Diagnosis is All Hypopneas - Am I On the Right Track?

I'm new to the whole sleep apnea scene after spending several years denying that I might have it. As a part of some other medical issues, my doctor (who is a DO) asked me to do a home sleep study. The analysis of this test was that I have 'severe sleep apnea' and that my O2 levels got down to 70%. As a result of this, my doctor asked me to do another sleep study/titration to define what I needed for treatment. I bought a Wellue O2 Ring and generated three weeks worth of data prior to doing the second sleep study/titration. The numbers supported her diagnosis - Average SpO2 91%, Min SpO2 74%, SpO2 Drop Index 37, % of Time in SpO2 Drop 44%.

So I did the second sleep study/titration and I just got the results. Here is a summary of the sleep report information:

RESPIRATORY INFORMATION

Respiratory events occurred, numbering 0 obstructive events, 54 hypopneas, 0 central events, 0 mixed events and 27 RERAS. The total apnea-hypopnea index was 19.8/hr, and respiratory disturbance index was 29.7/hr. REM sleep accounted for 5.0 minutes with a REM related AHI of 36.0/hr, and REM related RDI of 60.0/hr. The patient had 50.5 mintes recorded in the supine position, 0 minutes left, 113.0 minutes on the right side and 0 minutes prone. 50.5 minutes of sleep were recorded with the patient in the supine position, for a supine AHI of 22.6/hr and supine RDI of 30.9/hr. Patient had 0 apneas and hypopneas while REM supine with an AHI of 0.0/hr and REM supine RDI was 0.0/hr.

OXIMETRY DATA

The basal O2 saturation was 89% with a low SaO2 of 81%. There were 54 desaturations ≥ 4%. Time spent below 90% was 52.9% of time in bed. Time below 88% was 34%.

My doctor wrote an Rx is for 'CPAP @ 9 cm H2O - DX:05A' and I ordered a ResMed AirSense 10 Autoset from one of the on-line vendors - couldn't find a machine locally with the Phillips recall going on. The machine may be here by the end of next week.

So, some questions:

1. Is it likely that the APAP is going to help me reduce the hypopneas and increase my O2 levels?
2. Does 9 cm of H2O seem a high or low pressure setting for my symptoms?
3. Should I start out at the prescribed pressure setting in CPAP mode or should I let the Autoset determine the pressure?

I do plan to follow up with my doctor (GP - not sleep doctor. Small town medicine) after about three weeks on the machine (at her request). I'm hoping to have OSCAR data generated before that appointment to back up my evaluation on how I'm doing.

This forum is a great resource, and I am glad I found it. It has allowed me to educate myself about the CPAP situation, and I would greatly appreciate any council you wise folks have on what my path forward should be.

Thanks in advance!!

I have been using a machine for a little over six years, and like you I had very significant oxygen drop (low of 63%), and was primarily hypopneas. When you get your machine, I recommend you set it up as a variable pressure instead of a fixed pressure. This will allow the machine to operate as it was designed to. It may never go much over the recommended 9 cm pressure, but if it becomes necessary, it can do so. I do not normally track my oxygen levels when sleeping, but when I was hospitalized (4 times) and used my machine while sleeping, the oxygen levels alarm never sounded as long as I used the machine. If I doxed off during the day when I wasn't using it, my oxygen level would drop rather quickly and the alarm would wake me up. If it didn't, the nurse would immediately come in and wake me up to start me breathing again.