Understanding my Sleep Study

[wmcanally]

Hello. Iim a 44 year old male. I have snored for 20 years. Worse over the last 2 years. I talked to my doctor about having a sleep study. Many of my co workers have had the study and are being treated for sleep apnea. I went in for the study a few weeks ago. I didn't sleep well at all. All those wires and probes wasn't comfortable. I met with the Doctor and got my results. I was told i have severe sleep apnea. I go in tonight to have another study wearing a CPAP mask. PLease help me understand the readings:
Total recording time was 417.2 minutes
Sleep Latency was 7.0
REM Latency was 111.5
Number of Awakings was 15
Number of Arousals was 481
Arousal Index was 81

Stage N1 was 118.0 TST % 33.2
Stage N2 was 229.5 64.6
Stage NE was 0
NREM ( 1+2+3) 347.5 97.9%
REM was 7.5 min
Total Sleep time was 355.0 min
Wake after Sleep Onset was 41.0
Sleep Efficiency was 85.1
Respitory Events
Obstrutive Apenas Supine 15 Non 1 NREM was 16 Overall was 16
No Mixed apenas
No central Apenas
Hypopenas # Supine 227 Non Supine was 122 REM was 4 Non REM 345 Overall 349
Apenas + Hyponeas was Supine 242 Non Supine was 123 REM was 4 NREM was 361 Overall 365
Apena Index Supine 5.3 Non Supine .3 NREM was 2.8 Overall was 2.7
Hypopnea index Supine was 80.4 Non Supine was 39.8 REM was 32.0 NREM was 59.6 Overall was 59.0
Apnea + Hypopnea Index Supine 85.7 Non Supine was 39.8 REM was 32. MREM was 62.3 with a overall of 61.7 My doctor said this was bad

Oxygen Saturation Data

COntininous Oxygen Saturation mean: 93.7
Minimum was 82.5
02 Saturation
0.0- 90.0 was 8.7
0.0 to 85.0 was 0.4

Cardiac Data
Average heart rate during sleep 62.2
Highest during sleep was 96.0
Lowest during sleep was 52.0

No Movement events

Im new to this new event in my life. I will do whatever to get better. I know i will have a CPAP machine. I hope these reading are not the worst ever. Please any guidance wll be greatly appreciated. Sleep study tonight with CPAP. I do not drink oe smoke or take any sleeping pills . I fall asleep very quick at night. And surprising im not tired or sleepy during the day. DOnt wake up with headaches, or wake up coughing or short of breath. I do take medicene for high blood pressure and i do have Asthama.. Thank you so much for any feed back recieved

[robysue]

For a detailed tutorial on all these numbers you can read my Understanding the data in your sleep report

[JohnBFisher]

Though robysue is our great educator ... and I'm being serious about that - do take a look at her blog entry that explains sleep studies ... I thought I would try to answer some of your questions about your sleep study. My answers and thoughts will appear "in-line".

... Hello. Iim a 44 year old male. I have snored for 20 years. Worse over the last 2 years. ...

Greetings! Welcome to the forum. Many of us start snoring in our late teens and then the apnea becomes an issue when we hit our 30s or 40s. You were wise to put the experience of others to work for you ... learn from their struggles ... and avoid having the apnea become serious before you check to see if it was an issue. So, if you think "I should have waited...", don't! By waiting you would do serious damage to your body. Untreated sleep apnea can lead to cardiovascular problems (heart attacks, high blood pressure, strokes, kidney damage), as well as metabolic disorders (such as Type 2 Diabetes). Avoiding all of that is a VERY good idea.

... I went in for the study a few weeks ago. I didn't sleep well at all. All those wires and probes wasn't comfortable. ...

I've often wondered if the sleep study is a sleep torture test!

... I met with the Doctor and got my results. I was told i have severe sleep apnea. I go in tonight to have another study wearing a CPAP mask. Please help me understand the readings: ...

Again, some description of the section and my thoughts will be in-line. But remember, like you I am just another patient ... but one that's been doing this a LONG time. So, I've had some experience and reading behind my thoughts.

... Total recording time was 417.2 minutes
Sleep Latency was 7.0
REM Latency was 111.5
Number of Awakings was 15
Number of Arousals was 481
Arousal Index was 81 ...

They are trying to see how normal your sleep is .. and how often your sleep is interrupted. They recorded you for about 420 minutes (420/60 = 7 hours). It only took you 7 minutes to fall asleep ... not long at all. But it took almost TWO HOURS before you started REM sleep. That's delayed at least 30 minutes. We normally reach REM sleep every 60 to 90 minutes.

Arousals are when the body does not fully awaken, but has to lift itself from deeper sleep to lighter sleep to allow you to breathe more easily. So, in 7 hours you woke up 15 times (about twice an hour). But you roused from deeper sleep to lighter sleep about 81 times per hour!!! That's getting close to twice a minute!!!

