Question about PAP titration report

[jshu43]

I just got a copy of my CPAP titration study and I am confused on a couple of things. Here's a bit of it:

Sleep Architecture - Sleep efficiency of 65.6%. Sleep latency was 19.2 minutes. Total of 0 periods of Stage R, 11.1% of stage N1sleep, 33.4% of Stage N2 and significantly increased 55.5% of Stage N3 sleep. Arousal index was 20.5 per hour.

Impression: Moderate obstructive sleep apnea syndrome of the RERA variety.

I guess my main question is can they really come up with a good score and CPAP titration without any REM sleep? Am I getting much REM sleep?

[ozij]

jshu,
Is that the titration (where they try different pressures on you while you're wearing a mask), or is that the diagnostic part -- where they just observe you? How many nights did you spend in a sleep lab? One - a split night study, the first part of which was diagnostic, and second part titration (pressure titration = making slight changes in the pressure, up and down till an optimum is found) or did you have two nights, one for diagnostic, one for pressure titration?

Were you given a titration study at all? Could it be that the doc avoided a titration PSG (PSG is sleep study) because your results can't justify a pressure titration for your insurance?

My apologies if you've already given that info, however, I think it would clear confusion for all of us if you were to repeat it here.

The results you quote are not surprising, if they are from a diagnostic study. They don't make sense any sense in a titration study -- which also reports what happens at the various pressures tried.

O.

[jshu43]

ozij,

I had two sleep studies - one for diagnostic and one for titration. I have the first sleep study, but they faxed it to me and I can't read all of it, it's so blurred. It does look like I had REM sleep on the first test.

The report I posted was the titration report. They did have the CPAP titration report, which actually was confusing to me as well. The said my best level was a 7, but on the report, at 7 I had a RDI of 0.9 and on the chart, it shows level 9 was a RDI of 0.0. Oxygen was the same for both levels. I wonder why they thought 7 would be better than 9?

From the diagnostic test, they diagnosed me with Moderate Sleep Apnea of the RERA variety. On the diagnostic test I had an RDI of 21.9.

I guess my main concern is how accurate the titration can be without any REM sleep, and will the CPAP interfere with my getting REM sleep as perhaps it did on the titration test.

[ozij]

ozij,

I had two sleep studies - one for diagnostic and one for titration. I have the first sleep study, but they faxed it to me and I can't read all of it, it's so blurred. It does look like I had REM sleep on the first test.

The report I posted was the titration report. They did have the CPAP titration report, which actually was confusing to me as well. The said my best level was a 7, but on the report, at 7 I had a RDI of 0.9 and on the chart, it shows level 9 was a RDI of 0.0. Oxygen was the same for both levels. I wonder why they thought 7 would be better than 9?

From the diagnostic test, they diagnosed me with Moderate Sleep Apnea of the RERA variety. On the diagnostic test I had an RDI of 21.9.

I guess my main concern is how accurate the titration can be without any REM sleep, and will the CPAP interfere with my getting REM sleep as perhaps it did on the titration test.

Two valid questions, which should be answered by the professional who interpreted the study.
My amateur guesses:
Perhaps you spent a very short time at 9, or else experienced deeper sleep stages at 7 as opposed to 9.

Muffy would be able to respond about the architecture, and the possible impact medications may have on that. You sleep is deeper, but you still have almost the same number of arousals -- although apparently they are no longer related to respiratory problems.

I have no idea if RERA's can be REM related. Let's Muffy joins us on that as well.

O.

[jshu43]

Two valid questions, which should be answered by the professional who interpreted the study.
My amateur guesses:
Perhaps you spent a very short time at 9, or else experienced deeper sleep stages at 7 as opposed to 9.

Muffy would be able to respond about the architecture, and the possible impact medications may have on that. You sleep is deeper, but you still have almost the same number of arousals -- although apparently they are no longer related to respiratory problems.

I have no idea if RERA's can be REM related. Let's Muffy joins us on that as well.

O.

I did think maybe I didn't spend that much time at 9, but I spent more time at 9 than I did at 7. For some reason 8 was the worst of the bunch. But looking at the report, it looks like I was only asleep at 9 for a bit. I woke up with a mouth leak and couldn't go back to sleep. So that mystery is probably solved.

Now, it's just concerns about no REM sleep in my titration.