Hey Folks,
I have an appt. with my provider tomorrow to get my equipment, but before I met with them, I wanted to be as prepared with info as I could be. I was finally able to get a copy today of my sleep study results/recommendations. I'm confused as ever. Clarification/feedback/etc. from any of you regarding the following would be GREATLY appreciated:
POLYSOMNOGRAM RESULTS:
Total sleep time was 7.5 hours, total awake time 1.1 hours, for 87% sleep efficiency. Sleep onset 21 minutes. REM latency 300 minutes. Total time in bed 8.6 hours. Two REM sessions. 9% of time in bed spent awake; of total sleep time, 2% Stage 1, 72% Stage 2, 14% delta sleep, and 12% REM sleep.
Respiratory Data: 2 central apneas and 290 hypopneas noted for 292 respiratory events recorded. Pretreatment Apnea + Hypopnea Index of 60.4. 156 of the episodes occurred prior to CPAP. Minimum drop in oxygen saturation 91% with Arousal Index of 68.9, Desaturation Index of 3.1. Sleep efficiency was 81%. The patient slept 155 minutes of nonREM sleep prior to nasal CPAP. The patient was titrated up to 18 cm/H20. On 12 cm/H20 the patient slept 16 minutes in REM sleep, 8 minutes in nonREM sleep for Apnea + Hypopnea Index of 7.5. On 14 cm/H2O the patient slept 23 minutes in nonREM sleep and for an Apnea + Hypopnea Index of 8. On 15 cm/H20, the patient slept on 13 minutes for an extrapolated index of 18. On 18 cm/H20, the patient slept on 6 minutes for an Apnea + Hypopnea Index of 10.
POLYSOMNOGRAM IMPRESSION:
This overnight polysomnogram was recorded as a split night sleep study without and with nasal CPAP.
1. Prior to nasal CPAP, loud snoring recorded. Snoring controlled on CPAP.
2. Prior to nasal CPAP, severe level of obstructive sleep apnea/hypopneas, predominantly hypopneas noted with an Apnea + Hypopnea Index of 60.4 with minimum drop in oxygen saturation 91%.
3. Nasal CPAP at 14 cm/H20 reduced Apnea + Hypopnea Index down to 8 which is a mild range with minimum drop in oxygen saturation 94% with a baseline 96%-97%. CPAP was tried up to 18 cm/H20 without further reduction in the Apnea + Hypopnea Index. Therefore would recommend treatment at 1- cm/H20.
RECOMMENDATIONS:
Recommend treatment with nasal CPAP at 14 cm/H20 using with heated humidity and a Fisher-Paykel HC407 mask.
HELP!
Results/Recommendations from my Sleep Study...HELP!
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SelfSeeker
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JSGarner,
I do not know much and find it easier to actually look at the graphs. Tells me more.
I would ask the Dr those apneas that would not go away, were they centrals?
Did you only sleep 54 minutes total with the mask on? Would that be enough to give you a good Rx?
I do not know much and find it easier to actually look at the graphs. Tells me more.
I would ask the Dr those apneas that would not go away, were they centrals?
Did you only sleep 54 minutes total with the mask on? Would that be enough to give you a good Rx?
I can do this, I will do this.
My disclaimer: I'm not a doctor, nor have I ever worked in the health care field Just my personal opinions.
My disclaimer: I'm not a doctor, nor have I ever worked in the health care field Just my personal opinions.
I would insist on an autopap, because your results look a bit weird. You didn't have ANY REM sleep above 12 cm, yet they titrated you at 14, even though the time at 14 showed a slightly HIGHER AHI than your results WITH REM at 12 cm, despite having no REM. During REM sleep, the number of events tends to increase.
Also, an AHI of 8 is not really low enough. Most therapists and doctors try for under 5 for treated AHI.
Tell your doctor that you are afraid that they didn't get a good reading during REM sleep, so you would like an autopap. If needed, you can run it in straight cpap mode later, after you are more confident of your pressure needs.