You say you are not feeling rested? Well, THERE'S your problem! You are NOT!

... Stage N1 was 118.0 TST % 33.2
Stage N2 was 229.5 64.6
Stage N3 was 0
NREM ( 1+2+3) 347.5 97.9%
REM was 7.5 min
Total Sleep time was 355.0 min
Wake after Sleep Onset was 41.0
Sleep Efficiency was 85.1 ...

Our bodies cycle through various levels of sleep during the night. Stages N1, N2 and N3 are Non-REM stages of sleep (hence the "Stage N" designation). There is a normal distribution of sleep cycles for normal adults. You are getting VERY little REM and Stage N3 sleep. These stages are VITAL to your health. Stage N3 (deep sleep) allows your body to repair and reset from the previous day. REM sleep (and the dreams associated with it) are vital to proper functioning. When I was diagnosed (sleep apnea was not well understood at the time), I had reached the point where I would blink (during the day) and dream during the blinking. Talk about dangerous (imagine having that happen when driving!!).

Though it may not be obvious to you, this information points to an extreme disturbance in your sleep. Your sleep apnea has a severe impact on your sleep.

... Respiratory Events
Obstrutive Apenas Supine 15 Non 1 NREM was 16 Overall was 16
No Mixed apenas
No central Apenas
Hypopenas # Supine 227 Non Supine was 122 REM was 4 Non REM 345 Overall 349
Apenas + Hyponeas was Supine 242 Non Supine was 123 REM was 4 NREM was 361 Overall 365
Apena Index Supine 5.3 Non Supine .3 NREM was 2.8 Overall was 2.7
Hypopnea index Supine was 80.4 Non Supine was 39.8 REM was 32.0 NREM was 59.6 Overall was 59.0
Apnea + Hypopnea Index Supine 85.7 Non Supine was 39.8 REM was 32. MREM was 62.3 with a overall of 61.7 (My doctor said this was bad) ..

Here we have information about your breathing during the night -- and any respiratory problems encountered.

First, the obstructive apneas are separated by being on your back and not. As well as during REM sleep and not. As you can see, most of your respiratory events were on your back and during Non-REM sleep.

There were no "mixed or central apneas". This is good. Mixed apneas tend to start as a central apnea but end as an obstructive apnea. That is, there is no effort on the part of your body to breathe, but when you do resume the effort, there is an obstruction. Lack of any effort to breathe can occur due to several reasons. Fortunately, none of them apply to you. This is good, since either CPAP or BiPAP will help you address your problems.

Then the hypopneas (low breathing) is broken down by when you were on your back and note and when you were in REM sleep and note. So, in addition to the full blown apneas, you have some severe flow limitations (hypopneas). Though not as severe, it can cause arousals and oxygen desaturation.

The apnea index tells you the average number of apneas per hour (2.7). 5 or less apneas (AND hypopneas) per hour is considered "normal". So, that's not too bad. You will note the number if worse when you are on your back and in Non-REM sleep.

The hypopnea index tells you the average number of flow limitations observed per hour (59). Again, or less hypopneas (AND apneas) per hour is considered "normal". 59 is horrible. It means that about once per minute you have a flow limitation. You will note again that the numbers are worse on your back in and Non-REM sleep.

And finally the Apnea + Hypopnea Index (AHI) tell you the average flow limitations and stopages that occur per hour. 5 or less of both events per hour is considered normal. Almost 62 is considered "Severe". It means that about once per minute you either stop breathing or are not getting enough air to your lungs. Not good!

... Oxygen Saturation Data

COntininous Oxygen Saturation mean: 93.7
Minimum was 82.5
02 Saturation
0.0- 90.0 was 8.7
0.0 to 85.0 was 0.4

Cardiac Data
Average heart rate during sleep 62.2
Highest during sleep was 96.0
Lowest during sleep was 52.0 ..

And this is why. The flow limitation and stoppage can result in desaturation and impacts the heart. Though your situation is not horrible, it's not good either.

First, the good news is that you did not appear to have severe problems with your heart. While 96 is high, you do not (according to the information you typed) appear to have heart rhythm problems. Nor is the higher heart rate too high. It's not good, but not fighting to breathe should help it settle down.

My guess is that you are on the verge of developing high blood pressure. Getting your sleep under control will help keep that from becoming a big problem for you.

And while you did have oxygen desaturation (not enough oxygen in your blood), it was not too severe. Your average value stayed above 90%. Your lowest value was 82.5%. If nothing changed, anything below 88% requires supplemental oxygen. Fortunately CPAP therapy should keep your airway open and allow the oxygen levels to return to normal.

... No Movement events ..

You did not experience periodic limb movements ... sometimes our brains discover that if we have leg or arm jerks it arouses us, which helps keep the airway open. Unfortunately, it can take time for the periodic limb movement to subside after starting CPAP therapy.

