Hi Everyone,
I'm currently waiting for a second sleep study, as I recently questioned the one I had back in Jan. 06. At that time, I did not sleep after they put the mask on, and they kicked me out of the lab at 4:30 a.m.! Then they put me on a titration of 13 cm!
Anyway, I got a copy of the test results from Jan. 06 yesterday and am confused by the figures. I was just told last year that I needed a cpap because I had OSA. Can anyone tell me if these indicate mild, moderate or severe OSA? I appreciate it.
- Julie
Respiratory events:
Mixed: 0
Obstructive: 0
Central: 0
Apneas: 0
Hypopneas: 11
Total Apneas/Hypopneas: 11
AHI: 6.5 per hour
Resp. Dist. Index (RDI): 7.09 per hour
O2 saturation supine (79%), Left (85%), Right (87%)
REM: 0
NREM: 101.5 minutes (total sleep time)
Is This Severe, Moderate or Mild OSA?
Is This Severe, Moderate or Mild OSA?
I once was a bore who did snore
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
Re: Is This Severe, Moderate or Mild OSA?
[quote="Skodobah"]Hi Everyone,
I'm currently waiting for a second sleep study, as I recently questioned the one I had back in Jan. 06. At that time, I did not sleep after they put the mask on, and they kicked me out of the lab at 4:30 a.m.! Then they put me on a titration of 13 cm!
Anyway, I got a copy of the test results from Jan. 06 yesterday and am confused by the figures. I was just told last year that I needed a cpap because I had OSA. Can anyone tell me if these indicate mild, moderate or severe OSA? I appreciate it.
- Julie
Respiratory events:
Mixed: 0
Obstructive: 0
Central: 0
Apneas: 0
Hypopneas: 11
Total Apneas/Hypopneas: 11
AHI: 6.5 per hour
Resp. Dist. Index (RDI): 7.09 per hour
O2 saturation supine (79%), Left (85%), Right (87%)
REM: 0
NREM: 101.5 minutes (total sleep time)
I'm currently waiting for a second sleep study, as I recently questioned the one I had back in Jan. 06. At that time, I did not sleep after they put the mask on, and they kicked me out of the lab at 4:30 a.m.! Then they put me on a titration of 13 cm!
Anyway, I got a copy of the test results from Jan. 06 yesterday and am confused by the figures. I was just told last year that I needed a cpap because I had OSA. Can anyone tell me if these indicate mild, moderate or severe OSA? I appreciate it.
- Julie
Respiratory events:
Mixed: 0
Obstructive: 0
Central: 0
Apneas: 0
Hypopneas: 11
Total Apneas/Hypopneas: 11
AHI: 6.5 per hour
Resp. Dist. Index (RDI): 7.09 per hour
O2 saturation supine (79%), Left (85%), Right (87%)
REM: 0
NREM: 101.5 minutes (total sleep time)
SK,
Thank you for your reply. Yes, my results are questionable. I don't think the lab did a good job at all. The oxygen saturation is odd. Everything seems off! I hope that the next sleep study reveals more accurate numbers. At the very least, I would be very pleased to have a much lower rate of pressure! I even recall the oxygen finger clip coming off once or twice.
Also, the doctor who determined the findings noted, "The first part of this sleep study revealed moderate, intermittent snoring and a significant case of OSAS. The patient exhibited repetitive abnormal breathing events and had a minimum oxygen saturation of 79 percent. The patient's OSAS was worse in the supine position."
Then he goes on to say, "The second part of this sleep study was conducted with the patient's use of nasal CPAP to treat the OSAS. While on CPAP, the patient's minimum O2 saturation rose to 90 percent. The optimal CPAP pressure for this patient was 13 CM of H2O. The patient should do well with nightly use of nasal CPAP at a pressure of 13 cm of H2O."
Well heck, of course I had a good O2 level because I was awake and breathing at full speed!! Ugh.
