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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Tired Guy
 
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Help interpreting results of sleep study

Postby Tired Guy on Wed Apr 29, 2009 6:26 pm

First of all.... I am very pleased tonight.

I went to the respritory (sp) therapist today and got a ResMed Auto 25 without having to fight. Although Auto, it is set "hard" at 14 inhale and 9 exhale. I feel that this machine is the right machine for me (largely due to the opinion and input of folks here... so thanks) and my Dr was willing to finagle the system a bit to get it (ie insurance issues).

But the Dr and I spent so much time discussing how I sleep, my issues with compliance and machine choices (all this was yesterday) that I got only a cursory discussion on specific results of the test. We did spend almost 50 minutes together so I do not feel that I was "cheated" in that respect.

So all you stat freaks out there--and you KNOW you are out there :) can you pls help me interpret the following:

STUDY DURATION: 407 MIN

Obstructive Apnea 2
Central Apnea 4
Hypopnea 109
Hypopnea with 4% desat 56
Apnea index 1.2
Hypopnea Index 21.0
AHI 22.2

4% Index 11.94
Minumum Oxygen Sat 89% KM (mean = 95)

Arousals 137 (26.4 per hr of sleep)


What strikes me the most is the relatively small number of apneas..... (which is good obviously) and what I think is a very high number of Hypopneas 109 The stats in italics are the ones that I am not very sure what they mean and if they are typical... so Unfair question... and I know it is all relative etc... but does this indicate typical Sleep Apnea or more severe?

Thanks for the help.

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Tired Guy
 
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Re: Help interpreting results of sleep study

Postby Tired Guy on Wed Apr 29, 2009 6:55 pm

Ok.. maybe I was wrong... there are not stat freaks out there :)

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jnk
 
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Re: Help interpreting results of sleep study

Postby jnk on Wed Apr 29, 2009 6:59 pm

I assume that was a titration study? (If so, I believe that the numbers might need to be seen in the context of the charts to mean much.)

Is your full diagnosis "obstructive sleep apnea," or other?

Are there any other medical conditions that may be playing a role, such as the heart attack you mentioned in another thread?

Sorry that my post is only questions, not answers. But I think maybe your supplying answers to those questions might help others respond to your question more effectively.
"All quotes are actually misquotes."-- Never directly attributed to Bartlett.

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robertmarilyn
 
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Re: Help interpreting results of sleep study

Postby robertmarilyn on Wed Apr 29, 2009 7:03 pm

Tired Guy wrote:Ok.. maybe I was wrong... there are not stat freaks out there :)


I'm still learning so I'm waiting for those with the good explaining powers and knowledge to come in here and tell you what they think...then I will get to read it and learn more :D

But while we are waiting, for all of us, please go to the user control panel and then I think you would click profile and then equipment and you will be able to use the pull down menus to list your machine, mask, and other goodies. And it is best to pick the text option because the picture option makes it hard to distinguish exactly what equipment you have.

If you don't understand my sketchy explanation on how to list your equipment, just let us know and a good explainer will explain it better :lol:

mar

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Re: Help interpreting results of sleep study

Postby BleepingBeauty on Wed Apr 29, 2009 7:19 pm

Tired Guy wrote:
Obstructive Apnea 2
Central Apnea 4
Hypopnea 109
Hypopnea with 4% desat 56
Apnea index 1.2
Hypopnea Index 21.0
AHI 22.2

4% Index 11.94
Minumum Oxygen Sat 89% KM (mean = 95)

Arousals 137 (26.4 per hr of sleep)


What strikes me the most is the relatively small number of apneas..... (which is good obviously) and what I think is a very high number of Hypopneas 109 The stats in italics are the ones that I am not very sure what they mean and if they are typical... so Unfair question... and I know it is all relative etc... but does this indicate typical Sleep Apnea or more severe?

Thanks for the help.


Hi, Tired Guy, from another (former) Masshole). :D

I'm no expert, so take my opinion FWIW. But I'll try to help you out here. First, do some reading on this site; click on the yellow lightbulb at the top of the main screen (Our Wisdom). Read the "Where a Newbie Should Start" thread above. Lots of great info to be had on this site, not to mention many experienced and wise users, so educate yourself about this journey you're now on.

