Just talked to the sleep doc who analyzed my 2nd sleep study and they are telling me that I don't have sleep apnea anymore.  After my first study they prescribed me cpap, which I haven't been able to tolerate.  The 2nd study is not using CPAP, but I did lose 20 lbs since the first study.  Just curious if some people could evaluate the numbers and give me their opinion.  The sleep doc is saying that based on the numbers I don't have sleep apnea, something else might be going on, and I could keep trying to tolerate CPAP to see if that helps, but I don't have sleep apnea.

Almost all of my apneas for both studies (95%+) occur only during REM sleep.

Here are my 2 studies:

First Study:

5/2004 (Age 33)
Weight:  165 lbs (bmi: 27)
Sleep Efficiency:  72%
Low saturation:  78%
RERA #:  56
AHI: 7
% of sleep in REM:  10%
A lot of apneas in REM sleep (they didn't measure REM AHI back then)

2nd Study:

4/2008 (Age 37)
Weight:  145 lbs (bmi: 23)
Sleep Efficiency:  71%
Low saturation:  80%
RERA #:  20
AHI: 3
% of sleep in REM:  8%
REM AHI:  27  (29 minutes of REM sleep)

Do the results of my second study show I just don't have sleep apnea anymore?  I just don't feel any better at all, if anything I feel a bit worse than the first study.  Thanks for any help you guys can give me.

First, congratulations on your weight loss.

I can give an opinion, but I would need to point out that I am not a medical professional nor am I a sleep professional.
In looking at your results, and mindful of the other missing data, your overall AHI has gone from mild obstructive apnea (defined as an AHI from 5 to 15) to no sleep apnea (defined as an AHI under 5) and your number of respiratory effort-related arousals (RERAs) has diminished significantly.

It would be misleading, in my opinion, to end the analysis here. You were not getting enough REM sleep in your first study and you are getting less REM sleep now. You have moderate sleep apnea during REM sleep. In fact, I believe that if your REM sleep was where it should be the overall increase in your AHI should place your overall AHI in the mild category. You still don't sleep well (sleep efficiency is below what it should be in both studies) and your blood oxygen levels are dropping lower than they should in both studies. Your level of RERAs in your second study looks like it might be higher than it should. So it looks like one or more negative things are affecting your sleep and your health.

I would urge you to request full copies of both your sleep studies as these would provide a lot more information that should help you and your sleep doctor better figure out what might be going on with your sleep (trust me, the full report from the first study will give enough information to help figure out your REM AHI even if it is not mentionned in the summary you received). I would urge your doctor to help focus on the things that are still going wrong (low sleep efficiency, drops in your blood oxygen level, inadequate REM, and not feeling well) and to help come up with a plan to address these.

I hope this is of some help. I would be as interested as you in seeing how others might interpret these figures.

Do keep us posted on things.

Best wishes,
Bill



Last edited by justplainbill on Fri May 30, 2008 10:19 pm; edited 1 time in total

I'm no sleep professional either, just an apnea patient, but I concur w/Bill. In addition to what Bill had to say I will state that no one knows your body better than you do. The proof is there that you are NOT sleeping well. It is the sleep professional's job to determine WHY and to find a way to better it. If this one isn't willing, then find another more professional sleep specialist.

As Bill suggests, I would request a copy of the full scored data summary report w/condensed graphs (5+ pages). They are a part of your medical records and in the USA you have a LEGAL RIGHT to a copy under HIPAA.

Good luck and God bless!


_________________
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Concur with CrohnieToo and Bill.  Your sleep architecture is abnormal, and you appear to be one of those people who has apnea events to any degree, only during dream (REM) sleep.  This is enough to warrant CPAP even if you are free of events duing all other stages of sleep.

You may also be a positional SA sufferer.  Some people have a significant number of events only when sleeping on their back, others, only on their sides (I'm one that has most of my events if I'm on my side, which is most of the night!).  It is not possible to determine your position from the summary information you posted, but it will be present in the detailed study report (which CronhieToo has pointed out, you should have a copy of).

I do not like that your doc says you don't have SA, it looks very much to me that you do.  Please consider seeing another sleep doc, not connected with this one, and at least getting a second opinion, if not switching outright.

Your sleep appears to be poor so you still need treatment of some kind.  CPAP seems logical.

Blessings,
--pseudonym

(I, too, am not a doctor, nor do I work in the field of sleep medicine.)

Thanks a lot for the help guys.  I am going to keep trying to get used to CPAP and also go in for a second opinion to see what another sleep doc says.  I've always had a bit of a problem with sleep onset (usually takes me @30-40 minutes to fall asleep) and just can't seem to fall asleep with CPAP, so I might just take a light sleep aid with the CPAP to try and get used to it.  At least then I could get an idea if CPAP is gonna help me out (which I think it will -- or at least I really, really hope it will) .  

Sonata is a great one for sleep onset problems, IF it works for you.  We are all different, some people can use any of the sleep aids, some can only use one drug but not the others, etc.

Sonata in particular is a very short-lived drug, it works quickly (about 15 minutes) and is completely out of your system in about 4 hours.  So it is not usually responsible for a drug-hangover feeling as can happen with some of the others.

Sonata however is not cleared for long-term use, only for a short run such as a week or two.  But that may be all you need to break the 'awareness cycle' and get you sleeping well with your CPAP.  

Blessings,
--pseudonym