Sleep Study Results

[Randy32]

this is from from my titration study and i quote
" respitory events: Apnea/Hypopnea Index was 2.3/hour(AHI) Minimum Oxygen Saturation Was 85%.This was on a CPAP of 7cm of water. right in the transition from a CPAP of 5 to7,the patient had several hypopneas but this occurred during REM sleep And the patient desaturated down to 84 and 85%.CPAP was then quickly rasied to 7 and the patient stayed in REM for another hour and his SaO2 Remained Above 90% during that time on a CPAP of 7." approx 2 1/2 months after being on CPAP and i had complained to my Dr that i was not doing well i fell like i was suffocating so she ordered a 2 week study on Auto CPAP With pressures Of 5 TO 12. now having said that i still feel tired in the morning and tired throughout the day so i said something to my Pulmonologist and she wanted to see what i have been doing for 30 days so i turned the sd card over to the home health care company and they sent the results to my Dr i am still waiting to hear from my Dr but my reg Dr who ordered the sleep study said then i might need O2 at night but my pulmy wants an overnight Oxometer test still waiting for that to happen
i was just wondering what you guys might feel about what the titration study showed and as to why i am still so tired during the day Thanks Randy

[Taff]

Hi Randy!

Pay close attention to the Oxygen levels in that write-up! You may want to consider buying an oximeter and monitoring yourself, especially if you have other serious health issues. ConTec CMS-50E is the one I have on order, thanks to recommendations in these forums.

You still feel tired, because you are not at optimum therapy yet. You said it yourself, "I had complained to my Dr that i was not doing well i fell like i was suffocating." Listen to your body.

Basically, they showed that you were in fact 'suffocating' in the lab at a pressure of 5-7 by the low O2 levels.

What are your pressure settings right now? (Still no Rx?)
When will you get the results of the 30 day home study?

Hang in there. You'll feel better soon, once you/they get the right treatment for YOU.

[kteague]

I don't think there's enough detail there to say much, but it would take more than just keeping my oxygen above 90 to satisfy me. How long did it stay down near 90? Cause that's right at the borderline of being problematic. Not sure what yours usually runs though. Hopefully there's info on your data card that would reveal if there's a need to tweak your treatment settings. Seems wearing an oximeter while doing the trial on autopap set at 5-12 could prove very useful. It may be that 7 is just not enough for you when asleep in your normal environment. Your data should show that. You may want to ask for detailed copies of your reports for your own files. If you are having issues, you'll likely want to monitor your numbers and not wait between appointments and for doctors to get back with you. Why wait when something is wrong when the info is immediately available? The fact you feel like you are suffocating indicates a problem. Now, if you are under the care of a pulmonologist for other conditions, that could change everything, and I would want their expertise even before a sleep doctor if they weren't a pulmonologist.

Besides optimizing your OSA treatment, what other things have you been checked for? I have limb movements during sleep that have kept me tired even when the cpap is working well. I've also found use of some supplements has boosted my sense of well being. Then there's a host of medical issues that can cause tiredness, but I would think your doctor would have already checked those things. Sometimes treating OSA is just a piece of the puzzle. But knowing that piece is done effectively is key to knowing if other things need pursued.

[Randy32]

Thank You For Your reply's I should have been clearer i did do the 2 week study and here is the results for the 30 study


this is what it says under pressure 9
Map 186.3
% 4.7
FL 1.3
VS 9.0
OA 1.6
CA 0.3
H 0.0
RE 0.0
AHI 2.9

[url]http://www.facebook.com/photo.php?pid=3 ... 0822750851[/ur]

it says "there were no periodic limb movements"

currently i am on auto between 5 and 12

[JohnBFisher]

Does your sleep study also note the number of arousals? Not feeling well the next morning can be due to sleep apnea, periodic limb movements, and arousals (either spontaneous or related to respiratory events). You clearly now have the sleep apnea under control. That information looks good. From your last post it appears no periodic limb movements (or at least a normal amount) were observed. So, I would guess you might have a higher than normal amount of arousals.

Normally doctors try to address sleep apnea first, since the arousals and limb movements may be an effort by your neural networks to help clear the obstruction. Solve the obstruction problem with CPAP therapy, and it may solve the other issues. But sometimes the other issues may exist together.

What can be done about arousals? Well sometimes they can be due to breathing at against a CPAP device. In that case a BiPAP may be indicated. But certainly if you had a higher than normal arousal rate, it should be addressed.

So, what does your sleep study say about arousals?

And do consider asking more questions from your doctor about why you continue to feel poorly. Ask if a BiLevel device might help.

Hope that helps.

[Randy32]

for the first sleep study it says 55 arousals 16 were related to respitory events,6 associated with snoring,6 associated with desaturation episodes,and 27 were spontanious

the titration study says there were 58 arousals,most were spontanious no atypical EEG'S were found

[JohnBFisher]

Based on that, when talking with your doctor ask if the spontaneous arousals might cause you to continue to feel poorly. Fact is, it can, but sometimes it helps to ask leading questions.

[HoseCrusher]

Pardon me for pointing out the obvious here... but

Your sleep study showed that you had oxygen desaturation when the pressure was below 7 cm H2O.

Your 2 week study used a pressure range of 5 - 12 cm H2O.

Your results indicate that you spent 43.2 + 17.2 = 60.4% of your time below a pressure of 7 cm H2O.

If I spent 60+% of my sleep time with pressures that are known to desaturate my oxygen levels below 90%, I would probably be tired too.

You may want to consider the idea of increasing your lower pressure to 7 cm H2O and repeating the study.

Also, invest in a pulse oximeter that can record a nights worth of data. It is a worthwhile investment and all doctors understand the importance of oxygen saturation. If you hand your doctor a printout showing that your oxygen levels are desaturating to low levels, he can then see that the treatment is "less than optimized" for you.

[Randy32]

thanks hosecrusher that was might thought too i spoke with the dr's office today and was told no changes will be made

[jweeks]

thanks hosecrusher that was might thought too i spoke with the dr's office today and was told no changes will be made

Randy,

I'd get a 2nd opinion. Something really odd is going on here. The study data that you posted shows your 90% pressure was at 9, and that you still had events at 12. That suggests a possible range of 9 to 14 on an auto machine, or a straight 12 on CPAP. If you are running in the range of 5 to 7, that is below what most normal humans need in order to breathe. 8 is usually the lower limit for comfortable breathing.

If your current doctor doesn't want to address the problem, then find one that will. Or go off the grid and make the changes yourself if you cannot find a doctor that is willing to help. Low O2 levels can cause serious damage to your heart and brain, and it can trigger a stroke. Your health is too important to let this go unfixed.

-john-

[Randy32]

well i called my reg Dr today she i need to call the Home Health Care Company so i did i explained my problem and she feels that i need to call back my Dr and i need to tell my Dr i want an Overnight Oxometer on cpap so did it is the works The home health care company feels i need to get out of that 5-7 range that i might still be sesaturating so hopefully i will know something soon thank you for all comments and help

[Randy32]

well i must gotten through to some one cause they dropped off an oxometer to due an overnight study to see if i desaturate still and if i do down to what. tomorrow i have hernia surgery and they told to bring my cpap with me