Help understanding sleep report and setting APAP range.

[allynpsych]

Hello All,

Thank you in advance for all the help you provide toward personal empowerment!


I finally got a copy of my sleep study report. Please help me interpret this as my GP is an excellent doctor, but not a sleep specialist and we're trying to figure this out together (LOVE her and this is why I am still willing to drive an hour and 15 minutes to see her!).

During the observation phase of the study (114 minutes of sleep) I had:

"decreased sleep efficiency. Sleep latency was normal. REM was not achieved. Sleep architecture was notable for lack of REM sleep and increased N2 sleep."

"Increased arousals were noted. Mild desaturations were seen."

"Arousal index was 31 events per hour of sleep RDI was 49 events per hour of sleep. During supine position RDI was 19 events per hour of sleep."

"Loud continuous snoring was noted. Both apnea and hypopneas were seen."

So then they did the CPAP titration for 236 minutes of sleep.
"with a decreased sleep efficiency of 74%. Sleep latency was prolonged. REM latency was normal. Sleep architecture was notable for normal sleep stage distribution with rebound REM sleep noted."
"Compared with the fist part [of the study] there was significant improvement in sleep architecture."

"CPAP titration was performed. Sinus bradycardia was noted. The most appropriate pressure is 15 cm."


SO... during the first part I snored alot and had many disruptions. It was much better during the CPAP titraiton and I caught up on my REM sleep. My heart beat slowed (the bradycardia) which seems to be related to apnea.

The original perscription was for the CPAP at 15 cm. I've been sick with a cold/sinus infection for about 3 weeks which has made adjustment difficult and have tried 2 different masks. My GP doc agrees that I might have more success with an APAP especially since I woudl be able to make use of the better data collection abilities of the AS10 Auto. However, she wasn't sure how to write the Rx... so right now it says AutoCPAP with heated humidity and nasal mask. How do I (or the DME techs initially I guess) determine the correct range?

I've been using the AS10 CPAP sporadically for about a month, and always have AHI below 5, usually between 1 - 3 per hour. Now that I'm finally healthy again, I'm really looking forward to trying to get a machine/setting that works and being able to keep the damn mask on for more than 1 - 4 hours a night.

[OpalRose]

You can try a pressure range bracketed around the pressure of 15 that you were titrated at.
Something like 13 minimum and 18 maximum.

Then after using APAP for awhile, check your 90% numbers and adjust a range around that number.

[sdb7802]

Try to get a heated hose if at all possible. You can turn it off if you don't need heat.

Might as well start out loaded for bear.

[allynpsych]

Thanks. Can you explain the 90% numbers? I've downloaded Sleepy Head and am slowly familiarizing myself with that and once I upgrade to the AS10Auto I should have access to more data. What does the 90% refer to?

[robysue]

Thanks. Can you explain the 90% numbers? I've downloaded Sleepy Head and am slowly familiarizing myself with that and once I upgrade to the AS10Auto I should have access to more data. What does the 90% refer to?

A "90% number" refers to the 90th percentile of the data. For example, if your 90% pressure level is 15.2, that means that for 90% of the time the machine was running, the pressure was AT or BELOW 15.2cm and for 10% of the time the machine was running, the pressure was AT or ABOVE 15.2cm.

Likewise, if your 90% Leak Rate is 8.2 L/min, that means that for 90% of the time the machine was running, the leak rate was AT or BELOW 8.2 L/min and for 10% of the time the machine was running, the leak rate wase AT or ABOVE 8.2 L/min.

NOTE: On a Resmed machine, the Leak Rate is the excess leak rate; so you want the leak rate to be as close to 0 as is reasonably possible. An official Large Leak is set at 24 L/min. If your 90% leak rate is less than 24 L/min, then there's an excellent chance that you have no significant leak problem to deal with.

[allynpsych]

A "90% number" refers to the 90th percentile of the data. For example, if your 90% pressure level is 15.2, that means that for 90% of the time the machine was running, the pressure was AT or BELOW 15.2cm and for 10% of the time the machine was running, the pressure was AT or ABOVE 15.2cm.

Likewise, if your 90% Leak Rate is 8.2 L/min, that means that for 90% of the time the machine was running, the leak rate was AT or BELOW 8.2 L/min and for 10% of the time the machine was running, the leak rate wase AT or ABOVE 8.2 L/min.

NOTE: On a Resmed machine, the Leak Rate is the excess leak rate; so you want the leak rate to be as close to 0 as is reasonably possible. An official Large Leak is set at 24 L/min. If your 90% leak rate is less than 24 L/min, then there's an excellent chance that you have no significant leak problem to deal with.

Thanks robysue. I'll download my data from the machine I have now and see if it gives me that info... I think it only does overview and not a daily report. I really like the SleepyHead program... there's a learning curve, but the graphs are especially helpful.