Next, there is no good reason to have the type of mask in your prescription, although it is nice to know what kind you used during the study. Ask your doctor to write the prescription without specifying a brand of mask. That will give you the freedom to try several masks at the supplier, to see which fits best. If your medical supplier will not allow you to try on several masks WITH the right pressure, and lying down, then you will want a different supplier.
A couple of encouraging points. First, you have mostly hypopneas, few apneas, and as a result, your oxygen desaturation is not as bad as many patients. Having an apnea event means all of your air is cut off during the event, while a hypopnea means a lot of your air is cut off, but a little is still passing into your lungs.
You probably caught your apnea early, so with treatment, you can avoid some of the health problems that arise from untreated apneas. My doctor told me that very low oxygen kills brain cells, which is something most of us want to avoid!
Your AHI is in the "severe" range (over 30). That means the doctor will definitely want to get you into treatment.
Best of luck, and come back to the board to keep us posted on your progress!
Moogy
Also, an AHI of 8 is not really low enough. Most therapists and doctors try for under 5 for treated AHI.
Tell your doctor that you are afraid that they didn't get a good reading during REM sleep, so you would like an autopap. If needed, you can run it in straight cpap mode later, after you are more confident of your pressure needs.
Next, there is no good reason to have the type of mask in your prescription, although it is nice to know what kind you used during the study. Ask your doctor to write the prescription without specifying a brand of mask. That will give you the freedom to try several masks at the supplier, to see which fits best. If your medical supplier will not allow you to try on several masks WITH the right pressure, and lying down, then you will want a different supplier.
A couple of encouraging points. First, you have mostly hypopneas, few apneas, and as a result, your oxygen desaturation is not as bad as many patients. Having an apnea event means all of your air is cut off during the event, while a hypopnea means a lot of your air is cut off, but a little is still passing into your lungs.
You probably caught your apnea early, so with treatment, you can avoid some of the health problems that arise from untreated apneas. My doctor told me that very low oxygen kills brain cells, which is something most of us want to avoid!
Your AHI is in the "severe" range (over 30). That means the doctor will definitely want to get you into treatment.
Best of luck, and come back to the board to keep us posted on your progress!
Moogy
Moogy
started bipap therapy 3/8/2006
pre-treatment AHI 102.5;
Now on my third auto bipap machine, pressures 16-20.5
started bipap therapy 3/8/2006
pre-treatment AHI 102.5;
Now on my third auto bipap machine, pressures 16-20.5
Just a couple things I want to add to the great responses above.
The report says you had 2 centrals. It doesn't say if there were any while using CPAP and at what pressure you were at when they occurred.
I also agree with the question about what is going on with the rest of the events that were still above 5?
I agree with mask comment. Should be whatever you want. Why does it need to be nasal? I personally love nasal, but the choice should be yours.
Cflex or other exhale relief would be good to have on your prescription due to your pressure being fairly high (at least the pressure they think you should use) And if you take the advice to try to get the auto (I am a lover of auto) then Respironics is the only one that has exhale relief that can be used in auto mode.
Watch your out of pocket cost with DME. Enough said on this. Lots I have written and other too that you can search on. And if you have any issues with the DME check for other providers that are acceptable to your insurance company.
The report says you had 2 centrals. It doesn't say if there were any while using CPAP and at what pressure you were at when they occurred.
I also agree with the question about what is going on with the rest of the events that were still above 5?
I agree with mask comment. Should be whatever you want. Why does it need to be nasal? I personally love nasal, but the choice should be yours.
Cflex or other exhale relief would be good to have on your prescription due to your pressure being fairly high (at least the pressure they think you should use) And if you take the advice to try to get the auto (I am a lover of auto) then Respironics is the only one that has exhale relief that can be used in auto mode.
Watch your out of pocket cost with DME. Enough said on this. Lots I have written and other too that you can search on. And if you have any issues with the DME check for other providers that are acceptable to your insurance company.
6 posts
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