In your case, this is not a concern.

... I'm new to this new event in my life. I will do whatever to get better. I know i will have a CPAP machine. I hope these reading are not the worst ever. Please any guidance wll be greatly appreciated. Sleep study tonight with CPAP. I do not drink oe smoke or take any sleeping pills . I fall asleep very quick at night. And surprising im not tired or sleepy during the day. DOnt wake up with headaches, or wake up coughing or short of breath. I do take medicene for high blood pressure and i do have Asthama.. Thank you so much for any feed back recieved

Your blood pressure may return to normal after starting CPAP therapy. That often happens. It might not happen right away.

Though you feel "fine", you will be amazed at how much better you feel after starting CPAP therapy. Though it's a nuisance to use CPAP therapy, it sure beats the consequences of ignoring it.

And the good news is that with a good attitude and desire to learn more, you should adjust to CPAP therapy fairly easily. So, here's to you getting a lot more productive sleep in the nights ahead!!

Hope all this helps.

[Lizistired]

I hope your titration goes well. I look forward to hearing how you feel after you get some real sleep!

[wmcanally]

I cant begin to thank each of you for taking the time to help educate me. I've excepted that i have this problem and will do all and everything i can to control it. Thank each of you for guiding me through the available videos, posts info in different machines. This is my first time joining a forum of any kind. I have anxiety and believe me this helps talking to others who share my problem with sleep apnea. i look forward to a good nights sleep tonight with the study with the CPAP . ( at least i hope i do) May god bless you all.

Wayne~~~

[Mr Bill]

wmcanally, welcome to this forum! JohnBFisher and Robysue have both given you great responses. I just finished reading them and Robysue's blog link. @JohnBFisher, that is the most detail I have heard about stages of sleep, I found it very informative. @Robysue I like the way you have laid out the sleep study results.

Hello. Iim a 44 year old male. I have snored for 20 years. Worse over the last 2 years. I talked to my doctor about having a sleep study. Many of my co workers have had the study and are being treated for sleep apnea. I went in for the study a few weeks ago. I didn't sleep well at all. All those wires and probes wasn't comfortable. I met with the Doctor and got my results. I was told i have severe sleep apnea. I go in tonight to have another study wearing a CPAP mask.

JohnBFisher covered the results really well, I too got even less sleep during my first sleep study. I was a wreck all the next week. My sleep efficiency was ~24%. After my second sleep study when I was titrated for an ASV I only got 1.5 hours of sleep but I felt wonderful for the whole week while I was waiting for my ASV to arrive.

Im new to this new event in my life. I will do whatever to get better. I know i will have a CPAP machine. I hope these reading are not the worst ever. Please any guidance wll be greatly appreciated. Sleep study tonight with CPAP. I do not drink oe smoke or take any sleeping pills . I fall asleep very quick at night. And surprising im not tired or sleepy during the day. DOnt wake up with headaches, or wake up coughing or short of breath. I do take medicene for high blood pressure and i do have Asthama.. Thank you so much for any feed back recieved

I had no idea just how sleep deprived I had been until I started getting actual sleep. When you get finished with this first study they may or may not recommend a Durable Medical Equipment Provider (DME). My sleep tech gave me a list of local DME's and emphasized that he was not legally allowed to recommend any one over another. Be sure and post the recommended machine type here. Soon afterward, somebody who has that type of machine will respond and give you their opinion of the best model to try and get. You will want a data capable machine so you can monitor your progress at home. I too have high BP and mild asthma. I am sure your blood pressure will decrease. I suggest you get yourself a cuff and start taking your blood pressure each morning right after you wake up. My doctor says that blood pressure rises in the morning and that is when most people die of stroke or heart attack. I found my morning blood pressures dropped steadily as therapy continued. So, I think you will have good news to show your doctor. Also my asthma has a strong GERD component. Many of us with sleep apnea also have acid reflux. But there is no causal relationship demonstrated, so far. Acid reflux / GERD can exacerbate asthma by irritation of the vagus nerve which in turn causes sinus drainage. If this is ringing a bell, then consider raising the head of your bed by six inches. Well, good luck and again welcome to the forums.

[robysue]

Though robysue is our great educator ... and I'm being serious about that - do take a look at her blog entry that explains sleep studies ...

@Robysue I like the way you have laid out the sleep study results.

Thanks to both of you for the nice complements!

[quote"JohnBFisher"] I thought I would try to answer some of your questions about your sleep study. My answers and thoughts will appear "in-line".[/quote]And thanks for taking the time to do the line by line analysis of the OP's sleep study. When I have the time, I like to do that with folks. This morning, I didn't. And that's really the whole point of my blog. You did a great job John of going through the OP's post line by line and explaining stuff.