Diagnosed with OSA but had more CSA events during study?

Hi all,

I got the report from my sleep study today. I am a little confused because I was diagnosed with severe OSA, but according to the report, I had more CSA events than OSA events. My follow up appointment isn't for another 6 weeks or so, but I will definitely ask about it. I'm just wondering if anyone can offer any insight?

I've tried searching through this forum as well as another to see if I could find any info on this, but really didn't find anything. Any insight would be appreciated. Thanks!

Here is what the report says:


Your sleep study has shown that you have Obstructive Sleep Apnea (OSA).
During the study, your technologist was able to place you on PAP treatment and determine a reasonably effective treatment pressure or your provider would like you to use a special PAP device that will determine an effective pressure.
An order was placed for PAP therapy.

Split-Night Polysomnogram Interpretation


Baseline:
This study was performed in order to evaluate for OSA
Hypopnea Definition: Rule VIII.4.A
Due to the presence of respiratory events, this study was done in two parts (baseline, followed by titration). The total sleep time was 165.4 minutes. The sleep latency was 8.3 minutes, which is decreased. Sleep efficiency was 79.5 % which is decreased. The sleep architecture was fragmented with many sleep stage changes and arousals.
Sleep archictechture: Stage N1 21.2%, Stage N2 47.2% , Stage N3 31.7%, Stage R 0%, Stage WASO 24%.
Snoring reported as: soft;moderate;moderately loud.
Respiratory Events: Obstructive Apneas 6, Central Apneas 14, Mixed Apneas 0, Hypopneas 94, RERAs 34, were noted for an RDI of 53.7 and an AHI of 41.4. The REM RDI was (n/a). The lowest O2 saturation was 82% and the total sleep time SpO2 </= 88% was 13 minutes.
Positional data: Lateral AHI 23, Lateral RDI 33.8, Lateral TST 77.2 %, Supine AHI 103.6, Supine RDI 121.2, Supine TST 22.8 %.
This study indicates severe obstructive sleep apnea.

Titration
During the second part of the study, CPAP titration was performed.
The total sleep time was 209.2 minutes. The sleep latency was 0 minutes. The REM sleep latency was 105.1 minutes, while sleep efficiency was 89.7%, which is normal.
Sleep archictechture: Stage N1 15.1%, Stage N2 61.9% , Stage N3 16%, Stage R 6.9%, Stage WASO %.
Positional data: Lateral AHI 4.1, Lateral RDI 7.5, Lateral TST 42.3 %, Supine AHI 6.5, Supine RDI 10.4, Supine TST 57.7 %.
During the titration, there was significant improvement which resulted in the reasonable elimination of the apneas, hypopneas, snoring, and oxygen desaturations at the final effective pressure of 9 cm/H2O.
The total sleep time with an SpO2 </= 88% was 0.4 minutes.
Supine REM was observed at this pressure very briefly and sleep remained quite fragmented. further optimization and confirmation of CPAP pressure needs with an Auto CPAP would be beneficial.
Mask leak was within expected range. Was chinstrap used / was not used: no
The final effective mask was a Fisher & Paykel Medium (eson) Nasal mask.

Respiratory Events: Obstructive Apneas 6, Central Apneas 14, Mixed Apneas 0, Hypopneas 94, RERAs 34, were noted for an RDI of 53.7 and an AHI of 41.4. The REM RDI was (n/a). The lowest O2 saturation was 82% and the total sleep time SpO2 </= 88% was 13 minutes.

These two are what makes it obstructive.
They are suggesting an auto cpap for you because they weren't able to do much REM titration and they weren't satisfied with the sleep stages and wake ups.

A lot of CAs are caused when you switch from different sleep levels which you probably did frequently before they slapped the mask on.

Thank you for the clarification, Blackspinner.

I picked up my machine today, came home and promptly slept for 2 hours. Already, the tightness in my chest is gone. I can't wait for bedtime tonight!

They should have reported what the CA levels were during titration, not just during the initial test.

Be sure you get a good data capable CPAP machine. Read the links in my signature line to avoid being screwed by your DME when you get a machine. This is even more important than normal for you because you showed some CA during the sleep study.