Show me the light...

Procrastinator · Post by **Procrastinator** » Wed Jan 26, 2005 2:51 pm

Question,

What are the statistics/conditions that most alarm the doctors and result in your condition being considered severe? Is is the number of apneas? The duration of the apneas? The oxygen saturation (average or lowest)? Heart-rate? Hypopneas? I am sure it is a combination of all of the above, but how are the statistic amalgamated to draw a conclusion? If you are severe in one category is that enough to raise the alarm flag? It seems that most people in this forum have shocked their doctor, so how do you have mild apnea and is that important? Finally, does anyone know the importance of you sleep efficiency number?

rested gal · Post by **rested gal** » Wed Jan 26, 2005 2:59 pm

Interesting question, Procrastinator. I have no idea. It seems I've read that different clinics have slightly different criteria leading to the label they put on for mildness/severity ranges. Will be interesting to see the responses to this kind of question.

gailzee · Post by **gailzee** » Wed Jan 26, 2005 4:57 pm

My # was 41. I was told by the titration techie that was high. I think it's a formula of how many hypops, ap's, etc. My O2 sats stayed in the 70's%-tile, I knew that was low, pulmonary guy told me should be for me and my age, in the 90'%s. Non smoker, etc. I am not a doctor, but maybe a visit to the cardiologist could be in order, just to check things out and give you pc of mind? I had an overwhelming # of hypops, low # of ap's, so for me, the bigger question, is why do I need a CPAP, when it's a hypop problem. Well that's debilitating as well, and only GOD knows what this oxygen deprivation has done to my system. I used to exercise 30 mins a day, 7 days a wk. Now I am lucky to do a set of stairs, so obviously something is wrong.

Also weight is a big factor, something we all hate to admit.

Procrastinator wrote:Question,

What are the statistics/conditions that most alarm the doctors and result in your condition being considered severe? Is is the number of apneas? The duration of the apneas? The oxygen saturation (average or lowest)? Heart-rate? Hypopneas? I am sure it is a combination of all of the above, but how are the statistic amalgamated to draw a conclusion? If you are severe in one category is that enough to raise the alarm flag? It seems that most people in this forum have shocked their doctor, so how do you have mild apnea and is that important? Finally, does anyone know the importance of you sleep efficiency number?

Hugh Jass · Post by **Hugh Jass** » Thu Jan 27, 2005 7:32 am

Finally, does anyone know the importance of you sleep efficiency number?

Your SE number is the total time you spent asleep divided by the total time you spent in bed.

In other words if you actually slept for a total of 4 hours during an 8 hour study, your sleep efficiency rating would be 50%.

Dr.'s use this to diagnose primary insomnia, but since very few people sleep in a lab the way they do at home, in my opinion, it's essentially useless.

I read here that one person was only able to sleep for 15 minutes.

Assuming a 7 hour night in the lab, his/her SE would be .03% I doubt, however, that he/she sleeps that bad at home.

I know for myself, for the first study, I only slept about 1.5 hours, which is not normal for me. I can normally get at least 5-6 in my own bed.

Regards

-SWS · Post by **-SWS** » Thu Jan 27, 2005 8:20 am

Traditionally the medical community has used AHI (or RDI) numbers coupled with oxygen desaturation levels as an OSA severity indicator. That OSA severity scale is nicely described in this article:

http://aolsvc.health.webmd.aol.com/hw/h ... td1135.asp

However, as severity indicators go, the above ultra simplistic formula all too often neglects to portray a comprehensive picture of OSA patient wellness. Here is an article in which Dr. Colin Sullivan (inventor of the CPAP) and others take issue with AHI as a suitable means of indicating OSA severity:

http://www.respiratoryreviews.com/sep02 ... Index.html

Marie · Post by **Marie** » Thu Jan 27, 2005 8:21 am

I suppose all lab reports are different.
My sleep efficiency for the polysomnograph screening was 83.7 percent.I slept 82 minutes. I suppose after a little over an hour I had qualified for the cpap.
For the cpap titration trial it was 82.4 percent with a total sleep time of 202 minutes.I don't understand the percentages,but I'm leaving some "stuff"out.

