My Sleep Study Results

[iSnore]

Got my sleep study results this morning. Doctor had a copy of the full report for me without having to be asked! Didn't get to sleep soon enough for the split study, so titration is rescheduled for 9 June. My summary of the results follows. Your perspective of these results is welcome.

Total Recording Time: 438 minutes
Sleep Onset Latency: 131 minutes
Total Sleep Time: 238.5 minutes
Percent Sleep Efficiency 54.5%
REM periods: 2 for 14% of total sleep time
N3: 1.9%, N2: 82.2%, N1: 1.9%, R: 14.0%
Arousal index: 2.3 apnea + 5.3 hypopnea + 1.3 snore + 0.0 desat
+ 2.0 spontaneous + 0.3 limb movement + 0.3 periodic limb movement
+ 0.0 respiratory RLM = 11.3 arousal events per hour

40 obstructive apneas, 2 central apneas, 2 mixed apneas
148 hypopneas, 0 respiratory effort-related arousals
OA Index: 10.1
CA Index: 0.5
MA Index: 0.5
Apnea Index (AI): 11.1
Hypopnea Index (HI): 37.2
Apnea plus Hypopnea index (AHI) 48.3
RERA Index: 0.0%
Respiratory Disturbance Index (RDI) 48.3
Cheyne Stokes events: 0
Hypoventilation events: 0

Oxygen saturation min/mean/max
- Non-REM: 76.0%/89.2%/95.0%
- REM: 68.0%/86.6%/96.0%
% TRT SaO2 < 90%: 49.0%
% TRT SaO2 < 88%: 17.5%

Mean heart rate
- Non-REM: 70.2 bpm
- REM: 72.8 bpm

[DeepBreathing]

An AHI of 48.3 is pretty severe. The good thing is that it's all obstructive and hypopnea with a negligible number of centrals, no Cheyne Stokes etc. This should make it a fairly easy treatment.

It looks lke you went over two hours before falling asleep - that must have been fun (not).

[AlanE]

Yes one step closer to nirvana. June 9th is not that far away. It took a couple of months before I was scheduled for mine and another couple of months before I got my machine.

CPAP will help with O2. Are you on oxygen now?

[iSnore]

Thanks for the observations, guys. No, it wasn't much fun that first two hours. It's not typical for me, but it does happen occasionally. It's been two months so far since starting this journey, and I expect it'll be at least another before I'm on treatment. I can't wait to knock those arousals down. I'm tired of being tired.

Severe, but easily treatable is what the numbers looked like to me. It's great to have that confirmed by experienced members here. I'm not on oxygen now and I hope the CPAP will take care of that. I'm on Tramadol for leg pain and it's good to see it isn't causing a lot of centrals.

[AlanE]

I disliked both the sleep study and titration. I laughed at the guy after I was all hooked up. I said "You're kidding, right? People actually sleep with all this stuff on?" I tossed a lot but finally did sleep after an hour.The titration was better since I knew about all the wires and rubber bands. You definitely had a much longer time getting to sleep. Tramadol could be making obstructive apnea worse. I'm not a doctor but I did stay at a Holiday Inn Express... no, I read where pain medication can do that.

[Sleeprider]

Since you don't tolerate the clinical sleep setting very well as evidenced by your sleep onset latency, why not skip titration and just ask for an Auto-titrating Rx? You could save some money and time, and with an auto and sleepyhead, DIY your titration. You will eventually do that anyway. The only value a titration study has now is to approximate your therapeutic pressure and eliminate the slight possibility of complex apnea from CPAP therapy. You will know right away with an auto the answers to both those questions.

[iSnore]

I disliked both the sleep study and titration. I laughed at the guy after I was all hooked up. I said "You're kidding, right? People actually sleep with all this stuff on?" I tossed a lot but finally did sleep after an hour.The titration was better since I knew about all the wires and rubber bands. You definitely had a much longer time getting to sleep. Tramadol could be making obstructive apnea worse. I'm not a doctor but I did stay at a Holiday Inn Express... no, I read where pain medication can do that.

