Need help interpreting data and other Q's

[jabbered]

Went to a "sleep medicine specialist" today. Much better than my original doctor (who I never got to see), had to go to my PCP who had no idea about sleep medicine. I've been using CPAP since April 2008. My data pulled from my card was for the past year. My pressure, I've adjusted from a start of 13, ended up at 14.5, and back to 14 - adjusting on my own. The average for the year is 13.5


My average Obstructive Apnea Index is 1.0 - never gets above 2.0. My Average Hypopnea Index is 1.0, with an average AHI of 2.0.

I have an average Vibratory Snore Index of 0.9. I've never heard of this. What does it mean?

My average max leak is 101.6, average 90% leak 56.2, average leak 43.2. Now at times before this forum, I'd take my mask off if I need to go to the bathroom at night and left the machine blowing. I think this is why it's so high.



Over the last 7 days, my average leak is 39 LPM. My average AHI is about 1.0 for this time frame.



I still get tired in the afternoon, but no longer need naps every day. I've been having trouble staying asleep, waking several times during the night. I wanted to get a checkup before my insurance deductible reset, possibly getting a prescription for something to help me sleep. However, I'm a big guy (6'2, 350) and only 28. First thing he recommended was gastric bypass surgery. He didn't want to prescribe anything as he wanted a study to tell if my pressure was too high, too low, possible high leak rates, and also recommended maybe adding oxygen.


I will be going to get a new sleep study done later in the month. The doctor I went to pushed for it. I really didn't want one, but am ok with it. I wasn't happy with my original study. I was too afraid to roll to my side and only slept on my back (at home I sleep on both as well as stomach).



Do you think I should bother with the study? Try and find another doctor? Any recommendations for something I might do own my own with my therapy?

[Wulfman]

Went to a "sleep medicine specialist" today. Much better than my original doctor (who I never got to see), had to go to my PCP who had no idea about sleep medicine. I've been using CPAP since April 2008. My data pulled from my card was for the past year. My pressure, I've adjusted from a start of 13, ended up at 14.5, and back to 14 - adjusting on my own. The average for the year is 13.5


My average Obstructive Apnea Index is 1.0 - never gets above 2.0. My Average Hypopnea Index is 1.0, with an average AHI of 2.0.

I have an average Vibratory Snore Index of 0.9. I've never heard of this. What does it mean?

My average max leak is 101.6, average 90% leak 56.2, average leak 43.2. Now at times before this forum, I'd take my mask off if I need to go to the bathroom at night and left the machine blowing. I think this is why it's so high.



Over the last 7 days, my average leak is 39 LPM. My average AHI is about 1.0 for this time frame.



I still get tired in the afternoon, but no longer need naps every day. I've been having trouble staying asleep, waking several times during the night. I wanted to get a checkup before my insurance deductible reset, possibly getting a prescription for something to help me sleep. However, I'm a big guy (6'2, 350) and only 28. First thing he recommended was gastric bypass surgery. He didn't want to prescribe anything as he wanted a study to tell if my pressure was too high, too low, possible high leak rates, and also recommended maybe adding oxygen.


I will be going to get a new sleep study done later in the month. The doctor I went to pushed for it. I really didn't want one, but am ok with it. I wasn't happy with my original study. I was too afraid to roll to my side and only slept on my back (at home I sleep on both as well as stomach).



Do you think I should bother with the study? Try and find another doctor? Any recommendations for something I might do own my own with my therapy?

Well, your numbers sound "good".
Sounds to me like you don't REALLY want to do another sleep study......
Do you have any other medical conditions.....like diabetes?
Are you getting ENOUGH sleep?
Is your job stressful? Between this and the amount of sleep, I could see how any of these might explain your tiredness.
Are you taking any medications?

The VS (Vibratory Snore) is the average number of snores you have each hour......almost 1.......that's pretty good, too.

If you're NOT leaving your machine run when you take your mask off when you get up during the night, that should help keep your leak numbers "honest".
Any chance you're leaking air out your mouth? It doesn't appear to be the case in the leak number you mentioned.
Before submitting to another sleep study, and if your doctor really wants to help, have him get you an overnight pulse-oximetry. That will tell what your nightly blood oxygen is doing. And, it SHOULD be "FREE".

There could be any number of things that could be preventing you from feeling rested all day. Many of them may NOT be related to what may be found in another sleep study.


Den

[jabbered]

I have HBP and am taking Benicar HCT for that.

My cholesterol is borderline high as well as my blood sugar when tested, but my A1C was in the normal range. I'm also taking 2000 units of Vitamin D daily and periodically will take my prescription Topamax for my TMJ/headaches.

My job is helping take care of my grandmother and checking on my grandfather before he passed in August. She's 88 and has broken 2 bones in the past 2 years and has osteoporosis and should use her walker (but doesn't some and toddles around). She can't drive so I do that, some cleaning, cooking, etc. It's stressful as she likes to get up at 2-3 am and go get the paper in the dark.

I think this is part of the reason I wake up in the middle of the night. I also sit around the house most of the day (can't really leave her by herself or she tries to do things she shouldn't). I know I need to get more exercise, eat better, etc. She's moving to an assisted living center later in the week to try it so I should be able to get a better nights sleep not having to worry if she's up. I normally get about 7-8 hours per night.


I honestly don't think it's my oxygen levels at all, but it could be. I'll try calling the Dr. in a day or two to see if they'll do the overnight pulse ox.

[Wulfman]

Thanks for the info.
I don't really have any "answers", just trying to throw out some thoughts.
After reading your reply, I did have one other thought. If you're eating higher levels of carbohydrates (like at Noon), that could account for the tiredness in the afternoon. Try to cut down on the carbs (if that may be the case).


Den