Guess I will find out more as I go along this journey.
I'm still wakeing up after 4 hours of sleep. Sometimes I can go back to bed after an hour and sleep about 2 more.But,for some reason I can't do a total of 6 hours straight which would be great.My first night I slept 5 hours straight,and haven't done that since.
But,I am feeling much much better.
Good luck to all

steve7548 · Post by **steve7548** » Thu Jan 27, 2005 9:44 am

I've often wondered about whether my sleep apnea is as severe as my sleep study showed. According to the study, I averaged 63 events per hour, which fits in the severe category by any one's definition. Before treatment, I did feel some fatigue, but I never feel asleep in the car, at work, at movies, or in front of the television. I was also not one of those people who could fall asleep at the drop of a hat; it has always taken me a while to fall asleep. In addition, my blood pressure has never been high. Since starting CPAP, I've noticed a slight improvement in the way I feel, but the CPAP has certainly not produced the dramatic improvement that some people feel.

Procrastinator · Post by **Procrastinator** » Thu Jan 27, 2005 1:00 pm

Anyone with knowledge,

I understand oxygen saturation, what i don't understand is the weight given to average saturation versus lowest saturation. I spent my entire night below 90% as I descended to 49% oxygen desaturation.

If I could trouble you with a few more statistics:
# of central apneas: 343
# of OSA: 4
Number of Hypopneas: 198
AHI-RDI: 97.3
Sleep efficiency: 93%

I fell asleep in 9 min and started having trouble within 15 min. At one point, my heart-rate declined to 26 beats/min then stopped for several seconds; this occured several times during the night, but my average heart-rate was 61.

Oh and my bp reached 190/150 while I was going through all of this, but averaged 150/110 which was discovered through Doctors visits not the sleep study. I have been going to doctors and specialist everyday for the last couple of weeks, to speed the sleep studies along and get immediate treatment for outstanding issues (such as bp).

I am 35 year old male; 6'4" tall and I weigh 275 lbs. I was told my condition is severe, but my numbers seemed so bad that I frequently think the study was incorrect. My doctor just reiterated how fortunate I am to have the opportunity to get this under control. Do my numbers seem logical?

Guest · Post by **Guest** » Thu Jan 27, 2005 1:41 pm

Procrastinator wrote:I understand oxygen saturation, what i don't understand is the weight given to average saturation versus lowest saturation. I spent my entire night below 90% as I descended to 49% oxygen desaturation.

If I could trouble you with a few more statistics:
# of central apneas: 343
# of OSA: 4
Number of Hypopneas: 198
AHI-RDI: 97.3
Sleep efficiency: 93%

Average saturation tends to better describe the "overall" or "sustained" picture of how severe your oxygen desaturations were. Lowest saturation tends to reveal your worst moment regarding desats. These two statistics together help to depict your body's liklihood of hypoxemic damage.

Your numbers are entirely plausible IMO. That sleep efficiency number of 93% merely says that you spend little time wide awake throughout the night. It says nothing of the fact that your quality of sleep is severely deteriorated because of apnea, however.

Have you been titrated onto a PAP machine yet? Most patients with those numbers would be BiLevel bound versus CPAP or AutoPAP. If I were in your shoes, I would squeeze the doctor, insurance company, DME, etc. to get a machine very soon. There's absolutely no point in imposing those physiological risks on yourself every night now that the severity of your apnea condition has been assessed.

Somebody's rear out in "medical land" needs to put in gear ASAP so that you can terminate your current level of physiological risk and start to heal IMHO. What the heck are they waiting for???????

Procrastinator · Post by **Procrastinator** » Thu Jan 27, 2005 1:54 pm

Guest,

I got my machine this week. They use both CPAP and BiPAP, but said that I responded well to CPAP so we started with that. I can't complain about my care; I had a sleep study, titration and picked up my machine all within six days. The three things that were of concern to the doctor were the number of central apneas, oxygen desaturation and issues with the ticker. Away from sleep problem, they immediately started my on bp meds.

Thanks for your insight.

Show me the light...

Show me the light...

Re: Show me the light...

Severity Definitions

Sleep efficiency

ahi