Hi everyone,

Finally the doctor's office mailed me my results.  All the numbers are confusing to me and I was wondering if somone can tell me which numbers are the most important.  

It would take me forever to type the while thing out but this is most of it:

History: Poor Sleep Continuity. BMI: 26.5kg/m2

Interpretation: (Shorted-down):  
1) Total sleep times was suboptimal for purpose of study.  Sleep Latency was prolonged.  REM latency was prolonged.  Sleep staging revealed a normal percentage of slow-wave sleep and an absense of REM sleep when compared to normal sleep stage distribution.  The patient's sleep efficiency was poor.  
2) No evidence of periodic limb movements.
3) Snoring noted but mild.
4) Epileptiform activity was not noted.  Bruxism and parasomnias not noted.
5) Airflow and respiratory effort channels demonstrated evidence of mild obstructive hypopneas more than apneas.  The apna index was 0 disordered breathing events hr and the apnea hypopnea was 7.3 DBEs/hr.  Average DBEs was 22 seconds, longest was 63.5 seconds.  Disordered breathing was more severe during periods of REM sleep.  The study revealed normal baseline wake oxygen saturations of 96%.  Mild desaturations were recorded with DBES to a nadir 93%.
6) EKG monitoring revealed normal sinus to a nadir of 93%.

Diagnosis:
OSA, mild associated with mild oxyhemoglobin desaturations. Disordered breathing was worse in supine position and more severe in Stage REM sleep.

Recommendations:
1) Snoreball
2) Follow up with NPSG with titration and a clinical trial of nasal CPAP.
3) Follow up with doctor.


Then I have:

Sleep Staging Data
Recording Times

Durations:
Recording Time: 483.0
TIB 426.5
TST: 254.0
Wk before sleep: 81.5
Wk during sleep: 81.0
Wk after sleep: 7.0
REM Time: 7.5
NREM: 247.0
SWS: 47.5
Movement: 2.5

Latencies: (TST%)
Sleep Onset 84.5 mins
S1 6.9
S2 70.5
S3 7.1
S4 11.6
REM 3.0

Total Sleep Efficiency: 59.6%

Respiratory Events Summary:Whole lot of numbers but events are:
Number: 31
Max: 63.5
Mean: 22.0
Total time: 11.3

Respiratory Disturbance Index:
REM/h: 40.0
NREM: 6.3
TST: 7.3

Body Position Data:
Mostly on back

Oximetry Data:All #'s are 95 and 96

Snoring:
0

Heart Rate Data:
Mean: Awake 88.5, REM 61.2, Non-REM 68.2

Arousal Data:
Total # of arousals: 27
Associated with PLS: 0
Spontaneous: 24
Apneas w/desats: 2
Total # of arousals >15 secs: 8
Number of awakenings/movements: 20
Arousal index: 8.3

Periodic Limb Movement Data:Number of limb movements - 0

Technicians notes:
Patient had mild DBE's and snoring with a nadir of 93%.  No PLM's and a NSR.

I think I ended up typing most of it out  

Any help would be appreciated.  

Wendy

I would say the most important piece of information in the sleep study is the sleep efficiency.  Couple that with no sleep in the first study, I believe that when you go in for a CPAP titration that the night will be quite difficult.  Consequently, you should undergo a period of desensitizion prior to the titration night.  From another part of the forum:

http://www.sleepapnea.org/info/practitioner/cpappatient.html#techniques

Or if you don't feel like linking:

Quote:

CPAP MASK DESENSITIZATION TECHNIQUES

Gradual initiation of CPAP therapy is one accepted desensitization technique. Rather than having the patient lie down and immediately begin CPAP therapy at the prescribed pressure, first let the patient become acquainted with the mask and machine. Then, with the patient seated upright and the machine on but at a low pressure setting, let the patient hold the unstrapped mask loosely against his/her face for brief periods until he/she can breathe while holding the mask in place for a minute or more. After the patient is comfortable with the mask in place, strap the mask on and make sure it is comfortable (not so tight that it hurts and not so loose that leaks irritate the eyes). Once the patient can breathe with the mask strapped on and while still sitting up, let the patient breathe while the CPAP is "ramping" gradually to the prescribed setting. Once the patient is comfortable with that stage, let the patient lie down. This short investment of time with the initial titration study or mask fitting can be extremely beneficial to patients--and pay off in the long run.

Getting the patient acclimated to the mask only, outside of the sleep period and away from the bedroom, is another desensitization technique. It is natural for patients to need a period of time to adjust to sleeping with a CPAP mask on their face; no one is used to sleeping with such a mask. Patients who state that they cannot sleep with the mask on their face can become accustomed to it by wearing just the mask--with the exhalation port open--away from the bedroom while they do something relaxing, such as listening to music, for a while each day, preferably not just before bedtime, until they can wear the mask. (Patients who take the mask off during the night without knowing specifically why do well to try this method as wearing the mask while awake for a while may let them determine the site where the mask may become uncomfortable. Once the site is discovered, the better fit or style may be found.)

Patients can also practice using the machine with it turned on at a very low pressure, while they are awake and engaged in something relaxing and sedentary, for an hour or two each day or evening until they can breathe with the machine. Using it for short naps may also be beneficial and gives patients a measure of progress in acclimating to CPAP.

Encouragement at all stages of CPAP desensitization is helpful to patients.

In a nutshell it's a slow, gradual introduction to each step of the CPAP process, advancing to the next step only if the patient has accepted the previous step completely.  Practice each step 15 minutes, 4-6 times per day, during the day.  So it's having the patient place the mask on his face himself for a few moments (so he feels he has control of it), on and off.  Then hold in place continually.  Then attach with headgear (still no CPAP or tubing at this point, and do with patient sitting up).   Then add a little CPAP pressure (4-5 cmH2O).  Then have the patient do this lying down.  Then have the patient resting in bed in the evening, perhaps falling asleep or dozing.  Then going to sleep at night.  Add pressure as tolerated, use ramp feature, or BiPAP mode till the prescribed pressure is reached.

Once you are able to do this and sleep about 4-5 hours a night, you're ready for the titration.
sleepydave

Thank you so much.  This was really really helpful even though I am getting an auto machine on Thursday.  I will try these techniques at home.  Thanks!  

Wendy