Here are my sleep study results from my 1st study without CPAP
Polysomngraphic equipment: Alice  Study Type: PSG
40 year old male height 5’10 and 230 pounds

Sleep Parameters:
Times recorded in bed:    515 Minutes
Total sleep time:        306 Minutes
Sleep efficiency index:    59.4%
Sleep Latency:        190 Minutes
REM Latency:        116.5 Minutes
Wake After Sleep Onset:    15 Minutes

Sleep Stages:
Stage REM:            44.5 Minutes    14.5%
Stage I:                9 Minutes                    2.6%
Stage II:                253.5 Minutes    82.8%
Stage III:                0.0 Minutes    0.0%
Stage IV:                0.0 Minutes    0.0%
Total Sleep Time:            306 Minutes
Number of REM Periods:        2

Respiratory Parameters:
Central Apneas:            0
Mixed Apneas:            0
Obstructive Apneas:            9
Hypopneas:            206
Snoring Description:            Mild-mod
Respiratory Rate:            1012

Pulse Oximetry:
Baseline saturation awake:        95%
Mean Saturation during REM sleep:     94%
Mean saturation during NREM:                     94%
Mean saturation:            94%
Lowest saturation:            91%

Arousals:
Total Arousals:             63
Arousal Index:            13.1
Total Apneas & Hypopneas:        215
Apneas per hour of sleep:        1.8
Hypopneas per hour of sleep:        40.4
RDI / AHI:                42.2
REM RDI:                41.8
NREM RDI:                42.2
SUPINE RDI:            46.92
LEFT RDI:                0.0
RIGHT RDI    :            37.60
 
Here are my sleep study results from my 2nd study with CPAP
Polysomngraphic equipment: Alice  Study Type: CPAP
40 year old male height 5’10 and 230 pounds

Sleep Parameters:
Times recorded in bed:    460 Minutes
Total sleep time:        243.5 Minutes
Sleep efficiency index:    52.9%
Sleep Latency:        101.5 Minutes
REM Latency:        252 Minutes
Wake After Sleep Onset:    112 Minutes

Sleep Stages:
Stage REM:                7. Minutes      2.9%
Stage I:                15 Minutes      5.5%
Stage II:                223 Minutes 91.6%
Stage III:                0.0 Minutes  0.0%
Stage IV:                0.0 Minutes  0.0%
Total Sleep Time:            243.5 Minutes
Number of REM Periods:        1

Respiratory Parameters:
Central Apneas:            7
Mixed Apneas:            0
Obstructive Apneas:            0
Hypopneas:            151
Snoring Description:            Mild-mod
Respiratory Rate:            10-12

Pulse Oximetry:
Baseline saturation awake:        95%
Mean saturation during REM sleep:     94%
Mean saturation during NREM:                     94%
Mean saturation:            95%
Lowest saturation:            88%

Arousals:
Total Arousals:             56
Arousal Index:            14.3
Total Apneas & Hypopneas:        158
Apneas per hour of sleep:        1.7
Hypopneas per hour of sleep:        37.2
RDI / AHI:                38.9
REM RDI:                42.9
NREM RDI:                38.8
SUPINE RDI:            33.17
LEFT RDI:                48.07
RIGHT RDI:            43.46

Optimal CPAP pressure:        14-15
                CM


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Hi Haku!
Well, there's some good stuff in there and some stuff that needs work.  And there's something that's a little strange.
First, though, try to find out the number of desaturations you had in both studies.  Also, very important, your AHI on your ideal CPAP pressures, 14 or 15.
In order for a hypopnea to be a hypopnea, you need an accompanying desaturation of 4% and/or an arousal.  Now there's no set rule for everybody, for instance Medicare says you can only use desaturations, and they have to be 4%, but most labs report out both desats and arousals.
Now in the baseline study, you have 206 hypopneas, but only 63 arousals.  In adults, hypopneas almost always have arousals.
Then, you are basically at 94% oxygen saturation for the study.  Yet, your lowest oxygen level for the night was 91%.  If they use the 4% rule, you're really working in a narrow window here.  So how did they score all those hypopneas?  If they're using desats only, then there should be at least 206 desats.
So we need to know the number of desats, and also if they used the 3% rule instead of 4%.  But that begs another question.  If you only desat by 3% or less per event, how did you end up at 14-15 cmH2O pressure to handle them?  Again, there's no real way to predict how everybody will respond to CPAP, but that's an awful lot of pressure for a case of what more closely resembles UARS.  Course, how can you have UARS with only 63 arousals?
There may be perfectly valid explanations here, or maybe an error in transcription, so double check, and when you get the info, we'll take another critical look at your AHI and the pressure needed to control it.
Don't tell restedgal, but you might be a great autoCPAP case.
Find out if you had any PLMs, too.
I'm really being Mr. Skeptical here, but I think it's important to be sure you really need that 14-15 cmH2O pressure, and I would quiz the MD about that.
The bad news is your overall sleep architecture is a wreck, but that might be lab effect.  Is that anywhere near your normal night?  If so, time to review overall sleep hygiene.
And Haku, buddy, tough love here, drop 40 pounds, seriously.  That'll do wonders for everything, and depending on the data you get, weight loss in your case could be the deal-maker for OSA treatment.
sleepydave

I don't know what UARS is??? But it sound scary.
I have all the papers from the sleep center and can find no more on AHI then what I already wrote above.
I don't know what a PLMs is???

