I just saw my doctor about the titration and he is getting me a CPAP.  However, there were some things that were surprising to me in the study.  First, they recommended a pressure of 11 because they said I was uncomfortable at 13.  I don't remember being uncomfortable, and when I asked the doc about that, he said the mask leaked at 13.  I would think that is a different issue.  Anyhow, looking at the titration table I see I had one apnea in about 157 minutes (I'm not sure of the difference between TIB and TST minutes-- the 157 is TST) at 11 and none at 13, but they just did 17.5 minutes at 13.  

Second question -- heart rate -- Wow!  Is it normal for the heart rate to bezerk?  My average was  76, but it was spiking to 120+ (looks like most of that was during the apneas).  

I was disappointed that my sleep efficiency was still low, as I thought I had done so well.  Boy, if they rated my efficiency last night it would be murder.  The efficiency was at 78%, up from 56%.  Well, relatively it was good.

I did have more REM this time, in the normal range (26.6%), though the latency was still high (181 minutes).  My Stage III/IV was still higher than normal (34.9%) but it did go down.

The Sleep Doc said as part of his recommendation "Non-resolution of presenting symptoms should prompt further investigation."  Is this a normal CYA statement or is he suspecting that other stuff is going on and I might not feel better at all.

Boy, one does have lots of questions when one reads the study!

Judy

judyb wrote:

I just saw my doctor about the titration and he is getting me a CPAP.  However, there were some things that were surprising to me in the study.  First, they recommended a pressure of 11 because they said I was uncomfortable at 13.  I don't remember being uncomfortable, and when I asked the doc about that, he said the mask leaked at 13.  I would think that is a different issue.  Anyhow, looking at the titration table I see I had one apnea in about 157 minutes (I'm not sure of the difference between TIB and TST minutes-- the 157 is TST) at 11 and none at 13, but they just did 17.5 minutes at 13.  

Second question -- heart rate -- Wow!  Is it normal for the heart rate to bezerk?  My average was  76, but it was spiking to 120+ (looks like most of that was during the apneas).  

I was disappointed that my sleep efficiency was still low, as I thought I had done so well.  Boy, if they rated my efficiency last night it would be murder.  The efficiency was at 78%, up from 56%.  Well, relatively it was good.

I did have more REM this time, in the normal range (26.6%), though the latency was still high (181 minutes).  My Stage III/IV was still higher than normal (34.9%) but it did go down.

The Sleep Doc said as part of his recommendation "Non-resolution of presenting symptoms should prompt further investigation."  Is this a normal CYA statement or is he suspecting that other stuff is going on and I might not feel better at all.

Boy, one does have lots of questions when one reads the study!

Judy

Hi Judy,

Pressure is normally set at 95% of the max pressure required to clear all apnoea events. In your case, and I believe it to be normal practice, they have reduced the pressure to give you maximum comfort. Once your events are below 5 per hour you should be OK. If things don't work at 11, they can still bump it up to 13 without another test.

Glad you saw the heart rate figure. Can you imagine the damage to your heart if your condition were allowed to continue untreated. Most people think of sleep apnoea as a sleep or a respiratory problem, or a combination of both but what causes (IMHO) the most damage is the cardiac damage.

Stages 3 and 4 of your sleep cycle are the areas where you achieve rest. IMHO possibly the most important.

Looks like your doc is using this statement as a coverall. If your symptoms don't improve, back to the drawing board  

Kind regards,

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Thanks Daniel,

The person who got me into the testing was my pulmonologist.  However, what was motivating him was that I have atrial fibrillation that they cannot seem to control and that has led to other problems.  I was amazed to see those high heart rates.  When I had my first sleep study I was in afib so the high heart rate didn't mean much -- they didn't even put in the chart -- maybe it was off their chart as their high and low were pretty high.  Once I started reading about apnea I understood why the doctor started heading down this road, as there is such a strong correlation with it and heart problems.  Ever optimistic, I am hoping that it will help me considerably.  Then I will be really furious at the cardiologists of course! (Because they didn't care enough to explore causes).

Judy