Following a sleep study which my Dr. jokingly told me I failed, I am looking forward to speaking with the sleep center DR. and getting set up with a machine. My appointment is Sept. 5 and I can't wait.
They stopped my sleep study after two hours and put me on a CPAP and eventually added oxygen. I got 4 hours of the most restful sleep I can remember. I actually felt like getting out of bed when they woke me up the next morning. It seems I have a variety of things going on including two types of apnea and restless leg syndrome. I don't fully understand the report from my study yet but it would appear that I was waking myself up on average 132 times per hour. Is that even possible? Am I reading the report wrong?
No matter, I am sure the Dr. will explain it all to me.
I look forward to benefiting from the collective wisdom and experience on this forum!!
Tirider
Greetings
Re: Greetings
Hi Tirider, and welcome to the Forum!
Sounds like you PASSED the sleep test to me, since you're getting a CPAP out of it
It is very possible that you're having 132 events an hour... That's a LOT but there a few on this forum with slightly more
It basically means you stop breathing 2x a minute. If I were you I would be a wreck.
The number of events per hour (132) , is your AHI = Apnea Hypopnea Index. You can find more definitions here:
our-collective-cpap-wisdom/sleep-apnea- ... tions.html
If you start out reading all the good articles under the Yellow Light Bulb - "Our Wisdom" - you will find that you will be much more prepared when you go meet with the doc. For example, when they give you a machine, they will most likely try to give you a bare-bones device. What you want is a data-capable CPAP or APAP, so that you can track your own therapy. Most of the time they will say "go by how you feel" to determine whether the therapy is working, but that's difficult to do if you don't know whether you're having massive leaks at night, or whether your AHI is still high. The "bare-bones" CPAPS only give you compliance data = that is, the number of hours used. That will NOT be enough to track your own therapy. Think of it like a diabetic monitoring their own blood glucose levels at home - they don't rely on a once-a-year test to see how they are doing.
Also sound like you have Mixed or Complex Apnea - which means that your apnea's are both "obstructive" and "central". The latter is when your brain forgets to tell your body to breath. It can complicate therapy, which is another good reason to get the most data capable machine possible.
Others will for sure chime in on this so I'll hand over the baton to them now...
Welcome!
Sounds like you PASSED the sleep test to me, since you're getting a CPAP out of it
It is very possible that you're having 132 events an hour... That's a LOT but there a few on this forum with slightly more
It basically means you stop breathing 2x a minute. If I were you I would be a wreck.
The number of events per hour (132) , is your AHI = Apnea Hypopnea Index. You can find more definitions here:
our-collective-cpap-wisdom/sleep-apnea- ... tions.html
If you start out reading all the good articles under the Yellow Light Bulb - "Our Wisdom" - you will find that you will be much more prepared when you go meet with the doc. For example, when they give you a machine, they will most likely try to give you a bare-bones device. What you want is a data-capable CPAP or APAP, so that you can track your own therapy. Most of the time they will say "go by how you feel" to determine whether the therapy is working, but that's difficult to do if you don't know whether you're having massive leaks at night, or whether your AHI is still high. The "bare-bones" CPAPS only give you compliance data = that is, the number of hours used. That will NOT be enough to track your own therapy. Think of it like a diabetic monitoring their own blood glucose levels at home - they don't rely on a once-a-year test to see how they are doing.
Also sound like you have Mixed or Complex Apnea - which means that your apnea's are both "obstructive" and "central". The latter is when your brain forgets to tell your body to breath. It can complicate therapy, which is another good reason to get the most data capable machine possible.
Others will for sure chime in on this so I'll hand over the baton to them now...
Welcome!
PR System One APAP, 10cm
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
Re: Greetings
Echo,
Thanks for the warm welcome. Trust me, now that I know about my "problem", I now realize what a wreck I am and have been. Prior, I just thought I was getting old, tired, fat and forgetful. Maybe that's not the case!
I have been reading the "yellow light bulb" voraciously but still have a long way to go. I will definitely push for the best machine and equipment I can get. I feel (as others have mentioned) a real sense of control and understanding now that I know I haven't been getting the rest I need. Thanks to your response, I am better prepared to speak with the Dr.. It sounds like my situation might be more severe than I originally thought. The sleep technician STRONGLY encouraged me to follow up on my sleep study as quickly as possible. He couldn't give me details but he did hint that I may have had apnea for the last 20+ years and that my situation could be made better.
