TEST RESULTS

READYTOQUIT · Post by **READYTOQUIT** » Wed Oct 31, 2007 12:21 pm

CAN SOMEONE PLEASE TELL ME WHAT YOU THINK
1ST SLEEP TEST RESULTS 10/27/05
SLEEP EFFICIENCY 85.7% SLEEP ONSET 20.5 MINS STAGE AWAKE 38MINS
STAGE 1 8.7% STAGE 2 71.5% STAGE 3 5.8% STAGE 4 0%
STAGE REM 14% MEAN SPO2 89% MINIMUM SPO2 NREM 76%
MIN SPO2 REM 83% sorry forgot caps
total # arousals 97 awakenings 21 apneas 0 hypopneas 126
apnea hypopnea index 20.5/hour
periodic limb movement 5.5
recommendations cpap titration
interpretation severe osa with hypersomnia(apnea/hypopnea index 15.0/hr)ahi 20.5/hr desaturation to 76% 76.5% spent between 80-89%

test 2 cpap titration 2/09/06
results in order as above 86.8%, 36 min, 23.5, 7.7%,63.5%,9.6%,.4%, 18.7%,90%,86%,83% 114,14,106,15.9/hr and 0/hr
interp osa w/hypersomnia final titration pres 9cm h20 after study reviewed does not appear to have optimally controlled osa
ahi 18.5/hr after cpap titrated to 9cm h20
recom. cpap at 10cm h20 using ffm and heated humidifier

if anyone can interpit this please let me know

Guest · Post by **Guest** » Wed Oct 31, 2007 12:47 pm

Well.... I know that you want your AHI to be 5 or lower... That seems to be a high number to leave it at during the titration.

amos · Post by **amos** » Wed Oct 31, 2007 12:54 pm

First Of All I hope that your are just READYTOQUIT being sleepy, lethargic, tired, mentaly drained, and stop making multiple bathroom trips at night and READYTOSTART getting better.

I am sure that others on this forum will interpret you figures in more detail.

Basically, you have moderate Obstructive Sleep Apnea and the doctor has recommended that you begin cpap therapy with a pressure of 10 and use a heated humdifier. They are also recommending a full face mask becuase you breathe thru your mouth.

Best of luck.

Amos
Clarkston, GA

Guest · Post by **Guest** » Wed Oct 31, 2007 1:05 pm

I am hoping that you left out a number on your second test for the number of apneas. I put the ??? in there where I thought the missing number was. It looks like your numbers were a bit better for the second test, but not by that much.

I tried to put your info into chart form to make it easier to compare.

Sleep Study Date 10/27/05 2/9/06
Sleep Efficiency 85.7% 86.8%
Sleep Onset 20.5 min 36 min
Awake 38 min 23.5 min
Stage 1 8.7% 7.7%
Stage 2 71.5% 63.5%
Stage 3 5.8% 9.6%
Stage4 0% 0.4%
REM 14% 18.7%
Mean O2 89% 90%
Minimum O2 NREM 76% 86%
Minimum O2 REM 83% 83%
Total # of Arousals 97 114
Awakenings 21 14
Apneas 0 ???
Hyponeas 126 106
AHI 20.5 15.9
PLM 5.5 0

allisonandrews · Post by **allisonandrews** » Wed Oct 31, 2007 1:27 pm

Well, they sure don't like tables around here... or even tabs.

Slinky · Post by **Slinky** » Wed Oct 31, 2007 1:31 pm

Well, the main concern in the sleep evaluation (your first study) was the "desaturation to 76%; 76.5% spent between 80-89%"

Way too much of your night was spent below 90% 02 saturation levels. 3/4 of the night your body and organs were not getting sufficient oxygen.

During your titration study even at 9 cms of pressure your average 02 saturation was at the bare minimum.

Regardless CPAP did make for some definite improvement for you - just not enough - yet.

Evidently there may have been some concern that you were mouth breathing too much and thus the recommendation for a full face mask. Full face masks are not usually recommended due to the difficulty in finding a good fit and so many patients feeling claustrophobic w/them on.

Since 9 cms didn't quite "cut the mustard" the recommendation was to start you at 10 cms of pressure with a humidifier and a full face mask.

I would have expected that they would have further recommended an autoPAP or at the very least a FULLY DATA CAPABLE CPAP. I would also have expected that they would have followed up w/you w/in a month at the longest to download and study the data accumulated.

Your profile now says that you have the Respironics (non-M series) RemStar Pro II which is fully data capable and "should" have a data card stuck in it.

Based on that data they could then have a good idea of whether to adjust your pressure and/or order an overnight oximetry on CPAP to determine whether a higher pressure and/or 02 supplementation would be needed.

Most of the time, if 02 supplementation is needed in addition to CPAP the recommended level is 2L, on a few extreme occasions more than 2L but I sure have never heard of only 1L of 02 supplementation to CPAP therapy.

Your profile doesn't say if you have a humidifier, heated or not. If you do have an integrated humidifier it would be attached to the front of your Pro II and they would almost appear to be one piece. If you actually have the Respironics M Series RemStar Pro with an integreated humidifer it would be attached on the side and would almost appear to be one unit.

A humidifier can reduce events to some degree but while it would help I doubt it would make the amount of difference you need.

Your next step should DEFINITELY be either an overnight oximetry on CPAP or another CPAP titration study w/o and w/02 supplementation in my opinion. I know that sure is what I would be insisting upon.

