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the journey continues...
#1
the journey continues...
[parts of this thread were copied from our old forum]
Mar 6 2011

Just had my sleep study done ,they should rename it sleep not study as it was one of my worst night ,went home in the morning and straight to bed and slept for couple of hours , and pressure determination test scheduled in may ,here are the stats :

Scorer's report :the patient reported that the quality of his sleep was worse than usual .Sleep efficiency was poor (52.7%)with frequent awakenings and several prolonged wake across the night. sleep latency (33mins) was prolonged and the proportions of both slow wave sleep (3.9%) and REM sleep (9.3%) were reduced .continuous soft to moderate intensity snoring was reported by the overnight technologist.
Runs of repetitive hypopnoes and obstructive apneas occured during both NREM and REM sleep in all position ,and caused frequent arousals (arousal index 84.8) and moderate oxygen desaturations (min SaO2 85%) . small numbers of RERAs were noted . the overall RDI was 85.0 .there were no periodic leg movements. the ECG showed normal sinus rhythm (mean HR 68 bpm ).
Severe OSA

Sleep Staging Data :
Light out : 10.22.58 pm Sleep Onset : 10.55.58 pm
Light on : 6.01.58 am Sleep Efficiency : 52.7%
Time in Bed (TIB) 459.0 min Sleep Latency: 33.0 min
Total Sleep Time : 242.0 min REM Latency 241.5 min

sleep Staging %Total Sleep Time Normal Values Total Sleep Time (min)
Stage 1 6.2 (5%) Stage 1 18.0
Stage 2 80.6 (50%) Stage 2 195.0
Stage 3 3.9 (10%) Stage 3 9.5
Stage 4 0.0 (10%) Stage 4 0.0
Stage REM 9.3 (25%) Stage REM 22.5
Wake During Sleep 182.5 min Total Wake Time 214.0 min %Wake 46.6%

Respiratory Data :

Central Obstructive Mixed Hypopneas
#of Event 2 108 3 218
Mean Duration (sec) 12.0 18.2 17.3 24.3
Max Duration(sec) 14.0 37.5 19.0 71.0
Total Duration (min) 0.4 32.8 0.9 86.8
REM Non-REM Total Sleep Time
AHI/hour 37.3 85.6 81.1
Total RDI/hour (incl RERAs) 42.7 89.4 85.0

Oximetry Data:
Average SaO2 during wake 92% Average SaO2 in Non-REM 93%
Average SaO2 in REM 92% Minimum SaO2 value 85%

Positional Respiratory Data Time in position (mins) AHI/hr
Supine 61.8 100.0

Arousal Data:
Total number of u-arousal 342 Total number of arousal >15 sec 10
Apneas (with desats ) 196 Number of Awaking/Movements 57
Apneas (without desats) 100 Leg movement with arousal 0
Respiratory Effort Related Arousal 17
Spontaneous 31 Arousal index 84.8/hour

Periodic Limb Movement Data :
Leg movement with arousal 0 Leg movement with arousal index 0/hour
Leg movement without arousal 0 Leg movement without arousal index 0/hour

Thanks to all who share info , experiences and feedback is much appreciated .
..............................................................................................
JudgeMental wrote:
Hi Zonk.. thats quite an impressive and thorough report. Thanks for taking the time to share it with us. Your remarks arn't encouraging as to the amount of sleep that you had during the test. Most of the report is "Greek" to me. Most times its discouraging to see just how you score on a test, even when you are already aware that a certain condition exists. It just kinda demoralizes us. I didn't understand your remark about the pressure determination will be in May (do you mean the tritation part).. Why so long a wait?.

BUT, the testing is over (its behind us now) and we gotta move forward toward our goal of better sleep with the results that were obtained. It is what it is!! Life will start to look good again soon. Your participation in these tests show your concern for your health and thats a good and important thing. I enjoy your contributions on this forum.. All the Best and Stay strong, Mate..
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Alsacienne wrote:
Even though you sound a bit discouraged from the results and the poor nights of sleep that you are getting, you are doing well because you are persevering with your CPAP and not giving up. Things WILL get better, and we are here to support and encourage. At least there are some base line results so when you do have your titration study - usually just a question of reading the data from the machine - there'll be something with which to compare, and the machine will be reset to meet your needs better. By this time you should be feeling more confident in using the machine and hopefully well on the way to healthier sleep and a more wakeful daytime life. All good wishes.
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PaulaO wrote:
I am assuming the above was in table format and in the translation to here, the alignment was removed. I attempted to fix it but it won't let me. Basically the four columns would be Central, Obstructive, Mixed, and Hypo. The 4 numbers on each of the 4 lines below that would correspond.

