Sorry for the double posting.  I posted this under help then read further on that I should be posting here.

I guess I'm just looking for a bit of reassurance. From what I've been told, from what I read, etc....I'm not sure how bad this is. Some symptoms I think I have to have I don't...Please advise.

I'm 39 years old, 5ft 5in, 138 llbs. I've snored for a few years now, but it's increasingly gotten worse. I wake up sometimes and I can't breathe and I'm ALWAYS tired.

I had my first sleep study for weeks ago. The results came back "moderate amounts of partial obstruction and upper airway resistance"

Total sleep time: 420.5
Sleep latency S1 15.6
Sleep Latency S2 16.6
REM Latency 114.1
Sleep Efficiency 91%

Stage 1 Sleep 28.5
Stage 2 Sleep 279.5
Stage 3 Sleep 7.5
Stage 4 Sleep 0.0
Stage REM Sleep 105.0
WASO 25.8
# of Awakenings 6

Obstructive Apneas 0
Central Apneas 0
Mixed Apneas 0
Hyponeas 0
total of Disordered Breathing events 0
Lowest 02 95%
Baseline awake 97.1%
Baseline NREM 96.7%
Baseline REM 97.4%

Baseline Pulse 81
Highest Pulse 115
Lowest Pulse 64

Respitory Disturbance Index
18.6

Hypopnea mean duration 19.7 seconds

Arousal Summary
Respitory 131 Index 18.6

Lm followed by respiratory event 0
LM w/no association 142 index 20.3
Total LM not in PLM Sequence 34 Index 4.9
PLM Sequence 6 0.9
Total LM with Arousal 0

Any input at all would be greatly appreciated. I'm at a loss. Parts don't seem bad at all.
Yet, the Respitory arousals of 131 concern me. And last night I went in to be titrated for a CPAP and this morning the tech told me she had to put me up to 14. Sounded high, but again, what do I know?

Thank you so much, in advance, for any information you can send my way.

Hi Nonni!
Well, with no apneas or hypopneas, or an AHI of 0, you might be a candidate for one of the other therapies like dental devices, surgery, positional therapy or weight loss.  Look at any of those?  You would need follow-up testing after any of those that you tried.  Course, CPAP is pretty much the gold standard, the results from the others are not necessarily as predictable.
The RDI is composed of the AHI plus any other respiratory event that causes an arousal, like a snore or a minor breathing restriction ("flow limitation").  Anything over 5.0 can create a problem, so 18.6 is a fair amount.
14 cmH2O is very high for treatment of UARS, but during titration, many pressures are tried to see the response, so that doesn't necessarily mean that's what you're gonna end up with.
Write back when you get the other results, if the arousals pretty much disappear at your ideal CPAP setting, and your sleepiness is gone, then voila! you found everything you're looking for.
BTW, were there any spontaneous arousals, anything other than respiratory arousals?
sleepydave

Sleepy Dave,

Thank you so much for responding.  Made me feel so much better to find your message this morning.  I double checked the report and there's no spontaneous arousals either.  So, is this NOT sleep apnea?  Or just not bad.  See, that's why I'm so confused.  I read some other people's reports and their saturation is down and they actually have "apneas".  Is a respiratory arousal a very mild/not completely obstructed apnea?

BTW, I forgot to mention in my first post that my blood pressure is high.  They put me on Lisinopril this past week.  Boy, does that make me tired.

Any thoughts you have would be greatly appreciated.  As far as my weight.  I could probably use to lose a couple pounds.  But, I wear a size six.  There's not a whole lot to get rid of.

Thanks again for all your help.  I look forward to hearing from you again.  You can be certain I'll shout as soon as I hear anything.

All of these appointments have been made through my primary care.  Do you think I should ask to see and ENT doctor?

Hugs to you from NH,
Arline

Call me stupid but what is straight UARS?

Thanks,
Arline

Hi Arline!
UARS is the acronym for Upper Airway Resistance Syndrome.  It is characterized by respiratory events that are not severe enough to be classified as apneas or hypopneas still cause arousals.  These respiratory events can be snores or minor narrowing of the airway, but the increased negative intrathoracic pressure trying to draw air through the restricted airway, as well as the arousals, can cause the same havoc as plain old OSA.
Here's an interesting blurb that should perk your ears up:

UARS

So it's still nothing to sneeze at.
Sure, continue to gather more info, including maybe seeing an ENT.  Also keep in mind that surgery of the upper airway can have some significant associated hazards, so don't make that decision lightly.
See what the CPAP results bring, then maybe go from there.
sleepydave

Thanks again, Sleepy Dave.