- Julie
Thank you for your reply. Yes, my results are questionable. I don't think the lab did a good job at all. The oxygen saturation is odd. Everything seems off! I hope that the next sleep study reveals more accurate numbers. At the very least, I would be very pleased to have a much lower rate of pressure! I even recall the oxygen finger clip coming off once or twice.
Also, the doctor who determined the findings noted, "The first part of this sleep study revealed moderate, intermittent snoring and a significant case of OSAS. The patient exhibited repetitive abnormal breathing events and had a minimum oxygen saturation of 79 percent. The patient's OSAS was worse in the supine position."
Then he goes on to say, "The second part of this sleep study was conducted with the patient's use of nasal CPAP to treat the OSAS. While on CPAP, the patient's minimum O2 saturation rose to 90 percent. The optimal CPAP pressure for this patient was 13 CM of H2O. The patient should do well with nightly use of nasal CPAP at a pressure of 13 cm of H2O."
Well heck, of course I had a good O2 level because I was awake and breathing at full speed!! Ugh.
- Julie
Last edited by Skodobah on Thu May 24, 2007 3:22 pm, edited 1 time in total.
I once was a bore who did snore
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
Test Results
Skodobah,
Am I understanding correctly that the results you show are for the diagnostic portion of a split night study and there is no titration data due to not sleeping? This data serves to confirm that you have an issue, considering the hypops and desats, but with the study's limitations, I doubt it has much value as to determining the actual degree of severity of your condition or effective treatment.
Will this next test be a diagnostic study or a titration study, or another split night? For someone who has a hard time even attaining sleep, split night studies decrease the chance of obtaining meaningful data.
Hopefully this next study will answer your questions about your condition and how to best help you.
Kathy
P.S. The pressure required to splint the airway does not run a parallel increasing course with a diagnosis of mild, moderate, or severe OSA. There are so many variables as to the cause of the apneas (tongue, soft palate, uvula, etc.). One person could have many events that are easily resolved, while another may have a few very stubborn events.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration
Am I understanding correctly that the results you show are for the diagnostic portion of a split night study and there is no titration data due to not sleeping? This data serves to confirm that you have an issue, considering the hypops and desats, but with the study's limitations, I doubt it has much value as to determining the actual degree of severity of your condition or effective treatment.
Will this next test be a diagnostic study or a titration study, or another split night? For someone who has a hard time even attaining sleep, split night studies decrease the chance of obtaining meaningful data.
Hopefully this next study will answer your questions about your condition and how to best help you.
Kathy
P.S. The pressure required to splint the airway does not run a parallel increasing course with a diagnosis of mild, moderate, or severe OSA. There are so many variables as to the cause of the apneas (tongue, soft palate, uvula, etc.). One person could have many events that are easily resolved, while another may have a few very stubborn events.
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): Titration
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Last edited by kteague on Thu May 24, 2007 3:27 pm, edited 1 time in total.
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Kathy,
Thank you. I had an all-in-one sleep study... no split. They let me sleep without the cpap at the beginning, and the rest of the night I had on various masks and all kinds of pressure changes. I never did go back to sleep because they kept jacking the pressure around or coming in to change the type of mask. I have no doubt that I have some kind of apnea problem, but just how bad remains yet to be determined.
- Julie
Thank you. I had an all-in-one sleep study... no split. They let me sleep without the cpap at the beginning, and the rest of the night I had on various masks and all kinds of pressure changes. I never did go back to sleep because they kept jacking the pressure around or coming in to change the type of mask. I have no doubt that I have some kind of apnea problem, but just how bad remains yet to be determined.
- Julie
I once was a bore who did snore
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
But the sleep study said I had ap...
Now I wear the pillows and the hose
And am a member of cpap chat!
Julie:
I think it would behoove you to have another test. I am kind of in the same position as you as I do not think I am getting good treatment either. We really have to stand up for ourselves. My first time around I was just too tired to question anything so I went into the whole thing blindly without asking any questions.