From http://www.sleepdisordersguide.com/slee ... ary-a.html, some basic info:
"Apnea/Hypopnea Index (AHI) is the frequency of abnormal respiratory events per hour of sleep. These events are classified as Apneas or Hypopneas. Apnea is defined as temporary absence or cessation of breathing. Hypopnea is a partial blockage of airflow resulting in arousal and a possible drop in oxygen level. An AHI of 45 would indicate that the patient is experiencing complete or partial airflow blockage 45 times per hour."

So, with your numbers listed above, your AHI of 22.2 indicates that you have mild/moderate sleep apnea. As I understand it, the severity of an individual's AHI is measured by the following:

15 to 24 events per hour- mild sleep apnea
25 to 39 events per hour- moderate sleep apnea
40 or more events per hour- severe sleep apnea

So, no, your case is not severe. (My AHI was 107; that's severe!) ;) And it seems to me that your minimum oxygen desaturation of 89% isn't terrible, either. Ideally, I believe it should stay above 93%; but some of us have desats that are much lower (i.e., a significantly bigger problem than you're dealing with).

I'm sure others will come along with much more assistance than I can offer, but I hope that little bit helps. Welcome to the forum. :)
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Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

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jnk
 
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Re: Help interpreting results of sleep study

Postby jnk on Wed Apr 29, 2009 7:27 pm

I don't think the numbers from one persons diagnostic sleep study can be compared to numbers from another person's titration study in any meaningful way, if the numbers the original poster gave were, indeed, from a titration.
"All quotes are actually misquotes."-- Never directly attributed to Bartlett.

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DreamStalker
 
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Re: Help interpreting results of sleep study

Postby DreamStalker on Wed Apr 29, 2009 7:32 pm

Ok ... let me get my calculator ... hold on a minute ...........

Well 407 minutes = 6.8 hours for the duration of the study.
You had 2 OA and 4 CA = 6 apneas with an apnea index of 1.2 ... so 6 / 1.2 = about 5 hours of actual sleep during the 6.8 hour study.
You had 109 hypopneas ... so 109/21.0 = about 5.2 hours which confirms the above calculation.

AHI = apneas plus hyponeas divided by 5.2 hours ... so (109 + 6) / 5.2 = 22.2 for AHI

Your average blood oxygen was 95% and your minimum was 89%.

56 of your hypopneas resulted in a minimum of 4% drop in your blood oxygen (I presume relative to your 95% average).
4% Index of 11.94 suggests that all 6 apneas (4 centrals + 2 obstructives) resulted in a drop of at least 4% drop in your blood oxygen.

You had 137 arousals (I assume from REM but not sure) over the 5.2 hours of sleep resulting in an index of 26.4

Hyponeas can be just as damaging as apneas if they result in a significant drop in your blood oxygen levels (the slow death) ... think about it, every 5 minutes while you sleep, your blood oxygen drops 4% or more from normal ... that is like being Khalid Sheik Mohammed under enhanced interrogation over 2 or 3 nights of sleep.

I would guess that you are a tired guy ...

Welcome to the club! :D


BTW- I think this is the diagnostic part ... if it is the titration it is pretty damn crappy work.
Last edited by DreamStalker on Wed Apr 29, 2009 7:52 pm, edited 1 time in total.
Thanks Snoredog, GoofyUT, rested gal, GoofProof, Wulfman, NightHawkeye, snoregirl and all of the others.
From 102 AHI to 0.4 AHI for over 10 yrs now :)
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jnk
 
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Re: Help interpreting results of sleep study

Postby jnk on Wed Apr 29, 2009 7:50 pm

DreamStalker wrote:Ok ... let me get my calculator ... hold on a minute ...........

Well 407 minutes = 6.8 hours for the duration of the study.
You had 2 OA and 4 CA = 6 apneas with an apnea index of 1.2 ... so 6 / 1.2 = about 5 hours of actual sleep during the 6.8 hour study.
You had 109 hypopneas ... so 109/21.0 = about 5.2 hours which confirms the above calculation.

AHI = apneas plus hyponeas divided by 5.2 hours ... so (109 + 6) / 5.2 = 22.2 for AHI

Your average blood oxygen was 95% and your minimum was 89%.

