My poor, neglected sleep study

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
quirkyone
Posts: 6
Joined: Sun Mar 01, 2015 1:22 pm
Location: Metro Boston

My poor, neglected sleep study

Post by quirkyone » Sun Mar 01, 2015 1:40 pm

Hi all,

I hope someone with more sleep study experience is willing to weigh in on my sleep study report. My PCP received it last September, but never followed up with me about it. I finally obtained a copy myself and while there are zero OAs, the rest of the data suggests to me that my sleep is craptastic and could use some help. I just want some knowledgable feedback before scheduling a specialist visit.

Let me know if I miss anything of importance in the data below; I only have the scanned report, so I can't copy and paste.

TST 374.5
Sleep onset latency 38.5
REM latency 200.0
Sleep efficiency 73.8%
Wake 94/20.1%
N1 79/21.1%
N2 236/63%
N3 37.5/10%
REM 22/5.9%
Arousals 157
Arousal index 25.15/hr
OA 0
Central 17
Mixed 1
Hypopneas 181
AHI 31.88
RERA 46
RDI 39.25/hr

Thanks for any feedback. It feels like I've just had one thing after another this year. I need to know wether I'm adding a sleep specialist to my to-do list!

Chris

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

Re: My poor, neglected sleep study

Post by Julie » Sun Mar 01, 2015 1:48 pm

Maybe seem like an irrelevant question (tho' it's not) but do you sleep mostly on your back?

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: My poor, neglected sleep study

Post by Pugsy » Sun Mar 01, 2015 1:53 pm

Schedule that follow up....ASAP

374 minutes total sleep time is a little over 6 hours (6.23 hrs)
Hypopneas 181
AHI 31.88
divide total number of hyponeas (181) over that 6.23 hours and just the hyponea index (hourly average) is 29

Over 5 AHI earns you the diagnosis.
and you are at the low end of enough to make the "severe" category.
http://en.wikipedia.org/wiki/Apnea%E2%8 ... pnea_index

RobySue's blog might help you understand what your report says
http://adventures-in-hosehead-land.blog ... -test.html

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
chunkyfrog
Posts: 34377
Joined: Mon Jul 12, 2010 5:10 pm
Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: My poor, neglected sleep study

Post by chunkyfrog » Sun Mar 01, 2015 1:55 pm

Have you had any communication with your doctor?
Or maybe you need a new doctor . . .

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Airsense 10 Autoset for Her

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

Re: My poor, neglected sleep study

Post by grayghost4 » Sun Mar 01, 2015 2:00 pm

Are you currently on pap therapy ? Looks like you should be.
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
bwexler
Posts: 1507
Joined: Mon Nov 08, 2010 11:52 pm
Location: San Marcos, Ca. USA

Re: My poor, neglected sleep study

Post by bwexler » Sun Mar 01, 2015 2:08 pm

Well assuming you know nothing about sleep studies, I probably know twice as much as you.
So with AHI of 31, I would say you have moderate yo severe sleep apnea. Since you had no OA and 17 CA, I would guess you have central sleep apnea. I would then guess that you need an ASV machine like I use.
I would do some more reading here and choose either the AirCurve 10 or the PRS One 960 with heated tube humidifier.
I would than march into my PCP office and ask why I hadn't heard from him and demand a prescription for the exact machine I had chosen and mask of my choice, and any additional paperwork my insurance company might want.
I would than contact the insurance company and ask for a list of in network DMEs and for details on what and how they pay. After complying with insurance requirements I pick a DME and request they provide my new equipment. Any static and I would call the next DME on the list, until I got what I wanted.
Next, come back here and ask for help getting setup and adjusted for your best possible therapy.

Obviously if you don't take charge no one will.
Good luck

_________________
Mask: SleepWeaver 3D Soft Cloth Nasal CPAP Mask with Headgear
Additional Comments: AurCurve 10 ASV Also using Sleaplyhead 1.1, ResScan 6 and CMS50i

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: My poor, neglected sleep study

Post by Pugsy » Sun Mar 01, 2015 2:23 pm

bwexler wrote:Since you had no OA and 17 CA, I would guess you have central sleep apnea. I would then guess that you need an ASV machine like I use.
No...most likely just regular cpap.
The AHI was high because of hyponeas which normally responds well to regular cpap. I suppose that there is a remote chance that the hyponeas might lend to more central in nature but that wouldn't be common.

