I did the tritration test a few weeks ago and I should be getting a machine this week but I did have some questions regarding my results.  The first sleep study I had a really hard time falling asleep so on the second study I took 300 mg of Trazadone (per doctors orders) and I was out the minute the lights were out (according to my test, less than a minute).  Will this make a difference to my results?  I never fall right asleep!  Just for more info, here are my test results.

34 yo female

Total AHI  34.9/hr
Desaturation to 81%
Total minutes in bed 409.0
Total minutes asleep 368.00
Sleep efficiency 90%
Sleep onset latency was 0.00 minutes indicating sever hypersomnolence  (what is this?)
Stage 1- 2%
Stage 2- 81.3%
Stage 3 - 16.7%
No stage 4
No Rem Sleep
PLM 9.0/hr

They said that at 9cm H2O  I had a total of 1.3/hour AHI

My questions are if my sleep efficiency was 90% then why did I not get any REM sleep, or at least more of the 3 and 4 stages?
What is sever hypersomnolence and what to do about it.

Also  they put a full face mask on me just in case I needed it.  I don't think I sleep with my mouth open at all.  In fact I wake up with my jaw sore from grinding my teeth.  Now because the script is written for a FF how do I get just a nose one and would it just be better to stay with a FF if I can get used to it, just in case I really need one?

Any help I can get would be appriciated.

Thanks
LaDina

Hi Just Me Again,

[quote]>>> Replies below. <<<[/quote]

Just Me Again wrote:

I did the tritration test a few weeks ago and I should be getting a machine this week but I did have some questions regarding my results.  The first sleep study I had a really hard time falling asleep so on the second study I took 300 mg of Trazadone (per doctors orders) and I was out the minute the lights were out (according to my test, less than a minute).  Will this make a difference to my results?  I never fall right asleep!  Just for more info, here are my test results.

34 yo female

Total AHI  34.9/hr
Desaturation to 81%
Total minutes in bed 409.0
Total minutes asleep 368.00
Sleep efficiency 90%
Sleep onset latency was 0.00 minutes indicating sever hypersomnolence  (what is this?)
Stage 1- 2%
Stage 2- 81.3%
Stage 3 - 16.7%
No stage 4
No Rem Sleep
PLM 9.0/hr

They said that at 9cm H2O  I had a total of 1.3/hour AHI

My questions are if my sleep efficiency was 90% then why did I not get any REM sleep, or at least more of the 3 and 4 stages?

>>> Sleep efficiency is the time asleep devided by the total time in bed.  It does not directly relate to sleep archetecure.  See the post on this site:

Sleep Apnea Support Forum Index » Sleep Studies » Sleep Study Terms    <<<

What is sever hypersomnolence and what to do about it.

>>> hyper (extreemly) somnolence (sleepy) - to cure use the CPAP, take it easy, eat right and exercise.  <<<

Also  they put a full face mask on me just in case I needed it.  I don't think I sleep with my mouth open at all.  In fact I wake up with my jaw sore from grinding my teeth.  Now because the script is written for a FF how do I get just a nose one and would it just be better to stay with a FF if I can get used to it, just in case I really need one?

>>> It takes time to find out what works for you.  They may have seen something in the sleep study that made them recommend the full mask.  Be patient, relax, and let your body speak.  If it continues to be uncomfortable or does not work for you otherwise then seek another option I would say. <<<

Any help I can get would be appriciated.

Thanks
LaDina

Just Me Again   talk to your DME about getting a different mask,  you do not need a script  to get a mask, also check to see if your DME has a loaner program, where you can take a mask home and try it for a few days to see if you like and can use it. My DME let you take the mask home for up to 10 days, if you like it, they will set you up with one, if not then they will send you home with a different one, to try. Not all DME's do that though! but it is worth checking into! Good Luck to You!


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

Thank you both for responding to my questions.  I go to the DME today and I am very excited!  This is like getting water after having been thirsty for so long!

I will try the full face and see how it goes.  I am glad to know that you don't need a script to change the style of masks.  

I do have another question for anyone.

At night I put off going to sleep at night as long as I can.  It is not that I am not tired but that I feel half way awake and have more energy than any other time during the day.  I dread waking up the next morning just to feel tired and foggy.  This usually means that I go to bed at 1 or 2 in the morning and then have to force myself out of bed at 8 so I am not late for work.

Does this happen to any one else?

