Saw my doctor today for my sleep study results.  I asked for a copy of the report but he said it wouldn't really mean anything to me.

He told me that I had 103 apneas an hour, 22 of which lasted for a minimum of 30 seconds.  I also moved my legs 72 times an hour.

He said this is very severe apnea.  Is it?

He also said that when they put the CPAP machine on me (set at 11), all snoring stopped and I only experienced 7 apneas over the course of 5.5 hours, each lasting less than 10 seconds.

I am male, 5'7", 44 years old, 235#

Any thoughts?

Hi there,

And welcome!

Wow, 103 apneas an hour??  Yep, that's very severe.  That is likely AHI which is the Apnea/Hypopnea Index of how many per hour (apneas are total cessation of breathing; hypopneas are almost apneas, with a tiny amount of air getting through, but those are as serious as apneas).  An AHI of 5-15 is considered mild; moderate is 15-30; severe is 30 or more per hour.  So your number is exceedingly high.  If your AHI were 60, that's once per minute.  Yours is almost twice per minute.  So if you imagine some of those being at least 30 seconds long, you were barely breathing at all!  

The leg movements are significant, but they were likely related to all the arousals, your body reacting and trying to jumpstart your breathing.    And you can see how cpap virtually eliminated all of those apneas/hypopneas.  So you need the cpap!  

It's sad that the doc didn't think you'd understand the sleep study results.  Some of the other information would include how low your blood oxygen levels were.  It also shows how bad the apneas were while on your back versus sleeping on your side.  But regardless, your condition is plenty severe, and it's important that you use the cpap.  Have you gotten a cpap for home yet?  If not, I hope it's soon.   I think you will find it helps immensely.  But more important than how much better you will feel, the cpap could well save your life or at least from serious health consequences.  Let us know how things go for you.  And ask plenty of questions.


Linda


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Linda:

Thanks for making me feel so welcome.  I will call the doctor's office tomorrow and ask for a copy of my report.

So, it IS severe, huh?  Yuck.  Yea, the doctor told me that I had an apnea about every 30 seconds.

I am supposed to have my CPAP by this weekend.  Can't wait!

Again, thanks for making me feel so welcome.

Ken

I am not a medical professional or sleep professional.
I will let others comment on your doctor's rather patronizing reply to your request. Was this the sleep doctor you were dealing with or was it your primary care doctor (who may not fully understand the report himself)?
I would urge you to read the sticky post on "Sleep Study Terms" in this section of the forum.

The severity of sleep apnea is determined by a number known as the AHI (or Apnea Hypopnea Index).
This number is simply the number of apneas (periods of no intake of air into the lungs lasting 10 seconds or longer) and hypopneas (periods of significantly reduced intake of air into the lungs lasting 10 seconds or longer) divided by the number of hours of sleep. An AHI under 5 is generally considered to be normal. An AHI of 5 to 15 is generally considered to represent mild apnea. An AHI of 15 to 30 is generally considered to represent moderate apnea. When the AHI is over 30 it is generally considered to represent severe apnea. That is the scale. So yes, your apnea is very severe (although many people here have had sleep study results as bad or worse in terms of AHI.

My impression is that the 103 episodes of apnea an hour that your doctor mentioned represent apneas and hypopneas combined, although I cannot know this for a fact. Your 72 leg movements an hour are probably what are referred to as periodic limb movements (or PLMs). This is rather high also. Periodic limb movements can interfere with your sleep and cause problems even without apnea. But PLMs also may occur as part of the body's response to apnea. Sometimes PLMs diminish or go away when apnea is treated. Other times, PLMs may require their own treatment.

If you really want to know how severe your apnea is, ask your doctor (or sleep doctor) about your oxygen desaturation levels (drops in the amount of oxygen in your blood) associated with your apnea. Ask about your amount of slow wave (or stage 3 and 4) sleep and of REM sleep (these are generally considered to be the two most important stages of sleep in terms of restoring your mind and body). Ask about your number of arousals (abrupt transitions from a deeper stage of sleep to a more shallow stage of sleep). Ask how many arousals were associated with respiratory effort events and how many were associated with your leg movements. Ask about wheher you had many central apnea (apnea where there is no effort to breath) or mixed apnea (combining features of central and obstructive apnea) events or if all of your apnea events were obstructive apneas. Ask about what your AHI was during REM sleep as opposed to non-REM sleep. Ask about the difference between your AHI while you were on your back as opposed to your AHI when you were on your side.

To get a better idea of how much the CPAP helped, ask about whether the PLMs in the first part of your study went away when you were on the CPAP machine. Ask whether your levels of arousals also declined during your sleep study. Ask about whether there were changes in your blood oxygen level while you were on CPAP as opposed to before you were put on the CPAP.

