It just doesn't seem as severe as they are saying.  I read your stories and I am nowhere near where most of you are.

Here are my sleep study results.  Please read and tell me what the normal ranges are so I can tell how far I am out of 'normal'.  Of course they don't use the standard verbiage for me to figure this out myself (e.g.:  "at an index of 35" - Is this the AHI everyone refers to; is "slow wave sleep" the same as level 3/4?).  Also they say things like 'many' which is frustrating.  And nowhere do I see a reference to how many apnea events 'per hour' unless embedded in the 'index' reference.

The sleep doc took one look and went straight to CPAP.  I was hoping for more moderate intervention to begin with like increased allergy control.  However, a huge complicating factor for me is that I have had Type I diabetes for 20 years which greatly increases risk for cardio/vascular issues, my father and one brother both have apnea and both have severe cardio/vascular problems.  It is my understand that sleep apnea also contributes greatly to cardio/vascular risk level which may be why they seem to want to treat this aggressively.  Also I described some recent muscle/joint achy/burny 'attacks'to my neurologist.  His first words were "I'm scheduling a sleep test' (already done through the PCP).  

BMI – 24.3 (weight is not the problem)

Heart rate varies from 60-90 during the course of the night
sinus rhythm (What is this?)
no ectopy (and this?).  
EEG stable throughout.

420 minutes recorded with 344 minutes of sleep
resulting in sleep efficiency of 82%
Sleep onset latency - 37 minutes
REM latency – 99 minutes
There were 3 REM periods at 21% tracing,
and slow wave sleep at 11% of the tracing.  
19 awakenings
96 stage shifts and 19 stage I shifts were noted as a result
with many apneas and hypopneas at an index of 35
Respiratory arousal index of 19
Snore index 38  
Oxygen desaturations of 88%
Periodic limb movement index is 29
movement arousal index is 1.  

Clinical impression:  The patient has markedly disruptive sleep due to OAS and periodic limb movement disorder.  

They want to put me on a dopaminergic agent to control the period limb movement, but it seems so mild if I read the report correctly (movement arousal index is 1)

Thanks Soso much for any help.  I checked out the glossary someone kindly provided but there are no normal ranges to compare against.

Jammies



Last edited by jammies on Thu Aug 14, 2008 11:39 am; edited 1 time in total

Well you're over the severe theshold of 30 AHI, so you are still categorized as having severe sleep apnea.  Mild sleep apneas is an AHI of 5 to 15, moderate is 15 to 30, with 30 or greater being severe sleep apnea.  I can't help on the limb movements.  I'm sure others can help more than I on that and the specifics.


_________________
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CPAP start date: June 4, 2008

Yes, from what I understand, your AHI is the "index of 35" which also equals apnea episdodes/hour.  It looks like your periodic leg movements are not responsable for most of your arousals.  Rather, the arousals were caused by the apnea; 35 is in the "severe" range.  Maybe even though the leg movements are not arousing you, they are contributing to your daytime symptoms of aches & pains.  Hope  this helps.

Thanks guys for responding.  

You guys are right - I will make sure 'an index of 35' is the AHI, but I think it must be.   I think rather than trying to get you guys to give me the normal ranges I need to call the doctor's office and have them give me the detail I need.  An AHI of 35 regardless of how I got there is an AHI of 35.  And with the medical history against me...

I have had multiple bad experiences with doctors prescribing tests and treatments that I found out later were not necessary.

I suppose my next steps are to search the site to understand different types AP  CPAP, APAP etc. and machines and face masks. etc.

Hi Jammies,

You indicated oxygen desaturations of 88%.
I'm not sure if that's an average or the lowest (lowest is also labeled as nadir, I think).  Normal blood oxygen levels are in the upper 90% range.  If then dip below 90% there starts to be some real concern.  Heck, I've heard of oxygen levels dipping to as low as in the 40 percent range..... that person was nearly dead!  Reductions in blood oxygen is usually the result of untreated apnea, from you stopping breathing during sleep.  

It's clear you're in the severe range.  But it can be even worse of a situation for some people than for others.  How long you stop breathing, how long you've had the condition, the effects on your blood oxygen levels, along with other medical conditions that may have been created or worsened by untreated sleep apnea.  And yes, sleep can run in families in that we inherit physical attributes, including in the throat where most apneas occur.


Have you been tested with cpap yet?  

The cpap is a continuous positive airway pressure device.  During the second study (or sometimes it's done the same night as the first part, called a split night study) they test you to determine the best and minimum pressure needed to keep your airways open as you sleep.  The prescribed machine is set at that pressure.  An apap, is an auto cpap.  They still try and determine the one pressure that works, but this auto machine works using a range of pressures, and the pressure self-adjusts to meet your pressure requirements at any one moment as you sleep.  With a straight cpap they might prescribe a pressure of 10, for example.  An auto cpap machine might be set at a range around that, say 8 to 12, and the pressure may change within that range.  Auto cpaps are often used to titrate  people at home, or they are used when it's difficult during the overnight sleep study to determine a precise pressure.

Most people are given a straight cpap.  During the sleep study, they may find you need a bilevel (called a bipap by the manufacturer Respironics).  That uses one prescribed pressure for inhale, and a lower pressure for exhale.  The bilevels work better for some situations.  A bilevel machine can also be gotten that works as an auto, with pressure ranges.

Clear as mud?   lol

Perhaps this link has a better description:

http://www.apneasupport.org/viewtopic.php?t=10164&postdays=0&postorder=asc&start=0



Linda

Linda thanks for input.  I am disappointed in the ways in which the overview of my study were stated.  There are no references to nadir, or lowest or average.  I am only assuming that the index referred to is the AHI.  There does not appear to be a RDI.  They only refer to "Many" apneas and hypopneas. etc. etc.  I think I am going to call the doctor office and request the specific information.  I am a bit 'anal' when it comes to specifics and understanding the whole picture.  

I go back on the 7th or 8th of September to do the CPAP test.

Thanks to you and the others for your response and help and reference.  I will check it out.

Jammies