major concern about my husbands titration study

new-to-BiPAP · Post by **new-to-BiPAP** » Wed Jun 11, 2008 1:46 pm

We just got my husband's titration study results and I am concerned. His heart rate was minimum of 32 bmp and maximum of 255 bpm!!! They recommended cpap (didn't try bipap) but at the 'optimal' setting (although it lowered his AHI from 11 prepap to 3.1 during titration) he had 91 arousals. In addition 5.4 OD/h (which I don't know what that means). Is it typical to have such horrible numbers during the titration? Plus, if he is waking up 91 times an hour (it was 60 I think before) he is just swapping his 1 apnea for a few arousals...doesn't seem necessarily much better. They did say he could lower the number by one if he had problems with it (8 right now) but according to the results he actually did BETTER at 7!!! I am a bit confused and concerned...

Oh...if it helps at all...he has...

Respironics REMstarPlus M series w/ heated humidifier
opus 360 nasal pillow
CPAP level 8 w/ flex (set at 3)

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, Titration, CPAP, AHI

Sleeprider · Post by **Sleeprider** » Wed Jun 11, 2008 1:54 pm

I don't know about his somnography, but his heart rate varies between bradycardia and tachycardia. Ever done a stress test?

I think the readings are questionable, but if true need to be followed up upon with your primary physician, and perhaps a cardio referral.

socknitster · Post by **socknitster** » Wed Jun 11, 2008 2:23 pm

Has he had a follow up with the sleep doctor yet to discuss these things? Most folks schedule a follow up with the sleep doctor associated with the sleep clinic so they can discuss all this as well as the treatment.

I would seriously want some different experts looking at these numbers.

Jen

new-to-BiPAP · Post by **new-to-BiPAP** » Wed Jun 11, 2008 2:24 pm

Thanks for the suggestion. I questioned the heart rate being correct also but didn't think about getting it checked out. The weird pulse stuff was only in the first hour (along with frequent oxygen desaturation I think...on the graph). Only the graph and the numbers on a different page for the oxygen don't match. I'll hafta ask him if he remembers having any problems during that time.

I'm actually going to suggest he gets a second opinion with my sleep dr (which I think is much better).

Oh...one other thing I thought was strange. The sleep place just forwards the studies to his primary dr and his primary dr has to be the one to write a prescription for the cpap. So he saw his primary dr for that...which of course is not his speciality.

Oh...and I just realized...he did not get ANY stage 3 OR stage 4 OR REM during his titration. This gets more strange the more I look at it...

socknitster · Post by **socknitster** » Wed Jun 11, 2008 3:30 pm

I didn't have any stage 3 or 4 either until after they put the hose on me. Was this a split night. Do you think he was there long enough to get enough data?

I don't think a general practitioner has enough knowledge to be able to prescribe cpap. I would see a specialist!

Jen

new-to-BiPAP · Post by **new-to-BiPAP** » Wed Jun 11, 2008 3:42 pm

This was just a single night titration study. He had 79% sleep efficiency or 308 min total sleep time. It said sleep time was 'adequate' I'm assuming to come up with a pressure. However, I am questioning if this is really the correct pressure. Oh...he did get 120 minutes at PAP 9, and 87 min at PAP 8, and 94 min at PAP 7. According to the little graphs and numbers (which I am no expert on) he slept better at PAP 7. I guess I'm just concerned that he is not getting very good treatment and therefore not very good results. He hasn't seen the results yet. Will see what he things when he gets home...

sootired2 · Post by **sootired2** » Thu Jun 12, 2008 9:27 am

Sorry to hear your husband is having difficulty. I think it is not unusual at all to not have any stage 3 or 4 or REM sleep during a study. The environment is totally unnatural (duh!), and completely different to what we are used to sleeping. I've had 5 sleep studies and think I only hit REM in one, and it wasn't for a very long time. I was actually surprised. Some are lighter sleepers than others. Maybe what he really needs is another titration study!

new-to-BiPAP · Post by **new-to-BiPAP** » Thu Jun 12, 2008 9:34 am

I'm glad to hear you don't always get the deeper sleep during the study! He normally isn't an extremely light sleeper but had a lot of problems during the study. On lookin at it...it looks like the setting the dr gave isn't the ideal setting so we lowered it one to what should be better. He did say he slept better last night. I think I'm still gonna recommend a new dr w/ a new titration tho.

Thanks everyone!