I have been doing more research (I know, a little knowledge is a dangerous thing!), and I have some more questions.


Arousal: Apnea and Hypopnea: 23 index 4.4

<<Apnea (NREM)  11.53sec  12.16max
Hypopnea (NREM) 14.01sec  18.25max
Apnea (REM)        11.81sec  15.21max
Hypopnea (REM)   14.27sec  18.25max >>

Reading these times, it does not seem so bad -- until I hold my breath for 18 seconds! My poor brain!

<<Sa02@Nadir   NREM    REM
     Obstructive    93.39      0%
      Central         94.51   84.71
      Mixed            0%        0% >>

So, with my 1 obstructive my O2 goes to 93.39 at the lowest, but goes to 84.71 -- but for how long?

<<Sleep time(min): NREM 261.50   REM  52.50
    Obstructive Apnea:  1 NREM        0 REM
    Central Apnea:       1 NREM      12 REM
    Hypopneas:          15 NREM      32 REM
    Apnea Index:  NREM=  .46           REM=13.71
  **A/H Index:    NREM=3.90           REM=50.29 **>>

I was in REM for 52.50 minutes, with 12 Central and 32 Hypopneas, correct? That is 44 'events' -- so is the amount of time I was in REM continuous, or repeatedly interrupted? Is this a lot of Central events? A lot of Hypopneas?

How do I get an index of 23, when there were 44 events during REM and 17 events during NREM? Do hypopneas just not count? Or not count as much? If they don't count, then I only had 14 apneas. How does the index work?

Is it unusual that I only had 1 obstructive apnea, but 13 centrals? I assume the hypopneas are 'immature' obstructive apneas, is that correct? (I assume that because central is about the brain not sending the signal to the body to breathe, so there would not be reduced airflow, but none, correct?) So, I may have had the centrals for a while, but it seems like I am in the process of developing a more significant obstructive apnea? If I only had the 13 central apneas, would I still be considered moderate? I guess part of me wonders is the centrals are somehow worse than obstructive...

Also, everything I have read seems to indicate that there are 'causes' of centrals -- for instance, heart problems (which I again assume cause brain damage, which creates the centrals). My PCP does not think insurance will pay for a cardiologist, since I do not have any symptoms...I think just the fact that centrals are so closely linked with heart problems seems like a good enough reason for me. I have also requested a visit with the neurologist. I think everyone is right that my PCP is not going to be the best person to work with me on this -- I will request a meeting with a doctor who specializes in apnea when I am at the clinic tomorrow.

<<Apparently I have 6 (nonsupine) vs. 9 (supine) apneas+hypopneas in NREM,  44 REM Supine (non NONsupine). >>

Obviously, I need to not ever sleep on my back! How do I make sure I sleep on my side? Are there certain masks that work better when you sleep on your side?

<<Average heartrate: Wake 86   REM  81   NREM  81
Min. heartrate:      Wake 43   REM  60   NREM  36
Max. heartrate:     Wake 187  REM 105  NREM  187 >>

I'm curious why my heart rate is so high during wake and NREM -- if this is caused by the hypopneas/apneas, shouldn't this heart rate show up during REM? Or is it because it is not possible to maintain REM once your breathing is too shallow or stops, so you immediately go into NREM or Wake? Is this range really bad? I do not have hypertension, but my BP has been higher over the past year (I always figured it was due to my weight).

I go between feeling hopeful that getting this treated will make a real difference in my life, frustration that I know so little about it, and being struck by the reality that I have a physical disorder that will be with me for the rest of my life. My first...I mean, I have hypothyroidism and clinical depression, but I guess in my mind they are chemical issues that can be helped with a pill. I don't feel old enough for this, though I am 40. I wish I just had obstructive, so I could be sure it would be relatively easy to resolve (maybe), rather than centrals which seem to be more tricky.

Anyway, any input is appreciated. :)

Thanks!

