A few years back my wife noted to me she thought I had sleep apnea and informed me that I snored like a freight train. I'm not a heavy person with a BMI of 24.2, so I really didn't think much of it.
I work for a hospital and recently came across an article on sleep apnea and decided to read it and noticed I had a number of symptoms (waking up not feeling refreshed, always tired, irritable, etc). I set up a meeting with a doctor here at the Cleveland Clinic and he examined me and saw that I had a deviated septum. Because I have an artificial heart valve and am on blood thinners, he said he wanted to try non-invasive methods first so he ordered a PSG (with no CPAP). I have posted the results below and am awaiting my apt with the doctor to review these and the next steps.
Just curious if anyone could give their interpretation to all this. I'm new to the Apnea stuff, so not a lot of it makes sense to me.
Age: 42 (DOB: 4/14/1969) ESS: 7/24 Neck Circumference
Height (cm): 182.9 Weight (kg): 80.9 BMI: 24.2
Referring Provider: Alan Kominsky Mailcode: A71
Sleep history: The patient is a 42 year old male with snoring, witnessed
apneas, and excessive daytime sleepiness and fatigue.
Past medical history: Subclavian Aneurysm, Coarctation of Aorta, Valvular
heart disorder(mitral and aortic), Hypertension, Craniotomy for Aneurysm
Medications: Fluticasone Spray, Paxil, Coreg, Coumadin,
Lisinopril, Lipitor, Claritin, Ativan, Amiloride-Hydrochlorthiazide
Sleep procedure: PSG 4 or more addtl param PC (95810)
Procedure: The study was attended continuously by a sleep technologist. The
monitored parameters included: left and right EOG, frontal, central and
occipital EEG, mental and submental EMG, left and right anterior tibialis
EMG, single ECG waveform, snoring, continuous airflow with thermistor and
nasal pressure transducer, chest and abdominal effort, oxygen saturation,
EtCO2, and body position via video monitoring.
Hypopnea definition: The nasal pressure signal excursions (or those of the
alternative hypopnea sensor) drop by =50% of baseline. The duration of this
drop occurs for a period lasting at least 10 seconds. There is a =3%
desaturation from pre-event baseline or the event is associated with an
arousal. At least 90% of the event?s duration must meet the amplitude
reduction criteria for hypopnea.
The study started at 21:44:57 and ended at 06:03:57. Total sleep time was 423
minutes resulting in a sleep efficiency of 86.2% (TRT = 490 m). There were 23
awakenings with a total time awake after sleep onset of 40.0 minutes. The
sleep latency was 27.5 minutes and the REM latency was 301 minutes. The
patient spent 27.0% of sleep time in the supine position. The sleep stage
percentages were 8.5% stage N1, 49.2% stage N2, 21.2% stage N3 and 21.2% REM
sleep. There were 278 arousals, resulting in an arousal index of 39.4. There
were 160 stage shifts.
Moderate snoring was noted. There were 164 respiratory events consisting of
54 apneas (31 obstructive, 8 mixed, and 15 central) and 110 hypopneas. The
apnea-hypopnea index was 23.3. The mean oxygen saturation during the study
was 96.0%, with a minimum oxygen saturation of 81.0%. The patient spent 0.9%
of sleep time with an oxygen saturation below 90%. The patient spent 20.2%
of sleep time with an EtCO2 above 45 mmHg and 2.2% above 50 mmHg.
REM-Time REM-Index NREM-Time NREM-Index Total-Time Total-Index
Supine 58.0 m 67.2 56.0 m 26.8 114.0 m 47.4
Off-Supine 31.5 m 38.1 277.5 m 11.7 309.0 m 14.4
Total 89.5 m 57.0 333.5 m 14.2 423.0 m 23.3
LIMB MOVEMENT DATA:
There were 30 periodic limb movements during sleep, resulting in a PLM-index
of 4.3. Of these, 18 movements were associated with arousals, resulting in a
PLM-arousal index of 2.6.
The average heart rate during sleep was 62 beats per minute, with a range of
46 to 78. During wake, the heart rate ranged from 50 to 73 beats per minute.
Obstructive Sleep Apnea Syndrome [327.23]
1. Severe REM-related obstructive sleep apnea syndrome (the total AHI was of
moderate degree). The respiratory events were associated with significant
oxygen desaturations (nadir of 81% on room air).
2. Abnormal sleep architecture likely due to respiratory events and first