How to Interpret Detailed Sleep Test Results?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
ericlhyman
Posts: 24
Joined: Fri Jan 30, 2009 2:03 pm

How to Interpret Detailed Sleep Test Results?

Post by ericlhyman » Fri Feb 13, 2009 11:19 am

I know that greater than 30 apneas per hour is classified as "severe", but how can I get a better understanding of what the rest of the detailed data from a sleep test shows? What are the norms and what does it all mean?

The summary data from the report:

Percent of time in bed:
Total sleep time 92.7%
Total Stage N1 Sleep 1.5%
Total Stage N2 Sleep 43.5%
Total Stage N3 Sleep 33.7%
Total REM Sleep 14.0%

Latency to first epoch of sleep 0.2 hrs
Latest to first 10 min. of sleep 0.2 hrs
REM latency 2.1 hrs
Stage N1 latency 0.2 hrs
Stage N2 latency 0.2 hrs
Stage N3 latency 0.2 hrs

Range of obstructive apnea events 13-52 sec
Range of obstructive hypopnea events 11-65 sec
Range of central apnea events 0 seec
Average Sa02 During wake 95%
Lowest desaturation 85%

Total apnea/hypopnea index 27.5 NREM, 54.8 REM, 40.1 total
Avg 02 desaturation level -- 93% NREM, 94% REM, 93% total
Lowest 02 desaturation level -- 85% NREM, 87% REM, 85% total

REM Respiratory disturbance index 55/hour

PLM index 0
PLMs + PLMAs 0
Respiratory arousals index 35
Spontaneous arousals index 4.3
Total arousals index 39.3

Avg wake heart rate 73
Avg sleep heart rate 79

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rested gal
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Joined: Thu Sep 09, 2004 10:14 pm
Location: Tennessee

Re: How to Interpret Detailed Sleep Test Results?

Post by rested gal » Fri Feb 13, 2009 1:57 pm

I'm not a sleep professional. I'll just touch on a few of the things in your report that I think I understand (could be wrong, of course):

From "Lights out" when recording began, to "Lights On" when they stopped recording in the morning, you slept 92.7% of the time.

Latency is how long it takes for the person to reach "sleep onset", or whatever stage is being talked about.
It took you .2 hours (someone with better math skills than I have can figure how many minutes that was ) for you to fall asleep from the time the lights were turned off.

Stage N1 sleep might be described "just drifted off to sleep. Very light sleep, not really restful sleep -- more like a transition stage between "awake" and the more restful Stage N2.

Stage N2 is restful sleep.

Stage ]N3 (used to be divided into Stage 3 and Stage 4) is also restful sleep and is sometimes referred to as "deep sleep", "Delta", or "Slow wave" sleep. Human growth hormone is released during N3 sleep, I believe I've read. This might be considered the most "restorative" stage of sleep.

Infants and children spend a lot of time in N3. Older adults, less so.

Those 3 "N" stages can also be lumped together and called "NREM" (non-REM) sleep.

REM (Rapid Eye Movement) is when most dreaming probably takes place.

The first REM usually occurs about an hour and a half after a person has fallen asleep.
It took a little longer than that for you to reach your first REM. It took you a little over two hours to hit your first REM ("REM latency 2.1 hrs.")

Additional REM cycles happen about every 90 minutes throughout the night, with each REM stage usually getting longer and longer. Longest REM is generally toward the end of the sleep session.

Some excerpts from http://www.sleephomepages.org/sleepsyllabus/d.html :

REM occupies about twenty to twenty five percent of total sleep, a figure which remains relatively constant throughout childhood, adolescence and adulthood.
---
The alternation of NREM and REM sleep, which occurs at approximately 90-100 minute intervals in middle-aged adults
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In contrast to REM sleep, Stages 3 and 4 of NREM sleep (i.e., synchronized, delta wave sleep, slow wave sleep) show a steady decrease across the lifespan
---
Beginning in early adolescence, there is a gradual decline in delta wave sleep. Even within college age populations, this age-related decline can be observed. This decline continues throughout adulthood. This decrease in Stages 3 and 4 sleep is generally replaced by NREM Stages 1 and 2. By the time the average human reaches age 75, Stage 4 sleep, the sleep with the most abundant delta waves, may be virtually absent.
---


StillAnotherGuest (as sleepydave on another message board) once wrote this about "normal" sleep stage percentages:

Normal sleep% are:
Stage 1 - 5%
Stage 2 - 55%
Stage 3/4 - 20%
REM - 20%

Stage 1 is only a transition state from wake to stage 2 and has no real rest value. A lot of it means inability to initiate and/or maintain sleep.
Stage 3/4 (SWS) decreases as a function of age, or if you're subject to constant arousals, as in OSA. You may still be having some SWS, but isn't scored as such because it fails to meet scoring criteria.


Your study showed that you had no central apneas.

You had no "PLM"s (Periodic Limb Movements.) So, you don't have PLMD -- Periodic Limb Movement Disorder which is a sleep disorder in and of itself.

The things that are listed as an "index" are an "average per hour."

"Respiratory arousals index 35" means that your struggle to breathe while sleeping was interrupting whatever stage of sleep you were in, thirty-five times an hour on average.

"Total apnea/hypopnea index 27.5 NREM, 54.8 REM, 40.1 total" -- In the "non-REM" stages of sleep, apneas and hypopneas were hitting you to the tune of an average of 27.5 times an hour. In REM (where apneas/hypopneas do tend to occur most often for most people) you were getting slammed with an average per hour of about 55 apneas/hypopneas.

"Lowest desaturation 85%" -- the oxygen saturation shouldn't drop below 90% while we sleep.

"Range of obstructive apnea events 13-52 sec
Range of obstructive hypopnea events 11-65 sec"
That's how long your individual apneas and hypopneas were lasting. Some of them up to almost a full minute of not getting any air at all (apnea) or not anywhere near enough air (hypopnea) despite your struggle to breathe during those events.

Average heart rate looks good to me. But I'm not a doctor!

Looks like you're made for CPAP, ericlhyman. Using a machine already?
ResMed S9 VPAP Auto (ASV)
Humidifier: Integrated + Climate Control hose
Mask: Aeiomed Headrest (deconstructed, with homemade straps
3M painters tape over mouth
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