They had all my wires in a velvety cloth sleeve, so they were pretty easy to manage. I knew getting frustrated, and tossing and turning, would just make it worse, so I stayed relaxed. I suspect like yours, my titration will go much better, being familiar with the environment.

My PCP tried everything but the only thing that works for me is plain old generic Tramadol (no acetaminophen). He gets no points from his pharmaceutical sales folks for that. The Feds cut my allowed prescription from a year to six months, but at least I can still get it. I also got a TENS unit with the Russian mode--which helps tremendously when it really gets bad.

Here's a more positive way of looking at the oxygen:
51% of the time was > 90% SpO2
31.5% of the time was < 90% SpO2 but > 88% SpO2
17.5% of the time was < 88% SpO2
CPAP should take care of that.

[iSnore]

Since you don't tolerate the clinical sleep setting very well as evidenced by your sleep onset latency, why not skip titration and just ask for an Auto-titrating Rx? You could save some money and time, and with an auto and sleepyhead, DIY your titration. You will eventually do that anyway. The only value a titration study has now is to approximate your therapeutic pressure and eliminate the slight possibility of complex apnea from CPAP therapy. You will know right away with an auto the answers to both those questions.

Thanks for that input!

My sleep doctor gave the that option--he only prescribes autos because he believes patients' needs vary. He also gave me the choice of home or lab initial sleep study, and although he prefers Respironics, he'll get me a ResMed if that's what I want. He's really flexible--tells me what he prefers but is very positive about making alternatives work.

I actually enjoyed the sleep study and I think I'll do better on the second visit. My insurance approved a second visit for titration on the initial authorization. If it's called for, the lab titration will justify bi-level to the insurance. Perhaps I'd get used to it, but I feel like I potentially may have a problem with expiratory pressure--I was pretty surprised how hard it was to exhale into 4 cm during the mask fittings. I'm down to a DS560 or DS760 and want to make the right choice the first time, rather than have to be non-compliant without a BiPAP.

All this being said, I've had Sleephead on all my computers for two months now, LOL. I've gotten Encore Basic at least launching on my Macs using a version of Wine. I'm ready to do some self-monitoring and titration!

[me50]

I disliked both the sleep study and titration. I laughed at the guy after I was all hooked up. I said "You're kidding, right? People actually sleep with all this stuff on?" I tossed a lot but finally did sleep after an hour.The titration was better since I knew about all the wires and rubber bands. You definitely had a much longer time getting to sleep. Tramadol could be making obstructive apnea worse. I'm not a doctor but I did stay at a Holiday Inn Express... no, I read where pain medication can do that.

They had all my wires in a velvety cloth sleeve, so they were pretty easy to manage. I knew getting frustrated, and tossing and turning, would just make it worse, so I stayed relaxed. I suspect like yours, my titration will go much better, being familiar with the environment.

My PCP tried everything but the only thing that works for me is plain old generic Tramadol (no acetaminophen). He gets no points from his pharmaceutical sales folks for that. The Feds cut my allowed prescription from a year to six months, but at least I can still get it. I also got a TENS unit with the Russian mode--which helps tremendously when it really gets bad.

Here's a more positive way of looking at the oxygen:
51% of the time was > 90% SpO2
31.5% of the time was < 90% SpO2 but > 88% SpO2
17.5% of the time was < 88% SpO2
CPAP should take care of that.

what is the reasoning that you can only get tramadol for 6 months now instead of a year? tens units have been around for a long time and still pretty useful. I am surprised that there hasn't been another product that does better than the tens unit or else I just don't know since nobody in the family has a need for one.

[iSnore]

what is the reasoning that you can only get tramadol for 6 months now instead of a year?

Tramadol was previously unscheduled. Now it's a schedule IV controlled substance.

tens units have been around for a long time and still pretty useful. I am surprised that there hasn't been another product that does better than the tens unit or else I just don't know since nobody in the family has a need for one.

My pain causes muscle spasm. The TENS mode works pretty well when it's not bad, but the Russian mode is really intense and knocks out the worst case.