Help with PSGT results (Full data included)

[BIGsherm7272]

I had my PGST this past february and was diagnosed with severe OSA with an AHI of 33.3, and have been using my cpap mchine since 7/25/15. While I understand and can interpret all of the data very quickly and easily (I have a background in medicine), and have some of my own thoughts and opinions which may be valid or not regarding the results and diagnosis, I was wondering if maybe someone more educated and well-versed (or just even understands the data and has experience with OSA) could look over my data and give me any insights they might have on it, such as opinions of diagnosis, sleep hygiene changes vs. CPAP therapy, or just about anything you might infer or gather from the data. I would greatly appreciate and feedback on it. I tried to make the data as organized and easy to interpret as possible. If anyone has any suggestions, I am completey open-minded. Thank you in advance.


Study Date: 02/10/2015
Location: Morton Plant Hospital (Clearwater, FL)
Test type: Full PGST
Age: 26
Height: 5'10"
Weight: 330
BMI: 47.34

This study used the 3% hypopnea rule.
During this study, normal sinus rhythm was observed
During this study, Cheyen-Stokes respiration was not observed.
Summary: To summarize, the patient has what would be characterized as severe obstructive sleep apnea with an AHI of greater than 30 and an oxygen desaturation down to 68%. The patient did in fact meet the urgent criteria for recommendation of a CPAP titration study.


Legend: TST = total sleep time, REM = rapid eye movement sleep, NREM = non-rapid eye movement sleep, N1 = sleep stage 1, N2 =sleep stage 2, N3 = sleep stage 3
TRT = total recording time, SPT = sleep period time, LM = leg movements, PLM = periodic leg movements, AHI = apnea/hypopnea index, BPM = beats per minute

Study time stats -

TST: 340 min.
Sleep efficiency: 92%
REM latency: 98 min.
Awakenings: 18
Sleep stage changes: 112

Respirtory event count -
Format = (TST count / index) (NREM count / index) ( REM count / index )

Central: (3.0 / 0.5) ( 3.0 / 0.7) ( 0.0 / 0.0 )
Obstructive: (24.0 / 4.2) ( 2.0 / 0.5) (22.0 / 16.7)
Hypopnea: (158.0 / 27.8 ) (72.0 / 16.5) (86.0 / 65.3)
Mixed: (4.0 / 0.7) (1.0 / 0.2) (3.0 / 2.3)
Supine events: (180.0 / 43.9) (69.0 / 17.9) (111.0 / 84.3)
Non-supine events: (9.0 / 5.7) (9.0 / 5.7) (No REM spent in non-supine position)
AHI: 33.3

Oxygen Saturation -
Format = Awake / Non-REM / REM / TST

Mean %: 93 / 91 / 88 / 91
Min %: 79 / 76 / 70 / 70
Max %: 98 / 97 / 96 / 97

% of Total sleep time at Spo2 range
Format = Awake / Non-REM / REM / Total sleep time

90-100%: 91.3 / 87.6 / 48.3 / 78.5
80-89%: 6.1 / 12.2 / 45.1 / 19.9
70-79%: 0.5 /0.1 / 6.6 / 1.6
60-69%: 0.0 / 0.0 / 0.0 / 0.0

Time in sleep stages -
Format = minutes (% TST)

N1: 31.0 (9%)
N2: 230.5 (68%)
N3: 0.0 (0%)
REM: 79.0 (23%)
Supine (back): 246.0 (72%)
Non-supine (side): 94.5 (28%)

Rythmic Movements -
Format = events (index)

LM count: total - 36 (6.3)
LM arousal: total - 8 (1.4)
PLM count: total - 38 (6.7)
PLM arousal: total - 5 (0.9)
Total RM count: 73 (13.0)

Pulse rate -
Format = Awake / NREM / REM / TST / TRT

Mean pulse (bpm): 82 / 80 / 68 / 77 / 77
Min. pulse (bpm): 53 / 56 / 47 / 47 / 47
Max pulse (bpm): 109 / 102 / 95 / 102 / 109

% of time at bpm range:
Format = Awake / NREM / REM / TST / TRT

100+ bpm: 2.7% / 0.2% / 0.0% / 0.1% / 0.2%
90-100 bpm: 8.6% / 1.8% / 0.3% / 1.4% / 1.3%
80-89 bpm: 52.7% / 49.2% / 8.1% / 39.7% / 26.8%
70-79 bpm: 33.4% / 47.8% / 36.5% / 45.2% / 27.2%
60-69 bpm: 0.8% / 0.9% / 39.4% / 9.8% / 5.5%
50-59 bpm: 0.2% / 0.1% / 14/3% / 3.4% / 1.9%
under 50 bpm: 0.0% / 0.0% / 1.4% / 0.3% / 0.3%

Heart rhythm -
Format = Tachycardia / Bradycardia / Arrhythmia

Total events: 17 / 0 / 0
Index: 3.0 / 0.0 / 0.0
REM events: 2 / 0 / 0
REM index: 1.5 / 0.0 / 0.0
NREM events: 15 / 0 / 0
NREM index: 3.4 / 0.0 / 0.0

Snore results -
Format = TST count / TST index

Snore arousals: 19 events / 3.3 index
Snore total: 2,534 events / 446.5 index

Arousal summary -
Format: TST (count/index) NREM (count/index) REM (count/index )

Respiratory related: TST (92 / 16.6) NREM (37 / 8.7) REM (55 / 42.5)
PLM related: TST (13 / 2.3) NREM (13 / 3.0) REM (0 / 0.0)
Snore related: TST (19 / 3.3) NREM (17 / 3.9) REM (2 / 1.5)
Spontaneous EEG: TST (21 / 3.7) NREM (19 / 4.4) REM (2 / 1.5)
Total arousals: TST (145 / 25.6) NREM (86 / 19.7) REM (59 / 44.8 )


This is all of the data I could correlate on here, only info I couldn't include is a page with 5 graphs on it, which just makes the data visible anyways. If I am aable to use a scanner I will upload it on here. Again I know its lot of data, and I did my best to make it easy it understand and read, but if anyone has any suggestions or insight on to what some of it could mean, I would greatly appreciate.

[Pugsy]

I have some personal issues going on right now so no time to really offer much. So sorry and it may be a while before I can...so if anyone else can respond..please do so.

You might read this and see if what RobySue has written clarifies anything for you
http://adventures-in-hosehead-land.blog ... -test.html
then what needs clarifying...just ask a question

[Guest1]

looks like plain vanilla OSA to me. Here's what you need to remember:
1) don't try to overthink it. There is not much to Be had by tweaking incessantly. If a doc says try straight pressure of x, then you do it faithfully. Get leaks under control first. Then AHI. And give your body time to heal itself from the cumulativr damage of OSA.
2) If you can't tolerate Cpap pressure within 30 days, you may want to go to a doc and get a bilevel prescription.
3) Start a weight loss program when you feel your Cpap therapy is under control and you feel better. It may take upto 6 months or more to get there. The weight loss will get you The biggest bang for the buck at your age.

Good luck.

[Julie]

I think a huge part of your problem is that you sleep on your back - that has to be responsible for so many of the hypopneas, and if you can sleep on a side instead, and keep something in behind you so that you don't turn onto your back overnight, I think you'll see a big change in things. It will also help with mask leaks if that becomes an issue.