So I'm brand new here and this is my first topic, I haven't looked around too much on the site but plan on it later this week.  I had my study about 3 weeks ago and they just got back to me today with some info, they said they'd be sending more information through the mail, but the night I had it done the people performing the study said my apnea seemed pretty bad.  Anyway... the nurse, over the phone, said that I had 84 apneas an hour with an oxygen saturation of 72%, and I don't know what this means.  She explained to me what normal numbers are for people, but not how severe this might be.  I'm going to post the exact info when I get the more detail study in the mail.  By the looks of it by the little snooping around I did, it seems that 84 apneas an hour and 72% saturation is pretty bad.  How bad is this and what are some of the lowest saturation percentages you out there have seen or have?  I'll start looking around on here if some others have similar questions.  Thanks in advance.

Hi matt_o and welcome!

Yes please start looking around the site here.  Most or all of your questions are likely answered in the Announcements, FAQ's, and Sticky Posts at the top of each of these forums.  You might consider starting with FAQ on sleep study terms right at the top of this forum.

Please also spend some time with the search features -- there's a google-style search box in the upper right, and also an advanced search option in the navigation strip going across the top portion on each page.  Chances are any questions you have, have been asked and answered many times.

Please don't hesitate to post, though   We're all here to help one another.

Blessings,
--pseudonym

Hiya matt_o,

And welcome to the forum!

The AHI is the apnea-hypopnea index, or how many apneas or hypopneas you averaged per hour.  (apneas are total cessation, hypopneas have some air getting through the obstruction, but not much, so they are generally considered the same).

Anyhow, 5-15 per hour is considered mild; 15-30 moderate; 30 or more per hour is severe.  As you can see, you have 84 per hour, high in the severe range.  You stop breathing more than once a minute.  I'm not sure if your saturation of 72% was the lowest witnessed blood oxygen level, but that's likely.  The report will give an average as well.  But 72% is quite low.  Normal blood oxygen levels are in the upper 90's.  There have been lower oxygen levels and higher AHI's.  But yes, you've got it bad.  


Linda


_________________
Click here for link to FAQ and topics
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pseudonym wrote:

Hi matt_o and welcome!

Yes please start looking around the site here.  Most or all of your questions are likely answered in the Announcements, FAQ's, and Sticky Posts at the top of each of these forums.  You might consider starting with FAQ on sleep study terms right at the top of this forum.

Please also spend some time with the search features -- there's a google-style search box in the upper right, and also an advanced search option in the navigation strip going across the top portion on each page.  Chances are any questions you have, have been asked and answered many times.

Please don't hesitate to post, though   We're all here to help one another.

Blessings,
--pseudonym

Thank you pseudonym for making me feel welcome.  I'm 30 years old and wasn't expecting to have sleep apnea, let alone a severe case of it.

Linda wrote:

Hiya matt_o,

And welcome to the forum!

The AHI is the apnea-hypopnea index, or how many apneas or hypopneas you averaged per hour.  (apneas are total cessation, hypopneas have some air getting through the obstruction, but not much, so they are generally considered the same).

Anyhow, 5-15 per hour is considered mild; 15-30 moderate; 30 or more per hour is severe.  As you can see, you have 84 per hour, high in the severe range.  You stop breathing more than once a minute.  I'm not sure if your saturation of 72% was the lowest witnessed blood oxygen level, but that's likely.  The report will give an average as well.  But 72% is quite low.  Normal blood oxygen levels are in the upper 90's.  There have been lower oxygen levels and higher AHI's.  But yes, you've got it bad.  


Linda

Hey Linda,
Thanks for the info, I'm going to defenitly look around here some more to get more comfortable with the terms and what not, and to get more comfortable with this diagnosis.  Like I told pseudonym, I'm 30 years old and wasn't expecting this, more over, I wasn't expecting such a severe case.  I'm picking up my CPAP today, tonight will be my first night with it.  The one problem I had during the study was when they fitted me with the mask, it didn't seem like they could get the right fit.  I have a little bit of a beard and they weren't getting the correct "seal" for the mouth/nose mask, then they switched me to a sort of tube thing that went in both nostrils, then finally decided on one that fit around my nose.  Unfortunately I breathe through my mouth when I sleep, it kind of felt like I was fighting the machine, is this because I wasn't breathing through my nose?  I might have to retrain myself how to breathe through my nose.  Thanks again, and hope to have future conversation with you.
Matt O

Please accept my welcome to the forum as well, Matt O.  That "sort of tube thing" you tried during your titration would have been a nasal pillows style CPAP "mask" (interface). They are quite often the style most successful for those w/beards. There are more than one "model" and size of this style mask and you might have done better w/another style or size than the one they had you try.

