Hypopnea question

This isn't a CPAP question, but I figured this would be the best crowd to ask. I just got the results of my sleep study today, and have never had a CPAP. I was diagnosed with "moderate obstructive sleep disordered breathing" (in this case, hypopnia). My overall AHI is 19.9 (moderate), and my REM AHI is 35.6 (16.5 for NREM). My O2 saturation averaged 92.7% and was 83% at it's lowest. During my study (327 minutes of sleep time), there were 50 respiratory event related arousals.

Now the question: Can this cause cognitive problems? My doctor said that it could be the reason I am having memory and problem-solving issues. I am no expert, but an AHI of 19.9 is just over the threshold for Moderate... wouldn't it need to be higher for this kind of trouble? Also, I don't wake up feeling unrested, I don't even yawn once during the day, I don't fall asleep in front of the TV, and I actually have trouble falling asleep -- so I have prescribed Ambien. Any thoughts on this? Am I missing the big picture here? Or is my doctor barking up the wrong waffle iron?

Thanks for any input!

I think your Dr is right on. I also think that once you start CPAP therapy you will see your symptoms start to disappear. Lots of people, myself included, have many memory, problem solving and cognitive problems that are helped with CPAP. Also, many people have no idea how bad off they are until they start getting treated. Read the articles below, and browse through the articles under the Our Collective Wisdom section for more info. Best of luck to you.

viewtopic/t24108/I-have-severe-sleep-ap ... -else.html

viewtopic/t24642/so-what-was-you-wierd- ... mptom.html

cpaptalk-articles/evaluating-sleep-apnea-symptoms.html

[quote="lilFreddy"]This isn't a CPAP question, but I figured this would be the best crowd to ask. I just got the results of my sleep study today, and have never had a CPAP. I was diagnosed with "moderate obstructive sleep disordered breathing" (in this case, hypopnia). My overall AHI is 19.9 (moderate), and my REM AHI is 35.6 (16.5 for NREM). My O2 saturation averaged 92.7% and was 83% at it's lowest. During my study (327 minutes of sleep time), there were 50 respiratory event related arousals.

Now the question: Can this cause cognitive problems? My doctor said that it could be the reason I am having memory and problem-solving issues. I am no expert, but an AHI of 19.9 is just over the threshold for Moderate... wouldn't it need to be higher for this kind of trouble? Also, I don't wake up feeling unrested, I don't even yawn once during the day, I don't fall asleep in front of the TV, and I actually have trouble falling asleep -- so I have prescribed Ambien. Any thoughts on this? Am I missing the big picture here? Or is my doctor barking up the wrong waffle iron?

Thanks for any input!

Hypopnea is not a diagnosis - apnea is. Hypopneas are mini (or half-a'd) apneas and we mostly all have lots more of those than apneas, but they're not usually very meaningful if all the other data is good.

alnhwrd, thanks for all the great info. I will read these articles and get more familiar with this whole new world.

dsm, I just turned 39. Dont know how long I have had it.

Julie, I appreciate the correction!

The cognitive problems you describe are most likely caused by not getting enough sleep - and it doesn't take many arousals caused by apnea to ruin a night's sleep. The index is not the primary issue - sleeping deeply and waking rested is, so whether you are waking once a minute (AHI of 60) or once every three minutes (AHI of 20) you are still not getting the rest you need.

You oxygen levels are proof that there is a problem - your body will wake you when your blood oxygen level drops, and the drops mean that you need treatment.

Colin

Hypopnea is a diagnosis. Some people can have only obstuctive hypopneas, and you may one of them. The full name of the syndrome is OSAHS (Obstructive Sleep Apnea Hypopnea Syndrome) though we often drop the last two characters.

Your doctor is right in suggesting you try CPAP. It's a doctor's job to diagnose, and to do a differential diagnosis. Foget the treminology (mild, moderate, etc.) You're are being bumped of sleep at the rate of once every three minute, and during REM more than every two minutes. And if your RDI is 50, you're very firmly in the severe range anyway. Every reason in the world to thing the conginitive problems in an ( I assume) otherwise healthy 39 year old are caused by that.

This is no way for a person to sleep - and like Colin says - the oxygen nadir too indicates you have real problem.

You should also know that in the hospital, people whose oxygenation drops below 90% (nintety percent!) are give supplemental oxygen. You don't want to spend even a second there - and your average of 92% not too good at all for a 39 year old.

This was one night in the lab - and who knows how much better - or worse it is at home.

So, talk to your doc about a cpap with full data capability - tell the doc you want to track your results. And then get a machine that will let you do so.

O.

Thanks for the wonderful info, everyone. It is greatly helpful and I can sleep better at night knowing all this. When you don't have the knowledge, all you can do is wonder.

Freddy........

After reading everything I can get my hands on concerning my problem, I realized that......for most of us.....the bottom-line problem is not enough O2 at night.

Regardless of what the medical community says about an AHI of 5.0 being "normal" or "average", the biggie is the blood O2 saturation level maintained ALL night.

Using my honey as an example, we found that whenever her AHI score goes above 2.5, she isn't getting enough O2.....as shown on the charts we produce with the software furnished with my Oximeter.

We need to maintain our blood O2 level at 93% saturation or above....all night....every night. High apnea or high hypopnea scores are an indicator of not enough O2 saturation.

Because most of us don't have Oximeters, we have to "guess" at how we're doing....by guaging how we "feel"......and by looking at our CPAP reports.

I think the medical industry standard of AHI 5.0 being "OK" is unrealistic. What I'm seeing is that an AHI of 2.5 is an indication of minimal....and borderline O2 levels.

Keep your attention on what's important....your O2 levels at night.

Hope this helps.

Gerald