Frustrated and needing to vent.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
lookin4sleep
Posts: 52
Joined: Thu Jul 31, 2008 6:33 am
Location: New Mexico, USA

Re: Frustrated and needing to vent.

Post by lookin4sleep » Fri Sep 12, 2008 9:27 pm

fortomorrow wrote:ANOTHER UPDATE!
Total recording time 193.0 minutes. Total sleep sleep time 133.0 minutes. Sleep onset latency is 13.5 minutes. No REM latency during this recording. Sleep efficiency is 68.9%. The patient had 19.2% stage I sleep, 65.8% stage II sleep, 15.0% stage III/IV sleep and 0.0% REM sleep. Low oxygen saturation is 82.0%. The patient had 51 respiratory arousals with a respiratory arousal index of 23.0, 8 spontaneous arousals with a spontaneous arousal index of 3.6, 5 obstructive apneas, 46 obstructive hypopneas, 48 respiratory effort related arousals. The overall calculated apnea plus hypopnea index (AIHM) 23.0. Overall calculated respiratory disturbance index (RDI) 44.7. Periodic limb movements were 12 with an index of 5.4. Based on this evidence of severe obstructive sleep apnea with oxygen desaturations and lowered sleep effficency, the patient was place on nasal CPAP per protocol. Results of that nasal CPAP titration will be discussed in the next section.

Total recording time 272.9 minutes. Total sleep time 233.0 minutes. Sleep onset latency is 23.0 minutes with a REM latency of 30.0 minutes. The patient was started on nasal CPAP, 5cm water pressure, recorded for 44.4 minutes, but slept only 21.5 minutes. Efficiency was low at 48.4%, therefore titrated to a higher pressure.

CPAP at 8cm water pressure recorded for 109.5 minutes, slept for 106.0 minutes, sleep efficiency 96.8%. Entered REM sleep supine, 1 mixed apnea, 1 respiratory effort related arousal, fairly well-maintained oxygen saturations. Tried a 10cm water pressure with equally good sleep efficiency at 87.4% (EDITOR'S NOTE: How are 96.8% and 87.4% equal?), entered REM stage sleep, only 1 central apnea, 4 respiratory effort related arousals, well-maintained oxygen saturations. Also tried 12cm water pressure, excellent sleep efficiency of 93.1%. Patient was supine. No obstructive sleep breathing. Appeared to do best at this pressure. Significant reduction in periodic limb movements, down to 2.3.
Dont know if you still need this translated but: When they studied your sleep, you laid down for about 3 hours but slept for about two, which results in the sleep "efficiency " #. Latency is how long it took for you to fall asleep. You did not enter REM sleep, and they listed how much % of time you spent in other types of sleep. The lowest your oxygen got was 82%, regular folks have 95+ all the time, even when they are asleep. Apneas are NO breathing, Hypopneas are less than 50% of air getting through. in 2 hrs you had these 46 times, or 23 times/hour. other ways your sleep was disturbed were leg kicks and something I dont know. Now they try the cpap to see if it helps. this part went on for about 5 1/2 hours. took 23 mins to fall asleep and you got into REM sleep (dreaming) 7 mins later. Typically a person would work their way through other sleep types to REM, take maybe 1 hour, and stay in REM sleep for around 20-30 mins, then back to other stages and repeat. Going right to REM indicates you havent been getting it and it is essential for good health (mental and physical). [ one kind of torture involves waking people up so they dont get any REM, eventually they start hallucinating and it goes downhill from there] When you were sleeping with a pressure of 8, you got only ONE apnea, and 4 partial awakenings from trying to breathe, great result from the machine. Pressure of 10 and 12 were also tried,and 12 looked best to them.

This is a good report but more info would be better, like how long did REM sleep last? How much time in other sleep stages while they were trying the machine? <-- called titrating, makes it sound fancy, doesn't it? You should be able to get

"a] The doctor's dictated results of BOTH your sleep evaluation AND your titration studies
b] The full scored data summary report w/condensed graphs for BOTH your evaluation AND your titration studies"

I copied the verbiage above from a post by Corgigirl, felt I needed the exact language. I think you have the a], as much as you are going to get, you need to ask for the b]. They have to give it to you, by HIPPA regulations (guarantees your rights, fairly recent legislation).

Hope this helps, I am NOT an expert but did have my study done recently and learned a lot since then about the reports, including that it can be hard to get them!
Good luck,
Chris (lookin4sleep)

fortomorrow
Posts: 174
Joined: Thu Sep 11, 2008 9:57 am
Location: Sacramento, CA

Re: Frustrated and needing to vent.

Post by fortomorrow » Mon Sep 15, 2008 2:08 pm

Thanks, I will definitely ask my MD for the full report.

I'm not exactly sure how I'm going to convince him to give me a Rx for the APAP, but I'll keep researching around here.

I got my Breeze today. I assembled it and put it on and oh. my. gosh. I'm almost looking forward to going to sleep tonight. It will be so nice to go to bed without having anything on my face.

I say almost because I'm having some problems with dry mouth and leaking (I've tried chin strap, taping and chin strap + taping, but it hasn't really helped so far) so I'm thinking that it's a tongue/soft palate issue. It's also really difficult for me to exhale against therapy pressure, even with the C-Flex on 3. Most nights I wake up after a few hours of sleep and take the damn thing off because it's bothering me so much. I'm hoping tonight might be the night I leave it on.

And if not, then I'm going to think about a hybrid. If my doctor decides to grant me a prescription to change my mask. Heh.

_________________
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