Now that I look at the report UARS is exactly what it says, though my Primary Care said "Sleep Apnea".

Thank you for the link.  Guess this would explain my newly aquired blood pressure medication as well.  

Now I just have to figure out if my insurance will pay for everything it said it would when I used the diagnosis of "sleep apnea"  hhhmmm

Well, either way, I'm getting the CPAP.  I need to sleep.  Hopefully the next report will clarify everything for me.

Thanks for all your help.

Arline

Finally, I have returned!  I got the results of my titration study today.  Long story short of it all...it was worse than the first time.  Where I had had no total apneas last time, this time I had seven.  (I know, still not bad though)  I had five Hypopneas and two Central Apneas.  (Didn't see that one coming)  My RDI also went from 18.6 to 28.5 with 198 Respiratory Arousals.

This is what the written report said...Follow-up CPAP titration with pressure titration between 11 and 14 cm, H20.  At the pressure of 12 cm H20, including sleep in supine/REM, the AHI was reduced to 0.8hr with 02 saturation of 97.9%,  Heart rate ranged from 47 to 92 beats per minute  Arrythmia was absent.  Periodic limb movements  associated with arousal index was 0.3 hr.  Sleep architecture was noted with increased amount of awakening; and sleep stage shifting to stage 1 and 2 of non-restorative sleep.  The sleep efficiency was a low-normal range at 91%, with near total absence of stage 3 and 4 deep sleep.  Body position remained either supine/left with total body position changes 8.  Sleep architecture affected by the process of the CPAP titration.

Suggestions:  Innomed Nasal Aire/small, 12 cm H20 CPAP, heated humidifacation.

I guess, in the end, it's not all that bad, after reading how bad apneas are for some people.  I almost feel guilty posting.  But, I am curious about a couple things...I'm guess sleep architecture means when you change position.  Is that correct?  Also any ideas what someone can do to actually get to stage 3 and 4 sleep, or is that something that will come once I'm not having these partial apneas all night long.

thank you so much for your time.

Hugs from NH,
Arline

Hi Nonni:

Wow, that's a ton of CPAP for someone with UARS.  And on top of that, as you mention, the overall RDI took a beating, at least at first glance.

Get a hold of that sleep architecture graph and post it.  Also the one on limb movements.  And there is a table with all your attempted CPAP pressures and the resulting RDI from each as well as the time and body position spent on.  RDI 0.8 on 12 cmH2O would be great, but like to see it all in context.

Sleep architecture is the analysis of the sleep stages that you pass through during the night.  Delta sleep decreases as a function of age or can be reduced if your sleep continuity is continually being fragmented.

But I guess the long and short of it is, if your sleepiness disappears with this CPAP setting, all is right in the world.  In the meanwhile, we can certainly chat about the results.

sleepydave

Sleepy Dave,

Am I able to cut and paste in this forum to add the graph or should I email it to you somehow. Thank you so much for taking a look at it.  I'm really confused by all of this, to say the least.  Sadly, though I know my doctor has treated me very well for most things I've presented to her with, this is something she doesn't see every day.  I'm hoping the therapist who comes to the house this afternoon might know a thing or two.  When I get home from work I'll post the summary graph and the report itself if I can.  Have a great day.

Hugs,
Arline

Me again, Sleepy Dave

When the Resp. Therapist came to the house today he was very helpful.  For one thing, he explained a page was missing out of my report.  He had a complete one back at the office and said he'd send me a copy.  He told me not to worry so much about my setting.  He said he's seen people with absolutely horrible numbers at a setting of eight.  Each person is different and irregardless of  severity, everyone's number is different.  (Must be like that bed they talk about !)

He gave me the S8 Elite by ResMed, with the HumidAire3i.  My mask is a Ultra MIrage II Nasal Mask.  I actually like it better than the god awful thing they forced up my nostrils at the hospital.

I put it on this evening to sit and watch the news.  It was a bit overwhelming and claustraphobic when I tried it on with him there, so I thought I should sit down and relax and give it a shot.  Didn't seem to bad.

I'll let you know tomorrow if I sleep.  He told Bob to make sure he checks to see if I'm still snoring.

Now all I have to do is convince the cat not to play with the hose all night and we'll be good.

Sweet dreams!

Arline