Re: Shallow Breather Oscar Screenshots
Posted: Mon Apr 25, 2022 8:41 am
I don't know how to remove all the "transcription."
My 2nd titration was a bust because I only slept for 5 minutes the whole night.
My 3rd titration was a bust because the sleep tech didn't follow any orders and started me off at 5 cmH2O and never got to my treatment levels.
Here's the 4th:
SLEEP ARCHITECTURE:
The study started at 22:44:36 and ended at 05:29:41. Total sleep time (TST)
was 277 minutes resulting in a sleep efficiency of 69.6% (total recording
time (TRT) = 398 m). There were 33 awakenings with a total time awake after
sleep onset of 105.0 minutes. The sleep latency was 16.0 minutes and the REM
latency was 81 minutes. The patient spent 35.1% of sleep time in the supine
position. The sleep stage percentages were 7.9% stage N1, 65.4% stage N2,
6.5% stage N3 and 20.2% REM sleep. There were 109 arousals, resulting in an
arousal index of 23.6. There were 100 stage shifts.
POSITIVE AIRWAY PRESSURE DATA:
Bilevel was initiated at 11/6 cmH2O. Snoring was eliminated at a Bilevel
setting of 12/6 cmH2O. There were 59 respiratory events consisting of 11
apneas [0 obstructive (0%), 0 mixed (0%), and 11 central (100%)] and 48
hypopneas. The mean oxygen saturation during the study was 92%, with a
minimum oxygen saturation of 81%. The patient spent 7.8% (21.6 min) of sleep
time with an oxygen saturation below 90% and 4.7% (13.1 min) of sleep time
with an oxygen saturation at or below 88%. The wake supine transcutaneous
pCO2 (TcpCO2) value was not reliable. The maximum TcpCO2 during sleep was 41
mmHg. Cheyne-Stokes/Periodic Breathing was not present. Supplemental oxygen
was not administered. A back-up rate of 11 breaths/minute was added at the
start of the study. A medium Fisher and Paykel Simplus full face mask without
chin strap was used. The mask leak at the most effective pressure was within
normal limits.
PAP SUMMARY:
PAP BUR TST %Sup SupAHI REM RAHI CAI HI AHI ArIdx Nadr AvgSaO2
11 / 06 11 8.5m 100% 63.5 0.0m -- 0.0 63.5 63.5 35.3 84% 88%
12 / 06 11 38.5m 100% 18.7 0.0m -- 0.0 18.7 18.7 20.3 84% 91%
13 / 06 11 40.0m 84% 5.4 15.0m 12.0 1.5 12.0 13.5 13.5 82% 92%
14 / 06 11 24.0m 0% -- 0.0m -- 15.0 20.0 35.0 30.0 81% 93%
15 / 06 11 30.0m 0% -- 9.0m 0.0 0.0 8.0 8.0 24.0 90% 93%
16 / 06 11 109.5m 15% 14.5 24.5m 0.0 0.5 3.3 3.8 18.6 84% 93%
17 / 07 11 27.0m 2% 120.0 7.5m 0.0 6.7 2.2 8.9 11.1 85% 94%
MOVEMENT DATA:
There was excessive movement during wakefulness in the form of periodic and
aperiodic limb movements. There were 192 periodic limb movements during
sleep, resulting in a PLM-index of 41.5. Of these, 18 movements were
associated with arousals, resulting in a PLM-arousal index of 3.9.
ECG DATA:
The average heart rate during sleep was 71 beats per minute, with a range of
66 to 96. During wake, the heart rate ranged from 69 to 100 beats per minute.
No arrhythmias were noted.
OTHER NOTABLE FINDINGS:
The patient took Lunesta prior to the sleep study.
Experience to PAP therapy as stated by the patient on the morning after sleep
questionnaire: "I did benefit from using PAP therapy, deeper breathing; PAP
therapy was easy to use and comfortable"
ICSD DIAGNOSIS:
Obstructive Sleep Apnea Syndrome [G47.33]
Treatment Emergent Central Sleep Apnea [G47.39]
IMPRESSION:
1. At a PAP setting of 16/6 cmH2O with back up rate of 11 cmH2O, the
apnea-hypopnea and arousal indices were normalized including during
off-supine REM sleep, snoring was eliminated, and the mean oxygen saturation
was 93% with a nadir of 84%.
2. Frequent periodic limb movements not causing arousal from sleep and
periodic and aperiodic limb movements during wakefulness were observed that
is consistent with restless legs syndrome (RLS). The patient also endorses
symptoms suggestive of RLS on the pre-study questionnaire. Clinical
correlation is advised.
RECOMMENDATIONS:
Bilevel 16/6 cmH2O with back up rate of 11 cmH2O and humidification. This
setting may need to be combined with positional sleep therapy. A medium
Fisher and Paykel Simplus full face mask without chin strap was used.
