Confusion about sleep lab results

[annabot]

Hi. I was referred to a sleep lab a few weeks back and got my results in last week. I am 30 years old. I'm 5'11" and weigh about 235 pounds.

For the first hour of the test, I had an AHI of 106.7 (14 obstructive apneas, 21 central apneas, 25 mixed apneas, 28 obstructive hypopneas). My oxygen saturation dropped to 79%. After that first hour, they woke me and put me on a CPAP at 9cm. My AHI for the rest of the night was close to zero. My AHI average (I guess?) for the entire night was 14.6. What I don't understand is why I have so many of each type of apnea. A lot of reports I've seen tend to lean heavily towards one particular type. I have a lot of each of them. Is that bad?

I got my CPAP the day after the results and I've been sleeping great. I got the Resmed S9 Autoset with Humidifier.

I looked at the data on sleepyhead and according to it, my Autoset is set to regular CPAP mode. And it lists my AHI has very low (in between zero and 5).

But does CPAP not really work for central apneas? Because now I'm confused as to why I'd be sleeping so well according to sleepyhead if I had so many central apneas in the sleep test?

[palerider]

I got the Resmed S9 Autoset with Humidifier. ?

Hi, please fill out the equipment section of your profile, it helps folks to respond better.

also, can you do a screenshot of your night from sleepyhead, click the ^ over the calendar to turn that off, then drag the AHI chart down, so that we can see events, flow, pressure and leaks, at least.. (you can drag the charts around.)

[jnk]

Glad you got referred and that the treatment is a success. Be happy about both.

If you now have more energy, invest that on other thing that may help your overall health.

It is good to have an APAP even when running it in CPAP mode most nights. That way, for example, you can retitrate easily enough later or run it in APAP if your health changes to the point of making that a good thing to do. If one pressure is comfortable and doing the trick for now, that is great.

Sometimes having a lot of obstructive events is what causes a person's centrals and mixed events. So yes, straight CPAP can prevent those things from happening in that circumstance.

If that raises more questions, please feel free to ask them.

[annabot]

I got the Resmed S9 Autoset with Humidifier. ?

Hi, please fill out the equipment section of your profile, it helps folks to respond better.

also, can you do a screenshot of your night from sleepyhead, click the ^ over the calendar to turn that off, then drag the AHI chart down, so that we can see events, flow, pressure and leaks, at least.. (you can drag the charts around.)

Here are my sleepyhead results from last night:









Thanks!

[palerider]

nice looking... next time, hit "f8" to turn off the right sidebar, that'll expand the charts a bit better.

the main ones that people want to see are events, flow, pressure and leaks.... you can resize the charts to make them all fit on one page

I'd experiment with seeing how you feel with a lower EPR setting, you might do better without the pressure variations, you might not, it's a very individual 'feel' thing... but give it a few days when you change things, becasue you'll have good nights and less good nights and you don't want to make decisions on just one nights worth of data.

looking good so far... how're you feeling? that, in the end, is the most important thing.

[annabot]

I'm feeling great. I'm also waking up at 6am every morning, naturally, with no alarm or anything - something I've NEVER been able to do.

From what I can tell, everything is working great. I just was confused about how my sleep results showing so many central and mixed apneas, and other people saying how CPAP won't do anything for central apneas. So, I guess I was doubting my own anecdotal experience?

[Pugsy]

I just was confused about how my sleep results showing so many central and mixed apneas, and other people saying how CPAP won't do anything for central apneas. So, I guess I was doubting my own anecdotal experience?

CPAPs can't "fix" real centrals but they might prevent an OA from happening which might prevent an arousal which might cause a central (sleep onset maybe). So centrals might be reduced more as a by product of successful cpap therapy. Just a supposing idea...
Fix the known problem and as a by product the lesser problem gets reduced sort of thing.

I don't think we know for sure why...the centrals and mixed apneas in your sleep study could just as easily been a fluke night related to not so great sleep in a sleep lab setting or just a plain ordinary fluke.
One of those things we get to shrug our shoulders and move on....and since you sound like you are doing quite well with the therapy and your reports look extremely nice...that's what I would do if it were me.
There's too much about the central and mixed apneas during that sleep study that we don't know to come up with a clear cut answer as to why they are absent now.

