Need help with home sleep study results

[norestforwicked]

Hello everyone! This is my first post and I am here hoping you all might be able to offer some insight into my recent home sleep study. A little background: I have been suffering from migraines for the last 4 years and when I don't have a migraine, I seem to have a headache. I do take medications for the migraines, but nothing seems to completely rid me of regular daily headaches. When my neurologist started to dig, I realized that most often I either woke with the headaches or would get them within a few hours of being awake. My husband tells me I snore a lot and loudly too. Yay! Those details are what caused my neurologist to order the home sleep study.

I got the results back Friday, but I am confused as to what they mean. When I spoke to the tech on the phone she wasn't very helpful. They did suggest doing an overnight study in the lab because my RI level was elevated. I asked if this was bad and all I could get was "Well, it's not good" No explanation as to why it's not good or what it even was. She also seemed hesitant to send me my results, which bothered me. So now I am hesitant to pursue further testing if I don't need to. Based on the results below...do I have mild apnea? Should I do further testing or push my doctor for a diagnosis based on these results? I'm just not sure what to do next. Thanks!

Here are the results:

ahi: 3
ri: 7.8
apnea index: 1.1
hypoapena index: 1.9
odi oxyg desaturation index: 3.9
avg sat: 93
lowest desat: 88
lowest sat: 86
baseline sat: 95
min puls: 48
max pulse: 105
avg pulse: 63
avg breaths per min: 11.68
apneas: 7
obstructive apneas: 5
central apneas: 2
hypoapeans: 12
flow lim br w/out sn (fl): 2738
snoring events: 63
no of desaturations: 25
result: although the AHI is normal, the RI is elevated at 7.8

[ChicagoGranny]

do I have mild apnea?

Based on this one home test report, you do not have sleep apnea. You do have a mild case of sleep-disordered breathing.

The test is inconclusive. Home sleep studies do not include an EEG, so it can not be known how long you slept, and how long you slept in each sleep stage and each body position. You need an in-lab study to get this information. This information might lead to a more complete and conclusive diagnosis.

RI probably means Respiratory Disturbance Index. It's an estimate of how many times per hour your sleep is interrupted by breathing difficulties.

when I don't have a migraine, I seem to have a headache
snore a lot and loudly
RDI: 7.8
snoring events: 63
no of desaturations: 25

Given all of that plus an inconclusive home sleep study, I would go for a lab sleep study.

There is one thing you could do before making this decision. Force yourself to sleep off your back - sleep on your sides or stomach. You can pile pillows at your back, use a tennis ball pinned to the back of your pajama shirt or wear a small backpack stuffed with some items.

See if you feel better doing this and ask your husband if your snoring ceased. If the answer is yes to both, you at the very least have positional sleep apnea. You might treat this successfully by avoiding backsleeping. Or, you could benefit from using CPAP. Keep in mind that sleep-disordered breathing is a progressive condition, and you might eventually need CPAP anyway.

BTW,

Should I ... push my doctor for a diagnosis based on these results?

do you really mean to push a doctor for a diagnosis based on test results that are inconclusive?

Good luck.

[Julie]

Definitely stop back sleeping if it's a factor - you can use various things in behind you to help keep you on your sides when sleeping, but you don't qualify as having sleep apnea based on that test.

[jnk...]

Home sleep tests are VERY GOOD at proving you DO need PAP therapy.

Home sleep tests are COMPLETELY INCAPABLE of proving that you DON'T need PAP therapy.

That is the nature of home sleep tests.

In the case of migraine treatment, my opinion (as a nobody) is that response to treatment should dictate the role of PAP, much as it would dictate drug choice. Your doc's paperwork people may, or may not, have the skills needed to convince payers to cover a PAP trial to see if that helps the migraines. The RDI "results" may be enough. Or they may not. It is a nebulous area. And it may actually be that the neuro is just playing the home-test game as required by payers in order eventually to get you to an NPSG that will show what's really going on in the brain during sleep stages.

[kteague]

For-the reasons already stated plus my own personal bias, I would be eager to do the more detailed study. You have unknowns and this could give you some answers. and maybe even resolutions. Too many times we as patients (and our doctors) let unknowns drift around out there in neverland until they cause problems too big too ignore. I have been the queen of this, and paid a high price. Having a study done that looks at the brain, the heart, and our breathing is a LOT of good information to have. Not a pleasant night - to be sure - but in my mind very worth the temporary hassle when cost is not an obstacle.