My husbands sleep study from Dec. 2005, hope this makes sense to someone, because he has seen no real improvement in 8 months he has been on CPAP

42 yr old male
72 in tall
325 lbs


total 414 minutes
total sleep time 264 minutes
sleep efficiency reduced to 64%
sleep latency prolongs at 32 minutes and latency to persistent sleep 78 minutes.

370 arousals for index of 84.1

sleep stage
awake 30.8%
stage 1 7.2%
stage 2 52%
slow wave sleep 10%
rem 0%

the AHI was worse in the supine position compared to teh lateral position 141.8 versus 45.1

minimum  oxygen saturation was 83% during a central apnea

repiratory even summary

35 apneas for a index of 8.0 a total of 181 hypopneas for an index of 41.1.  103 respiratory event related arousals or a RERA index of 23.4.  overall RDI 72.5

all of the respiratory events resulted in arousal.  there were several  arousals each out not accouted for by respiratory events.

prior to CPAP the overall AHI ws 57.0. in non-rem sleep in the non-supline position, there were 11 central apneas, 2 obstructive apneas and 116 obstructive hypopneas for a AHI of 47.5.  in non-rem sleep in the supine postition theres were 2 central apneas, 3 obstructive apneas and 16 obstructive hypopneas for a AHI of 126.7.

following the application of CPAP in non-rem sleep  in the non supine position there were 12 central apneas, and 49 obstructive hypopneas for an AHI of 28.3.  in non-rem sleep in the supine position there were 5 central apneas.

positive pressure titration.  max pressure of 10 there 34 minutes of sleep with moderate sleep efficiency and the AHI was 65.3, pressure level of 8 51 minutes of sleep with AHI 7.1

no rem sleep was achived at any pressure level

there were 55 periodic limb movements of sleep, 22 of whick resulted in arousal, the periodic limb movement  index was 12.5 and periodic limb movement arousal index was  5.0


thanks in advance
theresa

Hi Theresa,

I am by no means an authority on sleep studies, they confuse me too.

But I've also read some of your other posts.  You mentioned the possible mouth breathing and use of a chin strap, and that you would be looking into another mask.  Any luck?  If there is significant leaking, from mouth breathing or the mask, then the machine cannot control the apneas sufficiently.

I too am a little confused by the pressure numbers of this sleep study (again, I am easily confused), but I do question why a bipap and why was the pressure reduced to a 9.  Is it still on 9?  I see from the study that a near-9 pressure reduced apneas to an AHI of 7.1.  Perhaps that's why they settled on 9.  But keep in mind, that will not correct it if the mouth breathing issue is not handled.  His apneas were definitely in the severe range.  But severity in terms of apneas per hour does not equate to pressure requirements.  

In his initial sleep study he never reached deep sleep, and from the sounds of it, he didn't reach that during the titration (with cpap) study.  Did your husband use a nose-only mask during the sleep study?  Did they try a full face mask (covers nose and mouth) on him?  If there was mouth breathing with a nose-only mask during this testing, I wonder what affect that has on the results.  

I have a hunch, the mouth breathing and mask is the key.  Once the mask is working right, it will be easier to judge if the cpap machine is calibrated to a proper pressure, in my opinion.    I equate mouth breathing issues to that of a leaky bucket -- the bucket can't possibly hold all the water if there's a  hole in the bottom.
 


Linda