Hi  
  
I am new to this site, so looking for some assistance in interpreting my sleep study.  
On the night of the study I didn't feel I could get to sleep at all, I felt i was mainly just resting. Normally I feel I'm a very deep sleeper and can sleep though loud noises and the such.  
I've been experiencing extreme daytime fatigue, for well over 10 years. I asked my GP if i could possibly have sleep apnea... she said only if I snored. I didn't think I snored but said "yes" so she would request the sleep study. Turns out I do snore after all!  
  
There's alot of information, so I'll just copy the parts I think are important... if there's anything I have left out, let me know and I will check my report.  
  
Sleep Statistics:  
Report time: from 22:42 to 05:45 = 423 min (they woke me up so early it was horrid LOL)  
Sleep latency: 6min  
REM latency: 129min  
Sleep period from 22:48 to 04:23 = 335min (ok maybe thats why i was woken early)  
Total time awake during sleep period: 76.7 min  
  
Stage 1 = 32min (12.5%)  
Stage 2= 150 min (58.1%)  
Stage 3 = 21 min (8.1%)  
Stage 4 = 21min (8.1)  
  
Total Sleep = 258.3 min  
NREM sleep: 224.3 min (86.8%)  
REM Sleep: 34 min (13.2%)  
Sleep Efficiency: (61.1%) (no surprises there given how hard it was to sleep with the wires)  
  
  
Respiratory/Sleep Statistics  
  
NREM  
  
SaO2% min average= Back: 93    Other: 94    All: 94  
Sa02% lowest= Back: 91     Other: 89    All:89  
  
Total duration (min)  
  
Central Apnea: All zero's....  
Obstructive Apnea: All zero's.....  
Mixed Apnea: All Zero's.....  
Hypopnea:= Back: 4.0      Other: 38.8     All: 42.7  
Apnea+Hypopnea: Back: 14.0     Other: 38.8    All: 42.7  
  
RDI  
Central Apnea: All Zero's....  
Obstructive Apnea: All Zero's...  
Mixed Apnea: All Zero's....  
Hypopnea:  Back: 14.0        Other: 30.4      All: 27.5  
Apnea+Hypopnea:   Back: 14.0     Other: 30.4     All: 27.5  


  
Now slightly different outcome, but for REM sleep  
  
REM  
  
SaO2% min average= Back: 94    Other: 93    All: 93  
Sa02% lowest= Back: 91     Other: 92    All:91  
  
Total duration (min)    
Central Apnea: All zero's....  
Obstructive Apnea: All zero's.....  
Mixed Apnea: All Zero's.....  
Hypopnea:= Back: 7.2      Other: 1.7     All: 8.9  
Apnea+Hypopnea: Back: 7.2     Other: 1.7    All: 8.9  
  
RDI  
Central Apnea: All Zero's....  
Obstructive Apnea: All Zero's...  
Mixed Apnea: All Zero's....  
Hypopnea:  Back: 40.0        Other: 34.3      All: 38.8  
Apnea+Hypopnea:   Back: 40.0     Other: 34.3     All: 38.8  
  
Total RDI= 29.0  
  
Sa02 awake average = 92%  
Average Sa02 desaturation = 2%  
Mean Apnea/Hypopnea duration= 24.8 sec  
Longest Apnea = -sec (yes - sec, no spelling error)  
Longest Hypopnea = 47.7sec  
  
Arousal Statistics  
  
Per hour  
  
Arousals REM: 47.6  
Arousals NREM: 48.7  
Total: 48.5 (hmmm what? lol)  
  
There's also some cool coloured charts...from what I can make out of them I slept on my left and right side mainly, tossing about per usual. I was on my back at some points, but much more time was on my sides. My heart rate chart is a bit hard to make out...I think it looks like my heart rate averaging between 65-80 mark...theres lots of spikes going up to about 100/115 and even one that spiked down to 20 (hmmm close to dying time? lol)  
  
My snoring looks pretty loud on this chart too (how come the boyfriend never picked up on it?)  
  
Then the report says: The study showed moderate sleep apnea due to hypopneas, particulary during REM sleep. Oxygen saturation was well maintained and the events were associated with recurrent arousals. Persistent snoring was recorded during the night. Sleep architecture showed a deficit of REM sleep with reduced sleep efficiency due to early waking. Severe sleep fragmentation was found. No periodic limb movements were recorded (strange, i thought for sure id have those...known to move about so much) and the ECG maintained sinus rhythm with some sinus arrhythmia (huh?) related to the arousals.  
  
Conclusion says: The study showed moderate sleep apnea due to hypopneas associated with recurrent arousals and sever sleep fragmentation. Persistent snoring found. Management options include use of a mandibular advancement splint or possibly a trial of CPAP treatment.  
  
I have booked an appointment with the sleep clinic for next week to discuss these options. Could some lovely people on this forum please explain to me what a hypopnea exactly is, and more so what is the cause of them? If i don't have any obstructions  or central things, then what is causing them? What else does my report reveal and which of these treatment options do you think would be the best to try. I just want whatever will fix my daytime fatigue.  
  