300 mg is a HUGE dose of Trazadone.  My son takes 25mg; I know someone who takes 60 mg....but 300?!?!  I am sure that is why you passed out so fast!  

btw...my son also showed no stage 3/4 and only 7% REM.....don't know if it's related to the trazodone, but if you weren't having arousals I would certainly wonder.  (what was your sleep architecture like during your 1st study?  did you have deep sleep then?)

A 50 mg dose is recommended when using Trazodone as a sleep aid.

Trazodone isnt known for altering REM percentage. It may increase slow wave sleep and dampen the severity of limb movement disorders.

My doctor told me to take anywhere between 100 and 300 mg because I fight sleep so much (only at night though, I can "nap" for 4 or 5 hours).  I normally don't take it at all because it makes me tired the next day and I need all the help I can get to stay awake.  
The first study I took 200 mg and was still awake on and off all night so I upped it for the second.  
I did not get a report from my doctor regarding my first study, just my second.  I will have to try to get that but I have not even seen my doctor since the study was first ordered.  I have just gotten a report faxed to me and then a script fax about what machine I need.  

embryopathy - Does your son now get 3&4 and more than 7% of Rem sleep?  Is he on a CPAP?  

My biggest fear is to have the machine and still be so tired all the time!

Thank everyone for all the help.  I would be so lost without this forum.

Just Me Again just remember to be patient, you will probably not feel the results of the CPAP right away, it will take time, sometimes it can take many months, but it will happen, You will start feeling better and not as tired, but it is a some what gradual change, so please be patient with your self and using CPAP. I might add for most of us, it was and for some still is, a very big challenge sleeping with the mask and machine, but not a challenge that cannot be over come and mastered. It takes time patients, persistence and perseverance, and above all attitude. If you think you can do it, YOU CAN! And you have all of us folks here at the forum to give you help and support. Good Luck to You!


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

Just Me Again wrote:

Thank you both for responding to my questions.  I go to the DME today and I am very excited!  This is like getting water after having been thirsty for so long!

I will try the full face and see how it goes.  I am glad to know that you don't need a script to change the style of masks.  

I do have another question for anyone.

At night I put off going to sleep at night as long as I can.  It is not that I am not tired but that I feel half way awake and have more energy than any other time during the day.  I dread waking up the next morning just to feel tired and foggy.  This usually means that I go to bed at 1 or 2 in the morning and then have to force myself out of bed at 8 so I am not late for work.

Does this happen to any one else?

Hi Just Me Again!

For me I note it as a tendency where anxiety (energy) increases if I am not asleep before 9p.  The tendency has been with me since childhood.  Sometimes I wonder if it is indeed related to SDB because I cannot imagine me not knowing that I suffer from oxygen emergencies even though I do not remember them consciously.

Things that seem to help me:

I listen to scripture by MP3 as I go to sleep.  I have done this since childhood and for me it is very soothing.  I also have used classical music.  I think that the sound of rain or crashing waves would also do the trick.

Try to not watch disturbing TV or see disturbing news stories after about 6p.  In my case I have PTSD from a traumatic attack I suffered in 2005 - so in my case I have found that this helps.

Do observe beauty and be thankful for friends, family, associates, and all the wonderful things that have happened in your life.  It is good to review such things often.

Do take two slow lumbering walks (with thankfulness and/or conversation), and two power walks (separate days) each week.

Do volunteer and be as helpful to others as you can during the day.

Try to not eat after about 6p (three or more hours before bedtime) but do take liquids.  No caffeine after 3p and not much before then.

May we both find good rest!

Todzo

Thank you all once again for the helpful comments.    

I went and got my Respironics Auto M Series with C-flex yesterday.  I am very excited and hopeful for "the change"!  It was very different to sleep with the mask (cofortLite) but I am sure I will get used to it.  Overall not as bad as I thought!

I do have a couple questions and maybe I need to place these in another area but here goes.

They disabled the ability to see how many AHI and mask leaks I had during the night.  
Does anyone know how to turn these features back on without taking the machine back to them?  I live 1 1/2 away and can't afford to take time off work just to have those turned back on.  My doctor has also set the range at 5-9cm and I don't like this.  I was still getting an average of 1.3/AHI in the sleep lab with the machine set at 9cm so I would think that the range should be maybe around 7-11cm.  Does anyone know how to change that with out going back?  

I know I should not mess with the machine but as you can see, I have control issues!  

Thanks for the help.

