First time to this site and glad it is here.  I just reviewed my sleep study results with my Doctor today but did not get a chance to discuss the "Sleep Architecture".  "The patient was shown to have increased stage 1 sleep at 30.4%, normal stage 2 sleep at 44.6%, decreased stage 3 & 4 delta sleep at 0%, and normal REM sleep at 24.8%.  There was a latency to sleep onset of 27 minutes and a long REM latencyof 191 minutes."  

Does this mean anything to anyone?  Where could I find out?


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Janice

Hi Janice:
Evaluation of sleep architecture must take into consideration all of the other data in the sleep study, as well as any pertinent underlying medical conditions or medications.  If you'd like to add those items, we'll try to put it in perspective.
sleepydave

Thanks SleepyDave - This is what I got:

Polysomnographic Results:
Sleep Architecture:
  Total Study time:  419.0 minutes
   Total Sleep time: 314.0 minutes
   Sleep Efficiencey: fair at 74.9%
   Total Number of Arousals:  99
   Arousals a/w Respiratory Events: 77

Sleep distribution:  Patient was shown to have increased stage 1 at 30.4%, normal stage 2 sleep at 44.6%, decreased stage 3&4 delta sleep at 0% and normal REM sleep at 24.8%.  There was a latency to sleep onset of 27 minutes and a long REM latency of 191 minutes.

Respiration:

Total Apneas:  Obstructive: 51  Mixed: 2  Central: 0

Apnea Index:  10.1/hr

Total Hypopneas: 132

Apnea/Hypopnea Index (RDI):  35.4/hr

Loud Snoring

Oxygen Saturation:  Minimum oxygen saturation:  62%

EKG:  no abnormalities noted

Diagnosis:

Moderate sleep apnea syndrom with significant hypoxemia




PAP Titration Polysomnogram Report (did not sleep well - could not adapt to the mask)


Sleep Architecture:

The patient was shown to have increased stage 1 sleep at 22.7%, increased stage 2 sleep at 53.9%, decreased stage 3 & 4 delta sleep at 0% and decreased REM sleep at 23.3%.  There was a latency to sleep onset of 34.0 minutes and a long REM latency of 130.0 minutes.  The pt demonstrated a poor sleep efficiency at 44.7%

Respiration

With CPAP - Apnea/Hypopnea index with CPAP: 1.5
Optimal CPAP pressure:  13.0cmH20
Minimum oxygen saturation on CPAP: 91%

EKG ; normal sinus rhythm noted.


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Janice

forgot to add - no other medical conditions - only medication is Prilosec


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Janice

kowchjr wrote:

Sleep Efficiency: fair at 74.9%
Total Number of Arousals:  99
Arousals a/w Respiratory Events: 77

Stage 1 at 30.4%, stage 2 sleep at 44.6%, stage 3&4 delta sleep at 0% and REM sleep at 24.8%.  There was a latency to sleep onset of 27 minutes and a long REM latency of 191 minutes.
Total Apneas:  Obstructive: 51  Mixed: 2  Central: 0
Apnea Index:  10.1/hr
Total Hypopneas: 132
Apnea/Hypopnea Index (RDI):  35.4/hr
Oxygen Saturation:  Minimum oxygen saturation:  62%
Moderate sleep apnea syndrom with significant hypoxemia

PAP Titration Polysomnogram Report (did not sleep well - could not adapt to the mask)
Stage 1 sleep at 22.7%, stage 2 sleep at 53.9%, stage 3 & 4 delta sleep at 0% and REM sleep at 23.3%.  There was a latency to sleep onset of 34.0 minutes and a long REM latency of 130.0 minutes.  The pt demonstrated a poor sleep efficiency at 44.7%

With CPAP - Apnea/Hypopnea index with CPAP: 1.5
Optimal CPAP pressure:  13.0cmH20
Minimum oxygen saturation on CPAP: 91%

Hi kowchjr:
Normal sleep% are:
Stage 1 - 5%
Stage 2 - 55%
Stage 3/4 - 20%
REM - 20%

Stage 1 is only a transition state from wake to stage 2 and has no real rest value.  A lot of it means inability to initiate and/or maintain sleep.
Stage 3/4 (SWS) decreases as a function of age, or if you're subject to constant arousals, as in OSA.  You may still be having some SWS, but isn't scored as such because it fails to meet scoring criteria.
RDIs over 30 are considered to be severe.
That 62% oxygen saturation is quite severe, but the CPAP obviously reverses that nicely.
Looks like the next step is getting used to that thing.  There's all kinds of posts here regarding mask selection, use of humidifier, etc.  Shop around.
That's a fairly high pressure, perhaps a machine with a pressure relief like CFlex would help.
Your machine should have a ramp option, punch that thing in as much as you like.  It will reduce the pressure briefly while you are awake, and perhaps allow sleep.
Prolonged CPAP intolerance might suggest the use of BiPAP.
Are there AHI categories for REM/NREM and supine?  And the titration table?
Is that GERD under control?  Any other reason for poor sleep, other than the wires, the mask, the strange place, the...
sleepydave

Thanks SleepDave

What is GERD?  I have asked to get the full sleep study report.  What I gave you is what I got.


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Janice

Hmmm, that other information would have been helpful...

GERD is the acronym for gastro-esophageal reflux disease.  Bad heartburn.  A few things here.  If you have GERD, it could contribute to your sleep apnea by (theoretically) increasing upper airway swelling.  And sleep apnea can increase symptoms of GERD by drawing up GI acids by the negative pressure of apneas.  And then prilosec may contribute to insomnia.

If you decide to pester them for more info, try to get those other things, the Sleep Architecture Graph, the CPAP Titration Table and the AHI/RDI Position and Sleep Stage Breakdown.
sleepydave

I have been told that I have GERD - never any formal test.  I have been on zantac and ranitidine(prescription version) and now prilosec for over 10 years.  Never knew the two (apnea and Gerd) could be related.  Both the ranitidine and prilosec seem to have virtually eliminated the reflux.  Is one better than the other re insomnia.  I don't get insomnia often but occassionally.

Janice


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Janice