First sleep study, want some help when talking with doctors.

I had my first ever sleep study last week. I was referred by my allergy doctor. I am always tired, snore very loud, wake up with headaches very frequently, have awoken a few times I remember gasping for breath.
During my study, I slept on my stomach the whole night. The report gives the following info:
REM latency 204 minutes. Sleep efficiency was 87.7 and sleep maintenance 88.8%.
No apneas and 29 hypopneas, for hypopnea index of 4.9 per hour.
During REM 30.9 AHI and only 0.4 in non-REM. Lowest O2 reading of 83%.
"The study does not reveal any significant OSA. Patient does have sleep apnea in REM cycle. Patient was not seen in supine (on back) position during sleep study, which may significantly underestimate the prescence of sleep apnea."
Also said I had sinus rhythm with PVC. I do not have high blood pressure or have had any heart issues that would lead to PVC.

What does this mean? I want to not be tired. My wife wants me to stop snoring and wants to stop wearing ear plugs that make her ears hurt. Does it seem like if my doctor thinks I don't need a CPAP I could see another doctor that may choose to treat me? I have to drive 45 minutes to class and work 5-6 days a week and I've almost fallen asleep driving a few times.

Hi nursingstudent. It strikes me that if it turns out you can't get therapy through a doctor and insurance, you could go ahead and purchase a lightly used cpap unit to maybe help with the snoring issue. I bet your wife would go along with that. Check out this article re. cpap and especially epap in snoring patients: http://www.sleepapnea.org/is-it-snoring ... apnea.html

Don't worry about PVCs as they're quite common and unless you have other cardiac issues shouldn't be a meaningful factor in OSA, though it's possible without OSA (or hypopneas) they might not show up at all. But you need to talk to your regular doctor about them and he may want to refer you to a cardiologist if only to rule out anything else and to help you relax.

You did have 02 desats to 83%, though haven't said for how long or how many times that occurred...?

Stomach sleeping could have improved things if anything during the test as it's how people unwittingly sometimes sleep to get relief of apnea, at whatever levels that may be present and you do sound like you have it, if only in REM sleep, but that could be a significant amount of time over a night, so I'd say your MD may not understand OSA well enough to encourage you to try Cpap, though I think he should, if only to prove you wrong! If you need to, get referred to another doctor who's more aware of things, possibly a pulmonologist or neurologist.

A couple of questions:

1) At home, does your wife indicate you sleep on your back? Do you snore in all positions?
2) What length of time during the study was your O2 level below 90% or 88%?

Your O2 desaturation, if long enough coupled with the AHI of almost 5 should be enough to get you a machine.
Headaches in the morning, sleepy in the day, etc. are all symptoms of untreated sleep apnea.

Here's some things I'd discuss with the doctors...
... With a 30.9 AHI during REM, are you suggesting I should just never get REM sleep?
... With a desat to 83, are you saying that's acceptable?
--- With a technically suboptimal test (no supine sleep in REM), are you suggesting we base my future on an incomplete test?
... If you don't believe I need to treat my sleep apnea, what's your plan for finding another cause for my symptoms that are classic for OSA?

I'm sorry. Feeling more than a bit riled up but I realize that's premature. Maybe the doctor will see the need to pursue treatment. I'll give them a chance. Please do not let them brush you aside. Can you imagine what your AHI might have been during REM if you weren't on your belly?!

The report doesn't say how long my O2 was at 83%. I sleep on my stomach at home. The report noted loud snoring. I've tried sleeping on a recliner and I wake up frok not breathing even when sitting up.

I'm upset they let me sleep on my stomach because I know if I slept on my back they would have stopped me early on and fitted me with a CPAP.

I'm a little surprised, in both of my studies (9yrs ago and the last one in Aug), they insisted I sleep on my back for them even though I am a stomach sleeper.

With CPAP therapy, my snoring stopped. Also my nightly visits to the bathroom stopped. Both of us are happy. Good luck, Earl