Respiratory Related Arousals

Hi,
I had two sleep studies last week, one without CPAP and the next one with CPAP. My doctor told me after the first study that I had respiratory related arousals where I would wake up but my oxygen levels never dropped so no apneas actually occurred. He said I needed to be treated. I guess the CPAP kept me from snoring during the second study although I'm wondering if it was related to the fact that I was given Afrin to clear up my nose during the second study but not the first. Anyway, I'm supposed to get an APAP this week to treat this non-apnea apnea (my term not the doctor's). Is anyone else using an APAP or CPAP to treat respiratory arousals that do not cause your blood oxygen to drop? On my APAP prescription, it does list the diagnosis as sleep apnea with an RDI of 13.

Thanks

Hi, I would look into whether I normally (including when at the study) sleep on my back, because that alone could cause events that might otherwise not occur if you sleep on your side - called 'positional' apnea. The other thing would be to see an ENT and find out if there's anything you can do to deal with your nasal problems, which could be the source of them. If you don't otherwise have apnea, you could be getting off easy, though I wouldn't just assume it (certainly even if you have nasal surgery, for instance, do have another study later on to be sure it did the job).

Dear Epichic,

If I understand, you want to know if CPAP or APAP can help with snores. Yes. I hope that ends up being useful for you. APAP machines with software can show how snores are or are not showing up during treatment if you or your doctor like to see data.

But since you are reporting little or nothing in the way of Obstructive or Central apneas, your doctor might be interested in a new study being done at Hopkins, which is being investigated as a useful alternative for those who have the arousals, but not the apneas. It just appeared in the online version of CHEST.
"Predictors for Treating Obstructive Sleep Apnea With an Open Nasal Cannula System (Transnasal Insufflation)"
Georg Nilius, Thomas Wessendorf, Joachim Maurer, Riccardo Stoohs, Susheel P. Patil, Norman Schubert and Hartmut Schneider
Chest 2010;137;521-528; Prepublished online December 1, 2009; DOI 10.1378/chest.09-0357
The online version of this article, along with updated information and services can be found online on the World Wide Web at:
http://chestjournal.chestpubs.org/conte ... .full.html

I was somewhat reluctant to post this, because I'm just a PAP patient and in no way involved in diagnosis. But maybe it would be interesting or useful for your doctor, if your doctor thinks this might someday fit your case or maybe some other patient.

Hi Epichic, It IS possible to have the obstruction without the desaturation. I'm one of those people. According to my sleep study ...

The total amount of time awake was 6.0 minutes and there were 21 arousals during the exam.
There were 0.00 periodic leg movements per hour.
The apnea hypopnea index was 30.63
There were 61 respiratory events consisting of 61 obstructive, 0 mixed, and 0 central.
The average event duration was 26 seconds, and the maximum duration was 62 seconds.
The body position that was most common during respiratory events was back.
The average baseline for oxygen desaturations was 98% and the minimum Sa02 during a desaturation event was 94%.

Conclusion: Abnormal polysomnogram with an apnea/hypopnea index of 30 events per hour of sleep. Events were not associated with significant desaturation but arousals were prominent and snoring was evident throughout the polysomnogram recording. The findings would support a diagnosis of obstructive sleep apnea.

Bottom line is that your breathing is causing you to wake/not get to deeper levels of sleep. Cpap should help.

Keep us posted!

Thanks everyone for your replies. Sleepy cpap, I will definitely check out the article although I'm not sure if my sleep doctor is the type to take suggestions. I'm supposed to pick up my apap at the store today and hopefully I won't have a lot of major problems using it. I'm not the most mechanically inclined person, so I'm a little nervous. I forgot to ask for a copy of my sleep study results so I don't know all the details other than my RDI of 13/hour, which from what I can tell, is not that bad.

Julie, I did ask my doctor if I could just sleep on my stomach or my side. He said I snored when I was on my side during the sleep study. I did see an ENT the other day but it was for an unrelated issue (ear infection and vertigo) and he really just specialized in ears so I didn't ask about my nose.

Thanks again everyone.

Happy sleeping,
epichic