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help with sleep study results please
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Post help with sleep study results please 
Thanks in advance for reading this.  It's probably way too wordy...

I'm looking for what these numbers mean to my symptoms...  For instance, is my need for a daily nap because of X?  And with regular CPAP use, will I truly see a difference in my life?

I just got the results of my first sleep study which occurred about a month ago.  The 2nd study with the CPAP was 2 weeks ago.  Found this site after that.  I've got a CPAP with the nasal pillows and have had it for about 10 days.  Haven't yet made it through the night with it on.  Still working on it.

I got tired of being tired so finally said something to the doctor.  After prescription vitamin D and regular vitamin B with no great improvement, she suggested a sleep study.  I thought it was a waste of time.  Almost didn't go.  Didn't believe them when they said I had severe SA.

I didn't know I had a sleep problem, but considered myself a light sleeper.  I'm 47.  I work 40 hours a week and try to take 1 or 2 college classes toward my degree each semester. I show and breed miniature horses, have a couple litters of dachshunds a year, and tolerate 3 live-in adult kids.  My house is a mess.
Long driving trips alone are impossible.  
One day of the weekend I would sleep all day and all night.  If I didn't I'd start the week very tired and go downhill from there.
Coffee is my best friend.  The girls at work would sometimes see me in a morning stupor and draw lines on my styrofoam cup and write one of their names-- that was the amount of coffee I'd have to drink before I could understand that person.  very funny. girls
I've noticed memory lapses at work-- not huge, just enough to kick myself.  
I spend a lot of time-- probably an abnormally large amount of time-- in my room where I have the TV and laptops.  (But I'm an extreme introvert.)

I don't seem to exhibit anything extreme.  It's not like my friends at work or manager had to pull me aside because my work was suffering.  But my family probably considered me lazy until I was diagnosed.

I have mild hypertension and depression.  Meds for depression control the moods but I've noticed an increasing lack of interest in activities outside the house (shopping, social time with co-workers, horse shows, etc.)

Can someone help me with how the results apply to my life?  

Total sleep time 5.6 hours

sleep efficiency 83%

latency to sleep onset 28 mins

REM latency 170 mins

10.4% = awake
N1 = 4.1%
N2 = 66.3%
N3 = 9.2%
REM = 9.9%
arousal+awakening index 31.7/hr

310 respiratory events (mix of obstructive apneas and obstructive hypopneas)

AHI = 55.6/hr

O2 saturation:
min = 81%
mean = 91%
desaturation below 90% was seen for 37% of study

periodic limb movements = 389
muscle-jerk-arousal-plus-awakening index = 5.7/hr
(technician said my legs were still jerking during the 2nd study and said it would probably go away)


Thanks in advance!


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I don't understand all of the numbers, but what I do understand is 31.7 arousals & awakenings.  This means out of one hour you only slept a total of 28.3 minutes.   So its no wonder you are tired.  So if you do this every hour for 8 hours (480 minutes)  Awakenings for 8 hours  (253.6 minutes) You are only getting about 4 hours and 22 minutes sleep a night.  That isn't very much sleep to keep a body healthy and prevent many other problems.  Coffee is not your friend. In the long run it just causes other problems.  

Your doctor should be able to break this all down for you and I suspect give you a script for a c-pap and mask.  It takes awhile to adjust, but well worth the effort.  The first time I slept for six hours straight I was hooked.  Your hypertension and depression could be greatly improved by c-pap therapy.  With all that you do, I don't think you could be called lazy, but I know from my own experience it is difficult to have any type of quality relationships if you are exhausted.  Hope you find relief soon !


_________________
REMstarplus, M Series with C-flex and heated humidification
C- Pap setting of 10
ResMed Mirage Quatro full face Mask
Sleep study showed 36 events per hour
Location, Nebraska

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Something new wrote:
I don't understand all of the numbers, but what I do understand is 31.7 arousals & awakenings.  This means out of one hour you only slept a total of 28.3 minutes.   So its no wonder you are tired.  So if you do this every hour for 8 hours (480 minutes)  Awakenings for 8 hours  (253.6 minutes) You are only getting about 4 hours and 22 minutes sleep a night.  That isn't very much sleep to keep a body healthy and prevent many other problems.  Coffee is not your friend. In the long run it just causes other problems.  


Not necessarily.

The arousal/awakening index refers to the number of times this (these) occur per hour. The fact is that they do not last any specific time duration (however most scorers choose arousals that last > 3 seconds, as anything under 3 seconds is very difficult for scorers to "mark" consistently.

It is true that this number does indicate that your sleep is severly fragmented, however I figured that id correct you on the timing issue because that isnt accurate.


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The arousal/awakening index refers to the number of times this (these) occur per hour. The fact is that they do not last any specific time duration (however most scorers choose arousals that last > 3 seconds, as anything under 3 seconds is very difficult for scorers to "mark" consistently.

It is true that this number does indicate that your sleep is severly fragmented, however I figured that id correct you on the timing issue because that isnt accurate.

How is the arousal/awakening index different from the AHI? I mean in measuring severity...or how does it apply to the results?

And I think I asked too complicated a question.  I think I need to learn more about Delta sleep and the stages.  Any recommendations on where to go for that?

I have personally heard of much worse cases and I have heard of milder cases.  On another forum a friend woke up 104 times an hour and her symptoms were life-threatening.  My sister had an index of 9 and the doctor told her to lose weight.  My ex was told he stopped breathing for 40 seconds.  (This was 9 years ago and I don't know anything more.)