56 of your hypopneas resulted in a minimum of 4% drop in your blood oxygen (I presume relative to your 95% average).
4% Index of 11.94 suggests that all 6 apneas (4 centrals + 2 obstructives) resulted in a drop of at least 4% drop in your blood oxygen.

You had 137 arousals (I assume from REM but not sure) over the 5.2 hours of sleep resulting in an index of 26.4

Hyponeas can be just as damaging as apneas if they result in a significant drop in your blood oxygen levels (the slow death).

I would guess that you are a tired guy ...

Welcome to the club! :D


BTW- I think this is the diagnostic part ... if it is the titration it is pretty damn crappy work.


Whatrya, some kinda math whiz? :lol:

You may be right about it being diagnostic, DS. But other posts by the OP made me wonder if the hypops might be centrals, given the mention of the many years forgoing treatment, the bilevel titration, and the heart trouble.
"All quotes are actually misquotes."-- Never directly attributed to Bartlett.

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DreamStalker
 
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Re: Help interpreting results of sleep study

Postby DreamStalker on Wed Apr 29, 2009 7:56 pm

jnk wrote:...
Whatrya, some kinda math whiz? :lol:

You may be right about it being diagnostic, DS. But other posts by the OP made me wonder if the hypops might be centrals, given the mention of the many years forgoing treatment, the bilevel titration, and the heart trouble.


I didn't go back to read the previous posts so I have no clue .... but it is the O2 desats that cause heart trouble regardless of whether they are caused by apneas or hypops.
Thanks Snoredog, GoofyUT, rested gal, GoofProof, Wulfman, NightHawkeye, snoregirl and all of the others.
From 102 AHI to 0.4 AHI for over 10 yrs now :)
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Re: Help interpreting results of sleep study

Postby Tired Guy on Wed Apr 29, 2009 8:21 pm

DreamStalker wrote:BTW- I think this is the diagnostic part ... if it is the titration it is pretty damn crappy work.


You are the second person to mention titration study vs diagnostics (or something along that line). Although I thought I was fairly well read on this I am confused by the reference.

These data are from the five page notes and graphs that I requested from my doctor after my sleep study. It contains other stuff on % stage sleep, position effect, sleep stage effect (where REM AHI is much higher) etc... I didnt post all those because I didnt want to where out my welcome :)

Did i answer your question?

OH... where the heck is the user control button so I can list my equip?

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jnk
 
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Re: Help interpreting results of sleep study

Postby jnk on Wed Apr 29, 2009 8:36 pm

Tired Guy wrote:
DreamStalker wrote:BTW- I think this is the diagnostic part ... if it is the titration it is pretty damn crappy work.


You are the second person to mention titration study vs diagnostics (or something along that line). Although I thought I was fairly well read on this I am confused by the reference.

These data are from the five page notes and graphs that I requested from my doctor after my sleep study. It contains other stuff on % stage sleep, position effect, sleep stage effect (where REM AHI is much higher) etc... I didnt post all those because I didnt want to where out my welcome :)

Did i answer your question?

OH... where the heck is the user control button so I can list my equip?


User control panel, top left of this page (that's where it is in my browser, anyway).

The diagnostic study is where they have you sleep without using a PAP machine to see how bad your sleep is untreated. The titration study is the one where they put a mask on you to see what pressure(s) seem to treat you best. Sometimes the two are rolled into one in what they call a split-night study.

Don't worry about wearing out your welcome. If that were possible, I would already have worn out mine several times over. For example, I just called DreamStalker "a math whiz," when, in fact, he actually IS a particularly gifted man in that area among others, a "wiz" of sorts. And see how nice he was to me, anyway! Feel free to post a link to pages of your sleep study if you put them up on a picture site. Many have done that. Just be sure to mask out any personal data. And some mask out the lab info as a courtesy to the lab.

I didn't mean to confuse earlier. The thing is, if you have a machine that gives efficacy data, you'll be able to see what your machine-esimated AHI is nightly with treatment. And that's what matters most, since you will be using the machine every night, all night, from now on, right?

jeff
Last edited by jnk on Wed Apr 29, 2009 8:43 pm, edited 1 time in total.
"All quotes are actually misquotes."-- Never directly attributed to Bartlett.

