Thoughts on my results please?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
reolhlains
Posts: 105
Joined: Tue Jul 28, 2015 7:05 pm
Location: Australia

Thoughts on my results please?

Post by reolhlains » Tue Jul 28, 2015 8:46 pm

Evening everyone!
I've been reading this forum (almost every post!) for the past six months or so since I first suspected sleep apnea. There seems to be a wealth of information - and it's helped put my mind at ease about it and want to get it diagnosed/fixed.
I finally did a sleep study and got my results last week - I'm interested in everyone's experienced thoughts!
On the sleep study, I was more or less awake for about the first three hours (I drifted off a few times) - basically cause I wasn't loving the experience!
Anyway, I finally slept for 4.2 hours. The feedback I am getting is that my results were likely understated due to the lack of sleep. Do we think 4.2 hours is enough to go on?
The advice (and current plan) is loose 10kgs (I have a bit of a chubby neck!), use the provent strips for a few months while I try to do this and then consider a mandibular splint and then CPAP.
It sounds like a good plan to me - and I am looking forward to having a go with the strips when I get them - but even last night I was aware that I was waking up due to apnea. I seem to sleep well for the first part of the night (i.e. about the 4 hours I slept during the sleep study) - but the later part of my sleep is when I am waking up frequently. When I wake up, my body feels quite stressed. I have (a few times in the past) woken up mid-deep breath, but that doesn't happen too often.
My numbers were (I don't even fully understand them despite a nurse and a consultant!):

AHI: 4.8
RDI: 23.5
Supine AHI: 2.5
Non Supine AHI: 5.05
REM AHI: 23.2
ODI: 0.7
Arousal index: 26.9

Total sleep time: 4.17
Sleep efficiency: 61.4%
Sleep latency: 52.5 mins
REM latency from sleep onset: 233.5mins
REM proportion: 11.4%
Slow Wave Sleep Proportion: 23.2%

Average Hypopnea/Apnoea length: 36.0 seconds
Time spent with SaO2 less than 90%: 0
Nadir SpO2: 93
Average heart rate: 68.8
BP: 126/73

I'd appreciate your thoughts on the results and my thinking around my plan. Just typing them in there made me focus on the REM AHI of 23 which, interesting, the consultant or nurse didn't mention!

Thanks!!!

_________________
MachineMaskHumidifier

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Thoughts on my results please?

Post by Julie » Tue Jul 28, 2015 9:27 pm

Hi... Well, unless I'm missing something, it doesn't look to me like you even qualify as an apnea patient. Your AHI was below 5 and your oxygen didn't go below 90. While you may have had some difficulty in REM sleep, I wonder if that wasn't due to sleeping in a lab overnight.

And something else struck me - the timeline of your treatment as laid out is backwards to what we have learned to be the best way to treat apnea, at least the obstructive kind. Cpap is the gold standard, and should be the first therapy tried, and tweaked until it works well for you. Provent doesn't necessarily work well for many people and is usually only recommended as a stop-gap type of thing (when travelling on planes that sometimes won't let you use Cpap in air, etc.) seems a strange first approach for you to be trying. And mandibular devices are often a last resort for some people who have given Cpap a serious and long trial, with various masks and pressure setting re-adjustments along with other factors, and are known to have their own set of problems - sometimes leading to temporomandibular joint problems. So I'm a bit concerned about who your doctors are (dental surgeons by any chance?), and where they get their information. Have you seen a pulmonoloist or neurologist who specializes in sleep medicine?

It does not sound at all like a good plan to me, especially in light of the fact you don't really seem to qualify... what led you to get a sleep study in the first place? Have you also had a thorough work-up for other conditions (thyroid, blood, hormonal, neurological) and ruled out other conditions? I think you need more advice before signing on to anything like MADs, and there are very experienced and knowledgable people here who can help. Please come back to this thread in future so your history will be in sequence.

Later - just saw Kaiasgram's note and she's correct that your RDI is high, and could indicate something called UARS, but was that anything that your doctor(s) talked to you about? It's not obstructive apnea as such but is related and would need to be treated if that's what's going on.
Last edited by Julie on Tue Jul 28, 2015 9:40 pm, edited 1 time in total.

User avatar
kaiasgram
Posts: 3568
Joined: Sat Jun 02, 2012 2:08 pm
Location: Northern California

Re: Thoughts on my results please?

Post by kaiasgram » Tue Jul 28, 2015 9:34 pm

reolhlains, welcome. The AHI is low but the RDI is not. Your RDI (Respiratory Disturbance Index) of 23.5 definitely earns you a sleep disordered breathing diagnosis. Did your doctor talk with you about Upper Airway Resistance (UARS)? CPAP is the first line treatment. I can't imagine what your doctor's reasoning was for his/her recommendation to try everything but CPAP before going to the gold standard.

