My Sleep Study Report + 14 Days on the Hose!

[JohnO]

As my previous notes on this forum indicated( viewtopic.php?f=1&t=80623&p=733707#p733707 ) , I had a sleep study about two weeks ago. It was a split study. Halfway through the night, I was placed on CPAP, which sort of tells you how the first half of the night went.

In the morning, after a shower and continental breakfast, they presented me with a shiny new Philips Respironics System One Auto-CPAP with heated humidifier. (60 Series), and True Blue Mask.

Today was my first follow-up appointment. We went over the sleep study, and looked at the data for the first 14 days.

Summary: A diagnosis of Severe Sleep Apnea. (Not a surprise, really…)

The key points:

Baseline Study (before CPAP):
Snoring reported as LOUD
Respiratory Events: 130 Obstructive apneas, 0 central apneas, 10 mixed apneas. A total of 29 obstructive hypo apneas and 168 RERAs were noted for an RDI of 53.4 and an AHI of 51. The REM AHI was 10.4. ** Lowest O2 Saturation was 75% **

CPAP Titration:
CPAP began at a pressure of 6 and completed at a pressure of 9. The report shows an elimination of apneas, hypo apneas, desaturations, and arousals at the final CPAP pressure of 9 cm/H2O. Supine REM was noted at this pressure.

Other:

EEG: Normal
PLM: Minimal, no arousals, none noted after CPAP applied
EKG: Normal

Prescription was for an Auto-CPAP set to 9-15 cm/H2O.

So, the main discussion surrounded the significant desaturations, which I was already aware of thanks to this forum, and the suggestion to get a recording pulse oximeter, which I did about two months ago. The Doc suggested that I was a poster child for OSA, and CPAP treatment. I started having significant Obstructive Apnea events as soon as I feel asleep. She said she could feel for the sleep tech as she probably got really uncomfortable when the O2 dropped below 80 4 times within 90 minutes…

As far as the 14 days on CPAP? As expected, the first two nights were rough. I did not want to go into the room with that machine on the second night!
I started to make peace with it on night three. I readily noticed that I was not waking up to go to the bathroom as much (or at all!). I have been playing with the velcro straps on the True Blue mask, trying to get it "just right" so that it does not leak when I switch sides, nor leave me with a sore bridge of my nose. I'm pretty close now.
For the past 3-4 nights I'd say the sleep is noticeably better than pre-CPAP. I think I should get some sort of hose cover, as the noise of the hose rubbing against the headboard when I move around is distracting. It might also help as the weather turns colder as I don't have a heated hose.

What data do I have to show for it? My CMS-50E reports that my O2 saturation hardly wavers now -- usually between 94-96%. When I've been able to keep the Zeo on my head, it is showing significantly more deep sleep and REM sleep. My AHI is around 1.2. My 90% (or is it 95%) pressure as reported from the machine is 10.1.

I would like to try nasal pillows of some sort, as I can't have my glasses on with this mask, nor is it easy to wear my Zeo, since the True Blue mask has a forehead component (or branding iron, as I like to say…). Thankfully, any marks on my face come out within an hour.

I'm so thankful for finding this forum! Everyone here has been so very helpful. It has made a stressful situation and diagnosis of a life-long condition so much easier to bear.

Please let me know if there are any questions I can answer. There is more data on the report, but I think I caught the high points.

John

[Xney]

Great work, glad you're getting some good results.

Sometimes there's so much discussion about problems with xPAP, you forget it's really working well for a lot of people relatively easily. I think you'll find as you get used to it and get it dialed in, it will simply become part of how sleep is an nothing to think or worry about too much!

[JohnO]

Now with graphs! Interesting that there were no Centrals noted during the study. Also i

First graph is sleep position. It was clear I prefer my side. They had to whisper to me over the intercom to get me on my back.

Second graph is sleep state. Line at top is awake. Lower is deeper. The double think lines are REM sleep. Much more of that while on CPAP. I can say pattern that continues with my Zeo.

Third graph is O2 saturation. As I mentioned, some pretty scary drops that go away once CPAP is applied.

Fourth graph is full of info. Top line is Central Apneas. None notes. Next line is Obstructive Apneas. Lots noted!. Third line is Hypo apneas. Fourth line -- I don't recall. It is labelled UD1. Fifth line is PLM. Some movement, but nothing to write home about as it did not wake up up. Sixth line is (I think) Arousals. It seems to be marked for all the apnea events above.

Final Graph is the CPAP pressure they tried. They started with 6 cm H2O and ended up at 9 cm H2O.

[jweeks]

John,

Congrats on being off an running on such a great start.

I readily noticed that I was not waking up to go to the bathroom as much (or at all!)

