Please help me understand my home sleep test results

I had a home sleep study and received a message from the sleep provider stating I have mild sleep apnea with an average of 5 events per hour and recommending I start CPAP. The message did not go into detail about the specific findings of the sleep study.

Could someone please explain the findings? The report is attached.

Would CPAP be of benefit, since it seems like my case is rather mild? I’m almost always exhausted, and I rarely wake up refreshed unless I sleep for 10+ hours.

oboeoboe wrote: ↑

Fri Feb 28, 2025 1:43 pm

The message did not go into detail about the specific findings of the sleep study.

Your provider, not us, has the detail. I would ask for an in-person consultation.

Some questions for the provider:

- Did I average 21 awakenings per hour?
- What is the significance of the 21 tachycardia events?
- How does my condition compare in the supine vs. non-supine positions?
- If the case is borderline, would you prescribe an in-lab study which is more thorough?

oboeoboe wrote: ↑

Fri Feb 28, 2025 1:43 pm

is rather mild? I’m almost always exhausted, and I rarely wake up refreshed

I wouldn't consider that mild.

Try sleeping exclusively on your side until you see the provider. Typically, sleep apnea is most severe on the back.

Your result is very similar to mine. My AHI was 5.9 and my minimum Sp02 was 87% Although my max pulse was only 97, I have a history of being tachy when awake, up to 120 frequently.

The following is just my story. Your mileage may vary.

Oh YES YES YES is it worth it. It makes a huge difference. I didn't even realize I was fatigued, but in retrospect I was. I woke up every morning disappointed that I was still alive. I felt like I had been run over by a train. I had to chug 28 oz of coffee before I could function. I would have maybe 3 hours during the day of feeling alert and energetic but crashed early in the evening. I thought I was just getting old.

From the very first night with CPAP I woke up happy and alert. Jumped right out of bed, still made coffee because I love it, but already alert and didn't "need" it. I stay alert and energetic all day, into the evening.

Even so I thought it could be placebo effect. Too good to be true. My imagination. I asked my husband and he said, "You're kidding, right? YES, it makes a HUGE difference in you!"

You would think if your sleep apnea is only mild, you wouldn't notice as much benefit from treatment. That those who are severe would feel a bigger difference, right? But maybe it's the other way around, maybe if it's mild, it's easier to fix. I don't know, just guessing about that. But I do think catching it early and treating it has bound to be better for you than ignoring it and waiting til it gets worse.

Yes the CPAP - actually I have APAP - is a big pain in the you know what. I'm on my third mask and still fiddling around with the tension and might change masks yet again, the hose business is irritating, the electronic report drives me nuts and so on. But... I can't imagine sleeping without it now. And I've only been on it for one month! I do not want to go back to that horrible me that was before. Even the sleep itself is better. I wake fewer times and only get up to pee 0 to 1 time whereas before I was going up to 3 times a night. The sleep itself feels more enjoyable, if that makes any sense for being unconsicous. I'm going to have to figure out how to travel with it because I'm not ever going to be without it now.

I don't want to get your hopes up but since unlike me, you are actually aware of your own exhaustion, I can't help but think you should benefit too.

ChicagoGranny wrote: ↑

Fri Feb 28, 2025 3:03 pm

Try sleeping exclusively on your side until you see the provider. Typically, sleep apnea is most severe on the back.

The nonsupine hypopneas double as compared to supine. Why would sleeping nonsupine be advised?

I see you have two AHI scores. Your AHI 21.4 is from hypopneas that do not cause a reduction of oxygen in the blood over 3%. Your AHI 5 score is from hypopneas that cause more than a 4% reduction of oxygen in the blood. It is interesting to see 0's for obstructional apnea and central apnea. Did the home test not have the ability to detect these? Can the "sleep provider," prescribe an overnight sleep study in a clinic?

If my AHI (composed of hyponeas, obstructional, central, and unclassified apneas) is 5, I adjust my machine to get better therapy. I do not feel better from CPAP therapy unless my score is less than AHI 2. (Some consider anything AHI <5 to be okay).

If I'm reading it right you have half as many events when in a supine position which is sleeping on your back so on your back is where the less hypopneas occur. For me, it is the opposite. When I side sleep I have a few apneas, roll to my back (supine) AHI goes to 70 and oxygen takes a nose dive. If you slept supine (on your back) throughout this home test the score would not the score have been less?