Slinky · Post by **Slinky** » Wed Oct 31, 2007 1:51 pm

And thank you, Allison, for putting that chart up for us. Sure did make it a lot easier to wade thru the info!!! I wish I knew how to do that type of thing. *sigh* I still don't know how to properly save a scanned image so that I can post it at photobucket or equivalent!!! Duh. And I have a Visioneer something or other that is supposed to be simple for scanner idiots and scanner dummies. Ha! The scanning is easy, how to properly save it is where I'm totally lost.

READYTOQUIT · Post by **READYTOQUIT** » Wed Oct 31, 2007 1:59 pm

Anonymous wrote:I am hoping that you left out a number on your second test for the number of apneas. I put the ??? in there where I thought the missing number was. It looks like your numbers were a bit better for the second test, but not by that much.

I tried to put your info into chart form to make it easier to compare.

Sleep Study Date 10/27/05 2/9/06
Sleep Efficiency 85.7% 86.8%
Sleep Onset 20.5 min 36 min
Awake 38 min 23.5 min
Stage 1 8.7% 7.7%
Stage 2 71.5% 63.5%
Stage 3 5.8% 9.6%
Stage4 0% 0.4%
REM 14% 18.7%
Mean O2 89% 90%
Minimum O2 NREM 76% 86%
Minimum O2 REM 83% 83%
Total # of Arousals 97 114
Awakenings 21 14
Apneas 0 ???
Hyponeas 126 106
AHI 20.5 15.9
PLM 5.5 0

_________________NO THATS WHATS ON THE TEST RESULTS 0

CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

READYTOQUIT · Post by **READYTOQUIT** » Wed Oct 31, 2007 2:02 pm

Slinky wrote:Well, the main concern in the sleep evaluation (your first study) was the "desaturation to 76%; 76.5% spent between 80-89%"

Way too much of your night was spent below 90% 02 saturation levels. 3/4 of the night your body and organs were not getting sufficient oxygen.

During your titration study even at 9 cms of pressure your average 02 saturation was at the bare minimum.

Regardless CPAP did make for some definite improvement for you - just not enough - yet.

Evidently there may have been some concern that you were mouth breathing too much and thus the recommendation for a full face mask. Full face masks are not usually recommended due to the difficulty in finding a good fit and so many patients feeling claustrophobic w/them on.

Since 9 cms didn't quite "cut the mustard" the recommendation was to start you at 10 cms of pressure with a humidifier and a full face mask.

I would have expected that they would have further recommended an autoPAP or at the very least a FULLY DATA CAPABLE CPAP. I would also have expected that they would have followed up w/you w/in a month at the longest to download and study the data accumulated.

Your profile now says that you have the Respironics (non-M series) RemStar Pro II which is fully data capable and "should" have a data card stuck in it.

Based on that data they could then have a good idea of whether to adjust your pressure and/or order an overnight oximetry on CPAP to determine whether a higher pressure and/or 02 supplementation would be needed.

Most of the time, if 02 supplementation is needed in addition to CPAP the recommended level is 2L, on a few extreme occasions more than 2L but I sure have never heard of only 1L of 02 supplementation to CPAP therapy.

Your profile doesn't say if you have a humidifier, heated or not. If you do have an integrated humidifier it would be attached to the front of your Pro II and they would almost appear to be one piece. If you actually have the Respironics M Series RemStar Pro with an integreated humidifer it would be attached on the side and would almost appear to be one unit.

A humidifier can reduce events to some degree but while it would help I doubt it would make the amount of difference you need.

Your next step should DEFINITELY be either an overnight oximetry on CPAP or another CPAP titration study w/o and w/02 supplementation in my opinion. I know that sure is what I would be insisting upon.

_________________sorry slinky my machine is just a resperonics plus with a heated humidifier no place for any type of card

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, humidifier, Titration, CPAP

READYTOQUIT · Post by **READYTOQUIT** » Wed Oct 31, 2007 2:07 pm

i just wanted to say thank all of you that are trying to help me on this and i promise i'll get this caps thing right

Slinky · Post by **Slinky** » Wed Oct 31, 2007 2:19 pm

Well, Ready, the avatar in your profile is for the Pro II. Why not use the text instead of the avatar option in your profile, it makes it easier to be sure it is the right item and we don't have to click on the avatar to go to the description of it.

That being said: given your results in MY opinion it was irresponsible of the doctor ordering your equipment to allow the DME supplier to provide you w/less than a fully data capable CPAP. No wonder they are foundering around like a fish outta water in trying to treat your apnea!!!!! And I sure can't blame your PCP for any of it. I"m sure she is not trained in apnea therapy and no one if providing her w/adequate data for her to even try to figure things out!!!! She's in over her head and no one is throwing her a lifesaver! Or you either!

Forget the other idiots in the chain. Talk some turkey w/your PCP. Ask her to write you a new equipment order (but first determine if you have the M series or the pre-M series Respironics cause you don't want to have to fight for a new humidifier too - this is gonna be a tuff enuff battle w/the DME).

I'd suggest the following wording (borrowed & altered a little from RestedGal):

1] Respironics REMstar (M Series) Pro (2) w/C-Flex w/heated humidifier
2] Pressure 10 cms
3] C-flex setting 3
4] Ramp off (unless you prefer it on)
5] Show AHI/Leak feature On
6] Nasal mask, Full Face mask, or nasal pillows mask of patient's choice.

Every word is important (except those in parentheses - you have to determine FOR SURE which humidifier you have now). If it is the non-M Series it MUST be the Pro TWO).

That's a much more detailed Rx than doctors usually write, but that will be clear about what machine and what settings the DME is to provide you.

TEST RESULTS

TEST RESULTS

thanks