The thing that does not jive for me with your diagnostic numbers versus what the doc wrote is I don't think your numbers are indicative of severe OSAS. It looks more like to me that those are the titration numbers, but I do not know for sure.
Good luck to you. I understand and can sympathisize with your frustration.
I think it would behoove you to have another test. I am kind of in the same position as you as I do not think I am getting good treatment either. We really have to stand up for ourselves. My first time around I was just too tired to question anything so I went into the whole thing blindly without asking any questions.
The thing that does not jive for me with your diagnostic numbers versus what the doc wrote is I don't think your numbers are indicative of severe OSAS. It looks more like to me that those are the titration numbers, but I do not know for sure.
Good luck to you. I understand and can sympathisize with your frustration.
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DeltaSeeker
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Julie, What you describe is what's called a split-night study. 1st part of the night without CPAP, 2nd part with and titrating the pressures.
Your AHI indicates mild OSA (anything over 5 and under 15), 15-30 is moderate, over 30 is severe.
My O2 sats dropped into the mid-80's during the 1st part of the study and even during titration. They only got up to a pressure of 9 and were still unable to get me to REM sleep on my back - only on my side (lateral) and therefore suggested re-titration after 30 days.
As Kathy said, AHI and tritration level aren't parallel. My AHI (hypopneas only) was in the 50's yet my pressure was set at 9. While skjansen's pressure is titrated at 13 for an AHI of 39.
You did sleep for a total of 101 minutes although it might not have felt like it. And your apnea/sats were worse when you were on your back (supine) (go figure -- it usually IS). The reason they kept messing with the pressure was to find what was optimal for YOU - what would get your apnea under control and keep the air passage open. BTW, my study had zero OA and NRA events as well, just HA events.
Best of luck,
Linda
Your AHI indicates mild OSA (anything over 5 and under 15), 15-30 is moderate, over 30 is severe.
My O2 sats dropped into the mid-80's during the 1st part of the study and even during titration. They only got up to a pressure of 9 and were still unable to get me to REM sleep on my back - only on my side (lateral) and therefore suggested re-titration after 30 days.
As Kathy said, AHI and tritration level aren't parallel. My AHI (hypopneas only) was in the 50's yet my pressure was set at 9. While skjansen's pressure is titrated at 13 for an AHI of 39.
You did sleep for a total of 101 minutes although it might not have felt like it. And your apnea/sats were worse when you were on your back (supine) (go figure -- it usually IS). The reason they kept messing with the pressure was to find what was optimal for YOU - what would get your apnea under control and keep the air passage open. BTW, my study had zero OA and NRA events as well, just HA events.
Best of luck,
Linda
To dream ... the impossible dream...
APAP since 4/12/07 still looking for the "perfect" mask. 1st ZERO AHI nite 6/7/07! 2nd 6/11
Using loaner Hybrid next 2 weeks. Fingers x'd
See http://www.urastarbooks.net for stats
APAP since 4/12/07 still looking for the "perfect" mask. 1st ZERO AHI nite 6/7/07! 2nd 6/11
Using loaner Hybrid next 2 weeks. Fingers x'd
See http://www.urastarbooks.net for stats
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Linda,
Oh, you are right! It was a split test. My brain is fried from all of this... I merely accepted everything for well over a year, and only now I am questioning it all. I just want to sleep well, have a machine and mask that aren't too noisy, and feel good in the morning (everyone here wants that).
I think I will do my darndest to sleep on my side for the next sleep study.
- Julie
Oh, you are right! It was a split test. My brain is fried from all of this... I merely accepted everything for well over a year, and only now I am questioning it all. I just want to sleep well, have a machine and mask that aren't too noisy, and feel good in the morning (everyone here wants that).
I think I will do my darndest to sleep on my side for the next sleep study.
- Julie
Re: Is This Severe, Moderate or Mild OSA?
I would question your sleep study with the doctor, how you can have O2 desaturation levels down to 79% with so few events?Skodobah wrote:Hi Everyone,
I'm currently waiting for a second sleep study, as I recently questioned the one I had back in Jan. 06. At that time, I did not sleep after they put the mask on, and they kicked me out of the lab at 4:30 a.m.! Then they put me on a titration of 13 cm!
