I'm a 67 year old male, Height (cm): 180.3 Weight (kg): 92.2 BMI: 28.3, who has been on CPAP for about a month. My main complaint before getting my first sleep test was day time fatigue and depression ( I have taken Cymbalta for several years ).

Since I nap every day after lunch, I don't really have a problem falling asleep during the day while watching TV or driving

My first test in July w/o CPAP showed severe REM-related obstructive sleep apnea syndrome (overall AHI of 9.4, REM
AHI of 59.3, non REM AHI of 1.2, arousal index of 25.8, minimum oxygen
saturation of 83%).

Then I was put on CPAP at 7 to get use to the CPAP, had my 2nd sleep study Sept 10 and is Below at the bottom:
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My questions are:

My doctor, yesterday, in my first consult after my 2nd test, told me the CPAP probably wouldn't help my fatigue, as I should of seen some improvement by now, but CPAP could prevent Cardiac problems down the road. I though that some times it would take several months of CPAP to show improvement ???

He also said that my Periodic Limb Movement was no big deal, and he wasn't going to treat it ?? Is this correct ??

Thanks Bob




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SLEEP ARCHITECTURE:
The study started at 22:04:12 and ended at 06:13:29. Total sleep time was 433
minutes resulting in a sleep efficiency of 90.2% (TRT = 480 m). There were 20
awakenings with a total time awake after sleep onset of 19.0 minutes. The
sleep latency was 28.0 minutes and the REM latency was 103 minutes. The
patient spent 63.0% of sleep time in the supine position. The sleep stage
percentages were 9.3% stage N1, 68.3% stage N2, 0.0% stages N3 and 22.4% REM
sleep. There were 116 arousals, resulting in an arousal index of 16.1. There
were 96 stage shifts.

RESPIRATORY DATA:
This is a CPAP titration study. Snoring was eliminated at a CPAP setting of 9
cmH20. The mean oxygen saturation during the study was 93%, with a minimum
oxygen saturation of 89%.

CPAP-BILEVEL SUMMARY:

IP EP TST REM %Sup Apn Hyp Tot SupIdx AHI RAHI ArIdx Nadr Mean SaO2
7 7 52.5 m 0.0 m 100.0% 0 0 0 0.0 0.0 0.0 13.7 91% 92.0%
8 8 40.0 m 0.0 m 100.0% 0 0 0 0.0 0.0 0.0 6.0 91% 92.0%
9 9 100.5 m 33.5 m 34.8% 2 0 2 3.4 1.2 3.6 10.1 89% 93.0%
10 10 174.0 m 59.0 m 63.2% 1 0 1 0.5 0.3 1.0 16.6 90% 93.0%
11 11 66.5 m 4.5 m 53.4% 0 0 0 0.0 0.0 0.0 22.6 91% 93.0%
LIMB MOVEMENT DATA:
There were 230 periodic limb movements during sleep, resulting in a PLM-index
of 31.8. Of these, 23 movements were associated with arousals, resulting in a
PLM-arousal index of 3.2.

ECG DATA:
The average heart rate during sleep was 60 beats per minute, with a range of
52 to 77. During wake, the heart rate was ranging from 54 to 81 beats per
minute. Frequent premature ventricular contractions and rare ventricular
contractions were noted.

ICSD DIAGNOSIS:
Obstructive Sleep Apnea Syndrome [327.23]

IMPRESSION:
1. The apnea-hypopnea index was normalized at all tested CPAP settings. At a
CPAP setting of 9cmH2O, snoring was eliminated, the arousal index was
improved and oxygen saturations were maintained at and above 89% at this
setting.
2. Frequent periodic limb movements were noted during sleep and wakefulness.
These movements are of uncertain clinical significance in the setting of
OSA/CPAP therapy. The patient did not endorse symptoms suggestive of restless
legs syndrome (RLS) in the provided sleep questionnaire. Clinical correlation
is needed.
3. Abnormal sleep architecture likely due to CPAP titration and first night
effect.

RECOMMENDATIONS:
CPAP 9 cmH20 with humidification.

Ask your physician to get your Iron levels checked or you could start an Iron supplement.

Limb movements can certainly be important, so long as they are not residual from untreated apnea and are not correlated with OSA whatsoever.

Its probably worth it to investigate this a bit more.