Next step would be an in lab titration sleep study with cpap and see if those hyponeas respond to regular cpap before worrying about that high end ASV machine. That would also be a good time to keep a watch on the centrals...an in lab sleep titration study in this case would be what would probably be the best way to go instead of just getting apap machine and letting it find the pressure.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
quirkyone
Posts: 6
Joined: Sun Mar 01, 2015 1:22 pm
Location: Metro Boston

Re: My poor, neglected sleep study

Post by quirkyone » Sun Mar 01, 2015 4:09 pm

Awesome! Something else to make my 2015 fun and exciting.

This is the last straw with my PCP. I contacted her multiple times after I received the data to ask whether she wanted to follow up with me about the results (I knew enough to know they were bad; I just wanted to be sure I wasn't misunderstanding something) and she never replied. She's wonderful when she knows how to handle a situation, but if she finds a question annoying or out of her comfort zone she ignores it. Overlooking this problem crosses a line that is really uncool.

Thanks to my amazing luck I took a spill down our stairs and I'm currently at a rehab facility (read: nursing home) due to a fractured ankle, two busted knees, an injured hip, neck issues, and some problems with vertigo. There's a special pulmonary care unit here, so I'm hoping that my doctor is willing to call on a pulmonologist to work the titration study into my stay. I'm sure I'll look stunning with both a cervical collar and nose pillows.

I'm sure I'll be back before too long once I've done some research. Thanks for all the newbie help!

User avatar
chunkyfrog
Posts: 34377
Joined: Mon Jul 12, 2010 5:10 pm
Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: My poor, neglected sleep study

Post by chunkyfrog » Sun Mar 01, 2015 4:14 pm

Ouchie! But Interesting,
A few people here have had good luck using a cervical collar in place of a chin strap.
Edit: good idea to push for titration right away.
Your broken bits need oxygen to heal!

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Airsense 10 Autoset for Her

User avatar
quirkyone
Posts: 6
Joined: Sun Mar 01, 2015 1:22 pm
Location: Metro Boston

Re: My poor, neglected sleep study

Post by quirkyone » Sun Mar 15, 2015 7:52 am

So I discovered that my PCP never followed up with me because she received only 3 pages of a 10 page report. Of course, the relevant data were included in the three pages, but she was looking for the summary with a diagnosis and treatment recommendations. We're not able to obtain the CPAP while I'm at the rehab center because the expected arrival date is my last approved day here at the facility. My PCP still isn't comfortable writing the prescription for the equipment herself (?) so I'm searching for a doctor who' s a little more concerned about me not randomly dying in my sleep.

One question, since you were all so helpful before. I was planning to get the ResMed AirSense 10 For Her, but the company's description says the machine has "the first algorithm designed to treat mild to moderate sleep apnea..." Does that just mean the special "for her" setting is designed for mild to moderate problems? I need to know whether the machine is in fact OK for treatment of severe sleep apnea.

Thanks again

User avatar
AMK
Posts: 398
Joined: Mon Feb 23, 2015 8:34 am

Re: My poor, neglected sleep study

Post by AMK » Sun Mar 15, 2015 8:07 am

I have severe apnea in REM sleep and I use that machine.

User avatar
archangle
Posts: 9294
Joined: Sun Mar 27, 2011 11:55 am

Re: My poor, neglected sleep study

Post by archangle » Sun Mar 15, 2015 10:46 am

quirkyone wrote:One question, since you were all so helpful before. I was planning to get the ResMed AirSense 10 For Her, but the company's description says the machine has "the first algorithm designed to treat mild to moderate sleep apnea..." Does that just mean the special "for her" setting is designed for mild to moderate problems? I need to know whether the machine is in fact OK for treatment of severe sleep apnea.
The for her model also does the same "for him" mode that the other autoset does.

It also has the "just blow a fixed pressure" manual CPAP mode.

The for her also detects RERA's, which the for him doesn't.

_________________
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Also SleepyHead, PRS1 Auto, Respironics Auto M series, Legacy Auto, and Legacy Plus
Please enter your equipment in your profile so we can help you.
Click here for information on the most common alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check for yourself.

Useful Links.

User avatar
quirkyone
Posts: 6
Joined: Sun Mar 01, 2015 1:22 pm
Location: Metro Boston

Re: My poor, neglected sleep study

Post by quirkyone » Sun Mar 15, 2015 11:57 am

Thanks. It's because of the RERA tracking I want that model. I'm not girly enough to care about the design. I'd probably have to hide the pink S9 under a throw pillow.