Sleep study results:

328 minutes of sleep
372 Arousals
AHI 59
Obstructive Sleep Apneas/hr 28
Central Sleep Apneas/hr 31
Oxygen Sat 83%

History:

I am 38 yrs old, 5' 11" 210 pds/  Quit smoking two years ago (after nearly 20 years), two years ago I weighed 165 pds and had been skinny all of my life until I quit smoking.  I still have my tonsils which are perpetually inflamed and have been covered in polyps as long as I can remember (15 years old I remember a Dr commenting on it).  Been trying CPAP for two months now with -0- success - fialed with the mirage II nose pillow and failing worse with the full face,

I have been extremely depressed, full of anxiety and mostly withdrawn and miserable most of my life.  Taken several antidepressants w/o improvement, but anti-anxiety drugs do calm me somewhat.  I have always been sleepy and unmotivated since my childhood.  Been taking naps since childhood, always been one to fall asleep in classrooms, and take naps when getting home from school.  I have been suffering from bruxism for at least 20 years, been wearing a nightguard for nearly 10 years (I now need gold inlays).  

I dont think there has ever been a time where I felt energenic except when high on caffiene or experiencing an adrenaline rush (both of which can be somewhat out of control).  I even remember doing cocaine as a teen and feeling nothing while friends were bouncing off the walls!  I am sooo very moody, have bad temper tantrums, sometimes agressive and sometimes completely shy and withdrawn.  I have never had much motivation to soicalize/have friends/date, though somehow got married 9 years ago during a period when I was taking Wellbutrin and Androstenodine.  I was once called soul-less by a girl I had dated.  IT HAS ALWAYS FELT LIKE MY WHOLE LIFE DAY TO DAY HAS BEEN A DREAM - and not a very good one.  It seems always everyday I wake up and think - what the f happened yesterday - as if I had been drunk!  Its like I know where I am, but I am not sure how I got here.  Nothing has much meaning to me - its like I am the living dead.

How bad is my sleep study compared to others and has anyone had such symptoms - would blaming my lifeless lifetime on sleep apnea be a case of giving sleep apnea way too much credit?

dave69 wrote:

Been trying CPAP for two months now with -0- success - fialed with the mirage II nose pillow and failing worse with the full face,

Hi Dave,

People who have sleep disorders experience a wide range of symptoms. Sleep disruption/deprivation is known to cause negative effects physically, mentally, and emotionally. The condition in your case is severe as indicated by AHI of 59. So it's very possible that the quality of your life has been negatively affected by this medical condition.

But your post brings up some other questions first:

Is this data correct: Central Sleep Apneas/hr 31
If so, with what type of sleep apnea were you diagnosed? Central Sleep Apnea?

These questions are important because the type of sleep apnea condition determines the type of PAP device needed for treatment.  There are various types of PAP treatment devices such as CPAP, auto-PAP, bi-PAP, etc. CPAP is primarily intended to treat people who have Obstructive type of sleep apnea. Patients who experience central apneas may not do well on CPAP. Instead there are newer more specialized devices such as bi-PAP or ASV-PAP that may better treat central apneas.

What type of physician are you seeing? A certified sleep specialist?

Regards,
Guest MJ



Last edited by Guest MJ on Thu Feb 07, 2008 4:27 pm; edited 1 time in total

dave69 wrote:

How do I rank?

I would say your up there on the scale.  An AHI over 30 is considered "severe".  You were having events every minute, all night long.  

I suspect you will see a BIG difference once you get comfortable with xPAP. You say you are "failing".  What exactly is or isn't happening?

If your tonsils are perpetually inflamed and have polyps, you may want to consider getting your tonsils removed.  Do you also get recurrent strep throat?

As far as AHI, I  was at work and doing from memory, but as I loook at my sleep study I wasnt far off...

OSA 38
CSA 21

Doc said I have OSA and the CSA is in response to the OSA.

I am seeing a well published expert sleep pulminologist (not that he's been any help so far).

I was always good for 3 or 4 streps per year as a child and then 2-3 as an adolescent.  Once I started smoking I probably averaged about between 4-6 per year.  I went through about three rough periods in my 20's where I would get strep infection after strep infection - probably 15 over one two year period.  I desperately pursued a tonsilectomy during my 20's but was disuaded by several different ENTs.  I have only had one strep since I quit smoking two years ago (knock on wood).  Also....now everytime I feel a sore throat coming on I bombard myself with cold-ease - perhaps thats the true saving grace?  Sleep Doc thinks removing tonsils at this point would not do any good at all.  

