I had no idea just how severe my problem is ...

Sleep Study 1 - No CPAP

423.3 minutes, total sleep time of 392.5.  Sleep efficiency 93.6%
Sleep latency 17.5.  Latency to REM 13.0 minutes.  33.8% Stage 1, 42.3% Stage 2, 6.9% Stage 3, Stage 4, 17.1% REM

523 episodes of apnea/hypopnea - respiratory index of 79.9 events/hour.
Mean length of apnea/hypopnea 32.5 seconds, longest hypopnea 44.6, longest apnea 77.3 seconds.
30 episodes of hypopnea, 366 episodes of mixed apnea, 31 of central, and 96 of obstructive.

Resp disturbance index 79.9 using UARS.  During nonREM 83.7 events/hour.  During REM, 61.8 events.
Index in supine position, 79.9, sleeping 392.5 in supine.

52.8% with O2 sat > 90%.  37.9% < 89%.  Lowest stat 67%.

Arousals 412.  63/hour.  Resp arousal index, 61.3/hour.  PLM noted

Snoring 9

Conculsion:  Evidence of OSA and upper airway resistance.  Evidence of hypoxia.

Recommend:  Evaluate for benefit of cpap.

Study 2 - with CPAP, full face mask

406.4 minutes, total sleep time of 359 minutes.  Sleep efficiency of 88.8%.
Sleep latency 17.0.  Latency to REM 80.5 minutes.
17.1% state 1, 40.4% stage 2, 20.9% stage 3, stage 4 and 21.6 rem.

125 episodes of apnea/hypopnea for a resp index of 20.9 events/hour.
mean length of apnea/hypopnea 25 seconds and the longest hypopnea was 101.3 seconds, the longest apnea was 79.3 seconds. spleeing
50 episodes of hypopnea, 10 episodes of mixed, 10 central, 55 obstructive.

Resp disturbance index 21.4 events, during non rem 26.0, and REM 4.6.
Resp disturbance in supine was 30.6 events/hour, slept 235 in supine.  RDI while on sleeping both sides was 2.4 events and slept 124 minutes.

99.8 percent of sleep time with O2 sat >90%.

Conclusion:

Improvement of respirator events and hypoxia with pap and best improvement noted at 12 cm, decreasing events to 2.7 events/hour.

Recomendation:

Treat with CPAP 12 cm utilizing Remstart Pro with ResMed QUattro Medium or best fit mask, headgear, chinstrap and heated humidifier.

F/U CPAP on 5/28.

Any thoughts, comments, things I need to discuss with Doctor, etc?

Hi there Bryonbnm,

Were both sleep studies done in one night or two?  I'm guessing in one night (split night study).

Yep, severe sleep apnea.  In sleep study No. 1, you sure had severe sleep apnea.  Severe is categorized as 30 or more apneas/hypopneas (AHI or RDI) per hour, and yours was nearly 80.  In this first study it looks like you slept entirely on your back, so there's no comparison of the severity it would have been sleeping on your side.  But apparently you slept on your side during some of the time during the titration (second study) and in that case nearly all of your apneas were on your back.  Now, I have trouble with understanding the apnea numbers during the titration because what they mean depends on the range of pressures used on you.  In terms of severity of how you are without sleep apnea, the important numbers are those from the first.

And yikes, on average you stopped breathing 32 seconds, and once you stopped breathing 77 seconds!!  You stop breathing a little over once an hour.  So if you stop breathing for about 30 seconds or more.... you're hardly breathing at all!  

The good news is that cpap sure helped you.  But you must be a mouth breather, that's why they recommended a full face mask or the use of a chin strap with a regular nasal mask.  I'm guessing they tried a full face mask on you (covers nose and mouth).  How was that for you?  

And are you a side sleeper?  Until you get setup with cpap, try not sleeping on your back if you can help it.

But I would say the important thing is to get setup with cpap ASAP.  Has anyone explained the process yet?  Where you get your cpap sometimes depends on the type of insurance you have.  There may be several medical equipment providers near you that can set you up with cpap.   Let us know how things go.


Linda


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There were two sleep studies performed a week apart - no way I could sleep 14 hours ..

I only recieved the Physician's summary report so don't yet know all of those details re:  pressures at different positions, etc.  I have requested the detailed report.

In any event, I requested the full face mask from the beginning because I'm a mouth breather even during the day.  I had no problems with it.

I'm usually a back sleeper and have been trying to sleep on sides/stomach while I'm waiting for the machine.

I was told that my Rx was sent to a DME vendor and told to wait about a week.  I'm going to call the Physician's office again.

bryonbnm wrote:

I was told that my Rx was sent to a DME vendor and told to wait about a week.  I'm going to call the Physician's office again.

You need to circumvent this quickly unless you want a bare-bones basic machine.  They are going to give you the machine they make the most profit on...not the best bang for YOUR buck.

Bryonbnm,

Find out which DME vender they sent your Rx to.   There may be several cpap equipment providers in your area.  If you want to shop around, call them and ask if they accept your insurance.  And if you find out which DME they sent it to, call the DME directly and let them know you want a setup appointment soon...... squeaky wheel sometimes works.  If you do shop around and find you  have choices with your insurance, then ask questions.  Some (very few) DMEs will actually come to  your home, which can be good to have it set up for you.  If you talk to the doc again, ask what is written on the Rx, what they asked for.  Did it specify a type of machine and mask and did it include heated humidifier (they usually do nowadays).  


Linda