Question about reading study

The doctor is treating me for RLS but I wanted to know some opinions of getting a second opinion for being treated for mild sleep apnea because strokes and sleep apnea runs in my family also high blood pressure. Do the numbers warrant this or not? Thanks
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Lights out occurred at 21 :24:32.
Lights on occurred at 05:04:33.
Total recorded time was 557.7 minutes, with a total sleep time of 345.0 minutes and a sleep efficiency of 75.0%.
Sleep latency was 77 minutes.
Latency to REM was 60.5 minutes.
7.0% of Stage Ni sleep, 67.2% stage N2 sleep, 18.6 % stage N3 sleep, and 7.2% REM sleep.
Total number of arousals was 396.
Arousal index was 68.9.

5 episodes of apneas and (4a) hypopneas (4% oxygen desaturations or greater)
Apnea/Hypopnea Index (AHI) 0.9 events per sleep hour.
Mean length of the apnea/hypopnea was 22.6 seconds and the longest was 41.9 seconds.

In addition to the above events there were other hypopneas(4b) and“respiratory arousals”which did not strictly fulfill CMS criteria for desaturation, but were associated with arousals or sleep disruption. When these were considered, the Respiratory Disturbance Index (RDI) was 9.4 events per sleep hour.

During non REM sleep there were 9.2 events per sleep hour, and during REM sleep there were 12.0 events per sleep hour. The AHI while sleeping in the supine position was 0.4 events per sleep hour and the patient slept 163.5 minutes in the supine position. The AHI while sleeping on both sides was 1.3 events per sleep hour and the patient slept for 181.5 minutes on both sides. Moderate snoring was noted.

99.7 percent of sleep time with oxygen saturation equal to or above 90%, the patient spent 0.1 percent of sleep time with oxygen saturation equal to or below 88% and the lowest oxygen saturation was 93%

Leg movements were noted,with a PLM index of 38.8 and a leg movement arousal index of 7.0.

I don't know enough to second-guess your doctor on the sleep study. But if you're concerned because of your family history, I suggest you consult a neurologist BEFORE you have a stroke. Prevention is one hell of a lot easier than recovery. So if you haven't already, gather up as much information about your relatives' strokes as you can and take it to a good neurologist.

deleted because is was wrong.
O.

izziguy wrote:The doctor is treating me for RLS but I wanted to know some opinions of getting a second opinion for being treated for mild sleep apnea because strokes and sleep apnea runs in my family also high blood pressure. Do the numbers warrant this or not?

izziguy wrote:during REM sleep there were 12.0 events per sleep hour.

This number alone would make me want to use CPAP. I don't think limb movements occur in REM, so the 12 events per hour in REM would definitely be respiratory events...not breathing well enough and probably disrupting REM, which is a rather important component of good sleep.

rested gal wrote:

izziguy wrote:The doctor is treating me for RLS but I wanted to know some opinions of getting a second opinion for being treated for mild sleep apnea because strokes and sleep apnea runs in my family also high blood pressure. Do the numbers warrant this or not?

izziguy wrote:during REM sleep there were 12.0 events per sleep hour.

This number alone would make me want to use CPAP. I don't think limb movements occur in REM, so the 12 events per hour in REM would definitely be respiratory events...not breathing well enough and probably disrupting REM, which is a rather important component of good sleep.

Good catch, rested gal, I missed that and will edit my post accordingly.

Apnea/Hypopnea Index (AHI) 0.9 events per sleep hour. Mean length of the apnea/hypopnea was 22.6 seconds and the longest was 41.9 seconds.

In addition to the above events there were other hypopneas(4b) and“respiratory arousals”which did not strictly fulfill CMS criteria for desaturation, but were associated with arousals or sleep disruption. When these were considered, the Respiratory Disturbance Index (RDI) was 9.4 events per sleep hour.

During non REM sleep there were 9.2 events per sleep hour, and during REM sleep there were 12.0 events per sleep hour. The AHI while sleeping in the supine position was 0.4 events per sleep hour and the patient slept 163.5 minutes in the supine position. The AHI while sleeping on both sides was 1.3 events per sleep hour and the patient slept for 181.5 minutes on both sides. Moderate snoring was noted.

The math here doesn't add up.
You can't get an AHI of 9.2 in NREM and 12 in REM and have a final AHI of 0.9 for the whole night.
Maybe they're counting the RERA's here.

The math here doesn't add up.
You can't get an AHI of 9.2 in NREM and 12 in REM and have a final AHI of 0.9 for the whole night.
Maybe they're counting the RERA's here.

My bet is that the AHI includes only the apneas and the 4a hypopneas.

The 9.2 NREM and 12 REM numbers are likely RDI numbers and include all the 4b hypopneas plus any other events that appear to respiratory related (RERAs).

That's how my own lab seems to score things: My diagnosis of moderate apnea is based on the RDI which included a slew of "hypopneas with arousal"

Thanks everyone. It seems like the consensus would be to take these results to another doctor to get a second opinion on them.

What should I tell the second doctor about the results that concerns me. ie. with an RDI of almost 10 and a family history of apnea and strokes should I be treated for this now before it gets worse?

Thanks again

izziguy, a pretty smart doctor -- the one who invented CPAP, as a matter of fact -- thinks that there are plenty of other good reasons for trying CPAP treatment even if the AHI that comes out of a sleep study is too low to warrant prescribing "CPAP."

I like the way Dr. Colin Sullivan thinks:

THE APNEA-HYPOPNEA INDEX: USEFUL OR USELESS?
http://www.respiratoryreviews.com/sep02 ... Index.html