Need help with results etc....Thank you

[bookworm]

Dori, Archangle, it looks identical to this....

http://www.google.com/products/catalogq ... CGYQ8gIwAQ#

and I use a comfortgel mask. It's a light blue color.

My oxygen:

without cpap:
WAKE: max sp02%=100, mean 98.1%, min 74%, sp02% <=89% (min) 1.1 TIME IN 90-100% RANGE: 93.1%
N-REM: max sp02%=100, mean 97.9%, min 85%, sp02% <=89% (min) 0.1 TIME IN 90-100% RANGE: 100%
REM: max sp02%=99, mean 97.5%, min 85%, sp02% <=89% (min) 0.1 TIME IN 90-100% RANGE: 99.8%
TST: max sp02%=100, mean 97.91%, min 85%, sp02% <=89% (min) 0.1 TIME IN 90-100% RANGE: 100%
TIB: max sp02%=100, mean 98%, min 74%, sp02% <=89% (min) 1.3 TIME IN 90-100% RANGE: 97.8%

WITH cpap:
WAKE: max sp02%=100, mean 98.8%, min 87%, sp02% <=89% (min) 0 TIME IN 90-100% RANGE: 93%
N-REM: max sp02%=100, mean 98%, min 95%, sp02% <=89% (min) 0 TIME IN 90-100% RANGE: 100%
REM: max sp02%=99, mean 97.4%, min 96%, sp02% <=89% (min) 0 TIME IN 90-100% RANGE: 100%
TST: max sp02%=100, mean 97.9%, min 95%, sp02% <=89% (min) 0 TIME IN 90-100% RANGE: 100%
TIB: max sp02%=100, mean 98.2%, min 87%, sp02% <=89% (min) 0 TIME IN 90-100% RANGE: 97.8%

HEART RATE WITHOUT CPAP

WAKE: max pulse 114, mean 80.4, min 63 / 53.3% of time in 70-79 range, 33.6% of time in 80-89 range, 5.5% in 90-100 range
N-REM: max pulse 103, mean 76.9, min 63 / 79.6% of time in 70-79 range, 15.8% of time in 80-89 range, .7 in 90-100 range
REM: max pulse 103, mean 85.2, min 72 / 25.8% of time in 70-79 range, 53.1% of time in 80-89 range, 20.9% in 90-100 range
TST: max pulse 103, mean 77.5, min 63 / 75.1% of time in 70-79 range, 18.9% of time in 80-89 range, 2.4% in 90-100 range
TIB: max pulse 114, mean 78.4, min 63 / 68.3% of time in 70-79 range, 23.5% of time in 80-89 range, 3.4% in 90-100 range

WITH CPAP
WAKE: max pulse 131, mean 78.9, min 62 / 10.2% in 60-69 range, 54.8% of time in 70-79 range, 19.5% of time in 80-89 range, 5.2% in 90-100 range
N-REM: max pulse 95, mean 75.1 min 63 / 10.2% in 60-69 range, 72.8% of time in 70-79 range, 10.9% of time in 80-89 range, .1 in 90-100 range
REM: max pulse 98, mean 84.2, min 73 / 10.2% in 60-69 range, 14.5% of time in 70-79 range, 79.7% of time in 80-89 range, 5.8% in 90-100 range
TST: max pulse 98, mean 75.8, min 63 / 10.2% in 60-69 range, 68.7% of time in 70-79 range, 15.7% of time in 80-89 range, .5% in 90-100 range
TIB: max pulse 131, mean 76.7, min 62 / 10.2% in 60-69 range, 64.3% of time in 70-79 range, 16.9% of time in 80-89 range, 2.0% in 90-100 range

[bookworm]

http://www.cpap-supply.com/REMstar-Plus ... s250hs.htm

PR System One REMstar Plus C-Flex, Heated Humidfier, SD Card

[Pugsy]

Looks like lowest Oxygen level was 74 % so you had some significant oxygen level drops even though not many apnea events. I suspect that also was figured into the diagnosis. Much improved on CPAP.

Bad news...the PR System One Remstar Plus with CFlex offers no meaningful data to perhaps shed a light on therapy.
It has a SD card but it only gathers how many hours you use the machine.