Four hours is generally enough sleep to get a diagnosis.

You said you don't understand all the numbers in your report -- if you have specific questions we can help interpret these results.

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + Aifit N30i Nasal Mask Bundle
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Additional Comments: SleepyHead-now-OSCAR software on Mac OSX Ventura

User avatar
reolhlains
Posts: 105
Joined: Tue Jul 28, 2015 7:05 pm
Location: Australia

Re: Thoughts on my results please?

Post by reolhlains » Tue Jul 28, 2015 9:57 pm

Thanks Julie and Kaiasgram
I think the leaving CPAP until last is more of a cost thing - rather than buy the machine just now, give weight loss a proper go for six months and see what happens - and these strips may help a little meantime.
I think that is coming from the results being not too severe.

_________________
MachineMaskHumidifier

User avatar
grayghost4
Posts: 1554
Joined: Wed Aug 20, 2014 6:52 pm
Location: Norther Illinois
Contact:

Re: Thoughts on my results please?

Post by grayghost4 » Tue Jul 28, 2015 10:43 pm

A MAD will cost more that a good cpap machine ... I know, I got one ... did not help much and caused a lot of pain in the jaw.
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

User avatar
kaiasgram
Posts: 3568
Joined: Sat Jun 02, 2012 2:08 pm
Location: Northern California

Re: Thoughts on my results please?

Post by kaiasgram » Tue Jul 28, 2015 10:52 pm

reolhlains wrote:I think the leaving CPAP until last is more of a cost thing - rather than buy the machine just now, give weight loss a proper go for six months and see what happens - and these strips may help a little meantime.
I think that is coming from the results being not too severe.
Your RDI of 23.5 is moderate, not mild. If it was 30 or above it would be in the severe category. Then there's your REM AHI which was also not mild.

Knowing what I know now about sleep disordered breathing (more than I wish I'd had to learn ), I would not be comfortable with that treatment plan. Not at all. It means you could have many, many months of questionable treatments before getting to the most reliable one -- positive airway pressure (PAP). Will your doctor be ordering sleep studies along the way to find out if any of these alternatives are actually working?

As for cost -- I don't know if in the end you'll save money. Months of Provent and then a mandibular device... Does your insurance not cover PAP therapy?

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + Aifit N30i Nasal Mask Bundle
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Additional Comments: SleepyHead-now-OSCAR software on Mac OSX Ventura

User avatar
reolhlains
Posts: 105
Joined: Tue Jul 28, 2015 7:05 pm
Location: Australia

Re: Thoughts on my results please?

Post by reolhlains » Tue Jul 28, 2015 11:32 pm

Yea, I don't think anyone suggested either of those results were mild? Just not too severe.

Does everyone thing that weight loss will not make any improvement? That was actually what the consultant's (respiratory and sleep specialist) recommendation was - the provent was more of an additional thing to try if I wanted, but just focus on weight loss for six months and then reassess.

They gave me enough provent for four days last week (all they had available at the time). My partner noticed absolutely no snoring which is a result in itself and I noticed feeling just that little bit fresher in the morning.

_________________
MachineMaskHumidifier

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Thoughts on my results please?

Post by Julie » Wed Jul 29, 2015 4:26 am

Researchers now believe that weight gain is likely a cause of apnea (along with anatomic ones like narrow jaws and airway structure), not the other way around, and therefore anyone trying to lose wt with untreated (by Cpap) apnea is going to have a hard time, plus it's been shown over and over that losing does not, in most cases, mean you can go off Cpap, that your apnea's 'cured'. Only in a real minority of cases (sometimes after bariatric surgery) does losing lead to being able to stop treatment and those have to be confirmed by new sleep studies. The majority of people who lose e.g. 30 lbs still need to use Cpap, even if sometimes at a lower pressure (but occasionally higher, for reasons not yet fully understood).

DeepFriedDuck
Posts: 75
Joined: Fri Jul 03, 2015 7:46 am

Re: Thoughts on my results please?

Post by DeepFriedDuck » Wed Jul 29, 2015 6:12 am

reolhlains wrote:RDI: 23.5
reolhlains wrote:REM AHI: 23.2
reolhlains wrote:Arousal index: 26.9
Forget the stupid industry scale of Mild/Moderate/Severe. You are really sick. Imagine being awaken an average of 25 times per hour by a door slamming. You would be sick as hell wouldn't you?

Get a CPAP outfit. Sleeping well will make it easier to lose the weight you need to lose.