This is a huge observation. When your body really wants you to wake up so you can breathe, it sends you a chemical signal to wake up. That signal is the same one that tells you that you have to go to the bathroom. It is funny how that works. Not having to go to the bathroom means that your body is already seeing a major improvement in your health. All those bathroom trips are also unhealthy since it forces your kidneys to work overtime, putting unnecessary stress on these key organs.

My CMS-50E reports that my O2 saturation hardly wavers now -- usually between 94-96%.

This is also a major victory for you. Just think how many brain cells would otherwise be dying if you were still having the oxygen desats.

Even if CPAP is a bit of a hassle to use, your body is sending the message loud and clear that it really likes what this CPAP machine is doing for your breathing.

-john-

[zoocrewphoto]

Great to see that you are off to a great start. My start has been similar. I am almost 4 months into it. I have had some ups and downs. Most of teh downs are due to two rounds of coughing 3+ weeks EACH. That really tends to mess with sleep. But even with the coughing, and only partial nights with my machine, I still feel better than pre-cpap.

Like you, I noticed fairly quickly that I was doing fewer trips to the bathroom. I used to go 2-3 times a night, and now it is only one, with a rare night of zero. I also noticed a few days in that I felt more cheerful. Happy. Mentally more alert. At one point, I was aware that I felt like dancing when good music came on, but I didn't feel energetic enough to dance. So, my mind was interested in doing things that I had not done in a while. The energy starting picking up later. Because of my ups and downs, I don't get several long good days in a row right now. But there have been a few really awesome days where I really felt way better than I have in years. Until my coughing starting up again, I actually went over 3 weeks without a single sip of an energy drink.

A lot of the initial changes were not big changes, but I was aware that I was feeling and thinking differently. It 's like a present that gets better and better, and it is fascinating to feel it and also to ponder these changes as they happen. It makes me wish I had done this years ago. And I am so eager to help others get this relief. I want them to feel as I good as I do. And for those who tried and did not have success, I feel so bad that they did not get a good start from their sleep study/doctor/dme; and obviously did not find this great forum. I wouldn't have either, except I was trying to find a cabinet suitable for my machine and wondered if anything was marketed with that purpose. I found this forum by accident.

[Chikorita]

Hello and thanks so much for sharing your story. I've been two weeks now too but not good enough at reporting the data to post anything like the detail you have. CPAP is amazing in that it really can make a difference. And this forum helps people to hang in there and wait while things change. Yay for the supportive members here. Without you I'd be poorer and far more stressed.

[BRPTsleeptech]

As my previous notes on this forum indicated( viewtopic.php?f=1&t=80623&p=733707#p733707 ) , I had a sleep study about two weeks ago. It was a split study. Halfway through the night, I was placed on CPAP, which sort of tells you how the first half of the night went.

In the morning, after a shower and continental breakfast, they presented me with a shiny new Philips Respironics System One Auto-CPAP with heated humidifier. (60 Series), and True Blue Mask.

Today was my first follow-up appointment. We went over the sleep study, and looked at the data for the first 14 days.

Summary: A diagnosis of Severe Sleep Apnea. (Not a surprise, really…)

The key points:

Baseline Study (before CPAP):
Snoring reported as LOUD
Respiratory Events: 130 Obstructive apneas, 0 central apneas, 10 mixed apneas. A total of 29 obstructive hypo apneas and 168 RERAs were noted for an RDI of 53.4 and an AHI of 51. The REM AHI was 10.4. ** Lowest O2 Saturation was 75% **

CPAP Titration:
CPAP began at a pressure of 6 and completed at a pressure of 9. The report shows an elimination of apneas, hypo apneas, desaturations, and arousals at the final CPAP pressure of 9 cm/H2O. Supine REM was noted at this pressure.

Other:

EEG: Normal
PLM: Minimal, no arousals, none noted after CPAP applied
EKG: Normal

Prescription was for an Auto-CPAP set to 9-15 cm/H2O.

So, the main discussion surrounded the significant desaturations, which I was already aware of thanks to this forum, and the suggestion to get a recording pulse oximeter, which I did about two months ago. The Doc suggested that I was a poster child for OSA, and CPAP treatment. I started having significant Obstructive Apnea events as soon as I feel asleep. She said she could feel for the sleep tech as she probably got really uncomfortable when the O2 dropped below 80 4 times within 90 minutes…

As far as the 14 days on CPAP? As expected, the first two nights were rough. I did not want to go into the room with that machine on the second night!
I started to make peace with it on night three. I readily noticed that I was not waking up to go to the bathroom as much (or at all!). I have been playing with the velcro straps on the True Blue mask, trying to get it "just right" so that it does not leak when I switch sides, nor leave me with a sore bridge of my nose. I'm pretty close now.
For the past 3-4 nights I'd say the sleep is noticeably better than pre-CPAP. I think I should get some sort of hose cover, as the noise of the hose rubbing against the headboard when I move around is distracting. It might also help as the weather turns colder as I don't have a heated hose.

