Questions about my polysomnogram results

[sportster]

Background, I have a lot of the symptoms like morning head aches, daytime sleepiness, snoring, 42 yr old male with a BMI @ 28. Also, I took an ambien before the test, my first time taking one.

Here are the results of my test:

Test duration: 424 mins
Sleep time: 402 mins w/ 95% efficiency
REM latency: 68.5 mins
Sleep stage distribution: Awake 5%, N1 3%, N2 74%, N3 0%, REM 18%
23 arousals & 15 awakening for a total arousal index (TAI) of 3 per hour of sleep
AHI of 1.5/hours
OxyHemoglobin levels 88-98%
0.1% below SaO2 of 90%

Obviously my AHI was <5 so here are my questions:
1. How does an 0% of N3 and a low REM percentage sleep affect the test?
2. Is a 0% of N3 sleep normal?
3. How is the TAI calculated? My math says it should be 5.7 per hour.
4. Should I accept the negative OSA result or request another test?

Any input would be appreciated. Thanks.

[PoolQ]

head aches are usually caused by not clearing enough CO2 from your system. Your O2 is getting on the low side, border line. Any reason to suspect COPD? smoking? high dust environment?

Others with more experience will chime in later.

[pholynyk]

It looks like they only counted the arousals and not the awakenings. I would ask them for the the raw data report, and maybe ask them why awakenings don't seem to count... Also, I'm not sure that arousals are the same as apnea events; they seem to be using non-standard terminology.

Certainly your other symptoms warrant further investigation.

[trish6hundred]

Hi sportster,
WELCOME! to the forum.!
Hang in there for more answers to your questions.

[foss]

I'm not a doctor but I would think the Ambien sleep medication would skew your results. ?

Jeff

[eseedhouse]

I'm not a doctor but I would think the Ambien sleep medication would skew your results. ?

Well, but not sleeping will also skew your results. If one's AHI came in at 6 or a bit mre one might argue that it was the sleeping pill, but not if you have more than a mild case. It it's the choice between a diagnosis with the pill and no diagnosis without one the choice is clear in my mind.

If you take a pill and the results show only mild apnea then it may be that the pill pushed you over the AHI 5 mark, but not if you have moderate or severe apnea.

[Sleeprider]

Usually arousals are measured as Respiratory Event Related Arousals (RERA) and are expressed as a RDI. No doubt the level of disturbance you experienced is disruptive, however it may not qualify for insurance reimbursement. If that turns out to be the case, you can still use the study results to persuade your doctor to prescribe CPAP, if you willing to buy your own equipment. You can buy a top of the line auto CPAP on Amazon for $444 with heated humidifier and heated tube (Philips Respironics System One Remstar Auto). It may be a worthwhile investment for you. Used machines can often be obtained for much less through vendors like SecondwindCPAP or even Craigslist if you know what you're looking for.

I would request a complete copy of the detailed study results and recommendations. Then if you feel PAP therapy may be beneficial, get a prescription and go find out for yourself.

[vsheline]

RERA stands for Respiratory Effort Related Arousal, which is related to needing to exert strong respiratory effort because of partial obstruction in the airway during inhalation.

The number of RERA per hour does not include apneas or hypopneas.

RERAs are not accompanied by large enough reduction in breathing volume or Oxygen desaturation to qualify as hypopneas or apneas, but nonetheless include arousals, interrupting or preventing deep restorative sleep. RERAs should be treated/prevented, and the best prevention is usually obtained by using bilevel CPAP, where the pressure during inhalation is greater than the pressure during exhalation. Optimally, RERAs would be treated with an auto-adjusting bilevel 'PAP machine.

[vsheline]

Background, I have a lot of the symptoms like morning head aches, daytime sleepiness, snoring ...
...
Obviously my AHI was <5 so here are my questions:
1. How does an 0% of N3 and a low REM percentage sleep affect the test?
2. Is a 0% of N3 sleep normal?
3. How is the TAI calculated? My math says it should be 5.7 per hour.
4. Should I accept the negative OSA result or request another test?

Any input would be appreciated. Thanks.

Regarding 1, I would say the test results of 0% of N3 and a low REM percentage sleep help to explain the daytime sleepiness.

Regarding 2, I am no expert but I think 0% of N3 sleep is not good.

Regarding 4, if I were you I would persue treatment with a fully data-capable auto-adjusting 'PAP machine, asking my primary doctor to prescribe one even if a second sleep study failed to document great enough need to warrant insurance coverage. This is your health and your quality of life which is being degraded by your "normal" amount of apneas and hypopneas and perhaps RERAs.

By the way, the sleep test results would be invalid if you happened not to spend a significant amount of time in your worst sleeping position for obstructive events, which for most of us is when we are sleeping flat on our back, supine. During your retest, be sure to spend at least some time sleeping supine or in whatever position is worst for you.

If you haven't already, would be good to read carefully the following advice about machine choices:

http://www.apneaboard.com/wiki/index.php...ne_choices

Take care,
--- Vaughn