Was this negligence?  I went back to school after study and actually failed most of my courses, resulting in a $20,000 loss.
  Another Dr. decided to treat me, after the damage.
"SLEEP ARCHITECTURE: The patient was studied for a total of 408.0 minutes. The Total Sleep Time was 285.5 minutes. The Sleep Efficiency was 65.5%, which is severely reduced. He spent 43.5 minutes in Stage One (16.8% of Total Sleep Time), 112.0 minutes in Stage Two (43.3% of Total Sleep Time), 20.5 minutes in Stage Three (7.9% of Total Sleep Time), 38.5 minutes in Stage Four (14.9% of Total Sleep Time) and 40.5 minutes in REM Sleep (15.7% of Total Sleep Time). The Latency to Sleep Onset was 17.0 minutes and the Latency to REM Sleep was 178.0 minutes, which is increased.
RESPIRATORY PROFILE: There were 33 Hypopneas, 7 Obstructive Apneas and 33 Central Apneas. The Respiratory Disturbance Index was 16.9 events per hour.
DESATURATION PROFILE: He spent 5.5 minutes below 95% Oxygen Saturation. The minimum Oxygen Saturation was 89% and the Desaturation Index was 20.5.
AROUSAL PROFILE: The Arousal Index was 40.4 events per hour. There were 37 arousals associated with respiratory events and there were 106 spontaneous arousals.
SNORING PROFILE: There was no snoring detected during the study.
PERIODIC LEG MOVEMENT PROFILE: There were no Periodic Leg Movements. There were 11 Leg Movements with a Leg Movement Index of 2.6 events per hour.
CARDIAC PROFILE: The Heart Rate was between 57 and 123 BPM. There was 1 PVC observed.
IMPRESSIONS: The patient is negative for Obstructive Sleep Apnea, with a Respiratory Disturbance Index of 16.9 events per hour. There were only 7 events of Obstructive Apnea. There were 33 events of Central Apnea and 33 events of Hypopneas. There was no snoring noted during the study. There were significant arousals with an Arousal Index of 40.4 events per hour."

After 6 sleep studies, I am waiting for my ASV titration results.  I had UPPP which had improved my AHI to 6.3.   Unfortunately, I was told I had to "DISCUSS" the results with the physician, possibly implying that ASV had failed to lower OSA any further.  I will know by Friday.

Actually, after the UPPP I do feel a lot more energetic.  I'm not sure it's worth it to treat this any further, but I'm extremely dependent on caffeine.  I stopped taking caffeine for 1 month in all its forms and staying awake was extremely difficult, all throughout.  The only problem is that caffeine gives me a tremendous amount of anxiety, and would rather treat my sleepiness in a different way.  I don't and never have smoked, I workout frequently.  I'm sure my respiratory disturbances through sleep DO cause problems with my sleep architecture.    Anyway, I am feeling completely better.  I used to get out of bed in the morning, do a workout, go outside to read, and breath fresh air, only to go back to my room and fall asleep.  That doesn't happen anymore.

joshgrant wrote:

IMPRESSIONS: The patient is negative for Obstructive Sleep Apnea, with a Respiratory Disturbance Index of 16.9 events per hour. There were only 7 events of Obstructive Apnea. There were 33 events of Central Apnea and 33 events of Hypopneas. There was no snoring noted during the study. There were significant arousals with an Arousal Index of 40.4 events per hour."

The report says you're neg for OSA but it seems to me you're Centrals are significant. It's the AHI that they use to determine the severity of your sleep apnea. 1-15 is considered mild. Do you have your AHI score?

You have a lot of hypopneas.  Besides the centrals being significant, so are your hypopneas.  Check out Upper Airway Resistance Syndrome here.  Read the explanation of UARS by sypark on page three of this thread.  I think you should discuss the potential of URAS and most certainly the centrals with your doc.

http://www.apneasupport.org/viewtopic.php?t=19067&postdays=0&postorder=asc&start=0

Vicki


_________________
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Von Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

Ok, just received my vpap adapt sv  (ASV) titration results.  It brought my AHI < 1 !  I felt very productive the day after the study but since I had no call in 2 weeks I was beginning to think that was just a placebo effect.  After 6 sleep studies I can finally bring some closure to being ineffectively treated.

First Dr. completely discounted I had any issue whatsoever.  AHI was 15.5.  So I went to another one.  We tried two cpap titrations, I couldn't sleep at both of them.  The we tried a turbinectomy, I still had issues.  Then a dental device, and for some reason my ahi jumped to 23.  We tried apap but I felt tired.  I had UPPP, tested and my AHI was now 6.3.  I had a bipap titration and I developed central apneas due to positive pressure.  I had an ASV titration, it brough my ahi to 0.0, with only 2 RERAs, and a complete shift in sleep architecture.  I get my ASV shortly.
I called the sleep center for results and they said, the physician has to see if it's worth it for you to use the ASV. I thought that meant the results were subpar but the case is the machine completely normalized my breathing.   Four years , several surgeries and 6 sleep studies to get to this point.

joshgrant wrote:

First Dr. completely discounted I had any issue whatsoever.  AHI was 15.5.  So I went to another one.  We tried two cpap titrations, I couldn't sleep at both of them.  The we tried a turbinectomy, I still had issues.  Then a dental device, and for some reason my ahi jumped to 23.  We tried apap but I felt tired.  I had UPPP, tested and my AHI was now 6.3.  I had a bipap titration and I developed central apneas due to positive pressure.  I had an ASV titration, it brough my ahi to 0.0, with only 2 RERAs, and a complete shift in sleep architecture.  I get my ASV shortly.
I called the sleep center for results and they said, the physician has to see if it's worth it for you to use the ASV. I thought that meant the results were subpar but the case is the machine completely normalized my breathing.   Four years , several surgeries and 6 sleep studies to get to this point.

Wow congratulations.  I hope you finally get some rest!  Good luck to you.  Please let us know how the ASV works out for you!

I've been on ASV therapy for a few months now, which has reduced my RDI to 1.3, all RERAs.  I'm extremely satisfied to report that I am successfully juggling full-time work with full-time college.  I definitely feel like I have much more control over my life than I ever did.  My worst days are like my average days before.
More importantly, I can now deal with fatigue and tiredness separately from sleepiness.  While my objective daytime sleepiness was normal, it was the desire to sleep, constantly, during times I simply shouldn't or couldn't do so, that produced in me so much anxiety, that it fed right back into normal feelings of fatigue.
The first month on therapy was very difficult.  I woke up once almost everyday at 5 am, and then forced myself back to sleep, in which I had several vivid dreams.  It was like being on strong sleep medications that lasted for several hours after waking.  I was also adapting to the mask, and skipped some nights because of irritation. Those side effects have now subsided completely.
Well, as I stated, I am VERY busy, so don't have much time to spend on this.  Just wanted to provide feedback and encouragement, and also a testimony on how much sleep apnea and its treatment has impacted me.

Congratulations, Josh. Your persistance finally paid off for you and you've gotten the relief you need and deserve. That's a good lesson for those who are getting discouraged w/the diagnosing process.


_________________
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 mask, ResScan 3.7, S8 ResLink, Embla oximeter.