I don't have my report in front of me but I recall that my average oxygen level was around 85%. From the little bit of reading I've done, that is sounding a little severe as well.
I will stop speculating and "patiently" wait for my appointment. Yea right. I can't wait to get on the road to relief, I might even remember a dream every once in a while. WooHoo!
Ti
Thanks for the warm welcome. Trust me, now that I know about my "problem", I now realize what a wreck I am and have been. Prior, I just thought I was getting old, tired, fat and forgetful. Maybe that's not the case!
I have been reading the "yellow light bulb" voraciously but still have a long way to go. I will definitely push for the best machine and equipment I can get. I feel (as others have mentioned) a real sense of control and understanding now that I know I haven't been getting the rest I need. Thanks to your response, I am better prepared to speak with the Dr.. It sounds like my situation might be more severe than I originally thought. The sleep technician STRONGLY encouraged me to follow up on my sleep study as quickly as possible. He couldn't give me details but he did hint that I may have had apnea for the last 20+ years and that my situation could be made better.
I don't have my report in front of me but I recall that my average oxygen level was around 85%. From the little bit of reading I've done, that is sounding a little severe as well.
I will stop speculating and "patiently" wait for my appointment. Yea right. I can't wait to get on the road to relief, I might even remember a dream every once in a while. WooHoo!
Ti
_________________
| Mask | |
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Re: Greetings
Go Ti! Sounds like we'll soon have one more VERY compliant xPAPer in the Hosehead gang soon
Sidenote - I noticed you said they put you on oxygen towards the end. If you have COPD, it seems that a Bi-level might be a better option you, but that's again my non-medical non-advice I assume that the pulmonologist can at least figure that part out. There are a few knowledgable people on the board regarding Bi-level PAPs so you wouldn't be alone.
Anyway, good luck at your appointment! Hope you get your machine REAL soon!!!!
Sidenote - I noticed you said they put you on oxygen towards the end. If you have COPD, it seems that a Bi-level might be a better option you, but that's again my non-medical non-advice I assume that the pulmonologist can at least figure that part out. There are a few knowledgable people on the board regarding Bi-level PAPs so you wouldn't be alone.
Anyway, good luck at your appointment! Hope you get your machine REAL soon!!!!
PR System One APAP, 10cm
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
Activa nasal mask + mouth taping w/ 3M micropore tape + Pap-cap + PADACHEEK + Pur-sleep
Hosehead since 31 July 2007, yippie!
Re: Greetings
I'd say you won the study too! When do you get your machine/mask? Do you know what you want for both?
_________________
| Mask | Humidifier | |||
 |  | |||
| Additional Comments: Pursleep, Padacheek, Regenesis™ Pillow, Neti Pot, Travel Buddy hose hanger | ||||
Re: Greetings
Gasp,
I think I will be getting equipment on my Dr. visit Sep. 5th. I am still researching equipment and reading about what you veterans are using. I know I will either need a chin strap or a full face mask. Otherwise, I want as many useful bells and whistles as possible. I also travel alot so I may try to get a second machine for travel. The Everest models have my interest right now.
Ti
I think I will be getting equipment on my Dr. visit Sep. 5th. I am still researching equipment and reading about what you veterans are using. I know I will either need a chin strap or a full face mask. Otherwise, I want as many useful bells and whistles as possible. I also travel alot so I may try to get a second machine for travel. The Everest models have my interest right now.
Ti
_________________
| Mask | |
|
Re: Greetings
DEFINITIONS:
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.
Normal Sleep Architecture should look similar to:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%
Stage3&4, REM decrease as we age.
Stuff seen on a PSG Report:
Arousal: An interruption of sleep lasting greater than 3 seconds.
BR Arousal index: The number of breathing related arousals(apnea, hypopnea, snoring & RERAs)multiplied by the # hours of sleep.
Bruxism: Grinding of the teeth.
Central apnea: A respiratory episode where there is no airflow and no effort to breathe lasting greater than 10 seconds.
EEG/EOG: Comments about sleep stages, brain waves (EEG), or eye movements (EOG)
EKG/ECG: Comments about heart rate, abnormal heart beats, etc.