And after you have gotten these answers, ask him again for a copy of your sleep study report and ask for a copy of the full report (which will almost certainly come to about 5 pages, as opposed to a summary that will be a page or 2).

Or you could just take what your doctor gave you and follow his recommendations. The big picture is that you do have significant and severe sleep apnea and CPAP has shown that it will help at the recommended pressure. You are not likely to go wrong with this, at least not in the short term. However, you may have some other sleep problems (such as your PLMs or some type of insomnia) which may also interfere with your sleep. If this were the case, you still need to address the apnea with CPAP but your results on CPAP may not turn out to be so obvious as if you had no other sleep problems. Also, you may find CPAP to be difficult to adjust to and it migt help you to understand in greater detail just what your sleep study has to say about how your apnea is affecting you.

In any case, congratulations on making it through your sleep study and best wishes on your adjustment to CPAP.

Do keep us posted on your future developments.

Bill

Bill:

Thanks so much for an excellent reply.  I should have had you with me when I was at the doctor.  He is, in fact, a Sleep Disorder Specialist.  I guess he just has a rough bedside manner!  LOL

I am an adjunct Stats Professor, so when I saw all the data and graphs, I started to salivate.  I sooo want a copy of that report.  When I get it, I will post all of the results and get everyone's feedback.  Since I am now convinced that this is severe, I want to understand it all.

Ken

kcliff01 wrote:

I asked for a copy of the report but he said it wouldn't really mean anything to me.

Just smile and say "Thanks, but I would like a copy anyway".  It is your right...whether you understand it (yet) or not!  

kcliff01 wrote:

He told me that I had 103 apneas an hour, 22 of which lasted for a minimum of 30 seconds.  I also moved my legs 72 times an hour.

He said this is very severe apnea.  Is it?

Yup...thats severe all right.  Imagine if 103 times an hour...all night long...somebody came into your room and poked you in the ribs.  You wouldn't get much sleep!

kcliff01 wrote:

He also said that when they put the CPAP machine on me (set at 11), all snoring stopped and I only experienced 7 apneas over the course of 5.5 hours, each lasting less than 10 seconds.

I am male, 5'7", 44 years old, 235#

Any thoughts?

Sounds like you are an excellent candidate for CPAP!  I would put money on you feeling a LOT better once you join the "Order of the Hose".    You probably won't thrash about as much either once you can breathe unencumbered.

"Order of the Hose."  I like that!  LOL

There are other practical reasons for obtaining a copy of the sleep study report.

When my doc went over the results, he pointed to the details of that report.  But I still had untreated sleep apnea -- my mind was mush!  Plus it was all mind-boggling just knowing I had this condition.  I knew I'd forget everything he told me.  Even if I didn't know what it all meant, it helped to have the same info the doc mentioned.

Plus, it could be a good idea to have a copy in case you have future sleep studies.  You will have something to compare, to have it for your records.  

I suppose docs worry you might misinterpret the report.  But that report is a summary anyhow.  There is little there to misinterpret.  There might be recommendations in the report that might be misleading.  I work in the office of a sleep lab and the reports often list alternive considerations such as surgeries... but that is misleading because surgeries or other procedures don't work for everyone.  Those might be generic recommendations they throw into every report.  Surgeries have risks and low success rates, and the success rates pertain to a mild or low moderate conditions.  The cpap is a non-invasive treatment, and it's a quick one.  Non-invasive and quick-response treatments should be considered the first choice of treatment, in my opinion, unless there are special extenuating circumstances.  Cpap gives you a fighting chance and it works right away.

Okay, everyone, thanks for the help and insight.  As a result, I just faxed off a request for a copy of the report.

Keep your fingers crossed!  LOL

You know that a lot of us find it hard to cope with the notion that we are incompetent sleepers... we all know we have our weaknesses, but to be told we don't know how to sleep properly and go to bed and don't do what we should!! SO  we get upset hearing we have OSA, let alone severe OSA. Sleep docs often don't seem to understand how worrying this is to the newly diagnosed patient, and how we hate waiting for results, and waiting for him to really explain, not just say "You need CPAP, talk to my secretary she'll set up everything."


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Arthur
Sleeping with a curvaceous blonde autoPAP (Resmed autoset). Surviving, and in small ways doing better. Maybe there will be that big surge of energy, and easier weight loss one day. Hope springs eternal.....

ArthurAnxious wrote:

You know that a lot of us find it hard to cope with the notion that we are incompetent sleepers... we all know we have our weaknesses, but to be told we don't know how to sleep properly and go to bed and don't do what we should!! SO  we get upset hearing we have OSA, let alone severe OSA. Sleep docs often don't seem to understand how worrying this is to the newly diagnosed patient, and how we hate waiting for results, and waiting for him to really explain, not just say "You need CPAP, talk to my secretary she'll set up everything."

So, true, my friend.