Hi all,

I'm 28 years old, 6' tall and weigh in at 207lbs (I incorrectly told them that I was 195 - I hadn't measured myself in a LONG time, and I honestly didn't feel any heavier). I used to be at 182 lbs and feeling good (but probably still had apnea - never got tested), but now I'm 25 lbs overweight. While this isn't extreme by any means, I'm wondering if this could explain why I've been having a lot of trouble waking up and staying awake recently. I never used to nap before, but I find that even while waiting at a dentist's office for 10 minutes, I'm nodding off. I've had to pull over on the side of roads and nap for a few minutes when driving late at night, even if only for about 10 or 15 miles.

I'm very forgetful. I can't remember things I did a couple months back with friends. They have to jog my memory before I say, "Oh, yeah! I remember that." It's possible that I'm just naturally forgetful, but I don't remember being this forgetful. ( *rimshot*   )

In any case, upon my ENT specialist's recommendation, I got my sleep study done. The results came in last Friday, and I've been looking over this website trying to figure out how bad I have it. The AHI came out to be 90 (188 events in 125.5 minutes). My desaturation level hit a nadir of 79%. After a couple hours of this, the tech put me on a CPAP and I did sleep a lot better. Here are my results:







Even on the CPAP, I wasn't getting any Stage 3/4 sleep. Is that a cause for concern or should I not take that too seriously, because it's just one data point? Also, my lowest oxygen level was 90.4 while on the CPAP. Is that another thing I should be looking at? Also, I don't have a sleep doctor as such, but I am going back tp my ENT specialist tomorrow.

In all probability, I will be getting a CPAP machine soon. I know to get a fully data capable machine (thanks to you guys) with a humidifier. Any specific brand I should go with?

Thanks to you folks, I'm now much better armed with knowledge!

maritan wrote:

The results came in last Friday, and I've been looking over this website trying to figure out how bad I have it. The AHI came out to be 90 (188 events in 125.5 minutes). My desaturation level hit a nadir of 79%. After a couple hours of this, the tech put me on a CPAP and I did sleep a lot better.

In all probability, I will be getting a CPAP machine soon. I know to get a fully data capable machine (thanks to you guys) with a humidifier. Any specific brand I should go with?

Thanks to you folks, I'm now much better armed with knowledge!

You are already making the right choices by learning all you can.  As for your severity an AHI of 30+ is considered "severe", so at 90 I think it is fair to say you are a worthy candidate.    Also any oxygen levels under 95% are worrisome and under 80% is a big concern.  It's like you are a near drowning victim every night.

Join the club...you will start feeling better quickly and wonder why you didn't do it sooner.  

(Geez I sound like a cultist or something huh!  C'MON!  TRY THE KOOL AID!  It's greeeeeeaaaaaatttt! )

Hi Maritan,

Yes, those numbers are of concern, however, it looks like you responded very well to treatment. A couple of comments:

Sleep studies of people with untreated sleep apnea often show no or very reduced amounts of REM and Stages 3-4 sleep, and this is what is indicated in your study results. The respiratory events disrupt normal sleep to the extent that a person is not able to acheive/maintain those stages.

Normal REM is 20-25% of total sleep.  While not being treated, the amount of REM sleep was 7min (5.6%). Then with CPAP treatment, it increased to 96 min (38.9%) This indicates that you may have experience REM rebound.

REM rebound is a marked increase REM sleep stage in people who have been deprived of REM sleep. This can last for several days. Dreaming is known to occur in REM sleep, but dreams can also occur during non-REM sleep. There are also theories that REM sleep may be involved in memory.

maritan wrote:

Even on the CPAP, I wasn't getting any Stage 3/4 sleep. Is that a cause for concern or should I not take that too seriously, because it's just one data point?

Keep in mind that the sleep study is not a normal night’s sleep, and you were treated for only half the night. It may not have been possible to cycle through the stages normally. It’s possible that the REM rebound was the main event, and that the stages would normalize after a few days of proper treatment. It is a good sign that you did reach Stage 3 sleep.

maritan wrote:

Also, my lowest oxygen level was 90.4 while on the CPAP. Is that another thing I should be looking at?.

The pressure was increased from 5cm to 8cm. During the time you were sleeping at 5, 6, and 7cm, the condition was not fully treated and you were still experiencing respiratory difficulty. Please note that the 90.4 occurred at a pressure of 5cm.

maritan wrote:

Also, I don't have a sleep doctor as such, but I am going back tp my ENT specialist tomorrow.

I would recommend that you consider seeing a Pulmonologist who is certified to practice sleep medicine. An ENT often specialized in surgery. The surgical treatments are controversial, in general. A pulmonoligist will probably be more up-to-date on PAP type treatments.

Guest MJ

Maritan,

You absolutely have something to be concerned about.  You do have SEVERE Sleep Apnea and you need to be put on a CPAP machine ASAP. The part that worries me is that since you did not actually go into REM sleep is that you might actually need more pressure than what is recommended. It is not abnormal not to go into REM when you have sleep apnea like you have.

I am an RT who has worked with CPAP's and also use to read Sleep studies. I also am a CPAP user. My AHI was 118 so I understand your situation first hand!

You did not include the notes of your sleep study which is what I was interested in but it is really none of my business either. LOL!

I do not know what kind of insurance you have but I would ask your Doctor if he/she could request that you get an APAP which is an Auto titrating CPAP machine. What it will do is when you are sleeping, it will determine which pressure you actually need at that time. My sleep study showed that I did well with a pressure of 7cwp. Of course being who I am and knowing what I know I was able to get an APAP and sure enough when I actually go into rem sleep I have to have higher pressures. Actually I was only on 7cwp for only a few minutes a night. LOL!! So with your AHI being so high, I am concerned that this might happen to you as well.  
Another thing I would recommend asking for is a CPAP or APAP with Cflex. It really helps to make you to tolerate your CPAP a lot easier.

Good luck and if you have other questions please feel free to let me know.

Sorry if I am stepping out of bounds here but I love helping other people!

Thanks,
RT

Barry, GuestMJ and RespPerson2 - Thank you for your responses.

I got me a ResMed AutoSet Vantage just last night and now my journey starts. (I have another question about this, but I'll post another thread about it later.)

I'm also in that age group 25 and 170
thats a high number I thought 40 was high I have my cpap titration study Tuesday which is rescheduled ONCE more because my numbers once was 288 episodes which came to 36 per hour and 320 per hour which is 40 , there trying to see which Tech is correct. But better safe then sorry mines go to where my heart flutters some and I'm a bit dizzy. Im sure you and I both will be on a cpap and resting good soon OR SO I HOPE.

Good luck to you as well

maritan,

It gets better.  In my first sleep study, my AHI was 68, and my oxygen sat was 73%, and I have no stage 4 sleep, and very little stage 3. .  I also had several episodes of chocking in the two years prior that made me afraid to go to sleep.

Since starting my CPAP treatment, my AHI is typically between 3-4 and I feel much better ever morning.  My blood pressure which had been moderately elevated has come back to normal as well.   I used to fall asleep on my train ride to work every morning, and fall asleep watching TV at 8pm.  Now, that is all gone away.  I'm also less punchy and more patient with people.  

I only wish I had started the treatment earlier.

I know how you feel when you're afraid to go to sleep. It's like you go to bed wondering how you'll sleep or are you going to wake up gasping for air.  My results will be in Tuesday for the first study which I already know my ahi is about 40 which isn't to good. Tuesday I'll be doing a cpap study to set me up on that. Just can't wait