[annabot]

I just was confused about how my sleep results showing so many central and mixed apneas, and other people saying how CPAP won't do anything for central apneas. So, I guess I was doubting my own anecdotal experience?

CPAPs can't "fix" real centrals but they might prevent an OA from happening which might prevent an arousal which might cause a central (sleep onset maybe). So centrals might be reduced more as a by product of successful cpap therapy. Just a supposing idea...
Fix the known problem and as a by product the lesser problem gets reduced sort of thing.

I don't think we know for sure why...the centrals and mixed apneas in your sleep study could just as easily been a fluke night related to not so great sleep in a sleep lab setting or just a plain ordinary fluke.
One of those things we get to shrug our shoulders and move on....and since you sound like you are doing quite well with the therapy and your reports look extremely nice...that's what I would do if it were me.
There's too much about the central and mixed apneas during that sleep study that we don't know to come up with a clear cut answer as to why they are absent now.

Awesome. Thanks!

So, my charts look good? I have no idea how to read them.

[Pugsy]

Yes, your charts look good...disgustingly good

Here's a little hint to make the leak line show things a little better (not that you need it).
Put your mouse cursor over the words "leak rate" ...wait for the little pop up to go away and then double click your mouse on the words leak rate and your leak graph will adjust so that it isn't needing to use that 120 scale and it makes for visually seeing the leak line a little better. Try it and you will see what I mean. When you don't use the fixed 120 scale the leak numbers will scale based on the maximum leak and thus the leak graph is more zoomed in for easier evaluation. Just for fun really. Helps if you actually get up close to that red line at times or you are like me...venture over it on occasion for short periods of time.

[The Latinist]

So, my charts look good? I have no idea how to read them.

The most important things to look at are your nightly average AHI in the orange box at left (which is just the number of events you have divided by the number of hours you sleep) and Leak Rate, which should stay below the red 24 L/min line as much as possible. As long as your AHI and leaks are consistently low, I would not worry much about anything else.

[Pugsy]

I don't bother with all those other graphs because the norms vary so much anyway and if the AHI is good and leak is good...not much need to look at the other stuff is there?
I do have a little tutorial about what SleepyHead shows if you want to read it. Top of the Announcements section on the main forum page or there's a link in my signature line.

[palerider]

So, my charts look good? I have no idea how to read them.

take a look at the forum main page, the top stickied post... pugsy's pointers for sleepyhead.... how to use it, how to read the charts

that pugsy's just overflowing with good information.

[palerider]

Here's a little hint to make the leak line show things a little better (not that you need it).
Put your mouse cursor over the words "leak rate" ...wait for the little pop up to go away and then double click your mouse on the words leak rate and your leak graph will adjust so that it isn't needing to use that 120 scale and it makes for visually seeing the leak line a little better.

*grumble* I tried that, and instead of autoscaling, it stickied the strip at the top.

maybe it's something weird in the 0.9.6 linux version?

[Mykale]

Here's a little hint to make the leak line show things a little better (not that you need it).
Put your mouse cursor over the words "leak rate" ...wait for the little pop up to go away and then double click your mouse on the words leak rate and your leak graph will adjust so that it isn't needing to use that 120 scale and it makes for visually seeing the leak line a little better.

*grumble* I tried that, and instead of autoscaling, it stickied the strip at the top.

maybe it's something weird in the 0.9.6 linux version?

Nope, same behavior in the latest 9.6 Windows version. Pinned mine to the top as well. Double clicking it again dropped it back where it came from. No auto-scaling occured either.

[jnk]

"Aside from [cases where CSA is associated with heart failure], about half of those suffering from CSA can be managed on CPAP alone."-- Quote of Michael Coppola, M.D., pulmonary, critical care and sleep disorders physician in Springfield, MA, who is a member of the American Sleep Apnea Association board of directors. ( http://www.sleepapnea.org/learn/sleep-a ... apnea.html )