I got my sleep study results while I was at the doctor today. They gladly made me a copy of them. The doctor joked about getting out the PDR and the doctors dictionary to help figure them out. He did say even for what I may not understand reading half of the junk contained in the report that it would make semi interesting bathroom reading material. He's such a nut.


I have muddled through it to the best of my ability but here's the details that it contains.

Diagnostic interpretation
1. Respiratory: A total of 127 obstructive hypopneas and 10 obstructive apneas were observed during the baseline portion of the study yielding an average apnea hypopnea index of 53 per hour. Snoring was present during 93% of the study.

2 Oximetry: Arterial oxygen saturation while breathing room air was normal. A severe degree of cyclic desaturation was obsered during the study with a minimum saturation of 59%

3. Sleep architecture: Sleep latency was shortened. REM latency was normal. The percentage of light sleep (stage I and IIO was increased. No Delta sleep (stages III and IV) were observed. The percentage of REM sleep was reduced. Sleep was fragmented by 149 arousals 15 of which were spontaneous, 134 of which were associated with respiratory events and 0 were associated with periodic leg movements of sleep. The average arousal index was 58 per hour. Thirteen stage shifts were observed. Sleep efficiency was normal.

4 Periodic leg movements of sleep: two plms were observed during the study non of which were associated with arousal.

5. Cardiac: Normal sinus rhythm with occasional ventricular premature beats.

Therapeutic Interpertation:
1. Respiratory: Application of nasal CPAP to a max of 18 cmh20 resulted in a reduction of the AHI to 8/hr
2. Oximetry Application of Nasal CPAP to a max of 18cmh20 resulted in marked improvements in cyclic desaturation.

3. Sleep architecture:  Application of nasal cpap to a maxiumum of 18 cm h20 resulted in a reduction in arousals and multiple episodes of REM (rem rebound) During therapeutic titration there were 117 arousals 54 of which were spontaneous, 62 of which were associated with respiratory events and 1 of which was associated with periodic leg movements of sleep. Twenty-five stage shifts were observed.
4. Periodic leg movements of sleep: During CPAP treament 18plms were observed
5. Cardiac: normal sinus rhythm with occasional ventricular premature beats.


So basically what I assume this says is that I had an AHI of 58 and with the addition of the cpap they assumed it would come down to approx 8 an hour.
The reduction in o2 sats explains my headaches that I would wake up with.. usually at about 330 in the morning. That would have been about the time that I was bottoming out when it would happen. I always knew if I was going to have a headache for the day it would have started before I woke up and would wake me out of a dead sleep then leave me bed ridden for the day out of agony. My previous doctor just chalked them up to Migranes.....

I know i feel better after starting the CPAP and am much more rested. I am getting to sleep easier and am waking up rested.  

I am wondering if the occasional ventricular premature beats is something I should be worried about.

The leg movement after the cpap was started I can assume goes back to the fact that I was battling a grumbling stomach that was retaliating against what I had for dinner... I have not typically been one to get up and go to the bathroom through the night.. I was up several times through the sleep study for emergency trips to the bathroom I know I was restless trying to cope with the grumbling feeling and holding off its avenged attack.  

Anyone have any insight on the results?

Thanks,
Trish


_________________
Optilife mask by Respironics
Remstar Plus M with c-flex and heated humidifier
Pressure set at 18
Started Cpap on 12-13-07

Trish, everyone has occasional premature ventricular heart beats.

I'm surprised that your AHI is as high as 8 even using a CPAP machine.  However, you say that are feeling better with the machine so I guess it must be doing enough good.

You seem to have adapted to the machine and mask very well.  That's good to hear, given the problems so many new users have.

There is one thing that puzzles me.  Before CPAP, you had 2 periodic leg movements.  With it, you had 18.  The same sort of thing happened with my husband's tests but we never got an explanation.  If you ever get one, I'd be interested in the answer.

Someone else may have more comments for you.

Keep in touch and let us know how you are doing when you have more time using the machine.

Hi Trish,

I concur with Frances, not to worry about the cardiac events as long as you don't have other complications in your health and your doctor is not worried.  

I am guessing -- and it is only guess as I don't see any information one way or the other -- they stopped at pressure 18 probably becase they ran out of time.  Unless they have reason to believe otherwise, they generally start around 4 - 6 and go up from there.  It would take them a long time to reach 18.  It is possible that a higher pressure would get your AHI below 5.  

It is great to hear you are sleeping well with the CPAP therapy and feeling rested!  That low of 59% oxygen saturation is not only the source of your headaches but is so hard on your heart and brain health.  The CPAP is taking care of that for you!  

It would be interesting to learn if your doctor will try to fine-tune your pressure to get your AHI under 5 (<5 considered "normal" for an adult).  I feel this is as much an art as it is a science and the 'numbers' from the a data-capable machine are just one part of the equation.  My 'numbers' were terrific (2.2 - 2.5 every night) but my doctor fine-tuned the pressure upward and now it's -0- many nights and almost always <1.  So you just never know!

What model CPAP do you have?  Is it fully data capable?  If it is, it is quite possible your doctor will examine the data and raise your pressure.  A 'regular' CPAP or auto-CPAP goes only to 20, a Bi-Level machine can be set as a CPAP and it will go to 25, some go to 30 or higher.  As we age the pressure requirements often go up (thought not for everybody).  Since you're pusing the line on a CPAP, you might be wise to switch to a Bi-Level just for the higher pressure it can provide.  

Again kudos to you for getting along with the CPAP and feeling rested even with AHI of 8, as Frances said that's not true for a lot of folk starting out.  Let us know about that machine you have, and keep us posted on your progress!

Blessings,
--pseudonym

Thanks for the comments,

I have had my Cpap since before Christmas (details below in my signature) Things seem to be going well.. just having some issues with finding that right mask set up.

I have noticed I have alot more energy and that I am sleeping much better.... I have even had a couple of nights that I have dreamed.. can't tell you when that last time I remember that happening was.

I think so far the biggest thing I have noticed since I started on the cpap is my sense of smell is increased. It must have something to do with the fact that I am not waking up plugged up in the mornings.

I will keep ya all posted  on the progress!


Thanks again,
Trish


_________________
Optilife mask by Respironics
Remstar Plus M with c-flex and heated humidifier
Pressure set at 18
Started Cpap on 12-13-07

I always ask, as people sometimes forget to update their siggy

The "Plus"model is not fully data capable, it only records compliance data (how many hours it was used, total blower hours).  Do you have insurance that covered the machine?  If so are they handling it as a rental for the first xx months (typical is anywhere from 3 to 9), then purchase it outright?  If so I would encourage you to trade it in for the "Pro" model which is the same CPAP but has full data recording capability.  You will be able to see your AHI and mask leak rates every morning, plus your doctor and/or DME will be able to unload hour-by-hour details for your last 7 sessions from the SmartCard.  

Even if the machine is not a rental you may still be able to trade it in if you were not a self-pay and/or you did not buy online.  A fully data capable "Pro"  model bills to insurance the same as the "Plus" so there is no additional cost to you.  Also, you only need to swap the machine, the humidifier fits both.

Please consider talking with your doctor about trading up for the "Pro" model, it is really helpful for both you AND him/her to be able to keep an eye on your therapy during the fine-tuning stages.

Blessings,
--pseudonym

My machine and everything has already been through my insurance. I will see about talking to my doctor about upgrading. Especially with the way the report talked about hoping to get to about 8 ahi a night with the current treatment.

Thanks for your suggestions!
Trish


_________________
Optilife mask by Respironics
Remstar Plus M with c-flex and heated humidifier
Pressure set at 18
Started Cpap on 12-13-07