Hypopnea vs Apnea

I am confused at hell at the sleep report I have been given. I did a sleep test and it found out that I had mild apnea, with no OSA/Central or REARS. I still have hypnoea but don't have OSA anymore. The strange thing is that the conclusion says that I have mild OSA. Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

Both are obstructive, but hypopneas are just less so, more like wannabe full apneas, but end up as partials. No one's trying to confuse or fool you and hypopneas respond to Cpap just as apneas do. You do have OSA, but a somewhat different form that may not arouse you as strongly as apneas, but still interfere with your sleep enough to do damage.

Julie wrote:Both are obstructive, but hypopneas are just less so, more like wannabe full apneas, but end up as partials. No one's trying to confuse or fool you and hypopneas respond to Cpap just as apneas do. You do have OSA, but a somewhat different form that may not arouse you as strongly as apneas, but still interfere with your sleep enough to do damage.

I am taking only shallow breaths I can tell. No wonder my BP is so low but from what I have read, hypopnea can be central as well as obstructive. Unfortunately, I can't tolerate CPAP very well. Would bipap be better in this situation or would an asv be?

SAS asks...Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

I think that hyponeas are highly under-rated as far as severity of secondary sequelae (health effects which result from the original condition of sleep disordered breathing.)

I strongly suspect that, in many cases, hypopneas would have been full apnea occlusions, but your body's fight-or-flight hormone response elevates your sleep level enough to avoid suffocation. The stress hormone epinephrine is a major culprit here; also, cortisol is released at the same time, all which do not play nice with your over-all health and well-being.

If one considers the possibility that hypopneas might be a fight-or-flight response to what might have been a full apnea, then their seriousness comes into better view.

Interestingly, a quick lit search could not locate any scientific studies to support my suspicion about hypopneas, but I'll look more thoroughly when I can take the time.

Good luck in your decision on whether to get that additional test.



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xxyzx - that sound like using BMI to see if someone is overweight.
It has Nothing to do with how much fat someone carries (very fit muscular male will show as obese in BMI table even though their fat % can way under the normal healthy level).
And same with someone that looks small but has a very high amount of fat (so BMI says normal but fat % says obese).
Yet somehow all Drs somehow use this measurement now - because it is very easy and not because it is accurate (though for typical person who doesn't do work out hard with a medium or small frame it often is reasonably correct).

sleep_apnea_suffer wrote:I am confused at hell at the sleep report I have been given. I did a sleep test and it found out that I had mild apnea, with no OSA/Central or REARS. I still have hypnoea but don't have OSA anymore. The strange thing is that the conclusion says that I have mild OSA. Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

I am confused by your statement. I see a few people have responded to you but I do not understand what you are saying. If you have OSA, then you have sleep apnea since OSA stands for Obstructive Sleep Apnea.

If you question is can you have OSA without any apnea events then the answer is yes.

Hyponeas are considered part of the AHI which is used for diagnosis for OSA.
Apnea Index (central or obstructive apneas)
Hyponea Index
add the 2 together and you get AHI

So a person having primarily hyponeas still gets the diagnsosis of OSA if the hyponea index is high enough to meet diagnostic criteria even if the apnea index is low or non existent.

Captain_Midnight wrote:SAS asks...Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

I think that hyponeas are highly under-rated as far as severity of secondary sequelae (health effects which result from the original condition of sleep disordered breathing.)

I strongly suspect that, in many cases, hypopneas would have been full apnea occlusions, but your body's fight-or-flight hormone response elevates your sleep level enough to avoid suffocation. The stress hormone epinephrine is a major culprit here; also, cortisol is released at the same time, all which do not play nice with your over-all health and well-being.

If one considers the possibility that hypopneas might be a fight-or-flight response to what might have been a full apnea, then their seriousness comes into better view.

Interestingly, a quick lit search could not locate any scientific studies to support my suspicion about hypopneas, but I'll look more thoroughly when I can take the time.




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Exactly! I have a high ahi consisting for very short events (10-15 seconds) with mostly good oxygen saturation. My brain's method of keeping me alive (pre-cpap) is to sleep lightly and arouse each time an event starts. So, my events are frequent, but don't last long. This keeps my oxygen level up, but totally trashes my sleep. I also have high blood pressure from the adrenaline. If I could stay awake, I would not have breathing events. But going without sleep is just as dangerous as having the breathing events.


My mom has the opposite problem. She has a much lower ahi with much longer events that really take her oxygen down. She "appears" to sleep really well, but her brain isn't doing much to try and keep her alive. Her blood pressure is normal without medication.

Both of us have a severe sleep problem, and our treatment is the same. We just have very different numbers, and our bodies are affected differently.

xxyzx wrote: really ?

no desats then no awakening

the lung has a minute of reserve oxygen
you should not feel a hypop of 10-15 seconds at all

There is a difference between awakening (And remembering it) and arousals (brain becoming more active).

