Dr says I don't have sleep apnea anymore but....

[HanzT]

Hi, I just had a sleep test after loosing about 15 pounds and now, according to my doctor, I should put my machine in the closet because "it's making it worse" since I can see events on my machine when I look at the data. I am both happy and somewhat questioning his conclusions. My test was done without the use of a CPAP machine and shows AHI of 1.1 but also Apnea/hypopnea/RERA index of 3.8/hr and some o2 desat to 85%. Most my events happen while on my back. Also, the amount of time in REM sleep seems super low to me. Could any of you experts comment on the test results? I just want to make sure its not a quick "you're fine now leave me alone" type diagnosis. Thanks much.

[sleepstar]

I do agree with you.
You've barely had any REM sleep. Normal is around 20-25% of the total sleeping time - yours is 4%. So ideally we would like to see more REM, and even better is seeing REM when you're supine. And, unfortunately, you haven't had any REM on your back. Additionally you seem to have slept poorly that night (you were awake for almost 40% of the time you were in bed)

Do you sleep on your back at home? What was your previous AHI? Did you sleep on your back during that study? Did you have REM? Would be interesting to see.

Keep in mind that these results are great in the regards there's no sleep apnea! And you did sleep on your back (when sleep apnea is usually worse) so this is great news!

[HanzT]

Hi, I try not to sleep on my back at home since I still have some GERD. I would have to look up my past AHI but it was in the teens to 20's from what I remember. What does EEG arousal mean? Does that wake you up or just mean change in brain waves? The page not shown on this post says no abnormal EEG/EKG events noted. Kind of confusing.

[sleepstar]

Hi, I try not to sleep on my back at home since I still have some GERD. I would have to look up my past AHI but it was in the teens to 20's from what I remember. What does EEG arousal mean? Does that wake you up or just mean change in brain waves? The page not shown on this post says no abnormal EEG/EKG events noted. Kind of confusing.

EKG is your heart. EEG is your brain waves.

EEG arousal is when your brain waves change briefly (at least 3 seconds) - called an "arousal". Arousals are normal up to an extent (many people have ~15 arousals an hour but don't have sleep apnea)

[grayghost4]

I don't think I would put it on the top shelf.... not yet .

[sleepstar]

Hmmm.

I may be very tired and reading the data wrong, but I don't think it makes sense.

It says you had 10 arousals all night. But you had 12 RERAs. To score a RERA, you need an arousal. So arousals can't be lower than RERAs.

Someone please correct me if I'm reading it wrong. I need sleep

[HanzT]

That 10 only refers to EEGs.

[sleepstar]

That 10 only refers to EEGs.

They should still be EEG arousals

Plus it says that the respiratory arousals are even less, saying 5 arousals

RERA stands for respiratory effort related arousal. You had 12 RERAs. So you should have at least 12 respiratory arousals. Instead you have 5.

[kteague]

I think you are right to question the doctor's suggestion in view of these results. I think my bottom line is that these results are inconclusive, and for the doctor to tell you to stop using your machine based on this information alone boggles my mind. You had no Stage 3 sleep. REM was limited. Though you were supine for a while, you were not supine in REM, which is where many run into the most trouble. Who knows how many events and how low the desats if all scenarios had been there for observation. When I had test results without REM while supine, my doctor termed the study "technically suboptimal". One cannot reach an absolute conclusion on incomplete information.

All that said, what caught my eye the most was the heart rate. Is this a typo? (Wake 41 NREM 14.1 REM 23.6) Are you under the care of a cardiologist? If this was already mentioned somewhere in your history I apologize.

[HanzT]

Thanks for your comments guys. Im building a good list of questions for my doctor for sure.

kteague, I noticed the heart rate numbers too. All I can think is that its an error. I have never seen numbers like that one any other study, not on my home O2 monitor (my lows are usually in the 40's), and I have even had a 24 halter test and that didn't show up. So it causes me to question the time my doctor took to look at this report if that didn't come up in our conversation. I also will ask about the REM and stage 3 sleep. Thanks!

[HoseCrusher]

Welcome back from the dead. A heart rate of 15 beats per minute under normal sleeping conditions is not good...

Bad sensor, perhaps?

A conversation may go something like this...

Hello doc. I noticed the lab reported my heart rate dropped to 14.8 beats per minute during NREM. Under what circumstances is that considered normal...?

Also, do any of your previous records indicate a waking pulse of 41?

[kteague]

Maybe some of our sleep professionals on here can say if this is appropriate, but in view of others discussing numbers that don't make sense and the seeming heart rate error, maybe someone else needs to review your test in its entirety and issue a revised report. You don't want erroneous information in your medical records. They can affect so many things, like maybe job eligibility, insurance approval, etc.