another sleep study, different results--opinion

Rogue Uvula wrote:
Since air is constantly flowing out of the mask port, I would guess that their software monitors for the minimum leak and subtracts it out so as to state a "zero" leak rate.

It subtracts the "passive leak" which is the designed leak of the exhaust ports.

How intelligent of it! I was used to my old machine (M-Series Pro) having a large-ish number, so I didn't realize.

So, I finally got the full results from my most resent sleep study. I do hope someone can help me figure out what's going on so I can treat myself as effectively as possible! There are 8 pages, so be warned. The graphs are on page 8. I'm sorry--I tried to figure out how to post these in the body of my email, but clearly, I failed. If anyone wants to tell me what to do, I'd be happy to fix them.

Page 1--http://www.flickr.com/photos/11276087@N ... otostream/
Page 2--http://www.flickr.com/photos/11276087@N ... otostream/
Page 3--http://www.flickr.com/photos/11276087@N ... otostream/
Page 4--http://www.flickr.com/photos/11276087@N ... otostream/
Page 5--http://www.flickr.com/photos/11276087@N ... otostream/
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Page 7--http://www.flickr.com/photos/11276087@N ... otostream/
Page 8--http://www.flickr.com/photos/11276087@N ... otostream/

How about we make the links actually work! Go into edit mode for your post:

1. Highlight the entire url for your first link. http://www.flickr.com/photos/11276087@N ... otostream/
2. Then click the URL button in the edit toolbar above the edit box
3. Then do that for each one
4. Click Preview below box to see if they are now in blue and clickable
5. Submit

Now folks can go to see your reports easily.

Here is an example of your first image as a post, I had to get the image url by first going into a size version and then right clicking the image to get the url. To do this, go to your report on Flickr, then choose to view the image in Medium size and then right click the Medium image and grab the Image URL. Put that url here, highlight it, and then click the IMG button in the edit bar.

Is that unusual for svh's hypopneas to be so heavily weighted toward NREM? I thought most people's events, if not equally dispersed, tend to be in REM?

With respect to whether you should/could go without CPAP given your oxygen saturations... My oxygen saturations were not quite as good as yours (92% minimum) and I was told this: We don't know much about what SDB does to the brain. We know that the cardiovascular risks of untreated sleep apnea are due to the oxygen desaturations. So, from what we know, there are no risks to not treating my SDB, except for the ones I was already experiencing, as well as some others: severe EDS, cognitive problems, irritability, depression, anxiety, etc. In short, it is a quality of life issue, and mine was bad.

That said, I think there is so much night-to-night variability, that I would never be confident that any one night was representative of all my nights (e.g., if my oxygen saturations were 92% that night, could they be 88% another night?). So I could not recommend to you that you not treat your SDB, and who wants to feel like crap every day, right?

You might want to digitally remove the physician's and technicians' names (and for that matter, yours), but as previously noted, the NPSG has the appearance of UARS.

"IMHO", follow-up PSG would be recommended to insure that the arousals (the "A" of RERA) decrease and architecture improves.

Good luck, gotta run, it's time for football!

NM

Thank you so much for your help, everyone! (Especially in making my links work.....)

I wondered about the events being NREM, too. It seems most people have trouble in REM sleep, no?

I've been using my new APAP every night since I got it, and am averaging an AHI of .4, roughly My highest night so far was 1.1, so that's good. I'm still tired, but I know it takes time. I seem to be spending most of my night at 8.5. Well, actually, I spend a while at 6, then have little spikes to as high as 10, but the bulk seems to be at 8ish. When I read the reports, it/s usually in the neighborhood of one or two obstructive apneas, usually one central, and one hypopnea. Seems like so little to make such a problem.......Of course, that's with the machine!

FWI, My NREM AHI was around 40 and only about 6 AHI in REM. All hypops, minimum desat around 92%. Overall AHI was 35 when averaged for the entire sleeping time (very little REM sleep i guess!). So not everyone has REM OSA.

I was titrated to somewhere between 7 and 10 cm, the doctor said to start at 7 and go up to 10cm if I didn't see an improvement. I eventually landed at 10.5 cm , that's where i feel the best. APAP was a no-go for me. This took several months of tweaking... My AHI was pretty much the same at 10.5 cm as at 7 cm (on average approx 1.0 AHI, and still is to this day)... I can only imagine that I titrated out a residual UARS component by going above 7cm so high (ie what would have been found in a follow-up PSG that NM mentions, had I had one). Who knows?

Good luck!