Sleep Study Results Obtained

I had my appointment with my sleep doctor yesterday and received a copy of my study--I can't believe it was back on October 16th. Sadly, because of a sneaky DME supplier, I only had five nights of data to present to her. But, that being said, she told me I keep waking up all night (OMG, really)?? Actually, she was very nice this time, but continues to believe that straight CPAP therapy is the way to go. She is going to increase my pressure from 12 to 14 for now to see if that helps me stay asleep. I asked her if I had OSA or CSA, and she answered that I have both. The study data lists severe OSAHS. I had "22 central apneas, 7 mixed apneas, 21 obstructive apneas and 173 hypopneas for an AHI of 36.9." It says that REM sleep was not achieved during the study.

When I again asked her about the apnea being opiate related, she maintained her belief that the morphine is not causing the apnea events. When I asked about additional therapy like ASV, she said she does not want to do that at this point because it becomes really involved with checking the blood gases, o2 saturation levels, etc. She said she will, of course, if necessary, but is hoping the increased pressure will work over time.

Since Advanced Oxy-Med dropped the ball by not giving me the full data machine initially (thanks to the folks here, I now have one), one of the Supervisors is coming here Monday to explain the machine and bring me a couple of other mask choices. My current PR System One C flex+ has a heated humidifier, but of course, they did not give me the heated hose. I think I should ask for that as well after reading about it. It makes sense to have it.

I am still very inexperienced in this apnea world and value any feedback on the study results that anyone may have. I guess I was just hoping that, after a month of therapy, I would be sleeping for more than 2 or 2 1/2 hours in a row. But, I'm trying not to stress too much over the fact that I'm not yet. I just hope there's a chance that I can get back on track after all these years. Thanks. ~Susan

Morphine may not cause apnea, but I believe it's likely responsible for the number of centrals you have... I'd almost be surprised if it wasn't!

perchancetodream7 wrote:, she said she does not want to do that at this point because it becomes really involved with checking the blood gases, o2 saturation levels, etc.

ignorance, or lies, not sure which.

Susan, can you get SleepyHead up and running and show us those five nights of data? I'd sure like to see what your sleep doctor was looking at when she decided that straight CPAP was still the way to go -- and at an even higher pressure.

perchancetodream7 wrote: I guess I was just hoping that, after a month of therapy, I would be sleeping for more than 2 or 2 1/2 hours in a row.

But remember, it's been a month of questionable therapy (remember, no treatment data?!?) and quite possibly on the wrong machine(s)!

perchancetodream7 wrote:She is going to increase my pressure from 12 to 14 for now to see if that helps me stay asleep.

Yeah that'll help.

palerider wrote:

perchancetodream7 wrote:, she said she does not want to do that at this point because it becomes really involved with checking the blood gases, o2 saturation levels, etc.

ignorance, or lies, not sure which.

I have to agree. I bypassed GO and went straight to an ASV machine because the cpap caused centrals to appear which is different than your situation but I never heard anything about checking blood gases or O2 levels. Although, I'm curious myself about my O2 and will probably go ahead and get an oximeter for my benefit but not because the sleep doc said I needed to be on one.

Ogeo wrote:I'm curious myself about my O2 and will probably go ahead and get an oximeter for my benefit but not because the sleep doc said I needed to be on one.

it's good to know these things. most people probably don't need to monitor, but, for instance, my friend with CHF, took his asv into the hospital with him when he had his cath done, and they stuck an oximeter on him, as is routine, and ended up putting him on supox, because even with the asv doing a good job, his o2 levels would get into the 80s for a while, after that I bought one of the cms50 units and after seeing that he was still having problems, i found a concentrator on craigslist, and got that going for him, and now he stays in the 90's all the time.

we haven't experimented to see if he still needs the supox now that he's much better, but do check his o2 sats overnight occasionally just to make sure that things still look good.

Great. Just great. Well, there is something I forgot to include in my post. The entire time I was with the doctor she kept trying to allude to the fact that I am causing my sleeplessness. She thinks I'm "obsessing" about not being able to get to sleep and that's why I keep waking up so often. She said I keep wondering if the machine will work...why isn't it working...blah, blah, blah. This really isn't the case. I went into this very optimistically and pro-actively. So perhaps this is a new kind of treatment option--when specialist cannot solve problem...blame patient!

I will play her game until the next appointment in three weeks; I kind of have to at this point. But, if in three weeks there is still zero change, I want an alternate therapy, or a new doctor. Honestly, I am still shocked that she wouldn't change the machine and even more shocked that she is saying it's due to my obsessing over sleep. I actually don't obsess over it--I just showed her a stack of research printouts from this forum and studies from the Journal of Clinical Sleep Medicine (of which she should be well aware of).
Her last words to yesterday were that this CPap therapy will be the answer. I don't believe it--for good reason.