EMG: Comments about leg movements and or teeth grinding (bruxism).
Hypopnea: A respiratory episode where there is partial obstruction of the airway lasting greater than 10 seconds. Also called partial apnea or hypo-apnea.
Non-supine: Sleeping in any position other than on the back.
NSR: Normal sinus rhythm.
NPSG: Nocturnal Polysomnogram, or sleep study.
(#)Number of Awakenings: The number of pages scored as wake after sleep onset.
Obstructive apnea: A respiratory episode where there is a complete cessation of airflow lasting greater than 10 seconds.
PLMs: Periodic limb movements.
PLM arousal index: The number of periodic limb movements that cause arousals multiplied by the number of hours of sleep.
PSGT: Polysomnographic technologist.
REM latency: Latency to REM(dreaming) from sleep onset.
RERAs: Respiratory effort related arousals. Episodes that are not apneas or hypopneas, often related to loud snoring, that generally do not cause a decrease in oxygen saturation.
Respiratory: Any specific comments about respiratory events.
RPSGT: Registered polysomnographic technologist.
Sleep efficiency: Total sleep time multiplied by time in bed.
Sleep latency: The first 30 seconds (one `epoch' of recording time) of sleep.
Sleep onset: The first 90 seconds (3 `epochs) of uninterrupted sleep.
Sleep stage shifts: The number of incidents of sleep stage changes.
Snoring intensity: Level of snoring loudness determined by the sleep technologist. Ranging in degrees from mild to very loud snoring.
Spontaneous arousal index: The number of spontaneous arousals (e.g. arousals not related to respiratory events, limb movements, snoring, etc) multiplied by the number of hours of sleep.
Stage 1: The lightest stage of sleep. Transitional stage from wake. top
Stage 1 shifts: The number of times the sleep stage changed to stage 1.
Stage 2: The first true stage of sleep.
Stages 3/4: The deepest, most restorative sleep.
Stage REM: The dreaming stage; Normally occurs every 60-90 minutes.
Supine: Sleeping on back.
Time in bed: The time in the study from `Lights Out' to `Lights On'.
Total arousal index: Total number of all arousals multiplied by the number of hours of sleep.
Total # of PLMs: The number of leg movements in sleep that last greater than 0.5 seconds.
Total sleep time: Total time asleep.
WASO: Wakefulness after sleep onset.
WNL: Within normal limits.
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.
Normal Sleep Architecture should look similar to:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%
Stage3&4, REM decrease as we age.
Stuff seen on a PSG Report:
Arousal: An interruption of sleep lasting greater than 3 seconds.
BR Arousal index: The number of breathing related arousals(apnea, hypopnea, snoring & RERAs)multiplied by the # hours of sleep.
Bruxism: Grinding of the teeth.
Central apnea: A respiratory episode where there is no airflow and no effort to breathe lasting greater than 10 seconds.
EEG/EOG: Comments about sleep stages, brain waves (EEG), or eye movements (EOG)
EKG/ECG: Comments about heart rate, abnormal heart beats, etc.
EMG: Comments about leg movements and or teeth grinding (bruxism).
Hypopnea: A respiratory episode where there is partial obstruction of the airway lasting greater than 10 seconds. Also called partial apnea or hypo-apnea.
Non-supine: Sleeping in any position other than on the back.
NSR: Normal sinus rhythm.
NPSG: Nocturnal Polysomnogram, or sleep study.
(#)Number of Awakenings: The number of pages scored as wake after sleep onset.
Obstructive apnea: A respiratory episode where there is a complete cessation of airflow lasting greater than 10 seconds.
PLMs: Periodic limb movements.
PLM arousal index: The number of periodic limb movements that cause arousals multiplied by the number of hours of sleep.
PSGT: Polysomnographic technologist.
REM latency: Latency to REM(dreaming) from sleep onset.
RERAs: Respiratory effort related arousals. Episodes that are not apneas or hypopneas, often related to loud snoring, that generally do not cause a decrease in oxygen saturation.
Respiratory: Any specific comments about respiratory events.
RPSGT: Registered polysomnographic technologist.
Sleep efficiency: Total sleep time multiplied by time in bed.
