? about my diagnosis - "respiratory arousals"

[MoneyGal]

There are parts of my diagnosis I still don't understand, and I was wondering whether people here could help me grasp this (googling isn't providing much useful info for me right now).

My diagnosis is severe OSA with an AHI of 91 events per hour.

My sleep study results say (in part):

There were moderately increased arousals (41 arousals per hour). These were primarily respiratory arousals. The respiratory events were associated with severe oxygen desaturation.

What does this mean? I had 91 events per hour (apneas and hypopneas), but how do arousals fit in with this? And if an arousal is not a "respiratory arousal," what is it? What is a respiratory arousal?

Thanks for any insight you can provide!

[karessamom]

From my understanding respiratory arousals are what wakes you up and distrubs your sleep so you can't get good quality sleep. They basically fragment your sleep architecture affecting the quality of your sleep. They can also as in your case cause desaturations in your oxygen levels. CPAP should take care of it.

[MoneyGal]

Thanks for your response. So, I had 91 events per hour during which I stopped breathing, and (an average of) 41 times per hour, I woke up from not breathing? Is that right? Why do I not see people discussing respiratory arousal events per hour here (or am I overlooking these discussions somehow?)

Is 41 a high number (I assume yes)?

[Aussiegrouch]

Hi,
This is an extract from:
http://www.thoracic.org/sections/educat ... oring.html

"Don't get me wrong-I do not infer that you are obese!!"

The new AASM scoring manual defines a respiratory effort related arousal as follows: ‘If there is a sequence of breaths lasting at least 10 seconds characterized by increasing respiratory effort or flattening of the nasal pressure waveform, leading to an arousal from sleep when the sequence of breaths does not meet criteria for an apnea or hypopnea.’

The new AASM scoring manual provides two definitions of a hypopnea:

Drop by ≥30% of baseline in the nasal pressure signal accompanied by a 4% desaturation from baseline (recommended definition); or
Drop by ≥50% of baseline in the nasal pressure signal accompanied by a 3% desaturation from baseline (alternative definition)
As there is no evidence of desaturation in the fragment, this event does not meet the definition of a hypopnea.
Reference: The AASM Manual for the Scoring of Sleep and Associated Events. Westchester, IL: AASM, 2007, page 46.

Cheers
Graham

[MoneyGal]

Thanks for your response!

I'm still left with questions. In my sleep study, I woke up 41 times per hour...but those arousals were not counted as part of my AHI score, yes? The link you provided *seems* to say that, but I'm not sure I'm completely understanding it.

Is it just another variable that is measured? Apneas, hypopneas, and arousals?

[Muse-Inc]

...but those arousals were not counted as part of my AHI score, yes?

Yes, they are in addition to the apena and hypops -- aren't ya glad you asked?