My doctor is out of town, but her office called to tell me that I tested positive for sleep apnea.  I'm going ahead with scheduling a second night at the sleep center, for the CPAP trials.  I did pick up my results - I'd appreciate it if anyone could help me interpret them, so I can figure out just how bad a case of this I have.  It looks bad to me - 253 apnea episodes during 251 minutes of sleep!

Recording time: 431 min
Total Sleep Time: 251 min
Latency to sleep: 19 min
REM Latency: 352.5 min
# of stage shifts: 199
% of sleep efficiency: 58.5%

Wake Time: 159.5
Stage 1 sleep: 73 min (29% of test)
Stage 2 sleep: 156.5 min (62.2% of test)
Stage 3/4 sleep: 13 min (5.2% of test)
Stage REM sleep: 9 min (3.6% of test)

Respiratory Analysis:
Number of apneic episodes: 253
Total sleep time (minutes):  251.5
Apnea/hypopnea index (AHI):  61.1
NREM AHI: 60.1
REM AHI: 26.7

Baseline % SaO2: 94
Min % SaO2: 87

Obstructive apneas:
    Prone: 0
    Supine: 59
    Left: 88
    Right: 106

Mixed Apneas:
    Prone: 0
    Supine: 43
    Left: 96
    Right: 111

Central Apneas: (events/hour):
    Prone: 0
    Supine: 81.4
    Left: 54.7
    Right: 57.0

Hypopneas (total):
   NREM: 241
   REM  : 4

Hypopneas w/4% desats:
   NREM: 119
   REM  : 4

Snoring: Very loud, frequent
Arousals: Frequent

Interpretation: This baseline polysomnogram shows obstructive sleep apnea primarily in the form of hypopneas and associated with mild hypoxemia.  The degree of obstructive sleep apnea may be underestimated by the lack of supine-REM.


_________________
--Frank (FJC)

Hi Frank!
Here's a severity summary:
 

Quote:

Mild:  An apnea-hypopnea index from 5 to 14.  An oxygen saturation of at least 86%.  Unwanted sleepiness or involuntary sleep episodes occur during activities that require little attention.  Examples include sleepiness that is likely to occur while watching television, reading, or traveling as a passenger.  Symptoms produce only minor impairment of social or occupational function.
Moderate:  An index from 15 to 30.  An oxygen saturation of 80% to 85%.  Unwanted sleepiness or involuntary sleep
episodes occur during activities that require some attention.  Examples include uncontrollable sleepiness that is likely to occur while attending activities such as concerts, meetings or presentations.  Symptoms produce moderate impairment of social or occupational function.
Severe:  An index greater than 30.  An oxygen saturation of 79% or less.  Unwanted sleepiness or involuntary sleep episodes occur during activities that require more active attention.  Examples include uncontrollable sleepiness while eating, during conversation, walking, or driving.  Symptoms produce marked impairment in social or occupational function.

AHI and EDS references from:
Flemons WW. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 1999;22(5):667-89.

BTW, none of the respiratory numbers seem to add up correctly.  You want to double check those?  It looks like you have a thousand events, including central, mixed and obstructive apneas.
The night was a wreck, but if that's not how you normally sleep, then we'll leave that for now.
sleepydave

They are confusing, that's why I'm posting for help. :)

I did some checking, and it seems like if I add up the number of Obstructive Apneas (0+59+88+106), it equals 253 - which is what the results also list as the total number of apneic events.

If I add up the Mixed Apneas, it's 251.  I'm thinking that whatever Mixed Apneas are, they are a subset of Obstructive Apneas.

Central Apneas I'm really clueless on, but those are reported as calculated events per hour, not total events.  For example, I wasn't even in a supine position for a full hour, so I think it's extrapolated out to be 81.4 events.


_________________
--Frank (FJC)

Hi Frank!
Hypopneas, obstructive apneas, mixed apneas and central apneas are all separate entities.  Therefore you have about 1000 respiratory events there (the central index times your 4 hours of sleep yields another 250 events).  Also your sleep AHI cannot be higher than BOTH your REM AHI and NREM AHI, only one of the two.  I'd bring the report back and ask them to recalculate.  There's a huge difference if you have 250 hypopneas or 250 central apneas.
sleepydave

Thanks, I'll ask my doctor about this and bring up your concerns about how the numbers aren't adding up.

Sunday night I had my CPAP titration study...ugh what a terrible night that was.  I tolerated the machine pretty well (better than I expected), but seemed to have more issue with the probes than the first night (seemed like no matter how I positioned myself, hair was being pulled).  I did sleep some, though, and actually remembered a short dream, so something must have worked.

I'm waiting on those results now.  What can I expect?  Will there be similar information as the first report, PLUS some details of what happened at what pressures?

Thanks!


_________________
--Frank (FJC)

Hi Frank!

Quote:

Will there be similar information as the first report, PLUS some details of what happened at what pressures?

Exactomundo.

sleepydave



Last edited by sleepydave on Thu Oct 06, 2005 7:49 am; edited 1 time in total

AHA!  I studied these results some more, and I think I've figured out why the numbers didn't add up right.  There's a critical section of the results that are somewhat jumbled, where the columns don't line up properly.  I think what I mistook for ONE table was actually TWO separate tables!  They should look like this:

NUMBER OF EVENTS:
                                          NREM     REM
Obstructive Apneas                 0          0
Mixed Apneas                         0          0
Central Apneas                       2          0
Hypopneas (total)                  241        4
Hypopneas (with 4% desat)    119        4
Wake apneas                          6          -

And this second table:
                           Position   Prone   Supine   Left    Right
Number of Events                  0          59        88      106
TST/pos. (min)                      0          43        96      111
Number of Events/hour          0          81.4      54.7    57.0


These seem to add up better - 2 central apneas + 241 NREM hypopneas + 4 REM hypopneas + 6 wake apneas = 253, which is what is listed as the total number of apneic episodes.

SOOOOO - with this new interpretation....I don't have OSA?  Instead I have a ridiculous number of hypopneas?  What exactly are hypopneas (and central apneas, and mixed for that matter?)  I understand what obstructive ones are....  

Thanks so much for your help.  I'm still waiting on my CPAP titration night results.  What the heck did we do before the internet?  :)


_________________
--Frank (FJC)

Hi Frank!
And I also see how the sleep AHI got higher than the REM or NREM AHI, they added in "wake apneas".  Not really such a thing in sleep medicine (Get it?  Sleep medicine?)
Anyway, hypopneas count the same as apneas, it's an AHI, and the "A" can be 0.  So that makes you severe.  Off to CPAP!
sleepydave