Anyway, I got a copy of the test results from Jan. 06 yesterday and am confused by the figures. I was just told last year that I needed a cpap because I had OSA. Can anyone tell me if these indicate mild, moderate or severe OSA? I appreciate it.
- Julie
Respiratory events:
Mixed: 0
Obstructive: 0
Central: 0
Apneas: 0
Hypopneas: 11
Total Apneas/Hypopneas: 11
AHI: 6.5 per hour
Resp. Dist. Index (RDI): 7.09 per hour
O2 saturation supine (79%), Left (85%), Right (87%)
REM: 0
NREM: 101.5 minutes (total sleep time)
Do you have a lung disorder like COPD?
Because if you have normal lung function and a normal beating heart, I would question how they came up with that SAO2 result.
Your doctor should have seen the same thing and sent you home with a SAO2 monitor to confirm the findings of the PSG. If those results came back positive then another PSG.
From what I can tell, they put you on CPAP only to bring your oxygen levels back up to normal. I would be asking lots of questions of your doctor, as you can see you are pretty close to Normal, very Mild case if any.
DEFINITIONS:
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.
Normal Sleep Architecture:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%
Stage3&4, REM decrease as we age.
someday science will catch up to what I'm saying...
I would agree that the O2 sat does not seem in line with the AHI. The pressure also seems very high from the limited knowledge that I have.
I have an AHI of 80.6 with an O2 sat of 70% and I am on a pressure setting of 17. Tonight is night 3 with CPAP and I have gained a ton of knowledge reading on this site.
Thanks to all who post
I have an AHI of 80.6 with an O2 sat of 70% and I am on a pressure setting of 17. Tonight is night 3 with CPAP and I have gained a ton of knowledge reading on this site.
Thanks to all who post
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Snoredog,
Thank you for your post. I, too, am perplexed with the results (and to think I only asked for them just yesterday. I should have asked for a copy way back when). I do not have a lung disease to my knowledge... I am 7 years quit as a smoker (yay!). I think the techs at the sleep lab were in a hurry and not the most attentive, particularly because they sent me home at such an awful hour of the morning (I should not have driven home, as I was very, very sleep deprived. Bad Julie.).
My doctor listened to my heart and breathing and says they sound good... my other dr., a rheumatologist, also said everything sounds very good in there. Go figure on why nobody questioned the results... at least now there will be another PSG coming up.
There is nothing I could want more, healthwise, than to have mild, if any, sleep apnea (I already have many other things, such as lupus, a blood clotting disorder, cataracts... you name it). I wonder if the lupus had anything to do with the O2 saturation...
- Julie
Thank you for your post. I, too, am perplexed with the results (and to think I only asked for them just yesterday. I should have asked for a copy way back when). I do not have a lung disease to my knowledge... I am 7 years quit as a smoker (yay!). I think the techs at the sleep lab were in a hurry and not the most attentive, particularly because they sent me home at such an awful hour of the morning (I should not have driven home, as I was very, very sleep deprived. Bad Julie.).
My doctor listened to my heart and breathing and says they sound good... my other dr., a rheumatologist, also said everything sounds very good in there. Go figure on why nobody questioned the results... at least now there will be another PSG coming up.
There is nothing I could want more, healthwise, than to have mild, if any, sleep apnea (I already have many other things, such as lupus, a blood clotting disorder, cataracts... you name it). I wonder if the lupus had anything to do with the O2 saturation...
- Julie
Julie,
I see a few problems with the study. Every lab had different protocols so I'm basing my opinion on what our lab would do.