It says that I average 3:36 per day.

Your overall average is less than 4 hours a night.

You need a minimum 6 1/2 to 7 1/2 hours of sleep using the machine EVERY night to have any chance of seeing improvement.
That said you have some other things that will also mess with how you feel each day and the cpap machine only fixes sleep apnea..it doesn't fix the other stuff. Time to take a hard look at those other things and see what you can do to improve things. My issue was bad back pain. Every time I turned over in bed the pain would wake me up. Frequent awakenings for any reason will sure mess with how you feel.

[archangle]

http://www.cpap-supply.com/REMstar-Plus ... s250hs.htm

PR System One REMstar Plus C-Flex, Heated Humidfier, SD Card

OK, that should say "REMstar Plus ...." somewhere next to the display. And 250 on the label on the bottom somewhere. Does yours say that?

[avi123]

Bookworm, please disregard completely whatever Avi is telling you, his posts are pretty outrageous and completely out of left field so we try to warn newbies whenever possible. He's doing what he accuses the veterans here of doing, being "doctor mavens" but no one ventures any medical "guesses" other than their experience with sleep apnea as it pertains to finding solutions to problems with masks, machines, pressure settings,etc. We also have many knowledgeable members who can talk about diet, nutrition, and some professionals like MDs, RTs who can give us a different perspective. You've come to the right place to get you started on the road to success, so please give us as much info as you can about your exact machine, name of mask, pressure settings,etc and read here as much as you can and ask lots of questions. The folks on this forum will amaze you and take you under their wings I assure you. Good luck.

Comment:

If you are so satisfied with the posters knowledge on this board, especially while helping you and your husband, as you posted many times, why have you posted recently asking from everyone to pray for your husband? Why do you assume that advice from real professionals instead of from laymen would not have done much better job? Overall, I have found your posts to show a complete ignorance of biological and medical terms. So you take seriously any suggestions given to you, blindly.

[77Godspeed]

Just a suggestion, have you had your thyroid checked? A friend of mine had same type of symptoms and ended up having hyperparathyroidisum.
Low vitamin D and high heart rate. There is a website about hyperparathyroidisum just type in that word and it should bring you to it. They are based in Florida I believe. She has sleep apnea as well.

[DoriC]

Well, I guess the prayers of everyone here must have been of some help to our wonderful team of doctors, don't you think, because my dear husband is doing much better now? Thanks for your concern! Now I'll have to ask for prayers to help me ignore you in the future. I can honestly say that in the 3 years I've been a member of this forum, you're the only one who's irritated me enough to engage in this nonsense and waste of time. I don't plan to continue.

[robysue]

Just noticed these numbers in your "results without cpap"

I'm thin, relatively young, don't sleep with my mouth open, don't snore, don't drink, don't do any drugs supressing my breathing - or drugs period - etc, don't have any tonsils, adenoids, and don't have the "throat of a sleep apnea person" according to the dr). After the test, he said I had sleep apnea.

My results without cpap:

sleep efficiency: 69%
awakenings after sleep onset: 57
sleep period 6:11
total sleep time: 276.5 mins (4.6 hrs)
Central sleep apneas: 0
Obstructive sa's: 0
Mixed apneas: 0
Hypopneas: 35 (7 on my back/28 on my left side)
RERA's: 184 (51 on my back/133 on my left side)

No apneas, a bunch of hypopneas and a whole lotta RERAs. Assuming these numbers are counts of events, these numbers give:

AHI = 35/4.6 = 7.6
RDI = (35 + 184)/4.6 = 219/4.6 = 47.6

Sounds like a more appropriate diagnosis might be UARS---Upper Airway Resistance Syndrome since there are no apneas and the RERAs are so numerous. UARS is similar to OSA in many ways. In particular, with UARS you have breathing problems at night that are presumably caused by an airway that is just beginning to collapse or one that is partially collapsed. But in UARS, you typically arouse to open that airway back up before the events turn into full fledged hypopneas or apneas.