Sleep latency: The first 30 seconds (one `epoch' of recording time) of sleep.
Sleep onset: The first 90 seconds (3 `epochs) of uninterrupted sleep.
Sleep stage shifts: The number of incidents of sleep stage changes.
Snoring intensity: Level of snoring loudness determined by the sleep technologist. Ranging in degrees from mild to very loud snoring.
Spontaneous arousal index: The number of spontaneous arousals (e.g. arousals not related to respiratory events, limb movements, snoring, etc) multiplied by the number of hours of sleep.
Stage 1: The lightest stage of sleep. Transitional stage from wake. top
Stage 1 shifts: The number of times the sleep stage changed to stage 1.
Stage 2: The first true stage of sleep.
Stages 3/4: The deepest, most restorative sleep.
Stage REM: The dreaming stage; Normally occurs every 60-90 minutes.
Supine: Sleeping on back.
Time in bed: The time in the study from `Lights Out' to `Lights On'.
Total arousal index: Total number of all arousals multiplied by the number of hours of sleep.
Total # of PLMs: The number of leg movements in sleep that last greater than 0.5 seconds.
Total sleep time: Total time asleep.
WASO: Wakefulness after sleep onset.
WNL: Within normal limits.
someday science will catch up to what I'm saying...
Re: Greetings
Snoredog,(#)Number of Awakenings: The number of pages scored as wake after sleep onset.
One day ya gotta explain that one to me. How does a "page" get stored as "wake"?
jnk
Re: Greetings
I received my equipment last Friday. I did ask my Dr. to prescribe the C-Flex and Software and he told me I could get what ever I wanted from the med. supply co. He was wrong. So I will be asking my Dr. to send a new prescription.
My first night was a little rough and I took the mask off after 4 hours. The following night the mask rubbed the skin under my nose until I was bleeding in the morning but I kept the mask on all night. The mask it turns out, is slightly too small. I will be fitted with a new mask on Friday. I have been sleeping through the night but waking up frequently to adjust my mask for air leaks. Now that I know it is too small, I'm looking forward to a good night's sleep. I feel a little more alert upon waking each morning but I still tire by mid day. I know it can take 4 weeks or more to feel the full effects.
I feel fortunate that I am able to adapt to the mask and machine. Some minor tweaking and I hope to be breathing like a pro all night long!
Thanks for the help and encouragement to all on this forum - YOU ROCK!
Ti
My first night was a little rough and I took the mask off after 4 hours. The following night the mask rubbed the skin under my nose until I was bleeding in the morning but I kept the mask on all night. The mask it turns out, is slightly too small. I will be fitted with a new mask on Friday. I have been sleeping through the night but waking up frequently to adjust my mask for air leaks. Now that I know it is too small, I'm looking forward to a good night's sleep. I feel a little more alert upon waking each morning but I still tire by mid day. I know it can take 4 weeks or more to feel the full effects.
I feel fortunate that I am able to adapt to the mask and machine. Some minor tweaking and I hope to be breathing like a pro all night long!
Thanks for the help and encouragement to all on this forum - YOU ROCK!
Ti
_________________
| Mask | |
|
Re: Greetings
If the machine in your profile is actually the one you have (in the link below), it won't capture ANYTHING that the software will interpret. In fact, it doesn't even have a smart card or C-Flex. You got screwed......until you can at least get an M Series Pro (next link).Tirider wrote:I received my equipment last Friday. I did ask my Dr. to prescribe the C-Flex and Software and he told me I could get what ever I wanted from the med. supply co. He was wrong. So I will be asking my Dr. to send a new prescription.
My first night was a little rough and I took the mask off after 4 hours. The following night the mask rubbed the skin under my nose until I was bleeding in the morning but I kept the mask on all night. The mask it turns out, is slightly too small. I will be fitted with a new mask on Friday. I have been sleeping through the night but waking up frequently to adjust my mask for air leaks. Now that I know it is too small, I'm looking forward to a good night's sleep. I feel a little more alert upon waking each morning but I still tire by mid day. I know it can take 4 weeks or more to feel the full effects.
I feel fortunate that I am able to adapt to the mask and machine. Some minor tweaking and I hope to be breathing like a pro all night long!
Thanks for the help and encouragement to all on this forum - YOU ROCK!