Arousals are one way the brain prevents the desats. That's the whole reason it trashes our sleep, and not just our oxygen. My oxygen only went below 90% for 13% of my sleep study, yet I had a 79 ahi (89 rdi). During that time, I never went into deep sleep or REM. My sleep was too trashed. HAd I done a full night sleep study, I probably would have been much higher with my ahi. But my oxygen desats are pretty mild, with the worst being 84% and very short.

xxyzx wrote:

zoocrewphoto wrote:

xxyzx wrote:

no desat to prevent if hypop only ten seconds as a minute of oxygen reserve still in lungs

The definition of a hypopnea includes oxygen desaturation.

"Hypopnea is related to sleep apnea and is a part of the same family of sleep disorders. In hypopnea, there is a decrease of airflow for at least 10 seconds in respirations, a 30-percent reduction in ventilation, and a decrease in oxygen saturation. "

If the event was scored in a sleep study as a hypopnea, then, yes, it did have a desat.

I don't know what to tell you about the oxygen in your lungs. I can tell you that MY lungs do not have the full amount of air that it should. I have never scored well on breathing tests. Nowhere near normal lung capacity. My airflow is already reduced to narrow airway.

Hypopneas under the latest definition of the American Academy of Sleep MEdicine do not necessarily require a desaturation to be included. Events more than 10 seconds that cause an arousal in sleep state also qualify.

sleep_apnea_suffer wrote:I am confused at hell at the sleep report I have been given. I did a sleep test and it found out that I had mild apnea, with no OSA/Central or REARS. I still have hypnoea but don't have OSA anymore. The strange thing is that the conclusion says that I have mild OSA. Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

Since this guest post makes no sense and has made no attempt to clarify/correct, I think it is best if it is ignored until the OP corrects the obvious mistakes in sentence 2, 3, 5.
I am not trying to be a PITA but when people pose questions which obviously displays confusion (or are trolls), I do not think it is best to give advice until the confusion has been resolved. But that is just my pet peeve.

xxyzx wrote:

TASmart wrote:Hypopneas under the latest definition of the American Academy of Sleep MEdicine do not necessarily require a desaturation to be included. Events more than 10 seconds that cause an arousal in sleep state also qualify.

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without a desat would there ever be an arousal from hypop alone?

yes. Why else would their newest definition specifically say that a hypopnea can be defined either as a desaturation or an arousal?

xxyzx wrote: the confusion is by the sleep industry using one term for two problems
he does NOT have OA
he does have hypops
he wants to know why they call that OSA when there is no apnea only hypops

the problem is AHI is used to diagnose OSA whether you have OA or not

the question makes sense
the use of AHI when there is no A is what is misleading
as is the diagnose of OSA when there is no OA

It might make sense if you use the whole word - hypopnea.

A hypopnea is simply a partial apnea. A partial blockage of the airflow compared to a full blockage. Both are obstructive as the airway is physically limited, as opposed to a clear airway with no blockage. They are basically the same thing, only one is partial and one is complete.

xxyzx wrote:

TedVPAP wrote:

sleep_apnea_suffer wrote:I am confused at hell at the sleep report I have been given. I did a sleep test and it found out that I had mild apnea, with no OSA/Central or REARS. I still have hypnoea but don't have OSA anymore. The strange thing is that the conclusion says that I have mild OSA. Why are these people who interpret these home sleep tests, mix the two up together(Hypopnea and OSAs), when are not the same thing. One is partial obstruction the other one is fully obstruction. Should I go for another test? As in Inlab sleep test?

~~~~~~~~~~~~~~~~
Since this guest post makes no sense and has made no attempt to clarify/correct, I think it is best if it is ignored until the OP corrects the obvious mistakes in sentence 2, 3, 5.
I am not trying to be a PITA but when people pose questions which obviously displays confusion (or are trolls), I do not think it is best to give advice until the confusion has been resolved. But that is just my pet peeve.

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the post makes perfect sense
the problem is with real english vs sleep jargon

there is no confusion by the guest
the confusion is by the sleep industry using one term for two problems
he does NOT have OA
he does have hypops
he wants to know why they call that OSA when there is no apnea only hypops

the problem is AHI is used to diagnose OSA whether you have OA or not

the question makes sense
the use of AHI when there is no A is what is misleading
as is the diagnose of OSA when there is no OA

I think we all agree that OSA is determined based on A and H. The OP does not have any A but does have H, but doesn't understand why the diagnosis of OSA is still valid since A=0???? If my understanding of the OP's confusion is correct, then the answer is simply that OSA is diagnosed based on A and H as both are relevant to OSA.