Thankyou!

Hypopnea involves episodes of overly shallow breathing or an abnormally low respiratory rate. It differs from apnea in that there remains some flow of air.  You might not be experirencing a complete collapse of your airway, but some obstruction none the less.


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Critstella-
I am not a sleep professional or a medical professional but I will do my best. You may find it helpful to review the sticky post on Sleep Study Terms in this section (Sleep Studies) of the forum.

As I understand it:
Apneas are sleep episodes lasting 10 seconds or more with no intake of air into the lungs.
Hypopneas are epsiodes lasting 10 seconds or longer with significant reductions in the intake of air into the lungs (exactly what constitutes a significant event may vary from one clinic to the next, a common definition is that te reduction must be at least 50%, sometimes a 3% drop in blood oxygen level and/or an arousal are also necessary for an event to count as an hypopnea).
Arousals are periods of abrupt transition from a deeper stage of sleep to a less deep stage of sleep.
Hypopneas can be central, mixed or obstructive in theory, but they are almost always counted as being obstructive in nature and in your case I would assume that this is the case for you as well.
In measuring the presence and severity of sleep apnea, hypopneas count as much as apneas. The yardstick used is the Apnea-hypopnea index (or AHI, this is the number of apneas observed plus the number of hypopneas observed divided bby your number of hours of sleep).

I think that your report is accurate as outlined. It looks like you may be having airway obstructions less severe than hypopneas which are contributing to your level of arousals and sleep fragmentation.

The other thing that strikes me about your report is that your baseline blood oxygen level (baseline SaO2) is somewhat on the low side. This suggests that you might be having some type of problem with your lungs and this might require more follow-up. It looks like you are not necessarily seeing a big loss in your blood oxygen level during your hypopneas although you do not report the low SaO2 level (sometimes referred to as SaO2 nadir). This figure shows exactly how far your SaO2 dropped at its worst during your sleep study.

I hope this is helpful. Do keep us posted on how things go for youo.

Best wishes,
Bill

justplainbill wrote:

Critstella-
I am not a sleep professional or a medical professional but I will do my best. You may find it helpful to review the sticky post on Sleep Study Terms in this section (Sleep Studies) of the forum.
 
As I understand it:
Apneas are sleep episodes lasting 10 seconds or more with no intake of air into the lungs.
Hypopneas are epsiodes lasting 10 seconds or longer with significant reductions in the intake of air into the lungs (exactly what constitutes a significant event may vary from one clinic to the next, a common definition is that te reduction must be at least 50%, sometimes a 3% drop in blood oxygen level and/or an arousal are also necessary for an event to count as an hypopnea).  
Arousals are periods of abrupt transition from a deeper stage of sleep to a less deep stage of sleep.  
Hypopneas can be central, mixed or obstructive in theory, but they are almost always counted as being obstructive in nature and in your case I would assume that this is the case for you as well.
In measuring the presence and severity of sleep apnea, hypopneas count as much as apneas. The yardstick used is the Apnea-hypopnea index (or AHI, this is the number of apneas observed plus the number of hypopneas observed divided bby your number of hours of sleep).
 
I think that your report is accurate as outlined. It looks like you may be having airway obstructions less severe than hypopneas which are contributing to your level of arousals and sleep fragmentation.
 
The other thing that strikes me about your report is that your baseline blood oxygen level (baseline SaO2) is somewhat on the low side. This suggests that you might be having some type of problem with your lungs and this might require more follow-up. It looks like you are not necessarily seeing a big loss in your blood oxygen level during your hypopneas although you do not report the low SaO2 level (sometimes referred to as SaO2 nadir). This figure shows exactly how far your SaO2 dropped at its worst during your sleep study.
 
I hope this is helpful. Do keep us posted on how things go for youo.
 
Best wishes,
Bill

 
Thanks, both of you, for the reply.  
 
The only Sa02 mentioned on my report is what I've written above. The lowest was 89, but that must be for the baseline blood oxygen level that you have mentioned?  
It's interesting that you mentioned about my lungs. I don't have anything wrong with my lungs (that I'm aware of anyway), but I do have alot of pain around my ribs and what feels like restriction, due to costochondritis. Perhaps that could be contributing towards the low baseline Sa02. I've always been a really shallow breather, sometimes I think i forget to breathe at times, so I'm not surprised that I have these hyponeas. Will a CPAP or mouth splint cure it, or only assist while using these long term? What is the general consensus on these boards as to the preferred treatment?

Cristella I like how one of the other members of this forum described  Hyponeas, that person describes them as Apnea want-a-be's, but they just don't quite make it to being full blown apneas! Neither the CPAP or mouth splints will cure the Hyponeas, they will only treat it, I personally think that the CPAP would be the way to go, because  besides treating the hyponeas, if you do start having  apneas, then you will be getting proper treatment for it as well. anyway Good Luck to You


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