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DreamStalker
 
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Re: Help interpreting results of sleep study

Postby DreamStalker on Wed Apr 29, 2009 8:41 pm

Tired Guy wrote:
DreamStalker wrote:BTW- I think this is the diagnostic part ... if it is the titration it is pretty damn crappy work.


You are the second person to mention titration study vs diagnostics (or something along that line). Although I thought I was fairly well read on this I am confused by the reference.

These data are from the five page notes and graphs that I requested from my doctor after my sleep study. It contains other stuff on % stage sleep, position effect, sleep stage effect (where REM AHI is much higher) etc... I didnt post all those because I didnt want to where out my welcome :)

Did i answer your question?

OH... where the heck is the user control button so I can list my equip?


Upper-left under the search box.

I don't recall asking any questions.

There is usually a diagnostic part of the sleep study with info on your OSA condition. The titration part is where the doc and/or tech hook you up to the air machine and try and tweak (titrate) the correct pressure to treat your OSA condition. Sometimes they do 2 separate sleep night sessions (1 to diagnose and 1 to titrate) and sometimes they do a "split-night" session where they diagnose you and titrate you right afterwards during the same night.
Thanks Snoredog, GoofyUT, rested gal, GoofProof, Wulfman, NightHawkeye, snoregirl and all of the others.
From 102 AHI to 0.4 AHI for over 10 yrs now :)
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Re: Help interpreting results of sleep study

Postby JoyD. on Wed Apr 29, 2009 10:02 pm

Welcome to the Forum, Tired Guy :)

Go to Control Panel > Profile Tab > Edit Equipment. Keep asking questions, and we will try to answer them or get you to clarify more.

Joy

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Tired Guy
 
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Re: Help interpreting results of sleep study

Postby Tired Guy on Thu Apr 30, 2009 7:10 am

Thanks all...

Obviously found the control panel so I added my machine info, etc... My study was the titration-type.... which is how I ended up with the 14 / 9 pressures being specified.

My machine is data capable (pretty high end machine from what I can tell) but the data is collected onto a pretty funky data card, not something that I would be able to use. It seems to me, many of you are getting much more real-time data. How is it that you guys are seeing your data and how are you able to "adjust" according to what the data is telling you? It doesnt seem like it is simply handing your data card to the sleep Doctor and getting feedback that way, but I am not sure.

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Re: Help interpreting results of sleep study

Postby jnk on Thu Apr 30, 2009 7:32 am

With that machine, you can get very good data from the screen without buying software or using the card, for now. Push the left arrow and right arrow down for three seconds or so, and that should give you your data. I wouldn't worry about adjusting anything just yet. If, for some reason, pushing the left and right arrow down at the same time does not give you your data, there is a way to fix that. The main thing is to get used to using the machine, since you have had compliance issues in the past. I think you will find that machine VERY comfortable to use. My machine is similar, and I can barely tell the thing is on when I use it, it is so comfortable.

If those numbers were from your titration, I would recommend that you find a way to post the pages of the titration and link to them here, if you want further observations.

It may be your doc is trying you on bilevel to see if that improves your numbers or makes them worse. He/she may be seeing if you need a machine designed to address central events, not just obstructive ones, for example. It is difficult to even guess what the doc has in mind without seeing the study. But you may want to ask your doc to explain what he has in mind, if he is willing to do that. My completely uninformed guess is that the doc is just trying to get you consistently using a machine for now. But without your knowing what the doc has in mind, I would hesitate to even think of changing anything on that machine. But that's just me.

jeff

Tired Guy wrote:Thanks all...

Obviously found the control panel so I added my machine info, etc... My study was the titration-type.... which is how I ended up with the 14 / 9 pressures being specified.

My machine is data capable (pretty high end machine from what I can tell) but the data is collected onto a pretty funky data card, not something that I would be able to use. It seems to me, many of you are getting much more real-time data. How is it that you guys are seeing your data and how are you able to "adjust" according to what the data is telling you? It doesnt seem like it is simply handing your data card to the sleep Doctor and getting feedback that way, but I am not sure.
"All quotes are actually misquotes."-- Never directly attributed to Bartlett.

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