Sleep test results...

[needsomezees]

I've been lurking around these boards in aniticipation of my sleep study last week. I suspected obstructive apnea, but not quite this severe. I met w/ my Doc today, but as is usually the case, I didn't have these questions until I left. So maybe someone can help me out? I will begin CPAP therapy next week, but in the meantime, I would appreciate some info on these stats:

- Total sleep time of 163 minutes, with a sleep efficiency of 73.3%... can someone translate the sleep efficiency???
- 12% slow-wave sleep. no evidence of REM sleep, with an arousal index of 65 per hour (apparently this is the part that contributes to my problems functioning during the day). Please advise on the slow-wave and arousal index.
- 116 apneas and 39 hypopneas, giving an apnea-hypopnea inex of 56.9 per hour. I understand 5 is normal...

The good news? According to my ENT I have a larger than average tongue that appears to be getting in the way... at least, that seems to be the primary issue... that's not really the good news. The good news is, once the CPAP was put on during the study, they were able to eliminate the apneas on a very low pressure setting... hopefully that means I should be able to adjust a little easier.

THANKS!

[jweeks]

Hi,

Don't think "dang", think "yippie". Yippie that you are going to get treated, yippie that your life will return much closer to normal, and yippie that they might have just saved you from a stroke or heart attack.

Sleep efficiency is what percent of the night you were sleeping. 73% means that you were awake over 1/4 of the night. 65 arousals per hour means that you were waking up more than one time per minute on average. 57 per hour is certainly bad, but not off the scale. I was waking up twice a minute during my first sleep study. Not good in either your case or my case. And the zero REM sleep is kind of amazing. People in studies that have been deprived of REM sleep start seeing things after a few days, and quickly go insane after that. You are an exceptionally strong person if you can hold your life together under these circumstances.

One number that you don't give is the blood oxygen level. Oxygen deprivation can really do some damage over the long haul. Anything under 92% is considered abnormal, and below 88% is an issue that needs to be treated.

Yes, it might seem like a bummer to have to use a CPAP machine. But keep in mind that if you have to have a long term chronic illness, OSA and CPAP isn't so bad. Compare it to being diabetic. You don't have to have shots, you don't have to draw blood several times a day, body parts don't fall off, and you don't go blind. You can do this, and your life will be much better shortly.

-john-

[timbalionguy]

- Total sleep time of 163 minutes, with a sleep efficiency of 73.3%... can someone translate the sleep efficiency???
- 12% slow-wave sleep. no evidence of REM sleep, with an arousal index of 65 per hour (apparently this is the part that contributes to my problems functioning during the day). Please advise on the slow-wave and arousal index.
- 116 apneas and 39 hypopneas, giving an apnea-hypopnea inex of 56.9 per hour. I understand 5 is normal... can anyone say SEVERE!!!

Sleep efficiency is the fraction of your in-bed time that you actually slept. 73.3 percent is low, even for many here. But this is explained by your high arousal index.

12% slow wave sleep: This is your most restful sleep. It is a bit low, but not distressingly low (I think somewhere around 15 percent is normal-- correct me if I am wrong.)(Mine was zero!)

No REM sleep is pretty normal for obstructive sleep apnea patients as sleep apnea is often at its worst during REM sleep. Again, your high arousal index easily explains this.

An AHI of 56.9 is high, but many here have much higher AHI's. Mine, for example, was 96, and well over 100 is not uncommon. Still, 56.9 is considered severe, and requires prompt treatment.

The good news? According to my ENT I have a larger than average tongue that appears to be getting in the way... at least, that seems to be the primary issue... that's not really the good news. The good news is, once the CPAP was put on during the study, they were able to eliminate the apneas on a very low pressure setting... hopefully that means I should be able to adjust a little easier.

THANKS!

You are very lucky. It sounds like you will have an easy time with CPAP, and have good results. Many here are not so lucky, and their therapy requires constant attention to keep it effective. (I am one of those-- I have failed two lab titrations, and after a year am finally getting good results with a very advanced machine.) Even so, try and get yourself a fully data capable machine so you can keep tabs on your therapy should you need to. Therapy can change with age, weight gain/loss, etc. Above all, take a positive attitude towards your therapy. I suspect that it will make a huge difference, easily worth all the hassle of masking up at night.

[needsomezees]

Thanks for the reply!

DANG was meant more for the results themselves. YIPPIE is absolutely correct. I probably haven't had a good sleep in 10 years. I was really excited about the test, and actually relieved when they brought the mask in during the study. That told me right there what I needed to know, and it is a blessing to actually to actually KNOW what the heck is going on! I am really and truely excited about starting therapy.

Can't believe I left out the oxygenation. Here's how it reads: "The pt had oxygen desaturation from 100% to 72% and spent 28.3 minutes of screening time with an oxygen saturation less than 90%". Again - this was based on 163 minutes of sleep prior to the CPAP.