But the problem with being diagnosed with UARS is that you then can run into real problems with whether your insurance company will cover a CPAP---which is the "gold standard" for treating UARS as well as OSA. For reasons that I don't understand, Medicare doesn't really recognize UARS and will only automatically cover a CPAP if the diagnosis is for moderate or severe apnea (AHI > 15) where the hypopneas are scored using the AASM "recomended" standard, which requires a 4% drop in O2 saturation, but does not recognize hypopneas with arousal, but no desat or RERAs, which do require an arousal. If the AHI is between 5 and 15 (mild apnea), then Medicare will cover a CPAP if the patient has severe symptoms. And since in another post you mentioned trouble getting covered, it could be your insurance company is piggybacking on the Medicare standards. And one way for the doc to fight for getting you covered under your insurance is to call your condition OSA instead of UARS. And of course, once you fell asleep at the wheel, that counted as "severe" symptoms.

The relevance of mentioning UARS becomes clearer when we look at the numbers coming from the titration study:

My results using a cpap:

sleep efficiency: 68.2%
awakenings after sleep onset: 29
sleep period 6:03
total sleep time: 305.5 mins (5.09 hrs)
Central sleep apneas: 0
Obstructive sa's: 0
Mixed apneas: 0
Hypopneas: 1 (1 on my back)
RERA's: 115 (115 on my back)

So while almost all the apneas were eliminated, there really wasn't much change in those RERAs. The RDI on the titration study is:

RDI = (1 + 115)/5.09 = 116/5.09 = 22.8

which is still plenty high enough to continue to cause daytime symptoms.

What were you titrated at? It could be that the lab was content titrating until the hypopneas were eliminated, but they didn't continue to increase pressure until the RERAs were largely eliminated. And that just might be part of why you are still having so many problems even while using the CPAP.

As others have pointed out the MSLT was the test for narcolepsy. I don't know how to interpret the MSLT numbers:

MSLT:

nap 1:
time in bed: 24 mins
total sleep time: 13 mins
sleep onset: 8:29
rem latency: 3:30

nap 2:
time in bed: 20 mins
total sleep time: 0
sleep onset: 0
rem latency: 0

nap 3:
time in bed: 27 mins
total sleep time: 8 mins
sleep onset: 11:00
rem latency: 10:30

nap 4:
time in bed: 26:30
total sleep time: 12:00
sleep onset: 11:30
rem latency: 2:00

He started me on nuvigil and while it helps me be alert the first couple hours of the day and helps to keep me from being very moody and crabby, I liked it. However, it does make me anxious and lately I've felt very emotional as far as being able to easily cry.

But since the doc started you on nuvigil, it's important to ask: Did he diagnose you with narcolepsy or not?

And have you reported the fact that you are now feeling anxious and overly emotional and often on the verge of tears? According to drugs.com and Nuvigil.com the serious side effects of nuvigil include mental or mood changes (eg, aggression, agitation, anxiety, depression, exaggerated sense of well-being, hallucinations, irritability, nervousness). So in my humble opinion you need to report this change in mental mood immediately to the doctor who prescribed the nuvigil. Maybe you would do better on provigil instead?

[Muse-Inc]

Just my opinion (not a doc), seems to me you need to figure out how to start getting 7-8 hrs of restful sleep and get your vitamin D levels into the 60-80 range (I hafta take 15,000 IU/day of D3 to keep mine at a good level we vary enormously in what we need to take, testing's important to figure this out); don't take D2 as it's the plant form that our body must convert to D3 and as we age, we don't do a good job of that. Getting D levels up affects so many functions in the body, it makes me sad to see how many suffer from low levels. Mood improvement might be the first really noticeable effect. The headache situation might be improved by taking the RDA of magnesium citrate (320 mgm/day for women, 380 mgms/day for men)...whatever you do don't take magnesium oxide as it's cheap but only good as a laxative!

RobySue's comments are excellent as usual, she's been thru hell fixing her own issues, and well worth paying attention to!

Welcome aboard! Great folks and info here!