I was first given the Mirage II nose pillows and used it for 6 weeks.  I felt no better, perhaps a touch worse.  I was waking up frequently breathing from my mouuth.  Doc told me (upon reading data card) I got -0- out of it and time to try a full face mask.  He fears my deviated septum prevents me from being a successful nose breather.

Most I have ever had the full face mask on was two hours and awoke with a panic attack and bad headache.  I have had a cough and cold for over three weeks and havent tried to wear it at all over this time.  I am starting to feel even more depressed and hopeless.  $hit it must be nice to feel good!


I am most curious to read of others' sleep results and symptoms.  I try to do searches but I usually come away not finding what I am looking for, therefore I wish for you to share your personal data and symptoms.

My psychiatrist told me that due to the pressence of CSA, If my condition goes untreated I will be lucky to live another 10 years.   I have a 4 year old daughter who I wish to watch grow up - not very encouraging.  Sick thing is I really cant say I have appreciated or even feel like I experienced the first four years - its all just a blur.

thanks for thoughts and experiences.

dave69 wrote:

[AHI data]OSA 38
CSA 21

Doc said I have OSA and the CSA is in response to the OSA.
My psychiatrist told me that due to the pressence of CSA
Most I have ever had the full face mask on was two hours and awoke with a panic attack and bad headache.

Hi Dave,

If the AHI of central apneas is 21, then that indicates that this is not a simple case of obstructive. I have not seen any reports that CSA is in response to OSA. The panic attack/headache after two hours on CPAP may be an indication that CPAP is not the best treatment for your condition. I suggest that you ask the doc whether or not the condition qualifies for a titration study on a PAP device that is FDA approved to treat central apnea. If it does not qualify, then please ask for an explanation. Also, does your sleep doc have any experience treating any patients with the new ASV technology? How many patients is he treating with it?

Following is a link article about treatment of central apnea with new ASV PAP technology:
New Sleep Apnea Technology Helps Patients Rest Easier
Link: http://healthnews.uc.edu/publications/findings/?/5282/5338/

ResMed VPAP Adapt SV™ is an example of a device that is approved to treat central apneas  
http://www.resmed.com/en-us/products/flow_generators/vpap_adapt_sv/vpap-adapt-sv.html?menu=products

If you want to see how well your condition was treated by CPAP, the info can be found in the sleep study report. Examples of the titration study data are in the following two threads:
http://www.apneasupport.org/about14823.html
http://www.apneasupport.org/about14734.html towards the bottom of the thread

If you look at your titration data, what was your AHI around the optimal pressure (the pressure that you are being treated)? Please note that AHI < 5 is considered to be normal for adults. How many central apneas were occuring during the titration and especially around the optimal pressure?

Regards,
Guest MJ

dave69 wrote:

  He fears my deviated septum prevents me from being a successful nose breather.

Hi Dave,

I am not knowledgeable about the tonsils / strep throat / situation. I do know that sore throat issues are associated with sleep apnea, and can be affected by the following:

Nasal drip due to deviated septum can aggravate the throat. People also report in posts that deviated septum can make it difficult to use PAP. The surgery to repair a deviated septum is the one surgery that seems to consistently get reports of positive results. Have you seen the thread:
Deviated Septum Surgery Experiences
http://www.apneasupport.org/about9963.html

Congestion / runny nose can be associated with CPAP, and increasing the humidity often helps. The first suggestion would be to try experimenting with increasing the humidity settings on the PAP humidifier.

GERD/Acid reflux is common in patients with sleep apnea, and can cause throat irritation. These should be treated separately as needed.

Switching to a full-face mask is good advice for people who have obstructive apnea. I do not know if it is good advice for someone with central apnea. Levels of carbon dioxide are believed to play a role in central apneas, and changing masks can change the CO2 balance. My suggestion for people who experience central apneas is to get a sleep specialist who has experience treating central apnea, and that woud include knowledge and experience with ASV-PAP.

Please keep posting with updates.

Regards,
Guest MJ