My first sleep study in a clinic gave results that I did not have sleep apnea. I knew I did. A second sleep study at another clinic produced a diagnosis of severe sleep apnea, as did a third, fourth, and fifth. A study overnight in a clinic will produce much more information and hopefully with better accuracy.

ejbpesca wrote: ↑

Mon Mar 03, 2025 1:46 pm

Why would sleeping nonsupine be advised?

Physics. On the back, gravity is directly pulling the tongue and soft palate toward the throat. On the sides, the effect of gravity is less direct.

ejbpesca wrote: ↑

Mon Mar 03, 2025 1:46 pm

The nonsupine hypopneas double as compared to supine.

Such an analysis would be incomplete and unreliable. It's unknown which sleep stages he was in during the two sleeping positions. Sleep apnea is often the worse in REM.

ejbpesca wrote: ↑

Mon Mar 03, 2025 2:15 pm

A study overnight in a clinic will produce much more information and hopefully with better accuracy.

+1

oboeoboe wrote: ↑

Fri Feb 28, 2025 1:43 pm

I had a home sleep study and received a message from the sleep provider stating I have mild sleep apnea with an average of 5 events per hour

oboeoboe,

There are two AHI's listed on your results. Are you on Medicare? Or private health insurance? It makes a difference.

Medicare requires hypopneas to result in an O2 saturation drop of 4% or more for a hypopnea to "count" towards a diagnosis of obstructive sleep apnea; those are the hypopneas listed under Rule 1.B.c.

But most sleep doctors and many private health insurers accept the idea that hypopneas that result in arousals OR a less severe O2 saturation drop should still "count" towards a diagnosis of obstructive sleep apnea. The hypopneas labeled as 1.A.c rule are those hypopneas that don't count under Medicare's criteria, but do count under the opinion of many (most) sleep doctors and that are recognized under many (not all) private health insurance policies, including many employer provided health insurance here in the states.

Your AHI under Rule 1.A.c puts you well into the category of moderate OSA. Your AHI under Rule 1.B.c barely qualifies you as having mild OSA.

and recommending I start CPAP. The message did not go into detail about the specific findings of the sleep study.

It looks like this was a home sleep study. As such, there might not be any more meaningful data such as summary graphs that list what sleep stage you were in when the hypopneas occurred.

Would CPAP be of benefit, since it seems like my case is rather mild? I’m almost always exhausted, and I rarely wake up refreshed unless I sleep for 10+ hours.

In general, people who are highly symptomatic (i.e. exhausted all the time or falling asleep easily when they don't want to fall asleep) tend to benefit from CPAP therapy even if their sleep apnea is officially on the mild or moderate side. It's also worth pointing out that people who are highly symptomatic often have an easier time adjusting to CPAP therapy than folks who don't feel exhausted all the time at the time a sleep study shows they have moderate sleep apnea.

So I would say that you would benefit greatly from trying CPAP therapy. If the doctor/outfit who did the home sleep study for you doesn't recommend an in-lab titration study, it's important to insist on getting an APAP---an auto adjusting CPAP machine. Most folks around here, including myself, would say it's worth insisting on getting an APAP even if you do have an in-lab titration study. If possible see if the durable medical equipment provider (i.e. the DME) they send you to will set you up with a Resmed AirSense 11 AutoSet or a Resmed AirSense 10 AutoSet.

And if you do decide to try CPAP, it's worth keeping this in mind: Finding a mask that works for you is critical. And masks are in the nose of the CPAPer: What works well for Person A is Person B's mask from hell and vice versa. But having said that, it's important to remember this: If you don't breathe through your mouth during the daytime, then there is no reason to assume that you breathe through your mouth in your sleep. And if nasal or nasal pillows masks are a lot more comfortable to you when you try them on, don't let the DME talk you into accepting a full face mask "just in case you breathe through your mouth." Conversely, if you breathe through your mouth a lot during the daytime, you probably ought to consider starting out with the most comfortable full face mask that you can find since breathing through your mouth a lot in the daytime probably means you breath your mouth a lot when you're asleep.