newbie sleep study results - good, bad? still not adapting

[dtrain84]

one night, two -part test with and with out CPAP

OSA 327.23 (what is this #)
Severe OSA(resp Disturb Index = 55.7 events/hour) that produced severe sleep fragmentation and oxyhemoglobin desaturation (low saturation=81%, with 1.4% of sleep time at a saturation <90%). Load snoring in all positions. CPAP at 7 cm H2O eliminated apnea.

Sleep architecture
Initial sleep latency on the baseline study was 37 minutes and the sleep efficiency was 45%. NO deep and NO REM sleep was seen. During the CPAP trial sleep efficiency improved to 79% and 31% REM sleep emerged.

recording time 450.5
total sleep time 291
sleep efficiency 64.6%
sleep onset 37
REM latency 253.5
% stage 1 14.9
2 62.9
3 0
4 0
REM 22.2

Number of Events
Obstructive Apnea 12
Mixed Apnea 0
Central Apnea 1
Hypopnea 75
AHI 18.1
Average Awake H2O Saturation 96
Total minutes with SaO2<91% 5.7
Total......................<81% 0
Lowest %O2 Saturation 81

Sleep Stage Effect NREM REM
# of Apneas and Hypopneas 83 5
Apnea + Hypopnea Index 22 4.7

SLEEP FRAGMENTATION
Arousal Index 16.9 (arousals/hr. of sleep)

POSITION EFFECT % SLEEP SPENT in POSITION
- AHI
Supine 52.2 Supine 23.7
Right 0 Right 0
Left 7.6 Left 76.3


Well those are the results, I Have been trying CPAP on and off for over a year and still can't get used to it. Thanks to this board I requested my sleep study and have converted from a nasal mask to a FF mask trying to reduce mouth breathing.

My machine has always been sent to 9 but the sleep study report recommends a pressure of 8 cm (indicated 7 cm worked during sleep study but upped it to 8 "to allow him some leeway in the event" of more supine sleeping. I plan on reducing the pressure to 8 for tonight. Also I have ordered the puresleep product ( I know that is a sore point for many on this board) but it won't be arriving for about 3 weeks. If i still can't get a hang of this or seeing some progress in the next few weeks I will try out the product.

Any feedback or suggestions would be helpful. Sorry for the length of this submission.

[Snoredog]

DEFINITIONS:
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.

Normal Sleep Architecture:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%

Stage3&4, REM decrease as we age.

You are were shown not getting any deep sleep or Stage3/4. use the pressure that allows you to sleep, put it at 8 cm, if you have problems falling asleep at that pressure use a Ramp at 30 minutes with a lower pressure. Your pressure requirement doesn't fluctuate that much unless you have gained/lost weight.

[dtrain84]

Thanks for the response snoredog - I know from my surfing of this site that you have a lot of knowledge. I have lost about 10 -12 lbs since the sleep study would that affect my rate of pressure? and just curious how my sleep study numbers align up with an "average" CPAP client ( I know there is no typical or average OSA individual) but is it average?, severe? less than average?
Thanks.

[kteague]

Feeling better is a reasonable expectation once one has their therapy optimized (mask, pressure, etc) and using it consistently, and getting an adequate number of hours sleep each night. You related, "I Have been trying CPAP on and off for over a year and still can't get used to it." It isn't clear how much of that time you've been at it consistently, but I would think expected results would be proportionate.

Have you asked your doctor about taking something to help you sleep while adjusting? Are you on any meds known to disturb sleep? Did your study mention any limb movmements? With your numbers looking decent, mouth breathing addressed, and leaks controlled, hopefully you will be able to sleep better, get some deep sleep, and thus feel results.

If you are doing your part and it's not happening, I think I'd be wondering what else is going on. I know I struggled for the longest with cpap, but the cpap wasn't always to blame. When my limb movements aren't under good control, I wake frequently and feel agitated, and the first thing to get on my last nerve is the mask and headgear. (Only thrown it across the room once though.) When the movements are calm, I hardly notice the mask. Just saying, could anything else be contributing to your difficulty adjusting to this treatment?

Wishing you success in treating your severe OSA - some may have it worse, but yours is technically worse than mine and mine kicked my butt big time. Hang in there.

Kathy

[dtrain84]

bump