My 2nd titration was a bust because I only slept for 5 minutes the whole night.
My 3rd titration was a bust because the sleep tech didn't follow any orders and started me off at 5 cmH2O and never got to my treatment levels.
Here's the 4th:
SLEEP ARCHITECTURE:
The study started at 22:44:36 and ended at 05:29:41. Total sleep time (TST)
was 277 minutes resulting in a sleep efficiency of 69.6% (total recording
time (TRT) = 398 m). There were 33 awakenings with a total time awake after
sleep onset of 105.0 minutes. The sleep latency was 16.0 minutes and the REM
latency was 81 minutes. The patient spent 35.1% of sleep time in the supine
position. The sleep stage percentages were 7.9% stage N1, 65.4% stage N2,
6.5% stage N3 and 20.2% REM sleep. There were 109 arousals, resulting in an
arousal index of 23.6. There were 100 stage shifts.
POSITIVE AIRWAY PRESSURE DATA:
Bilevel was initiated at 11/6 cmH2O. Snoring was eliminated at a Bilevel
setting of 12/6 cmH2O. There were 59 respiratory events consisting of 11
apneas [0 obstructive (0%), 0 mixed (0%), and 11 central (100%)] and 48
hypopneas. The mean oxygen saturation during the study was 92%, with a
minimum oxygen saturation of 81%. The patient spent 7.8% (21.6 min) of sleep
time with an oxygen saturation below 90% and 4.7% (13.1 min) of sleep time
with an oxygen saturation at or below 88%. The wake supine transcutaneous
pCO2 (TcpCO2) value was not reliable. The maximum TcpCO2 during sleep was 41
mmHg. Cheyne-Stokes/Periodic Breathing was not present. Supplemental oxygen
was not administered. A back-up rate of 11 breaths/minute was added at the
start of the study. A medium Fisher and Paykel Simplus full face mask without
chin strap was used. The mask leak at the most effective pressure was within
normal limits.
PAP SUMMARY:
PAP BUR TST %Sup SupAHI REM RAHI CAI HI AHI ArIdx Nadr AvgSaO2
11 / 06 11 8.5m 100% 63.5 0.0m -- 0.0 63.5 63.5 35.3 84% 88%
12 / 06 11 38.5m 100% 18.7 0.0m -- 0.0 18.7 18.7 20.3 84% 91%
13 / 06 11 40.0m 84% 5.4 15.0m 12.0 1.5 12.0 13.5 13.5 82% 92%
14 / 06 11 24.0m 0% -- 0.0m -- 15.0 20.0 35.0 30.0 81% 93%
15 / 06 11 30.0m 0% -- 9.0m 0.0 0.0 8.0 8.0 24.0 90% 93%
16 / 06 11 109.5m 15% 14.5 24.5m 0.0 0.5 3.3 3.8 18.6 84% 93%
17 / 07 11 27.0m 2% 120.0 7.5m 0.0 6.7 2.2 8.9 11.1 85% 94%
MOVEMENT DATA:
There was excessive movement during wakefulness in the form of periodic and
aperiodic limb movements. There were 192 periodic limb movements during
sleep, resulting in a PLM-index of 41.5. Of these, 18 movements were
associated with arousals, resulting in a PLM-arousal index of 3.9.
ECG DATA:
The average heart rate during sleep was 71 beats per minute, with a range of
66 to 96. During wake, the heart rate ranged from 69 to 100 beats per minute.
No arrhythmias were noted.
OTHER NOTABLE FINDINGS:
The patient took Lunesta prior to the sleep study.
Experience to PAP therapy as stated by the patient on the morning after sleep
questionnaire: "I did benefit from using PAP therapy, deeper breathing; PAP
therapy was easy to use and comfortable"
ICSD DIAGNOSIS:
Obstructive Sleep Apnea Syndrome [G47.33]
Treatment Emergent Central Sleep Apnea [G47.39]
IMPRESSION:
1. At a PAP setting of 16/6 cmH2O with back up rate of 11 cmH2O, the
apnea-hypopnea and arousal indices were normalized including during
off-supine REM sleep, snoring was eliminated, and the mean oxygen saturation
was 93% with a nadir of 84%.
2. Frequent periodic limb movements not causing arousal from sleep and
periodic and aperiodic limb movements during wakefulness were observed that
is consistent with restless legs syndrome (RLS). The patient also endorses
symptoms suggestive of RLS on the pre-study questionnaire. Clinical
correlation is advised.
RECOMMENDATIONS:
Bilevel 16/6 cmH2O with back up rate of 11 cmH2O and humidification. This
setting may need to be combined with positional sleep therapy. A medium
Fisher and Paykel Simplus full face mask without chin strap was used.