Kimberly

   

Quote:

[quote="cimmaryn"]I have been doing more research (I know, a little knowledge is a dangerous thing!), and I have some more questions.


Arousal: Apnea and Hypopnea: 23 index 4.4

<<Apnea (NREM)  11.53sec  12.16max
Hypopnea (NREM) 14.01sec  18.25max
Apnea (REM)        11.81sec  15.21max
Hypopnea (REM)   14.27sec  18.25max >>

Reading these times, it does not seem so bad -- until I hold my breath for 18 seconds! My poor brain!

<<Sa02@Nadir   NREM    REM
     Obstructive    93.39      0%
      Central         94.51   84.71
      Mixed            0%        0% >>

So, with my 1 obstructive my O2 goes to 93.39 at the lowest, but goes to 84.71 -- but for how long?

If you get the full data section of your report it will tell you.

Quote:

<<Sleep time(min): NREM 261.50   REM  52.50
    Obstructive Apnea:  1 NREM        0 REM
    Central Apnea:       1 NREM      12 REM
    Hypopneas:          15 NREM      32 REM
    Apnea Index:  NREM=  .46           REM=13.71
  **A/H Index:    NREM=3.90           REM=50.29 **>>

I was in REM for 52.50 minutes, with 12 Central and 32 Hypopneas, correct? That is 44 'events' -- so is the amount of time I was in REM continuous, or repeatedly interrupted? Is this a lot of Central events? A lot of Hypopneas?

Each sleep cycle last for anything from 90 to 120 minutes, cycles arre then repeated on average 4 to 6 times per night Non REM Sleep Stages 1 through 4 and then REM Sleep)...........The amount of time in REM Sleep lengthens with each cycle, with the longest period during the last cycle...........all these cycles constitute your sleep architecture. Again, the data secti8on of your sleep report should show a graph of your sleep cycles and architecture.
Most of your events are during REM Sleep, which is fairly normal.
Centrals representing 25% (I think) of your total events has to be investigated and dealt with.

Quote:

How do I get an index of 23, when there were 44 events during REM and 17 events during NREM? Do hypopneas just not count? Or not count as much? If they don't count, then I only had 14 apneas. How does the index work?

The index is the hourly average of Apnoea plus Hypopnoea events over the time spent asleep.

Quote:

Is it unusual that I only had 1 obstructive apnea, but 13 centrals? I assume the hypopneas are 'immature' obstructive apneas, is that correct? (I assume that because central is about the brain not sending the signal to the body to breathe, so there would not be reduced airflow, but none, correct?) So, I may have had the centrals for a while, but it seems like I am in the process of developing a more significant obstructive apnea? If I only had the 13 central apneas, would I still be considered moderate? I guess part of me wonders is the centrals are somehow worse than obstructive...

Yes. There is a full description of hypopnoeas in the sticky at the top of the page.

I can't figure out your logic........maybe I'm just tired.

Quote:

Also, everything I have read seems to indicate that there are 'causes' of centrals -- for instance, heart problems (which I again assume cause brain damage, which creates the centrals). My PCP does not think insurance will pay for a cardiologist, since I do not have any symptoms...I think just the fact that centrals are so closely linked with heart problems seems like a good enough reason for me. I have also requested a visit with the neurologist. I think everyone is right that my PCP is not going to be the best person to work with me on this -- I will request a meeting with a doctor who specializes in apnea when I am at the clinic tomorrow.

I explained in an earlier post that centrals have nothing to do with your heart.

Quote:

<<Apparently I have 6 (nonsupine) vs. 9 (supine) apneas+hypopneas in NREM,  44 REM Supine (non NONsupine). >>

Obviously, I need to not ever sleep on my back! How do I make sure I sleep on my side? Are there certain masks that work better when you sleep on your side?

Unless you have been diagnosed with positional apnoea (usually mild), this will not make much difference.