At the sleep study the test I had are;
Pulmonary Function Test
Cardio Pulmonary Stress Test
Echo Cardio
Holter Monitor which said that evidence of intermittend bradycadia rate in the low 40s, mainly occuring in early morning.
Sleep Study
Lab work
High Resolution CT Chest scan

and that is it on the test.

Your right on the wieght loss, I need to lose 50 pounds, I will work on it and keep you all posted

That is why in my forums sig, I am a fat bear that has fallen over lol


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Haku!
When you do a sleep study, there's the original 900 pages or so of raw data.  There there's a 5-7 statistical analysis summarizing the PSG.  Finally an interpretation of the statistics.  You probably only have the interpretation, you may have to call for the other info.
UARS (Upper Resistance Airway Syndrome) is when subtle respiratory events, not quite severe enough to be called even a hypopnea, cause arousals, or breaks in sleep continuity.
Palms (Periodic Limb Movements) are leg (usually) movements that occur at at about 20-40 seconds intervals and may also disturb sleep continuity.
To get the additional info, you'll have to get the more complete report from your physician.
And again, you should get explanations of these points from your physician.  If there's a good reason to be on 14 or 15 cmH2O, that's fine.  But if there are opportunities where you can be on lower pressures, at least some of the night, that might result in you better complying in your therapy.  With you only sleeping 53% of the night while on CPAP, and if that's what you're still doing (your initial posts said you had trouble sleeping on your side), you really need to pursue this until it's addressed.  Sleeping only half the night is not anywhere near an acceptable lifestyle nor should it be, and we have to dig.  On the other hand, if you're now doing well with your therapy, sleeping through the night and feeling good (plus you're on BiPAP, right?-- that should be a heckuva lot better than a straight 14 cmH2O), then talking about numbers is great to help understand what's happening, for you and all the readers, but it may be academic.  Stay in touch.
sleepydave

What about an Remstar Auto w/ C-Flex CPAP Machine?
Would this machine with the software allow me to take better control of my theorpy?
If I trade my ResMed BiLevel VIII for the Remstar Auto w/ C-Flex CPAP Machine I might not be able to swap back?
Is the swap a good idea?
Or should I keep the ResMed BiLevel, and get a script to buy the Auto on my own?
Oh and is the Remstar Auto w/ C-Flex CPAP Machine like a BiLevel?  with the C-Flex, how close is the C-Flex to a BiLevel?


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Haku!

Quote:

With you only sleeping 53% of the night while on CPAP, and if that's what you're still doing (your initial posts said you had trouble sleeping on your side), you really need to pursue this until it's addressed. Sleeping only half the night is not anywhere near an acceptable lifestyle nor should it be, and we have to dig. On the other hand, if you're now doing well with your therapy, sleeping through the night and feeling good (plus you're on BiPAP, right?-- that should be a heckuva lot better than a straight 14 cmH2O), then talking about numbers is great to help understand what's happening, for you and all the readers, but it may be academic.

How are you doing now?

Before you drop a grand on a machine to fix something, make sure you know what it is you're fixing.  And if it ain't broke...

Ok, look at it this way.  There's 3 things you to consider:
1.  Desaturations and apneas cause all of the medical issues in OSA-- stroke, high blood pressure, etc.  CPAP needs to get rid of all the respiratory events and desaturations.
2.  Arousals or breaks in sleep continuity cause you to feel sleepy during the day, and put you at risk for auto accidents and the like.  By stopping respiratory events with CPAP, you hope to stop all the arousals and sleep soundly through the night.
3.  If after doing this, your sleep architecture is still a wreck or you still have a large number of arousals, awakenings and awake time in bed, you either have another sleep issue or your CPAP is causing you more grief than benefit.  And differentiating the two can be very difficult, there may be underlying issues that are not put in these posts that are very significant, and which is why you still need to go back to the MD for complete explanation.

So, if you're still having trouble sleeping, there are things to do that may make your CPAP experience more tolerable.  If after doing those things, and you're still doing poorly, you may have another problem that needs to be addressed.  But if you're doing well on all fronts, sitting on what you got might be a good idea, too.

So what is it that you're trying to fix?
sleepydave

I know that pressure you need changes.  What I am trying to fix is that.  If my pressure changes higher, or lower I want a machine that will tell me this so I can change it.  Right I would have to have a sleep study to find this out.  That last sleep study never came up with an answer on the correct pressure, the Dr. guess what a good pressure for me would be.  Also I heard on the forum that BiLevel machine was not a good treatment for OSA.  

What I have seems to be working ok.  I do feels as though I get more sleep now.  But at the same time I feel like I need to have more control, information on this sleep thing.  Would paying $1000.00 dallars on this Auto pap do this?


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Haku!
The short answer is yes.  You're interested in day to day management of your OSA, my whole diatribe above was "Gee, this titration really doesn't look clean in a few spots", your situation has and is still evolving, so sure, you might get some great benefits with the autoCPAP.

But don't forget

Quote:

If after doing this, your sleep architecture is still a wreck or you still have a large number of arousals, awakenings and awake time in bed, you either have another sleep issue or your CPAP is causing you more grief than benefit. And differentiating the two can be very difficult

There's a heckuva more to sleep than just OSA and PLMs, and autoCPAP doesn't always equate to autoFIX everything.  Keep an open mind and open path to the physician's office, which I know you already are.  I'm going to pass on the machine recommendations, though, I can't see how that original 14cmH2O came about, then you went to BiPAP 14/8 if I recollect, and now going to auto, bi-, c-flex or combo, we've drifted a bit from the scientific approach.  I'd go back to your physician, review those parameters in question, and then get your plan together.  Good luck, check back.
sleepydave