But the most important bit of information is the O2 values. A value of 85% is dangerously low. Even if you consider that his waking O2 is 92%, it's still low. (do you have lung issues?)

Why are they waiting until May to do a pressure test? That's far too long with numbers like that.
...............................................................................................

zonk wrote:
Thanks to Judge - Alsacienne -Paula for your concern ,encouragement and good wishes .
The sleep report do confirm that i have OSA ,and will discuss it with my cardiologist on my friday appointment .
.............................................................................................
SuperSleeper wrote:
Quote:
[Oximetry Data:
Average SaO2 during wake 92% Average SaO2 in Non-REM 93%
Average SaO2 in REM 92% Minimum SaO2 value 85%]

On the surface that "Minimum SaO2 value of 85%" may appear bad, but keep in mind that your average REM O2 Sat is at 92%. That means that you're averaging 92% blood oxygen saturation while you're in REM (deep) sleep. That's actually pretty good. Anything above 90% is where you want to be. Your 93% during non-REM sleep is really good as well.

The minimum value of 85% isn't actually all that bad. I've seen people's minimums during a sleep study go down into the 40-50% range, which is much worse. The real question is how long does it stay down there? The average SaO2 during sleep (REM & non-REM) is what you're more concerned about, and at 92 & 93% - you're real good there.

Don't worry about that temporary drop to 85%, that happens with most people for a few seconds at some point during the night, especially sleep apnea patients. Proper CPAP treatment will help raise the O2 Sats over time. What counts is your average.

Sleep well, Zonk!

Bed
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#2
RE: the journey continues...
the journey continues..
part two: Sleep Study..........Titration (May 11 2011)

I have slept better this time and in the morning the technologist told me that my titrated pressure is 8 ( which i thought was very low in comparison to 95th percentile pressure about 11 in auto mode setting of 8-15 at home ) prior to my doctor appointment i experimented with pressure at 8 , 9 and 10 in cpap mode on consecutive nights and the AHI was on average 0.2 but on the rescan it showed some flow limitation which i suspect that the titrated pressure at 8 is not 100% correct .

Titration report : (CPAP was titrated from a minimum pressure 4cm H2O to a maximum 9cm H2O .CPAP 8-9cm H2O appeared adequate to control snoring and OSA in both NREM and REM sleep and maintained SaO2 mostly greater than 93 %. some very mild flow limitation persisted on pressure 8cm and therefore a trial of 9cm H2O should be recommended )

That is exactly what i find out in my experiment at home , so really the sleep study did confirm my finding and the doctor was surprised when i showed them my download on the lap top which i brought with me he looked at me with amazement and said that he has never seen a patient bring their download , he scroll through the reports and said you are doing fine and leave in auto mode as it is treating better and see you in 6 months time with your download .
............................................................................................
HeadGear wrote:
Interesting outcome and not surprising, zonk! Your doctor sounds like a good sport, too!

.................................................................................................
zimlich wrote:
zonk, glad to hear you were right on with your titration. I'm sure the doc was impressed. I'm sure very few people show your level of interest, knowledge, and compliance. My DME RT tells me how many people just don't use their machines. He treats me like an intelligent, cooperative, compliant client. He responds to my level of knowledge and interest by not talking down to me and acknowledging that I have good experience and can be trusted making changes with my machine. I appreciate his attitude toward me and all his help so he is always willing to take good care of me. Let me try all kinds of masks when I was trying to find the right one- he knew I wasn't wasting his time and wasn't going to stick the machine in the closet when he walked out the door.
................................................................................................
SuperSleeper wrote:
Quote:
[the doctor was surprised when i showed them my download on the lap top which i brought with me he looked at me with amazement and said that he has never seen a patient bring their download , he scroll through the reports and said you are doing fine and leave in auto mode as it is treating better and see you in 6 months time with your download .]

Awesome! If all patients were like Zonk, those doctors would not be as swamped as they are.

Good to see a doc that is impressed with patient empowerment. Well-done
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