Sleep Study Results REM AHI vs NREM

[Meeseeks]

So I just got my sleep study results. My overall AHI came out to 20.6, but my REM AHI was 57.6 compared to 15 AHI with NREM. Shouldn't my sleep apnea be considered to be more severe if my REM AHI was so much higher? Isn't Rem sleep the most important sleep to get? Shouldn't your Rem AHI be the most important factor?
I'm assuming my overall AHI was considerably lower because they weren't able to record much rem sleep.

I know 20 AHI is still considered moderate sleep apnea, but there is a huge different between 57 AHI and 20 AHI.

Thanks for the help.

[BlackSpinner]

It doesn't really matter what it is called. You qualify for a xpap. Where it may matter is with your pressure needs. But pressure and severity have nothing to do with each other.

[Meeseeks]

It doesn't really matter what it is called. You qualify for a xpap. Where it may matter is with your pressure needs. But pressure and severity have nothing to do with each other.

I just feel like 20 AHI isn't really all that high in the grand scheme, at least compared to 60 AHI during rem sleep.

[BlackSpinner]

AHI is just an average useful by the power that be. There is a huge difference between and AHI of 20 when they are all 11 seconds and an AHI of 20 when they are 30 seconds long.

Anything over 15 is considered as something that needs treating if there are no other issues (like High Blood pressure, or dropping your O2 below a certain amount) If your overall AHI was below 15 but REM was over 60 then the REM AHI would probably be considered as important to the insurance company otherwise you met criteria and they don't care. This is why we tell people that you are the only one who really cares about your health.

[Pugsy]

What you have is actually quite common. I have it myself and in numbers very similar to yours.
The medical community has to have some sort of numerical evaluation and they don't really take the fact that while you only spend around 20% of the night in REM they can't extrapolate the AHI any better.
Mine was 12 in Non REM and 53 in REM but my oxygen went down to 70% and O2 levels aren't in there at all.

It is what it is though and it's kinda like being pregnant...there's not much in between.

These type of results to pose a serious argument for auto adjusting pressure machine though...apap.
Often when the OSA is worse in REM the pressure needs in REM are also substantially higher.
With apap machine you can use lower pressures for the times of the night where the pressure needs are lower and only use higher when needed in REM.
Let me tell you that 10 cm most of the night and having the machine go to 18 only when needed is much more comfortable than having to use 18 all night to cover the REM events.

[Meeseeks]

What you have is actually quite common. I have it myself and in numbers very similar to yours.
The medical community has to have some sort of numerical evaluation and they don't really take the fact that while you only spend around 20% of the night in REM they can't extrapolate the AHI any better.
Mine was 12 in Non REM and 53 in REM but my oxygen went down to 70% and O2 levels aren't in there at all.

It is what it is though and it's kinda like being pregnant...there's not much in between.

These type of results to pose a serious argument for auto adjusting pressure machine though...apap.
Often when the OSA is worse in REM the pressure needs in REM are also substantially higher.
With apap machine you can use lower pressures for the times of the night where the pressure needs are lower and only use higher when needed in REM.
Let me tell you that 10 cm most of the night and having the machine go to 18 only when needed is much more comfortable than having to use 18 all night to cover the REM events.

Yep. I guess part of it is also trying to prove to people that I'm not crazy, and it's not just "in my head"

[Pugsy]

If it is friends or family who are telling you it is all in your head have them watch this little video.
https://www.youtube.com/watch?v=-gie2dhqP2c

Or if it spouse... go to bed and stay awake and poke him/her in the ribs until he/she wakes up...do it once every 2 minutes for 3 or 4 hours...that should be enough to educate him/her well enough.
There's so much more to sleep apnea than just annoying snoring.
Or...to simulate what happens in REM...wait about 90 minutes after he/she goes to sleep which is usually when first REM hits and poke him in the ribs for about 15 seconds every minute for about an hour. Then repeat about 3 other times during the night especially in the last 3 hours of the night (that's when we usually have more REM).

Do you have to get up often during the night to pee? I did...often 3 or 4 times...that totally went away with effective therapy. Even if nothing else improved I always said that having the nocturia go away was enormous relief all by itself.

[Meeseeks]

If it is friends or family who are telling you it is all in your head have them watch this little video.
https://www.youtube.com/watch?v=-gie2dhqP2c

Or if it spouse... go to bed and stay awake and poke him/her in the ribs until he/she wakes up...do it once every 2 minutes for 3 or 4 hours...that should be enough to educate him/her well enough.
There's so much more to sleep apnea than just annoying snoring.
Or...to simulate what happens in REM...wait about 90 minutes after he/she goes to sleep which is usually when first REM hits and poke him in the ribs for about 15 seconds every minute for about an hour. Then repeat about 3 other times during the night especially in the last 3 hours of the night (that's when we usually have more REM).