Well I moved the pressure to 7-13 (from the 5-9cm) and after one week I stay at an average of 12.9cm.  I am loving the machine. The masks are a different story.  I just tried a ResMed Mirrage nasal pillow one and that was easier to manage during the night but I woke up very stuffy.  I am not sure what that is about.  
I am thinking that maybe my pressure is going up is because I might be getting into REM sleep now (stayed in stage 2 almost the whole time in the titration) , therfore having more AHI's than 9cms can handle.  I don't know just a thought.

My question is, should I go back to my doctor and tell him that I just don't think I should be on the 5-9 because of the changes I made and the end resulting average?  I don't want to play doctor but I feel like I know a lot more about this than my GP (who I have never spoken to since the first order of the sleep test).  I don't want him to just agree with me and send me on my merry way!

Everyone talks about their sleep doctor but I don't have one and am not sure where to find one.  Any help there?  Are they called sleep doctors?  I kindof don't think so.


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RemStar Auto w/C-flex
Comfort Lite nasal mask

Everyone talks about their sleep doctor but I don't have one and am not sure where to find one. Any help there? Are they called sleep doctors? I kindof don't think so.

My family (2 vpap and 1 cpap user) is followed mostly by a Pulmonologist but they're also seen by an Allergist (lots of enviro/seasonal allergies), an ENT (minor surgery i.e. tonsils/adenoids removed, velum/cleft palate repair, deviated septum repair, etc...) and a GI (reflux).  For us it has taken a combination of doctors (including a neurologist at times) but most people only need an ENT or a Pulmo (at least that's what I've heard).  

Sorry...I'm not the best person to answer any of your other questions.  Hopefully someone else can help you.

Just Me Again  increasing pressures to high can induce central apneas in some people which  causes a whole new set of problems and defeats the original purpose. So be careful about that and most machines don't register centrals so you won't necessarily know about them unless you wake up when your having them.
Also if nothing else try Google and Sleep Apnea Specialist  and your area, I think this forum also has something on finding sleep specialist  for your one area. Look for Board Certified Sleep Apnea Specialist, allot of them are Pulmonary doctors or Neurologist but can be of any field in medicine. Good Luck to You


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

I explained (confessed) that I had moved my pressure from 5-9 to 7-13.  I explained why.  I did it because in my titration I never got into 4 or REM sleep and that apneas increase when you are in those.  Because I am on an Auto with C-Flex machine I did not think that it would give me more than I need.  I also told him that I had it at this pressure for about 1 1/2 weeks and that I was staying at around 11.9cm with an average of apneas at 1.9.  He said that what I did was really good and that he should have thought of that.  I did ask him about Central Apneas and he said he did not think that those would be a problem but we would see how I am doing in anther month.  He also thought that it was really good that I am taking an active part in my SA.  I told him that the machine he got me (Respronic M series Auto with C-flex) was great and that there was a new one out that had an A-Flex instead of a C-flex.  He asked if I wanted that one instead.  I said that I did not think that they would trade mine in for it and he said they will if it is not working for you.  I said I was fine for now and he said to just let him know and he would write a new script for it.
I love my doctor because he really listens to me.  I also told him that I wanted a script for Provigil and he said he thought that was a great idea.  

So... my new question is, should I push for the Respronic with A-Flex?  What is the big difference between the two?  Can the A-flex detect Centrals and was I wrong to push for Provigil after only two week on a CPap?


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RemStar Auto w/C-flex
Comfort Lite nasal mask

Just Me Again I am not sure that any of the XPAP machines on the market can detect Centrals, I might be wrong about that but Centrals  are caused by the brain not telling you to breath, there is a disconnect in the system, and it can be caused by many different things. I believe that with to high of pressure in some folks it keeps the body form detecting Carbon Dioxide build up, which which is part of a feed back loop that signals your brain that you need to breath. I think that is the way it goes anyway I am not the right person to be trying to describe this to you, but there are thought, to be many different causes for CA,  Brain stem injury, CHF and more, and I think the only real way to detect them is thru a regular Sleep Study.
 As far as  taking Provigil I had it prescribe to me close to two years ago, my insurance wouldn't pay for it and it was way to expensive for  me to pay out of pocket, at that time and at the pharmacy I used, they wanted close to 600 dollars for a months supply. I am sure it is much cheaper than that now, and more insurance companies cover it.  I know that there are several people posting in this forum that have used it an have posted  what they think about it. I personally think I would wait a while longer to see how you feel with your CPAP treatment two weeks isn't very long. It does sound like you have an excellent Sleep Doctor and that can make a world of difference in your success with this CPAP adventure! Good Luck to You


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White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0