pseudonym wrote:Hello Barb, see my answer to you in the main help forum.
Someone correct me if I'm wrong, I believe the 16.6 arousal index means you wake up an average of 16.6 times per hour. This is due to whatever -- apneas, hypopneas, alpha wave intrusions, even unknown arousals. My sleep study reports gave a breakdown on the arousal events, sometimes there are unknown events, did your report indicate you had any? If so a repeat study with PES (esophageal pressure monitoring) *might* be indicated, a sleep doc would know for sure if you are a UARS candidate (upper airway resistance syndrome) which PES will monitor. I was not diagnosed until my second study because I didn't have PES until then (I have severe hypopnea/UARS we found out through PES).
Hope that helps, Blessings,
Linda wrote:Hi Gypsysavage,
The number I don't see is AHI or RDI. AHI is the apnea/hypopnea index, how many you had per hour. RDI is similar. Arousal index may or may not be the same as AHI, for arousals can occur for more than one reason.
Severity is defined by AHI or RDI (how many you averaged per hour). Mild is 5-15 per hour; moderate is 15-30; severe is 30 or more per hour. If your AHI was the same as the 16.6 arousal index, that would put you in the low moderate range. I can approximate from the 43 apneas over a 4 and a half hour period as about 10 or so (my math isn't so good), and if that's your AHI, that is in the mild range.
But mild doesn't mean you don't have sleep apnea. An AHI of over 5 is considered to be sleep apnea. And I've seen plenty of people who have mild apnea and real bad symptoms. It can be a function of how long the apneas were (imagine holding your breath for 10 to 30 seconds many times an hour) as well as oxygen desaturations and how long you might have been suffering from the condition. Bottomline is you have sleep apnea and that is likely the reason you feel so bad. Plus you have atrial fib and that can make you feel bad. But atrial fib can be caused by untreated sleep apnea. You definitely have many of the classic symptoms. Untreated sleep apnea puts your body and life at risk, so I wouldn't be too focused on the severity.
Is the sleep study report a copy of the one generated by the sleep study center? (I'm assuming you had a study at a sleep study center) Usually those reports are from the sleep study center and the doctor receives a copy. Are you going back for the second sleep study where they test you using cpap and mask? In effect, that is like a second opinion. They test you almost the same as the first study, but they give you the cpap and mask and gradually increase the cpap pressures to see what pressure best controls your apneas.
Sleeping in a recliner? Yes, some people will do that as they wait for their cpap sleep study or to get their equipment, and that can ease some of the symptoms and lessen the apneas. But don't be fooled by that, for it does not eliminate the sleep apnea. And besides, who sleeps that way?
Sounds like you have sleep apnea. That may seem like bad news, but it can be very good news. If your symptoms and even your atrial fib and other health issues are caused by the sleep apnea, then cpap treatment can make a world of difference. Take a look at the topic Success Stories posted at the top of this section, you can see how cpap has helped people.
CrohnieToo wrote:It sounds like all you have in hand is the dictated results report from a doctor who has a "generic" form to which he adds what he considers the pertinent info from the summary report and data generated during your sleep evaluation. I encountered the same "risk of falling asleep while driving", etc. and I hit the roof because the ONLY incidence I reported on the form they have you fill out was falling asleep whilst watching TV. Like you I hit the roof! I raised holy h*ll about that "driving" comment!!! I don't even know who the doctor was who dictated the report, I've never seen him. My appointments are all w/one of the main sleep doctors at this sleep lab - most likely because I did raise such a stink.
To ease your mind I would insist on a copy of the full sleep evaluation data, including graphs; the summary report is usually about 5-6 pages whilst that dictated report is just 1-2 pages.
By all means, make it clear to this doctor that you view the entire sleep evaluation w/GREAT SKEPTICISM BASED ON HIS DICTATED REPORT! Point out his comments you found especially disturbing and inaccurate. You just might save the next patient similar worries!
Actually, tho, the data itself, i.e. desaturations number and duration, etc. will be accurate in the summary data as they are recorded and reported by a pulse oximeter and software. Most of us experience more "events" during REM sleep and also when sleeping on our backs.
Keep in mind that pain and medications can also affect your sleep so you may well have more going on than "just" sleep apnea AND that sleep apnea can contribute to the pain you are experiencing.
CrohnieToo wrote:That questionaire you filled out, the data from your sleep evaluation, etc. are all part of your medical records and in the USA patients have a LEGAL RIGHT to COPIES of ALL of their medical records. Put your request in writing, send it Certified Mail, Return Receipt Requested. If they fail to comply you have them by the short hairs. They do have the right to charge you a "reasonable fee" so you might want to request that they be sent to your family doctor - just be sure to specify your "entire medical file". Then go thru it and if they left anything out let them know you are aware they failed to send the entire file. I had ONE doctor try to pull that stunt. I called and asked if they would be more responsive if my attorney contacted them for my file. Two days later my doctor had the full file - and so did I! Fortunately, I have a close friend who is an attorney so it wasn't an idle threat. I talked it over w/her first.
CrohnieToo wrote:I've always been a firm believer in DOs - until the last 15 years or so. They are becoming more and more "medical" and less and less osteopaths. There are a few good ones still around so I wish you great luck with this new Primary you are scheduled with!
HouseDO wrote:unfortunately a lot of today's DO students are people who tried to get into MD schools and didn't, so it ends up being a backup plan.
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