Can someone help me interpret my sleep study results?

[nunanuna]

I’ve been having many of the symptoms of sleep disordered breathing we are all familiar with, most noticeably excessive daytime sleepiness and brain fog. I did a sleep study and the doctor told me there was no evidence of sleep disordered breathing significant enough to cause any symptoms with an AHI of 4.5. I was confused since so many of my symptoms indicate sleep apnea (waking up out of breath, dry mouth, debilitating daytime sleepiness and fatigue, brain fog, ADHD, etc.) This led me to do my own research and come to the conclusion that I have UARS based on my symptoms and the sleep study results showing an RDI of 15.4. I bought my own APAP and have been struggling this past month to self titrate and keep the mask on for more than an hour, so I see no improvement yet. I am starting to think that maybe I jumped to conclusions too quickly with the UARS self diagnosis, so could someone take a look at my results and either confirm that it may be UARS or give any suggestions as to what else could be the issue as evidenced by the study? Is an RDI of 15.4 even severe enough to make me want to stay in bed all day? ( DISCLAIMER: I UNDERSTAND I NEED A DOCTOR FOR A PROPER DIAGNOSIS BUT I AM NOT FINANCIALLY ABLE TO DO THAT RIGHT NOW SO I WOULD JUST LIKE SOME FEEDBACK THAT I UNDERSTAND IS NOT PROFESSIONAL)

Sleep onset: 68.4 minutes
Total sleep: 346.8 minutes
Sleep efficiency: 79.7%
Min oxygen: 94%
Mean oxygen saturation: 98%
Snoring present
AHI: 4.5
RDI: 15.4
REM latency: 94 min
WASO: 20 min
REM arousal total number: 10
REM arousal total index: 11
NREM arousal total number: 68
NREM arousal total index: 14
Arousal >15 sec total number: 14
Arousal >15 sec total index: 24
Total arousals: 94
Total arousal index: 16.3
Respiratory event related arousal with desat: 0
Respiratory event related arousal total without desat in REM: 9
Resp event related arousal total without desat NREM: 62
Resp event related arousal without desat total number: 87
NREM sleep time: 292.3 min
REM sleep time 54.5 min
NREM hypopneas: 18
NREM apnea + hypopnea + RERA: 75
NREM RERA: 57
NREM RDI: 15.4
NREM hyopnea index: 3.7
REM sleep time: 54.5 min
REM hypopnea: 8
REM apnea + hypop + RERA: 13
REM RERA: 5
REM RDI: 14.3
REM hyopnea index: 8.8
Non supine RDI: 11.23
supine RDI: 50.3
TOTAL RDI: 15.4
All apneas: 0
Hyopnea mean duration central: 0 sec
Hyppnea mean duration obstructive: 17.5 sec
Hyopnea max duration obstructive: 24 sec
Average heart rate during sleep: 74.7 bpm
Highest heart rate during sleep: 97 bpm
Oxygen <88%: 0

[LinkC]

Have you asked your Dr? He /She works for you!

[palerider]

Have you asked your Dr? He /She works for you!

At a rather higher rate than the people here.

[nunanuna]

My doctor doesn’t even believe UARS exists and dismisses me whenever I try to bring anything related up. as I mentioned in my post, I am not capable of changing doctors right now due to financial reasons hence why I’m using this forum

[SDBud]

I’ve been having many of the symptoms of sleep disordered breathing we are all familiar with, most noticeably excessive daytime sleepiness and brain fog. I did a sleep study and the doctor told me there was no evidence of sleep disordered breathing significant enough to cause any symptoms with an AHI of 4.5. I was confused since so many of my symptoms indicate sleep apnea (waking up out of breath, dry mouth, debilitating daytime sleepiness and fatigue, brain fog, ADHD, etc.)

Those same symptoms could very well be caused by other things, like afib, or whatever.

With an AHI of 4.5, and pretty much NO loss of O2 Saturation, apnea seems unlikely, r low grade,
but a full sleep test would be the deciding factor.

What tests HAVE you had done other than what's in your original post??

[Pugsy]

RDI: 15.4

Total arousal index: 16.3
Respiratory event related arousal with desat: 0
Respiratory event related arousal total without desat in REM: 9
Resp event related arousal total without desat NREM: 62
Resp event related arousal without desat total number: 87

I bought my own APAP and have been struggling this past month to self titrate and keep the mask on for more than an hour, so I see no improvement yet.

Some of my thoughts about all this.
1....Just because you don't desat doesn't mean that you are getting good quality sleep. All it means is the oxygen levels don't drop much but there is so much more to good restorative sleep than just oxygen levels.
2....Respiratory related...that means airway related...15 per hour average which means roughly every 4 minutes you get woke up which you may or may not remember.
Add in a few spontaneous arousals which aren't related to the airway and it all points to highly fragmented sleep architecture.
Some really crappy sleep quality. Not getting the normal progression of the sleep cycles in the normal percentages to let the restorative powers of sleep help the body mend.
What I call crappy sleep....and with crappy sleep you want to stay in bed and you feel like crap during the day....No matter what the cause.
Read this but substitute anything for alcohol...it's a good description of why normal good quality sleep architecture is needed.
https://www.sleepfoundation.org/article ... tity-sleep
It's not just alcohol...it's anything that disturbs our sleep that messes with things.
3....I don't know if you have UARS but it's very suspicious for UARS. It would be my first thought as well.

It's extremely difficult to treat UARS with cpap even with the medical care team behind us because available markers (data from the machines) that the typical OSA patient has to help them aren't going to really help all that much because the usual stuff like AHI is already fairly low since there aren't enough OSA events happening. UARS patients typically have to go on how they feel more than anything else....subjective feelings which are hard to quantify.

Often UARS patients have to use more pressure than what the machine might be wanting to use when in auto adjusting mode because remember....the machine algorithm is using OSA parameters to dictate its responses and UARS patients won't have many of those events anyway. The auto response won't want to do much for UARS.

So obviously cpap is the first line of defense for fighting UARS and it's difficult enough to see positive results even when people can use the mask and machine successfully all night .....impossible when someone is just managing 1 hour with the mask and machine.

So you have crappy sleep and it's very possible that it is airway related crappy sleep. Of course there can be other causes but cpap can help with the airway related stuff IF you can use it and have the patience to take the time needed to figure out a pressure that will help the airway stuff. You gotta use it all night though to have an inkling of a chance of it helping.