Ti
https://www.cpap.com/cpap-machine/Respi ... chine.html
https://www.cpap.com/cpap-machine/Respi ... -CPAP.html
If it wasn't the equipment the doctor wrote the prescription for and the machine you WANTED, you shouldn't have accepted it.
But, I'm glad to hear you're getting some sleep and adapting to the therapy.
Good luck.
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
-
sleepycarol
- Posts: 2461
- Joined: Thu Aug 30, 2007 7:25 pm
- Location: Show-Me State
- Contact:
Re: Greetings
Make sure your doctor writes the script for the machine you want. The DME will screw you unless you do and stand your ground and do NOT accept less!!!
You will want a data capable machine at the least.
You will want a data capable machine at the least.
Start Date: 8/30/2007 Pressure 9 - 15
I am not a doctor or other health care professional. Comments reflect my own personal experiences and opinions.
I am not a doctor or other health care professional. Comments reflect my own personal experiences and opinions.
Re: Greetings
Hey Gang,
I wouldn't say I got "screwed" but indeed I was a little misled. I decided it would be better to take the machine they offered and start my therapy right away. I am in the process now of getting the better machine and mask. I wasn't expecting to get everything right the first time. An adjustment or change here and there and I will be good to go!!
My Dr. would have supplied me the machine I wanted but he wasn't approved by my insurance to provide the equipment. Something about a conflict of interest. So I need to work through my insurance company. I am fortunate that thus far they are covering 100% of everything. So I am counting my blessings and trying to work within the system. I am sure I will have it all perfected within another week.
Thanks!
Ti
I wouldn't say I got "screwed" but indeed I was a little misled. I decided it would be better to take the machine they offered and start my therapy right away. I am in the process now of getting the better machine and mask. I wasn't expecting to get everything right the first time. An adjustment or change here and there and I will be good to go!!
My Dr. would have supplied me the machine I wanted but he wasn't approved by my insurance to provide the equipment. Something about a conflict of interest. So I need to work through my insurance company. I am fortunate that thus far they are covering 100% of everything. So I am counting my blessings and trying to work within the system. I am sure I will have it all perfected within another week.
Thanks!
Ti
_________________
| Mask | |
|
Re: Greetings
" a little misled"Tirider wrote: I wouldn't say I got "screwed" but indeed I was a little misled. Ti
.....yea, I know.....
been there,
done that,
have the t-shirt.
I'm sure you will......I know......Tirider wrote:I am sure I will have it all perfected within another week.
been there,
done that,
have the t-shirt.
Good attitude. All the best to you as your journey begins.
" a little misled..."
"If your therapy is improving your health but you're not doing anything
to see or feel those changes, you'll never know what you're capable of."
I said that.
to see or feel those changes, you'll never know what you're capable of."
I said that.
Re: Greetings
I can relate! My AHI was 102, and they wanted to start my CPAP therapy right away, even before my titration. I figured if >30 = severe, then 102= super triple severe. I had spent two weeks reading the forum prior to my first sleep study so I had decided I wanted data capability. However, like you I was anxious to get this thing going and get some relief. I ended up accepting a basic Resmed S8 with heated humidifier and mask (long story, lot's of double talk) while they billed my insurance $1,900.00.Tirider wrote:Hey Gang,
I wouldn't say I got "screwed" but indeed I was a little misled. I decided it would be better to take the machine they offered and start my therapy right away. I am in the process now of getting the better machine and mask. I wasn't expecting to get everything right the first time. An adjustment or change here and there and I will be good to go!!
My Dr. would have supplied me the machine I wanted but he wasn't approved by my insurance to provide the equipment. Something about a conflict of interest. So I need to work through my insurance company. I am fortunate that thus far they are covering 100% of everything. So I am counting my blessings and trying to work within the system. I am sure I will have it all perfected within another week.
Thanks!
Ti
I did get a prescription however, and just waiting for the right machine on CPAP auction. Anyway I've moved on. The machine works. The important thing for me is preserving the brain cells I still have left, and waking up in the morning. Do something about that mask though, mine was a big factor in getting adjusted to this stuff.
Good luck.
"Good people sleep peaceably in their beds at night only because rough men stand ready to do violence on their behalf." George Orwell