Help reading initial sleep study

[overzero]

hello everyone, 

I wanted to ask you all because I am a little confused about my sleep study results... I have been struggling a great deal with constant periodic breathing patterns on OSCAR and over 95% of my apneic events are labeled clear airway. My AHI is consistently below 5 which I recognize is good but I wake up more than once each night still and do not feel well rested. 

My sleep doctor told me when I first started a couple years back that I have "obstructive sleep apnea." From the results of the sleep study info that I got from my doctor's office though I cannot see how that is the case. You will see why with the photos below-it looks like the majority of my events were actually central apneas rather than obstructive. Any guidance is appreciated, I have not seen my sleep doctor since because I thought he was very dismissive and short which turned me off. I should note that I feel like absolute dog sh*t every day still and get headaches without fail by noon and could fall asleep at my desk. Sleeprider has helped with my CPAP settings and my AHI looks good, but if you zoom in you will see a ton of periodic breathing patterns which I think is causing arousals for me although I am not sure. I am wondering if a different machine could help, but now my sleep DR dropped my insurance so I don't have one at the moment to consult -_-. any help is appreciated!!!!

[Sleepy Quixote]

@overzero
You might want to black out your personal info and repost that report.

[overzero]

oops.. how do i remove the photo? @Sleepy Quixote

[Sleeprider]

overzero, I removed your attachment. You can simply redact the personal information and post it again.

I reviewed the sleep study and it appears you have very mild sleep disordered breathing with an obstructive apnea index only 0.1, but a central apnea index of 1.0 and hypopnea index of 4.1. Overall your AHI of 5.1 may not qualify for CPAP treatment unless comorbid conditions of fatigue, sleepiness and other issues are considered significant. Your oxygen saturation was very good through the night with one brief dip at the beginning of the study resulting from a cluster of sleep-onset central apnea followed by several hypopnea. Without any other history, I would conclude you have mild mixed apnea and I would suspect you may experience increased therapy induced central apnea with CPAP. This is the concern you expressed in your post, and I agree with your conclusion.

[overzero]

@sleeprider thanks so much for the response. 


I do have issues with daytime, sleepiness, as well as cognitive “fog”. There have been many times where I felt as though I would fall asleep while driving home from work. If I did want to pursue treatment for this issue, do you recommend something other than CPAP? my sleep, doctor is worthless and told me I have obstructive sleep apnea and sticks with it… He clearly did not look very closely at my test results. What would be the most viable way to try and improve my sleep quality at this point?

[Sleeprider]

I sure can't recommend alternative or more expensive therapy based on what we know. CPAP is universally the first step for sleep disordered breathing regardless of cause, and you have such mild SDB that a recommendation of bilevel or ASV would be irresponsible. If you try something, it should be CPAP, and preferably the Resmed Airsense 10/11 Autoset.

[overzero]

@sleeprider thank you for your reply. I have tried CPAP for several months now my AHI is usually below five with CPAP therapy but I have several nighttime awakenings. I believe I have had a total of two flags obstructive events in the past four months, everything else has been central apneas and hypopneas. It seems based on the way forms of my breathing in my sleep I have some mild periodic breathing as well. This is not flagged by Oscar but fits the description when seen on this forum. Funny enough I do have access to a BiPAP and ASV machine, my brother has complex sleep apnea and lives very close by, he told me if I needed to. I could have a trial on either machine if needed. 99% of my events that I saw on Oscar were central apneas and a lot of unflagged, periodic breathing or hypopneas. 

With CPAP, I was having a difficult time adjusting to the exhalation pressure because I am an anxious person. Also, I was continuing to struggle with nighttime awakenings, even more so than without using CPAP. I have tried several different pressures, settings, masks, and have come to the conclusion that I do not believe CPAP is therapeutic for me. Do you think that the comfort measure of a BiPAP along with the ASV’s ability to correct central apneas or periodic breathing events could help me? I can try and air curve 10 with no cost if needed. 

I recognize that you are not a Physician, however, like I said, before, I have seen my sleep doctor on multiple occasions, and he refuses to listen to the idea that I have had issues with the central apneas. Thanks again for your recommendations, I look forward to hearing back.

[Gideon]

Post a screenshot of your daily page so we can see what is going on. Unknown to most is that ResMed CPAP devices (AirSense) can accurately mimic a BiLevel with up to 3 cmw of pressure support.

Let us at least try and see.