What data do I have to show for it? My CMS-50E reports that my O2 saturation hardly wavers now -- usually between 94-96%. When I've been able to keep the Zeo on my head, it is showing significantly more deep sleep and REM sleep. My AHI is around 1.2. My 90% (or is it 95%) pressure as reported from the machine is 10.1.

I would like to try nasal pillows of some sort, as I can't have my glasses on with this mask, nor is it easy to wear my Zeo, since the True Blue mask has a forehead component (or branding iron, as I like to say…). Thankfully, any marks on my face come out within an hour.

I'm so thankful for finding this forum! Everyone here has been so very helpful. It has made a stressful situation and diagnosis of a life-long condition so much easier to bear.

Please let me know if there are any questions I can answer. There is more data on the report, but I think I caught the high points.

John

John,
As a Registered Sleep Tech I'm glad to hear your feel better. I would recommed trying the ResMed Swift Fx if your DME company carries them, they are small easy to adjust and light weight.

[deltadave]

Please let me know if there are any questions I can answer.

I have one. Have you ever had an echocardiogram to look for patent foramen ovale (PFO)?

[deltadave]

So, the main discussion surrounded the significant desaturations...

Your area of concern does not appear to be "desaturations"-- rather, it is a baseline drop:



How many desaturations did you have?

Of interest is that there are NO respiratory events (including supine REM) while in other positions other than right side prior to initiation of pressure (although the histogram registers 0 cmH2O, that may have been a data entry error).

[deltadave]

As a Registered Sleep Tech I'm glad to hear your feel better. I would recommed trying the ResMed Swift Fx if your DME company carries them, they are small easy to adjust and light weight.

Thanks for that tip! That's very helpful information!

[JohnO]

I want them to feel as I good as I do. And for those who tried and did not have success, I feel so bad that they did not get a good start from their sleep study/doctor/dme; and obviously did not find this great forum.

Isn't that the truth? I have met people who have had a CPAP machine in their closet for years. They tried it for a few days, then gave up years ago.

Thanks,

John

[JohnO]

I would like to try nasal pillows of some sort, as I can't have my glasses on with this mask, nor is it easy to wear my Zeo, since the True Blue mask has a forehead component (or branding iron, as I like to say…). Thankfully, any marks on my face come out within an hour.

John,
As a Registered Sleep Tech I'm glad to hear your feel better. I would recommed trying the ResMed Swift Fx if your DME company carries them, they are small easy to adjust and light weight.

I had a -great- Sleep Tech. She was clearly well educated in the facets of sleep, and the sleep study. She was also incredibly efficient at all the work she had to do to monitor her two patients that night. She helped put me at ease.

Thanks for the Swift FX recommendation. I've been looking at that mask, or perhaps the Aloha, or the Opus 360. No hurry, I guess.

[JohnO]

Please let me know if there are any questions I can answer.

I have one. Have you ever had an echocardiogram to look for patent foramen ovale (PFO)?

No, I have not.

[JohnO]

So, the main discussion surrounded the significant desaturations...

Your area of concern does not appear to be "desaturations"-- rather, it is a baseline drop:


How many desaturations did you have?

I actually don't see a count on the report. From my pre-CPAP and post-CPAP SpO2 monitoring, a typical night before CPAP would have more than 200 desaturation events. Afterwards, maybe 1 or 2, but no drops below about 94%. I've got some graphs I might upload with that info.

Of interest is that there are NO respiratory events (including supine REM) while in other positions other than right side prior to initiation of pressure (although the histogram registers 0 cmH2O, that may have been a data entry error).

I think there are a couple of data errors. First, though, you can see some events on my left side between 2:40 and 3:10. We discussed that there did seem to be some data error when CPAP was first initiated, as if perhaps I was awakened and masked, but the recording was somewhat muddled until the CPAP line pops up to 6 around the 4:20 mark.

[deltadave]

I actually don't see a count on the report. From my pre-CPAP and post-CPAP SpO2 monitoring, a typical night before CPAP would have more than 200 desaturation events. Afterwards, maybe 1 or 2, but no drops below about 94%. I've got some graphs I might upload with that info.

I'd love to see them.

The NPSG desaturation(s) above are atypical (ya THINK?) of OSA.

If it isn't a PFO (BTW, PFOs in OSA patients are frequent) then it could be poor signal quality that should have been addressed at the time of acquisition.