BTW, Sludge, is it safe to assume you were being sarcastic when you said "yeah that'll help" regarding increasing the pressure from 12 to 14. I was very disappointed when she said that. Her rationale was that maybe the extra pressure will keep the airway more fully open and allow me to stay in REM longer.

Thanks for the replies and all the help. This is a nightmare. ~S

kaiasgram wrote:Susan, can you get SleepyHead up and running and show us those five nights of data? I'd sure like to see what your sleep doctor was looking at when she decided that straight CPAP was still the way to go -- and at an even higher pressure.

We are still waiting for the card reader to arrive; my husband thinks he will be able to use Sleepyhead once he gets that. As soon as that happens I will download my info and love to know what you think. Thanks.

perchancetodream7 wrote: So perhaps this is a new kind of treatment option--when specialist cannot solve problem...blame patient!

no no, that one's as old as the hills, it's a time honored go-to.

perchancetodream7 wrote:

kaiasgram wrote:Susan, can you get SleepyHead up and running and show us those five nights of data? I'd sure like to see what your sleep doctor was looking at when she decided that straight CPAP was still the way to go -- and at an even higher pressure.

We are still waiting for the card reader to arrive; my husband thinks he will be able to use Sleepyhead once he gets that. As soon as that happens I will download my info and love to know what you think. Thanks.

Can't wait! Meantime, what is your machine showing for your AHI over the past five nights and what is the central component of that AHI?

perchancetodream7 wrote:When I again asked her about the apnea being opiate related, she maintained her belief that the morphine is not causing the apnea events. When I asked about additional therapy like ASV, she said she does not want to do that at this point because it becomes really involved with checking the blood gases, o2 saturation levels, etc. She said she will, of course, if necessary, but is hoping the increased pressure will work over time.

Well, that is certainly no surprise:

Sludge on ASAA Wed Dec 03, 2014 9:50 am wrote:IIWY I'd get those sleep study results right now so you'll be able to have a more to talk about on the 12th. If there is something critically wrong, you may not be able to determine that there and more time will be wasted. If there is nothing obviously wrong, all they come up with is "You need to give it more time", but (if) what you really need to do is head in a whole new direction, then it's going to take even longer.

But I guess the other forum collapsed before you read that.

Did you not have a CPAP titration?

perchancetodream7 wrote:I asked her if I had OSA or CSA, and she answered that I have both. The study data lists severe OSAHS. I had "22 central apneas, 7 mixed apneas, 21 obstructive apneas and 173 hypopneas for an AHI of 36.9." It says that REM sleep was not achieved during the study.

When I again asked her about the apnea being opiate related, she maintained her belief that the morphine is not causing the apnea events. When I asked about additional therapy like ASV, she said she does not want to do that at this point because it becomes really involved with checking the blood gases, o2 saturation levels, etc. She said she will, of course, if necessary, but is hoping the increased pressure will work over time.

Based on those results, your total sleep time was 6.04 hours, which makes your central apnea index 3.6.

Consequently, you didn't/won't qualify for an ASV anyway, since that index needs to be > 5.0.

I suppose you could buy one out-of-pocket, but IIWY I'd get a new car instead.

kaiasgram wrote:

perchancetodream7 wrote:

kaiasgram wrote:Susan, can you get SleepyHead up and running and show us those five nights of data? I'd sure like to see what your sleep doctor was looking at when she decided that straight CPAP was still the way to go -- and at an even higher pressure.

We are still waiting for the card reader to arrive; my husband thinks he will be able to use Sleepyhead once he gets that. As soon as that happens I will download my info and love to know what you think. Thanks.

Can't wait! Meantime, what is your machine showing for your AHI over the past five nights and what is the central component of that AHI?

The machine AHI, reads: 7 day average 6.7 (adding the last two nights as well). I don't know the central component of that. If it's there, I can't find it.

Sludge, the other did in fact go down before I read your post. Yes, I had a titration study done, but when I was in the doctor's office Friday I asked the receptionist for a copy of my sleep study, believing that she would give me the complete package. All she copied was the initial test. I guess it's my fault, once again. I just assumed she'd realize I wanted my before AND after results.

She also told me to take a klonopin tablet every night before putting the mask on to "help" me stay asleep. I am not comfortable with that because #1--it doesn't keep me sleeping, and #2--I feel it may intefere with the accuracy of the therapy results. Thanks again to all who've been helping me; without you I would probably have cracked like an egg by now. ~S