Once the CPAP was on, it was all systems go, and it only took be 10 minutes to fall asleep. With the CPAP, my sleep eff went to 91.7%, 19% slow-wave, 22% REM, w/ a REM latency of 72 minutes (whatever that is). Arousal index was 10/hr. Major improvement.

As far as the "NO REM", I was exceedingly restless during the test, and seemed to be keenly aware of everything. I too was really surprised about that part, but suspect that it is not indicative of a normal night...

[needsomezees]

An AHI of 56.9 is high, but many here have much higher AHI's. Mine, for example, was 96, and well over 100 is not uncommon. Still, 56.9 is considered severe, and requires prompt treatment.

I clearly have a lot to learn. I immediately regret calling my AHI of 56.9 severe, not even thinking about how much worse someone else may have it. My sincere apologies. I know how horrible I have felt for the last 10 years, and am so excited to get started I can hardly see straight. You will all have a place in my prayers, and look forward to hanging out with you all for a long time to come!

[timbalionguy]

REM latency it the time from when you fell asleep to when you entered REM sleep.

Your restlessness is not at all unusual. I was quite restless through both of my sleep studies. Both sleep studies had no SWS. The first study had no REM sleep, even after starting CPAP after just 2 hours. The second study did not show a lot of consistent REM sleep until they has switched me to Adaptive Servo Ventilation (ASV) (The lab tech was instructed to try anything he thought might work, and he did!)

Your numbers suggest both a SWS and a REM rebound even during your study. Correcting those O2 desats should have a tremendous benefit for you.

Good luck!

[jdm2857]

You have nothing to apologize for. According to the definition, any AHI of 30 or above is classified as severe.

[needsomezees]

CRUD... another question I forgot to ask...

What the heck kind of machine should I get? My dad just got the Resp Sys One REMstar Auto. It's his first, so he can't compare it to anything to know whether it's better or worse than other options. I'm fortunate that I will be able to use a nasal pillow, but any suggestions on that one?

again, THANKS!

[elena88]

Hi there, it sounds like you are well on your way to having an easy transition as an "apnean"

I have had the respironics system one with aflex auto machine, it was very nice, however, it only gave weekly averages on the screen.
The filtration system is really good on that machine..

If you get an auto machine, it can run in cpap mode, or one pressure, or auto, and automatically find the right pressure for you..
I would suggest since you are severe, that you get an auto machine, which is fully data capapble, and we dont JUST mean compliance data,
we mean you can see all your stats yourself and be a part of your own wellness adventure with your machine.

If you have allergies, have positional apnea, meaning your apnea is much worse in one position, you should get an auto..
IF you have a big tongue, I DO, you should also get an auto.. when that sucker falls back, it could plug the hoover dam, but on your stomach,
it might be bad at all, but if you have a straight cpap, youll get the same amount of pressure no matter what. I takes some tweeking to figure it
out too, and you cant be going back to the doc every couple days to figure out what your best range is..
however, you said they elimanated your apneas at a very low pressure setting, that is wonderful news! BUT, things can change and if you need
a higher pressure, you can suffer a long time before you get things figured out..
I now have the resmed s9 autoset.. That is an excellent machine, you can easily see your NIGHTLY numbers ont he screen in the morning, it has
a mask fitting feature to test for mask leaks, the screen is very easy to see, and you can easily take the sd card out and download your information
in your computer to see what went on the night before.. go check out some of the threads with "s9 graphs"
It does sound like maybe you will be an easier case, but you dont know till you are set up at home..
The reason some people prefer cpaps over apaps is that the pressure changes might disturb some people as they sleep, and a low straight pressure might
be the way to go.. but YOU can do either with an apap! thats an auto machine..

Check out the cpap definitions icon on this page, the cpap wiki, and you probably already read new users..
Keep us all posted, and keep reading and asking questions!

elena

[brazospearl]

Welcome, needsomezees! Isn't it great to finally have an answer to the What The Heck Is Happening To Me question? You're on the road to being healthier and feeling lots better. Keep reading here, there's plenty to learn and a steep learning curve because you need to know some important stuff before dealing with the equipment provider. Which machine should you get? You must INSIST on a FULLY DATA-CAPABLE machine. You also need an auto-titrating machine, so you'll have the most options for getting effective therapy. If you're in the U.S. and have "regular" insurance (not an HMO) the insurance codes are the same for all cpap machines, whether they have full data capabilities or not, auto titrating or not, so do not let your supplier try to sell you anything less. Also, you need to be able to sample numerous masks--there's no way to tell which is going to work best until you try them--so be sure to find out how your DME handles that. Keep reading here, keep asking questions, we're here to help.