Quote:

<<Average heartrate: Wake 86   REM  81   NREM  81
Min. heartrate:      Wake 43   REM  60   NREM  36
Max. heartrate:     Wake 187  REM 105  NREM  187 >>

I'm curious why my heart rate is so high during wake and NREM -- if this is caused by the hypopneas/apneas, shouldn't this heart rate show up during REM? Or is it because it is not possible to maintain REM once your breathing is too shallow or stops, so you immediately go into NREM or Wake? Is this range really bad? I do not have hypertension, but my BP has been higher over the past year (I always figured it was due to my weight).

The increased heart rate should be closely linked to the length of individual events. The longer the event the higher the heart rate. You would need to see the full raw data.

I go between feeling hopeful that getting this treated will make a real difference in my life, frustration that I know so little about it, and being struck by the reality that I have a physical disorder that will be with me for the rest of my life. My first...I mean, I have hypothyroidism and clinical depression, but I guess in my mind they are chemical issues that can be helped with a pill. I don't feel old enough for this, though I am 40. I wish I just had obstructive, so I could be sure it would be relatively easy to resolve (maybe), rather than centrals which seem to be more tricky.

As I explained to you before, the titration study with cpap will show whether or not it will deal with your centrals.

Because of your other conditions it is very important that you deal with a sleep specialist and that you bring a list of medications with you. These issues may have a bearing on the central events.


Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

<<So, with my 1 obstructive my O2 goes to 93.39 at the lowest, but goes to 84.71 -- but for how long?[/quote]


If you get the full data section of your report it will tell you.>>

Ah...that makes sense -- I don't have the FULL report. I will ask for that tomorrow.


<<Each sleep cycle last for anything from 90 to 120 minutes, cycles arre then repeated on average 4 to 6 times per night Non REM Sleep Stages 1 through 4 and then REM Sleep)...........The amount of time in REM Sleep lengthens with each cycle, with the longest period during the last cycle...........all these cycles constitute your sleep architecture. Again, the data secti8on of your sleep report should show a graph of your sleep cycles and architecture.
Most of your events are during REM Sleep, which is fairly normal.
Centrals representing 25% (I think) of your total events has to be investigated and dealt with.>>

I will definitely get answers about this!

<<I can't figure out your logic........maybe I'm just tired.>>

It is much more likely to be me, not you!

<<

Quote:

Also, everything I have read seems to indicate that there are 'causes' of centrals -- for instance, heart problems (which I again assume cause brain damage, which creates the centrals). My PCP does not think insurance will pay for a cardiologist, since I do not have any symptoms...I think just the fact that centrals are so closely linked with heart problems seems like a good enough reason for me. I have also requested a visit with the neurologist. I think everyone is right that my PCP is not going to be the best person to work with me on this -- I will request a meeting with a doctor who specializes in apnea when I am at the clinic tomorrow.

I explained in an earlier post that centrals have nothing to do with your heart. >>

I understand that -- centrals are caused by the brain. But, it is my understanding (I could be wrong) that the problem in the brain is often brought about by something (such as heart problems). Is that right?

<<Obviously, I need to not ever sleep on my back! How do I make sure I sleep on my side? Are there certain masks that work better when you sleep on your side?[/quote]

Unless you have been diagnosed with positional apnoea (usually mild), this will not make much difference.>>

Well, pooh. That is not good to news! I was hoping to have something I can do to help. <sigh>


<<The increased heart rate should be closely linked to the length of individual events. The longer the event the higher the heart rate. You would need to see the full raw data.>>

I will ask about getting the full raw data -- at least to have it when I see the sleep specialist.

<<As I explained to you before, the titration study with cpap will show whether or not it will deal with your centrals.>>

I know, and I am scheduled for the study tomorrow. It's just that the research I have been doing indicates that central SA is not as common, nor as (mostly) straightforward as OSA. I am probably just borrowing trouble, though. I'll know a lot more soon. :)

<<Because of your other conditions it is very important that you deal with a sleep specialist and that you bring a list of medications with you. These issues may have a bearing on the central events.>>

I am working on this one! :)

Thanks, Daniel!

Kimberly