My numbers are in...

bobby_tee · Post by **bobby_tee** » Thu May 22, 2008 8:30 am

I have to admit, I feel a little funny posting my sleep study numbers here and asking for feedback, but based on what I've read here over the past month or so, that seems like the thing to do! I met with my lseep Dr thi smorning to review the results of my 2 sleep study nights.

First, the overall: He told me that I had very loud snoring (no surprise there- my wife told me that years ago!), and that I had unequivocal sleep apnea. He made some general reference to the numbers, but I had to ask for specifics. He was writing the prescription pretty much the minute I walked into the office. He mentioned the option of surgery, and said if I wanted to look into that, I would go through my regular Dr.

The Dr told me that their office could handle the equipment for me, and I asked about getting the precription (tip picked up here). He then said I could take the precription myself and go to wherever I wanted. I did that, but told him I may still use them, I just wanted the choice. I asked for a copy of my report, which he gave me. It's actually a copy of the 2 letters he prepared for my regular Dr, but it includes all the numbers. And here they are:

Patient has OSA (*327.23)

Polysomnogram
AHI: 53.91
REM AHI: 55.38
Sleep Efficiency: 92.87%
Sleep Latency: 3 min.
REM Latency: 125.5 min.
Arousal Index: 46.49per hr
PLM Index: 0

Titration
AHI: 16.63
REM AHI: --
Sleep Efficiency: 93.03%
Sleep Latency: 1 min.
REM Latency: 94.5 min.
Arousal Index: 16.33per hr
PLM Index: 1.2

They started me at 5cm in the titration and increased to 11cm, where they say the AHI was 3.2. The prescription I have is for 11cm.

So based on this, I guess the bottom line is that the CPAP did indeed reduce the apneas. Any thoughts based on experience are appreciated!

Whew! I hope that makes sense to some of you. (I'm sure it does to all of you by now.)

NightHawkeye · Post by **NightHawkeye** » Thu May 22, 2008 8:59 am

Hi bobby_tee,

Congratulations on getting the prescription in hand. You've already gotten past the place where lots of folks have problems.

You've may already have a preferred machine, but I'd like to strongly recommend you get one which records your events and is compatible with software which you may find useful sometime. DME's may give you grief, but it's a competitive marketplace so just find a DME that offers you the best machine. APAP is also highly desirable, but many folks find they do better with straight CPAP. APAP's can also operate in CPAP mode, so there's no loss of performance.

Oh, and good luck with the mask ..., that's a trial and error and torture process. Keep trying until you get one that works well for you. It often takes folks a day or two or longer to recognize that the mask they thought was so great initially ain't so great after all

Hope your therapy goes well.

Regards,
Bill

bap40 · Post by **bap40** » Thu May 22, 2008 9:02 am

Agreed, Data Capable machines are invaluable in our therapy. Not just compliance data as some DME's will try and tell you!

bobby_tee · Post by **bobby_tee** » Thu May 22, 2008 9:09 am

Thanks for the quick response. I did ask about the data capable machines (again, based on tips from this forum) and the Dr said "You need a card reader for that." I see that he wrote "smart card" on my prescription. Will that do the trick?

Bob

ww · Post by ww » Thu May 22, 2008 1:32 pm

It is confusing at first. Spend a day and a couple of nights reading this forum for topics similar to yours and you will gather a lot of valuable information including the yellow lightbulb and cpap faq at the top. There is also a pretty good comparison of CPAP and for APAP (automatic CPAP) on cpap.com. The prices for respironics are negotiable (the listed price is the minimum list price) if you are paying for them. On many insurance plans, it is cheaper to pay out of pocket from an internet supplier than the co-pay for the higher prices charged by the DME's. You have to buy the software and card reader yourself, anyway as most insurance will not pay for accessories.

bobby_tee · Post by **bobby_tee** » Thu May 22, 2008 2:30 pm

I've read a lot on here about being tough with your DME about what unit to get and not settling for bottom of the line. My prescription reads as follows:

CPAP 11cm Smart Card
Heated Humidification
Small Comfort Gel or mask to fit

Does that limit me at all? Or am I free to wrangle for the best unit I can get? And what rights do I have to demand the best unit?

My insurance covers 100% in network.

Thanks,

Bob

alnhwrd · Post by **alnhwrd** » Thu May 22, 2008 3:07 pm

I would recommend a machine with some form of exhalation relief as well. You might grow out of it, but it is very nice at the start of your therapy. This means EPR, A-flex or the new "Easy Breathe". Also, don't let them stick you with a machine that only records usage and tell you it is "data capable". Try on as many different masks as you can. Browse this site and CPAP.com for awhile and see what is out there. Make a list of what looks interesting to you and take it with you to the DME and ask to try the ones they have you were interested in. Good luck my friend!

bobby_tee · Post by **bobby_tee** » Thu May 22, 2008 3:30 pm

Thanks! I've been browsing for quite a while now, so I am much more literate than I was. One thing I'm wondering is about the mask. During my titration, they only used one, a nasal mask, that I felt was strapped to my head way too tightly--as born out by the raw spots on my face in the morning. But the real question is about mouth-breathing. The tech came in and put a chin strap on me, as I was opening my mouth as I slept. Combined with the tight mask fit, the addition of the chin strap made my head feel like basketball with several rubber bands wrapped around it.

While I'm not all excited about using a full face mask, I'm wondering if it's preferable to the chin strap or taping my mouth shut, bit of which sound very unappealing.

Any thoughts?

Bob

bobby_tee · Post by **bobby_tee** » Fri May 23, 2008 8:13 am

Any recommendations on the full face mask question? Thanks!

ww · Post by ww » Fri May 23, 2008 12:11 pm

bobby_tee wrote:Any recommendations on the full face mask question? Thanks!

Not too many choices for full face masks. I think the ResMed Ultra Mirage Full Face mask, properly fitted as there are six sizes is a good choice for most people. The fasteners are easy to fasten and unfasten unlike the Respironics Comfortful2.

bobby_tee · Post by **bobby_tee** » Fri May 23, 2008 2:04 pm

Thanks, double dub.

Snoredog · Post by **Snoredog** » Fri May 23, 2008 7:38 pm

You NEED to obtain the copy that came from the Sleep lab, NOT the one your doctor was preparing for the GP Doctor, because if it only includes the above data you are being short-changed.

Those arousals: What did your doctor say about them? A "residual" AHI=16.63 it totally unacceptable to me, they didn't fully titrate you at the lab and I'd question the pressure given.

While your sleep efficiency is fine (anything greater than >85% is good), there appears to be a lot of remaining arousals that are unexplained,

may be just the way you copied it that it was taken out of context, getting the report that came from the sleep lab is what you want, it should be 4 or more pages long.

Because what will happen is if you go on therapy with cpap and which may fully address your OSA, you can still be left fatigued, answers for that are contained on the part of the report you apparently didn't get.

Tell your doctor you'd line to have a copy of the sleep lab findings for your medical file along with his professional recommendation should you decide to seek a 2nd opinion. This saves you from having to get another PSG should you go that route.

You are entitled to it, get it, you will need it in the future.

bobby_tee · Post by **bobby_tee** » Sat May 24, 2008 7:16 am

Snoredog,

Thanks for that feedback. I was a little surprised to get the data in letter form when I saw that the Dr was looking at a detailed report (pie charts, graphs, etc.) when he was talking to me. I'll call the office and tell them I want the full report.

Have a great holiday weekend!

Bob