[ozij]

Bookworm, please disregard completely whatever Avi is telling you, his posts are pretty outrageous and completely out of left field so we try to warn newbies whenever possible. He's doing what he accuses the veterans here of doing, being "doctor mavens" but no one ventures any medical "guesses" other than their experience with sleep apnea as it pertains to finding solutions to problems with masks, machines, pressure settings,etc. We also have many knowledgeable members who can talk about diet, nutrition, and some professionals like MDs, RTs who can give us a different perspective. You've come to the right place to get you started on the road to success, so please give us as much info as you can about your exact machine, name of mask, pressure settings,etc and read here as much as you can and ask lots of questions. The folks on this forum will amaze you and take you under their wings I assure you. Good luck.

Reply:

If you are so satisfied with the posters knowledge on this board, especially while helping you and your husband, as you posted many times, why have you posted recently asking from everyone to pray for your husband? Why do you assume that advice from real professionals instead of from laymen would not have done much better?

This another example of how bad Avi123's logic and reading comprehension skills are.
Most probably, his memory is shot as well, since Dori 's recent request for prayers had nothing to do with sleep apnea.

Bookworm, and any other newbie happening to read this thread, please Ignore anything Avi123 has to say. You will not miss anything by ignoring him, and will save yourself much confusion, and possibly harm, by doing so.

Unlike those of us whose ignorance made them learn about sleep apnes, Avi does nothing to make himself less ignorant:

Case in point:

Question:

The above results were from sleep study (PSG) or from a mobile XPAP at home, and why do you call them naps?

Narcolepsy: Tests and Diagnosis
http://www.mayoclinic.com/health/narcol ... -diagnosis

Multiple sleep latency test. This examination measures how long it takes you to fall asleep during the day. You'll be asked to take four or five naps, each nap two hours apart. Specialists will observe your sleep patterns. People who have narcolepsy fall asleep easily and enter into rapid eye movement (REM) sleep quickly.

Not knowing naps are used during an MSLT to diagnose Narcolepsy does not keep Avi from commenting on MSLT results, and suggesting "alternative" diagnoses.

Avi's cognitive functioning as it is expressed on this forum shows many impairments - ignore him.

[moresleep]

But, the thyroid test sounds like a good idea, if you haven't already checked this out.

[bookworm]

Thanks for the comments everyone. For those of you who have mentioned thyroid...yes, I normally get checked every year because my immunoligist said I was borderline Hashimotos. But not enough for meds yet and I haven't been back to him in over a year so it is time to get checked. As for my anemia and vitamin d, I do take ferrelat for anemia daily and I've got a prescription for taking a vitamin d pill once a week, it's 50,000 once a week. Just had my levels retested and I'm back to normal with the anemia and vitamin d issues. I will tell the dr about the nuvigil...especially since I'm highly susceptible to anxiety problems. I'm very sensitive to any meds so it never fails that I have problems anytime I'm prescribed something. I will need to probably always take supplements for the anemia and vitamin d...just because of stress, I don't eat a lot of meat because it makes me nauseaus when I do, and I'm very pale and rarely go out in the sun....It wasn't until all this happened that I realized how important these type of vitamins are so I will definitely stay on top of that.

[ozze_dollar]

Just my opinion (not a doc), seems to me you need to figure out how to start getting 7-8 hrs of restful sleep and get your vitamin D levels into the 60-80 range (I hafta take 15,000 IU/day of D3 to keep mine at a good level we vary enormously in what we need to take, testing's important to figure this out); don't take D2 as it's the plant form that our body must convert to D3 and as we age, we don't do a good job of that. Getting D levels up affects so many functions in the body, it makes me sad to see how many suffer from low levels. Mood improvement might be the first really noticeable effect. The headache situation might be improved by taking the RDA of magnesium citrate (320 mgm/day for women, 380 mgms/day for men)...whatever you do don't take magnesium oxide as it's cheap but only good as a laxative!

RobySue's comments are excellent as usual, she's been thru hell fixing her own issues, and well worth paying attention to!

Welcome aboard! Great folks and info here!

I started taking magnesium 2 at night.I am having some side effects. Loose stools and upset stomach(much like acid reflux).The container says Total magnesium 325mg(from oxide - heavy 507mg) It would seem I have bought the wrong one.

[ozze_dollar]

Magnesium...been doing a bit of reading and it seems the best type of magnesium is the "amino acid chelate" Of course thats what some people say.