First of all it is really questionable to do a split study with an RDI of 6.5. Secondly 101 minutes of total sleep time is not sufficient in determining an accurate diagnosis with the severity of the apnea shown. Medicare states that a minimum of 200 minutes of sleep must be achieved for an "accurate" study. I have always felt that split studies put a lot of pressure on a technologist and our protocol to qualify for a split study is a lot higher than the number that your study showed. Most labs also have trigger events that along with severe apnea would result in emergency CPAP being applied. These events would be something like severe cardiac arrhythmias such as ventricular tachycardia or severe desaturations below a threshold of like 50 or 60 percent. I would think that a desaturation to 79 % would not be enough to qualify. Desaturations like this are a common occurence in the sleep lab in patients that have sleep apnea.
As snoredog stated your RDI is close to being normal or not qualifying for pressure therapy. Although Medicare states that RDI's higher than 5 qualify for CPAP, some physicians have different thresholds and may not treat an RDI of 6.5. Also, when you have your repeat sleep study, you should sleep on your back because that is when you will be at your worse (apnea wise). As apneas are usually worse in REM while supine. It is also important during a titration study that you sleep on your back or an optimal pressure can not be achieved.
Good Luck.....Joe
I see a few problems with the study. Every lab had different protocols so I'm basing my opinion on what our lab would do.
First of all it is really questionable to do a split study with an RDI of 6.5. Secondly 101 minutes of total sleep time is not sufficient in determining an accurate diagnosis with the severity of the apnea shown. Medicare states that a minimum of 200 minutes of sleep must be achieved for an "accurate" study. I have always felt that split studies put a lot of pressure on a technologist and our protocol to qualify for a split study is a lot higher than the number that your study showed. Most labs also have trigger events that along with severe apnea would result in emergency CPAP being applied. These events would be something like severe cardiac arrhythmias such as ventricular tachycardia or severe desaturations below a threshold of like 50 or 60 percent. I would think that a desaturation to 79 % would not be enough to qualify. Desaturations like this are a common occurence in the sleep lab in patients that have sleep apnea.
As snoredog stated your RDI is close to being normal or not qualifying for pressure therapy. Although Medicare states that RDI's higher than 5 qualify for CPAP, some physicians have different thresholds and may not treat an RDI of 6.5. Also, when you have your repeat sleep study, you should sleep on your back because that is when you will be at your worse (apnea wise). As apneas are usually worse in REM while supine. It is also important during a titration study that you sleep on your back or an optimal pressure can not be achieved.
Good Luck.....Joe
My comments would be inline with what everyone else is saying. The huge concern for you is your oxygen levels, it should never drop below 90. You can have some serious health concerns with extended levels below 90 like you have. If that data is accurate at all, it just doesn't make sense to have an AHI that low and all the O2 desaturation....it would seem that you have other issues that need to be addressed. Seek another doctor's opinion and find a differenent place to do a REAL, full, study.
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justplainbill
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Julie-
I do not know if you have a copy of the summary of your first sleep study or if you have a copy of the full study (in which case it would have charts and graphs also). If you don't have the charts or graphs you might want to request them or else you might want to ask the doctor who did the first study further about your oxygen levels (most likely what are being reported is the lowest drop in blood oxygen level during your study but the full study should also help indicate your average O2 levels during sleep and the amount of time your O2 levels were below certain target levels) and also about your sleep during the second part of the study (it is not unknown for a person undergoing a sleep study to get more sleep than they they perceived at the time).
I would agree that it looks like you're on the right track getting a second sleep study.
Good luck and best wishes,
Bill
I do not know if you have a copy of the summary of your first sleep study or if you have a copy of the full study (in which case it would have charts and graphs also). If you don't have the charts or graphs you might want to request them or else you might want to ask the doctor who did the first study further about your oxygen levels (most likely what are being reported is the lowest drop in blood oxygen level during your study but the full study should also help indicate your average O2 levels during sleep and the amount of time your O2 levels were below certain target levels) and also about your sleep during the second part of the study (it is not unknown for a person undergoing a sleep study to get more sleep than they they perceived at the time).
I would agree that it looks like you're on the right track getting a second sleep study.
Good luck and best wishes,
Bill
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