QUESTION: So why is my sleepiness the only outward symptom if I have severe apnea? Is it because the O2 saturation isn't all that bad (mean of 91% with only 37% under 90%)?   And I'm getting at least 1/2 of the REM sleep I need?  Is it the sleep efficiency (83%) that isn't bad?  

Or am I just kidding myself that it wasn't that bad because I've forgotten what a good quality of life is like??

Quote:
Coffee is not your friend. In the long run it just causes other problems.

Average day I'd have 24 ounces in the morning and maybe 12 ounces of soda at lunch.  Bad days I'd need a boost about 2:30 or 3.  On my driving trips it would mean chain-drinking while driving and sleeping as the passenger. Show days I'd be utterly exhausted afterwards because there isn't usually time for that second dose of caffeine.  

Quote:
it is difficult to have any type of quality relationships if you are exhausted.

A very good point.  



 Applause  Applause  Applause
GOOD NEWS: I slept for 6 hours with the CPAP last night.  Woke up maybe 3 times during those 6 hours.  I did notice being more awake in the afternoon at work today, even though I was reading program documentation!!


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bitoblue wrote:
Quote:
The arousal/awakening index refers to the number of times this (these) occur per hour. The fact is that they do not last any specific time duration (however most scorers choose arousals that last > 3 seconds, as anything under 3 seconds is very difficult for scorers to "mark" consistently.

It is true that this number does indicate that your sleep is severly fragmented, however I figured that id correct you on the timing issue because that isnt accurate.

How is the arousal/awakening index different from the AHI? (Yes I've read this forum through a couple times including definitions.  It's the application that is a little beyond me.)

And I think I asked too complicated a question.  I think I need to learn more about Delta sleep and the stages.  Any recommendations on where to go for that?

I have personally heard of much worse cases and I have heard of milder cases.  On another forum a friend woke up 104 times an hour and her symptoms were life-threatening.  My sister had an index of 9 and the doctor told her to lose weight.  My ex was told he stopped breathing for 40 seconds.  (This was 9 years ago and I don't know anything more.)

QUESTION: So why is my sleepiness the only outward symptom if I have severe apnea? Is it because the O2 saturation isn't all that bad (mean of 91% with only 37% under 90%)?   And I'm getting at least 1/2 of the REM sleep I need?  Is it the sleep efficiency (83%) that isn't bad?  

Or am I just kidding myself that it wasn't that bad because I've forgotten what a good quality of life is like??

Quote:
Coffee is not your friend. In the long run it just causes other problems.

Average day I'd have 24 ounces in the morning and maybe 12 ounces of soda at lunch.  Bad days I'd need a boost about 2:30 or 3.  On my driving trips it would mean chain-drinking while driving and sleeping as the passenger. Show days I'd be utterly exhausted afterwards because there isn't usually time for that second dose of caffeine.  

Quote:
it is difficult to have any type of quality relationships if you are exhausted.

A very good point.  



 =D>  =D>  =D>
GOOD NEWS: I slept for 6 hours with the CPAP last night.  Woke up maybe 3 times during those 6 hours.  I did notice being more awake in the afternoon at work today, even though I was reading program documentation!!


Ill try to touch a bit on your questions:

- How is the arousal index different from the arousal index? Well, the AHI is only a measure of apneas (complete collapse) and hypopneas (partial collapse). The arousal index can involve any factors that cause arousals and awakenings (limb movements, spontaneous arousals, etc.)

- Where to go to learn about delta sleep? Well, its not really all figured out, but you can certainly get the more recent theories on a reputable internet source (id stick away from forums) or you can get some of most recent sleep medicine texts (however they are usually behind the curve due to the time it takes to get them to print).

- Sleepiness may be the only symptom that you are noticing. There may be other issues that your body is suffering through that will eventually improve with less fragmentation and improved oxygensation.

- A mean of 91% oxygenation-wise is not very good considering that a lot of physicians do not want to see patients dip below 90%. 98.x% is the proposed maximum that one can have (due to venous return into the oxygenated supply [from supplying the heart itself]), yet there is a huge difference between a mean of say 97 and 91. On top of that, a third of the night under 90% is something that deserves attention. CPAP can do a wonderful job at improving oxygenation unless maybe an underlying lung disease prohibits said improvement.

- I am not sure that you ahve forgotten what a good nights sleep is, but like many others, you have learned to accept that as normal.


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Post sleep study 
I had my sleep study 3 weeks ago and am now on Resmed, but am not sure what to think about  my study. They said I had 129 episodes an hour and that the oxygen level was 81% and that I never hit Rem sleep...reading what I have in here that scaed me alot....is it as serious as it sounds?


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Thanks for your clarification on this RAM.  There is so much to understand and it is nice that we have others here willing to be helpful.  Bitobue ofen it takes time to get caught up on the rest your body has needed.  There are still days that you might feel tired, but the difference is that it won't be EVERY day.   I have been loseing weight with the hope I might be able to get off of c-pap, but even with weight loss there are no guarantees.  Either way I figure it can only make me healthier in general.  Good luck in your journey.


_________________
REMstarplus, M Series with C-flex and heated humidification
C- Pap setting of 10
ResMed Mirage Quatro full face Mask
Sleep study showed 36 events per hour
Location, Nebraska
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