Hi All,
I've just recieved my results from my inital sleep study, my Dr. was really not that helpfull in his explanation and now i'm in a bit of a panic & my minds racing, can any one shed some light on my results?

Me:
184cm
86.1kg
non-smoker / non-drinker

Total Sleep   =324.50min
NREM Sleep  =277.50min 85.5%
Stage 3        =34.50min 10.6%
Stage 4        =32.50min 10.0%
REM Sleep    =47.00min 14.5%
Sleep Latency       =10.50min
REM Latency         =140.50min
Sleep Efficieency   =83.3%
Arousal index        =20.3/hr

SaO2% lowest       =95% (nadir)
RDI
                            
Central Apnea          0
Obstructive Apnea    0
Hypopnea              120
Apnea + Hypopnea 120

Total RDI               =16.1
Longest Apnea       =0.0 sec
Longest Hypopnea  =43.5sec
PLM Index              =0.0

- Mild snoring in supine & non-supine position
- 4 periods of REM Sleep (1 period was supine), slow wave sleep mainly in first half of night.

Conclusion
Mild OSA with majorityof events being subcriterion events. (what does this mean)
consider CPAP or MAS (is CPAP or MAS the only options?)

I've tried to unerstand the above and kind of get it but where do i sit in the scheme of things. How serious is MY condition?


Cheers.
Roachy

Well, this sure isn't my forte. I'm just an OSA/xPAP patient.

The "Mild OSA with majority of events being subcriterian events" is referring to the hypopneas, the lack of obstructive apneas and central apneas (that lack is good).

W/o leaving this reply to check the Sticky of sleep apnea terms I can't be specific, but that RDI refers to Respiratory Disturbance Index which is where you had quite a few (16.1 per hour, about 1 every 4 minutes all night) that didn't quite make it to apnea or hypopnea status because they didn't last long enough and/or your 02 saturation didn't drop enough to qualify as one or the other. But they were enough to convincingly disturb your sleep.

I'm sure you know what a CPAP is: continuous positive airway pressure, the machine that provides the air pressure necessary to keep your airway open. But I don't know what MAS is unless maybe referring to jaw advancement such as (I'm taking a guess w/o looking it up) Mandiublar Advancement S.....??? surgery?? system??


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This might be what some call Upper Airway Restriction Syndrome.  This is when the body has to work hard to get air and arouses prior to actually going without air (apnea) and therefore the oxygen levels don't drop.  My understanding is that this is usually not diagnosed until the arousal index is above 15, which yours is 20 so.........mild.  I believe that insurance will often not pay for cpap for a diagnosis of UARS so a diagnosis of OSA is used.

embryopathy wrote:

This might be what some call Upper Airway Restriction Syndrome.  This is when the body has to work hard to get air and arouses prior to actually going without air (apnea) and therefore the oxygen levels don't drop.  My understanding is that this is usually not diagnosed until the arousal index is above 15, which yours is 20 so.........mild.  I believe that insurance will often not pay for cpap for a diagnosis of UARS so a diagnosis of OSA is used.

Keep in mind that while his arousal index is 20.3, we have no way of knowing what caused them. For instance, they seem to be lumping all of the arousals into one comprehensive index (Spontaneuos, Limb, Reras, and respiratory). Its not a good value on his report because its largely unknown. With him having 120 hypopneas, you would almost have to guess that some of those were causing arousals. Upper Airway Syndrome cant be the complete diagnosis with the data presented as is.

RAM_Sleep wrote:

Keep in mind that while his arousal index is 20.3, we have no way of knowing what caused them. For instance, they seem to be lumping all of the arousals into one comprehensive index (Spontaneuos, Limb, Reras, and respiratory). Its not a good value on his report because its largely unknown. With him having 120 hypopneas, you would almost have to guess that some of those were causing arousals. Upper Airway Syndrome cant be the complete diagnosis with the data presented as is.

ok...but I was thinking that they hypopneas would be a part of the UPRS (cause and/or result).

wow thanks for all the quick responses - does make me feel better to know that there are people out there to listen/explain things.
I'd gone in for what I thought was going to be insomnia, and came out with OSA or UARS....

I found that the study conditions were, as you'll all know, not the most comfortable - I did unplug myself a couple of times, oops. Environment definitely could have contributed to my arousal index.
I'm not sure about the insurance in regards to UARS, I’ll have to follow this up.

I feel that maybe my condition is genetic (I’m not a big guy) nor is my father, undiagnosed but terrible snorer falls asleep at the drop of a hat. hmm I’ll have to talk to him.

So at the end of the day is CPAP the only (non-surgical) solution? Not a fan of surgery, unless absolutely necessary.

Well, if you ask me, the numbers don't make sense.  324.5 minutes of Total Sleep/60 minutes = 5.4 hours, 120 hypopneas/5.4 hours = AHI 22.2, so how can Total RDI (which would have included RERAs) be 16.1?

M.



Last edited by Morbius on Mon Aug 04, 2008 5:39 am; edited 1 time in total

Hi Morbius, i see what you mean...I may have got this wrong initally, i was freaking out a bit.

The 120 Hypopneas are broken down as:
NREM
Back = 23.9
Other = 8.2
All = 15.6

REM
Back = 36
Other = 17.1
All = 19.1

sleep time was broken down the same way:
NREM (in min)
Back = 130.5
Other = 147
All = 277.5

REM (in min)
Back = 5
Other = 42
All = 47

sorry if i confussed things.

ok, so you just added up all the categories to get 120 hypopneas?  the breakdown you wrote above still doesn't make sense...did you make a typo?  shouldn't the highest numbers be "all" (instead of "back")?   In which case you had 60 hypopneas (not 120) which is 11/hr, right?

So, 87 total hypopneas?

Different from 120, but still indicates an issue.

no typo - that's as written on the report. i'm going to phone the lab i think....rang the lab, it's a computer generated report
they said the figures in these categories make no differenc to the Total RDI of 16.1

Whats the differnece between my Arousal index of 20.3/hr and total RDI of 16.1?

Roachy wrote:

no typo - that's as written on the report. i'm going to phone the lab i think....rang the lab, it's a computer generated report
they said the figures in these categories make no differenc to the Total RDI of 16.1

Whats the differnece between my Arousal index of 20.3/hr and total RDI of 16.1?

RDI is a measure of respiratory disturbances.

Arousal index (as I mentioned above) is a general index that may be including everything (limb movement arousals, spontaneous, RERAs, and apnea/hypopnea arousals).

Roachy wrote:

So at the end of the day is CPAP the only (non-surgical) solution? Not a fan of surgery, unless absolutely necessary.

...and then what do i look for? (i know, jump across to the CPAP part of the forum)

Roachy wrote:

Roachy wrote:

So at the end of the day is CPAP the only (non-surgical) solution? Not a fan of surgery, unless absolutely necessary.

...and then what do i look for? (i know, jump across to the CPAP part of the forum)

You can try an oral device. Results are variable, but if you do not want to go with CPAP (which is the best tx), then you may want to explore the mouthpieces first. Its up to you.

The numbers on the report still dont seem to add up. It makes me wonder if all of their reports are miscalculating...

Perhaps respiratory events (the hypopneas) were counted during periods that included Wake, but RDI/AHI only reported out events during sleep.  There's enough room in that marginal sleep efficiency to allow that.

Or the other 33 events were the aforementioned "subcriteria" events.  But then they should never have been reported as hypopneas in the first place, nor are they the majority.  Or one would think that "subcriteria" events should have shown up as RERAs.  Unless they were microarousals.

Side-sleeping would put a good-sized dent in that AHI.

M.