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My Sleep Study Results - Very Confused
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Post My Sleep Study Results - Very Confused 
I received my sleep study results today and I have been diagnosed with Severe Obstructive Sleep Apnea Syndrome with Hypersomnia. I had a split study. Below are the results and I am not sure what to make of them. As you will see, I have not had a chance to talk to the doctor.

First Part (w/o CPAP)
Total Sleep Time: 168 minutes in bed; 126 sleep time
Sleep Efficency: 75%
REM: 0 minutes
Stage 1: 14.5 minutes; 11.5% TST
Stage 2: 108 minutes; 85.7% TST
Stage 3/4: 3.5 minutes; 2.8% TST
Arousal Index: 90.5/hour of Sleep
Respiratory Arousal Index: 90.5
Spontaneous arousal index: 0.0
PLM arousal index: 0.0

Respiratory Events: 193 with an RDI of 91.9/hour
REM RDI Index: 0.0
Obstructive Apneas: 121
hypopneas: 72

Oxygen Saturation: 85%
Min Oxygen Level: 72%


Second Part (w/ CPAP)
Total Sleep Time: 245 minutes in bed; 206 sleep time
Sleep Efficency: 84%
REM: 57.5 minutes; 27.8% TST
Stage 1: 11 minutes; 5.3% TST
Stage 2: 65 minutes; 31.5% TST
Stage 3/4: 73 minutes; 35.4% TST
Arousal Index: 10.5/hour of Sleep

Respiratory Events: 40 with an RDI of 11.6/hour
REM RDI Index: 2.1
Obstructive Apneas: 1
Central Apneas: 2
Hypopneas: 37

Oxygen Saturation: 92%
Min Oxygen Level: 82%

CPAP Pressure increased to 14 cmH2O

Recommendation:
Begin CPAP as above
Weight Loss, although not likely to be curative

Here are my questions
What is Hypersomnia?
How severe is my OSA?
Is it a bad thing that I had a central apnea with the CPAP?
What are Hypopneas?
What is TST with the sleep stages?
Whay would the doctor mention that weight loss would not cure my sleep apnea? Does he mean weight loss and surgery will cure it?
Does it look like I had a successful second part of the sleep study?


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1] Taber's medical dictionary defines hypersomnia as sleeping for excessive longths of time.

2] Your RDI (respiratory disturbance index, i.e, number of breathing events per hour of sleep) was 91.9 meaning that your sleep was disturbed by a distrupted breathing event more than once a minute!

3] Not really. As they titrate for the pressure you need they go higher than what you need, which can trigger a central apnea, before they back the pressure down to the point it stops or greatly reduces your apneas w/o triggering a central apnea. In addition it is not at all unusual for anyone to have a few occasional central apneas.

4] Hypopneas are apnea "wannabees". Your breathing was only partially obstructed.

5] TST = total sleep time

6] As a gentle hint that you could benefit from losing some weight but that weight loss itself is almost never a cure for OSA. What weight loss CAN do, but no guarantees, is reduce your pressure needs.

7] Its not as easy to get a good titration during a split night study as it is if they were able to get a full night's titration. The longer you sleep the more sleep cycles you go thru and the easier it is to accurately titrate the pressure you need to keep your airways open. You had DRASTIC IMPROVEMENT w/your titration portion of the night which is a good sign.


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CrohnieToo wrote:

6] As a gentle hint that you could benefit from losing some weight but that weight loss itself is almost never a cure for OSA. What weight loss CAN do, but no guarantees, is reduce your pressure needs.


Is there actually a cure for Obstructive Sleep Apnea? I am overweight and need to lose 70 lbs to get to my recommended weight. After seeing the ENT, I have a deviated septum, enlarged tonnsils and a very long uvula. I know you have warned me before about having the surgery, but is it a possibility that surgery and weight loss could cure my OSA? I am completely open to CPAP therapy, but I have always looked at it as a temporary fix until I could lose some weight. Should I begin to look at my CPAP therapy as a lifestyle change that will be with me forever?

Also, I notice a lot of people mentioned a AHI number, but I didn't see that on my report. Is there one or two numbers that I should pay attention to in order to know if my therapy is working or that I am getting better?


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RDI (respiratory disturbance index) is similar to but not quite the same as the AHI (apnea/hypopnea index). Both indicate the number of "events" per hour (index) but the RDI includes hypopnea "wannabees", reduced breathing but not enough to qualify as a full fleged hypopnea, most likely not lasting long enough to meet the hypopnea criteria, but enough to disturb your sleep.

Deviate septum and tonsil surgery can both reduce you AHI and even pressure needs as can weight loss but I would NOT count on either or the combination to "cure" sleep apnea. Personally, I would NOT even for one second consider surgery for the long uvula. Its too much to go thru for a minor reduction in pressure needs, slight chance of TEMPORARILY avoiding the need for CPAP therapy and enhanced risk of more severe problems than prior to the surgery IN MY PERSONAL OPINION.

Yup, I'd consider CPAP therapy as a lifetime lifestyle change. And it "ain't" all that bad given the alternatives!!!! If you lose the weight, or even have the tonsilectomy and septoplasty, and a miracle occurs and you avoid needing CPAP therapy, great. But DO NOT count on it and you won't be disappointed.

AND BEFORE I would agree to the septoplasty and/or tonsilectomy I would be SURE to get an INDEPENDENT SECOND opinion.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

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I have Primary CNS Hypersomnia...Yep, sleeping excessive amounts of time...normally more than 10 hours per night.

Quote:
Recommendation:
Begin CPAP as above
Weight Loss, although not likely to be curative



A good sleep Dr would tell you if surgery would correct you...it was not noted here so I would also discuss it with him also...not just the ENT.  They also usually always suggest weight loss if the BMI is high...and add the disclaimer that it is not going to cure you.

My sleep Dr (pulmonary)explained to me when surgery works and does not work.  He did say that I should someday have my deviated septum taken care of...will help my breathing but, if I am not getting infections and blockage from it to not do it at this time.  It is not going to cure my apnea in my case and he does not want me...(neither do I) to be off the xPAP during the healing process.


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