Well, I met with the sleep doctor today... and good news! He does not want to start me on CPAP yet. I am so relieved! However, he did say that I do have mild sleep apnea where I stoppe breathing 8 times per hour. What concerned him most though, is that it took me 1 1/2 hours to fall asleep, and woke up several times during the night, AND that I never got past stage 2 of sleep. So, I never had deep sleep and never entered REM. (Didn't suprise me much. And that was with the Ambien!) He said he is not sure if my sleep apnea would be worse if I did sleep deeper. But he wants me to keep a sleep diary for two weeks and then he'll decide from there. I am just happy that he does not want to start that CPAP... yet (he said he may still want to later).
   

Hopefully your Dr is accreditied in Sleep Medicine.  Most people have a higher AHI in REM...therefore once you do enter REM you will probably have a higher AHI...even enough to change your apnea from mild to moderate or severe.

I am curious as to what a sleep diary will do for the treatment of SA?  What types of things does your Dr want you to keep track of?  I wonder if you arousals/awakenings were due to your apnea..that would explain at least 8 times of an hour waking...and also could explain why you did not get beyond stage 2 of sleep.

Please keep us posted ... I have not heard of mild SA being handled this way and would like to learn .


_________________
I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?

The sleep diary has nothing to do w/OSA. It can provide good solid clues to other sleep disorders (I understand there are some 88 sleep disorders). It will also give good clues to sleep hygiene. My sleep neurologist had me keep a sleep diary for two weeks as well.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

lorelei_66 wrote:

Well, I met with the sleep doctor today... and good news! He does not want to start me on CPAP yet. I am so relieved! However, he did say that I do have mild sleep apnea where I stoppe breathing 8 times per hour. What concerned him most though, is that it took me 1 1/2 hours to fall asleep, and woke up several times during the night, AND that I never got past stage 2 of sleep. So, I never had deep sleep and never entered REM. (Didn't suprise me much. And that was with the Ambien!) He said he is not sure if my sleep apnea would be worse if I did sleep deeper. But he wants me to keep a sleep diary for two weeks and then he'll decide from there. I am just happy that he does not want to start that CPAP... yet (he said he may still want to later).
   

Extended sleep latency is common enough during a sleep study. 90 minutes is very extended.........BUT the effects of being 'wired up' can have a big bearing.

Mild apnoea, based on AHI alone might not be the end of the story. Even though you woke up during the sleep study, the fact that you didn't get any deep sleep (I assume he means Stage N3) is of concern, also REM Sleep. As Mrs. RVW stated there is usually a higher AHI during REM Sleep. Any mention of your O2 sats or possibly PLMD.

Keeping a sleep diary may point towards other problems, you should try and be as accurate as possible. Record anything out of the ordinary and while completing the diary, don't allow entries to build up.....as we can get a little confused over time  

You obviously have a fractured sleep architecture, which may or may not be caused by sleep apnoea.

Best of luck.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Thanks for replying to me. The input really helps. I feel like I am just confused about the whole thing (and I have a strong medical knowledge having been working in health care for 20 years). I do not understand what he wants to see from the sleep diary, except just how little I do sleep. I got a copy of the report from the sleep study, and it says my O2 sats dropped to 81%. But the doctor never mentioned it. Was he not concerned about that? At what level of desaturation do they consider abnormal? (I know normal daytime levels, but don't know much about what is normal in sleep). Anyway, yes, he is accredited in sleep medicine, and I should have faith that as he is the expert, he knows what he is doing... but I am not understanding it. He said he didn't need to see me right away, that I could just fax the sleep diary to him, but I am just coming up with a whole bunch of questions, so I think I am going to schedule to see him again. I have several questions already, but does anyone have any suggestions that I should be asking about? I appreciate it.

It is best to never drop below 90% 02 saturation - BUT - the IMPORTANT issue is HOW LONG and HOW OFTEN one drops below 90% during sleep. (Actually, Medicare requires 88%, not 90%).

Too many sleep doctors are no where near as worthy of having much faith at all in them or their expertise as should be. You know that doctors don't walk on water and often slip and fall flat on their face on the ice the same as we peons do.

Which report copy did you get? The sleep doctor's dictated results )1-2 pages) OR the full scored data summary report w/condensed graphs (5+ pages)? That full scored data summary report w/condensed graphs will have data on what occurred in each sleep stage, how long you were in each sleep stage, what positions you slept in and when and the "events" that occurred in each stage and position as well as your desats when and for how long.

If I were you I would do as you are contemplating doing - make the appointment and ask the questions. Whether your doctor likes it or not it is his job to see to it that you have some understanding and things make sense to you. How else are you to form an intelligent decision as to what course to agree to and follow?


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

I too would schedule an appointment....your questions and concerns noted are the same I would ask.  The desat often depends on the length of time you are in it..but I would still want an answer.  Also, how many Leg Movements were noted in the study..and were they associated with an 'event' or on their own.  

I would also want to know his theory for not treating the SA.  I do know that some insurance companies have a hard time paying out for equipment with a dx of mild SA when the AHI is not much over 5...I think 20 or so years ago when my AHI was probably that low..if I were treated at them time I would be better off today.  The gradual creeping up over the years of the AHI has left risidual affects on me that can not be repaired...and due to it, I barely function many days.


_________________
I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?

Related continuation of OP's Sleep Study/DX process:

http://www.apneasupport.org/viewtopic.php?p=143380&highlight=#143380

http://www.apneasupport.org/viewtopic.php?p=144295&highlight=#144295


_________________
I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?