-supine; 27.3 REM, 24.5 supine REM). There were 0 respiratory effort-related arousals (RERA). The RERA index was 0.0 events/hr. Total respiratory disturbance index (RDI) was 14.2 events/hr. RDI results showed: supine RDI 28.4/hr; non-supine RDI 8. 1/hr; REM RDI 27.3/hr, supine REM RDI 24.5/hr.
Based on AASM criteria (using a 3% oxygen desaturation and /or arousal rule for scoring hypopneas), there were 16 apneas (5 obstructive; 10 central; 1 mixed), and 45 hypopneas. Apnea index was 3.8. Hypopnea index was 10.7. The apnea-hypopnea index was 14.4 overall (28.4 supine, 5.8 non-supine; 29.1 REM, 24.5 supine REM). There were 0 respiratory effort-related arousals (RERAs). The RERA index was 0.0 events/hr. Total respiratory disturbance index (RDI) was 14.4 events/hr. RDI results showed: supine RDI 28.4/hr; non-supine RDI 8.5/hr; REM RDI 29.1/hr, supine REM RDI 24.5/hr.
Respiratory events were associated with oxyhemoglobin desaturations (nadir during sleep 75%) from a mean of 92%). There were 0 occurrences of Cheyne Stokes breathing.
LIMB MOVEMENTS: There were 0 periodic limb movements of sleep (0.0/hr), of which 0 (0.0/hr) were associated with an arousal.
OXIMETRY: Total sleep time spent at, or below 88% was 19.1 minutes, or 7.5% of total sleep time.
BODY POSITION: Duration of total sleep and percent of total sleep in their respective position is as follows: supine 76 minutes (30.0%), non-supine 177.5 minutes (70.0%); right 175 minutes (69.0%, left 00 minutes (0.0%, and prone 00 minutes (0.0%). Total supine REM sleep time was 22 minutes (66.7% of total REM sleep)


Comments
TREATMENT: CPAP was first started @ 4ch20 per patient request for comfort (wanted EPR as well, but explained that at such a low pressure EPR has no effect) and titrated to 12 cmh20 to eliminate the majority of respiratory events supine w/ a RESMED AIRTOUCH F20, LARGE mask (brought from home) ...Supine and lateral sleep was observed with most stable breathing occurring on his side.. The FFM did appear to help further block his airway when head is in a certain position, so may benefit from a nasal mask or positional therapy on lower pressures After waking up, patient struggled to tolerate 12 cmh20 so pressure was decreased to 7 cmh20. About 10 minutes later patient complain that 7cm was still too high to fall back asleep so decreased back to 4m EKG showed persistent premature beats



Whats good or bad about what my machine says?

my last nights airsense11 data says 
pressure  6
leak       2L/min
AHI           9.0
Total AI      6.9 
obstructive AI  5.8
central    AI   1.1

annother night
Pressure 13.8
Leak   5L/min
AHI      5.4
Total AI 1.8
Obstructive AI 0.4
Central AI   1.3
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#2
RE: overnight sleep study results--newbie here
I tried to add the snapshots of graphs & charts with my Iphone. (as attachments) but since I'm a newbie maybe I'm limited.

It would have taken me 5 attachments to fit all thee sleep data charts. I don't know of it y'all consider important.
I was aiming to put three in the initial message & two in the second message. Is this attachment method legal here?

Anyway all the info is in the google doc

Thanks knowledgeable ones!
Brian
Post Reply Post Reply
#3
RE: overnight sleep study results--newbie here
Welcome to Apnea Board,

Your sleep study indicated a predominant Central Apnea bias of 10 Central vs 5 Obstructive Apnea with 1 mixed and a lot of Hypopnea, about 45-50 of those.

You're going to 8 to download the free OSCAR program, which is safe to load. You'll need an SD card in your CPAP on the left side before sleeping to capture detailed data. There's going to be a lot more details that your screen on the CPAP can't possibly display. And you'll want this data just for yourself, because you need to own the therapy, take control of your settings. And with CA being on the test, you need to track those in the OSCAR chart.

There's settings that's wanting updated too. You can do it yourself. Get the ResMed clinical manual available on the Board for your machine.
Mask Primer

Positional Apnea

Attach OSCAR, etc.

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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