Do you have to get up often during the night to pee? I did...often 3 or 4 times...that totally went away with effective therapy. Even if nothing else improved I always said that having the nocturia go away was enormous relief all by itself.

My sister is a physician assistant and she pretty much thinks I'm crazy. She said "only obese people came in to get treated and you're not obese." Shits frustrating yo. Now that i got my results, it's definitely a relief.

[klv329]

Of course, now you may get to disect your ahi into obstructive and central apneas if have both. If you have centrals, well, those are in your head, I guess, and harder to explain to uncaring persons who want to explain away everything as 'it's all in your head.'

Sleep apnea is fairly prevalent. Quite a few people in my work group have it, and I can see face mask marks on a few others around work in the morning. Maybe some people need to be educated, but I haven't met anyone who doesn't understand it's a real health problem.

[Pugsy]

She's a PA and she still believes that old wives tale...don't know I would be seeking her help for anything serious.
Unfortunately she isn't alone in that line of thinking. A lot of doctors still feel that way...and a lot of skinny people..men and women..don't get treated because of that "only fat people get OSA" stigma.

I weighed in at 110 lbs when my symptoms first started popping up...I didn't have it all my life...mine was a second gift from menopause. Mother Nature has such a sense of humor. The hot flashes eventually faded but the second gift has stuck with me.
For 2 years the diagnosis for the headaches and nocturia was "anxiety/depression"...so my doc wasn't any better than your sister.
No one ever asked about my sleep or snoring...and I weighed 110 and I think my neck was maybe 11 inches around (skinny neck).
Took a move across the country and a new doc who actually asked some half way intelligent questions to get me diagnosed. "Do you snore"...yep..."Do you stop breathing during the night"...my husband says I do it all the time...."Okay...probably sleep apnea...schedule sleep study".

The video probably won't help your sister get educated. She's already stuck in her thinking ...those people I usually suggest that you tell them where to go...might not be so easy with it being family though. Though...I did tell my brother where to go the other day and he still isn't talking to me which is kinda nice.

[Meeseeks]

She's a PA and she still believes that old wives tale...don't know I would be seeking her help for anything serious.
Unfortunately she isn't alone in that line of thinking. A lot of doctors still feel that way...and a lot of skinny people..men and women..don't get treated because of that "only fat people get OSA" stigma.

I weighed in at 110 lbs when my symptoms first started popping up...I didn't have it all my life...mine was a second gift from menopause. Mother Nature has such a sense of humor. The hot flashes eventually faded but the second gift has stuck with me.
For 2 years the diagnosis for the headaches and nocturia was "anxiety/depression"...so my doc wasn't any better than your sister.
No one ever asked about my sleep or snoring...and I weighed 110 and I think my neck was maybe 11 inches around (skinny neck).
Took a move across the country and a new doc who actually asked some half way intelligent questions to get me diagnosed. "Do you snore"...yep..."Do you stop breathing during the night"...my husband says I do it all the time...."Okay...probably sleep apnea...schedule sleep study".

The video probably won't help your sister get educated. She's already stuck in her thinking ...those people I usually suggest that you tell them where to go...might not be so easy with it being family though. Though...I did tell my brother where to go the other day and he still isn't talking to me which is kinda nice.

Agreed. My mom is a lot worse. She loves Dr. Oz, and is obsessed with natural medicine and hates everything GMO/Non Organic. That should tell you all you need to know. It hurts more coming from my sister because I expect her to be more sane and logical, especially considering her profession.

[BlackSpinner]

My sister is a physician assistant and she pretty much thinks I'm crazy. She said "only obese people came in to get treated and you're not obese." Shits frustrating yo. Now that i got my results, it's definitely a relief.

Tell her to get with this centuries medicine! She needs to get some updating courses!

[SewTired]

It doesn't really matter what it is called. You qualify for a xpap. Where it may matter is with your pressure needs. But pressure and severity have nothing to do with each other.

This is the most important thing. This is also why an auto machine is generally superior to straight pressure. Many of us don't need much pressure for most of the night - just during REM or near-REM. Unless you have a medical issue or are simply awakened by changing pressures, automatic changes to address your immediate needs are going to be more effective and more comfortable for you.