The "nose/mouth" style mask you tried is what we call a full face mask and again, another "model" or size might have worked much better for you, possibly successfully. On the other hand, full face masks are often more difficult to get a comfortable, leak free fit. The final mask you used, the one that fit just around your nose is called a nasal cushion and as w/the full face and nasal pillows style, the come in many models and sizes and another might have fit much better for you.

If you do a lot of mouth breathing during the day it is pretty difficult to train yourself NOT to mouth breathe at night. And, yes, if you are having a lot of leaks due to mouth breathing or a poorly fit mask you will find yourself fighting the therapy and not being able to breathe comfortably because most of your "therapy" is blowing out the leaks instead of opening and/or keeping open your airway.

Very few of us adjust to CPAP therapy overnight, Very few. Most of us struggle w/it for awhile before we start seeing marked improvement. Often improvement is gradual, even much more gradual than we like. Hang in here, it does get better, it just takes some time, patience, perseverence and a sense of humor.


_________________
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 & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

My dh is also 30 and had a sleep study with a similar outcome to yours.  His AHI was 90 something and they put him down as having markedly severe obstructive/central and mixed apnea.  I think that he also spent 25% of the night with sats under 90%, but I don't know what the low was.  He doesn't fit the typical profile for someone with apnea that severe and we definitely weren't expecting it to happen.  He's at a healthy weight, non smoker....??  

I just had a thought regarding the mask that you were fitted for.  My ds (who's 4) was initially fitted for a full face mask but he was terrified of it so the DME guy went ahead and gave him one similar to what you were describing that only covered his nose.  The problem that we were running into was that he is a mouth breather and hardly ever uses his nose.  We temporarily solved that by adding a chin strap to keep his mouth closed at night.  Is that something that might work for you??  At least until you're able to find a better fitting full face mask??  

I hope that things go well for you tonight.  It does take a while to get used to.  Hang in there.  Hopefully before long you'll be sleeping well and won't even notice the mask/cpap anymore.  Good luck!!

matt_o  Welcome aboard the Sleep Apnea adventure! You have came to a good place for help and support, there is a lot of fine folks here! And they are all willing and eager to help!  Anyway if your a mouth breather and have a beard, have you thought about  trying the Hybrid mask or the Mirage Liberty mask. The mask are kind of a cross between the nasal pillow and the bottom part of a full mask, so you get the best of both! I also have a beard and am a mouth breather and I have used both and still use them!  To me the Hybrid is more comfortable, but I am kind of liking the Liberty a bit too! You might want to give one or both a try! I have had to mod them a bit to get the nasal pillows to stay in place but it works great. See the posts if your interested. Good Luck to You


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

THANKS, WhiteBeard! Boy! Color me red-faced. I forgot, failed, to mention the "hybrid" type masks, which could well be the type that Matt O tried during his titration study. Duh. A combination of nasal pillows AND mouth piece in one mask.


_________________
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 & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Thanks.  This information will help me greatly.  I'm just at the begining of all of this and I have to say that I'm a little scared, but I'm sure that's the case for most.  Thanks again for the info.
Matt O

matt_o in the beginning it can all seem a little overwhelming, after all, your dead tired and all you really want is a good nights sleep, and not to be bothered with all this other stuff! We have all been there, and we understand how you must feel. You will do alright though, we are all here  if you need  support , and if you have questions or problems we're also here to help you. Good Luck to You


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

Hi everyone,

I just had my third sleep study (second titration). Can I just tell you what an ordeal my first CPAP study was...  I woke up in the middle of the night and the pressure was cranked up.  When I opened my mouth, the air came gushing out. Trying to breathe felt like I was riding a motorcycle without a helmet! I couldn't catch my breath. The tech must have noted the sharp rise in my pulse and lowered the pressure.  The next time I woke up, the machine was in "bi-pap" mode and the impression I got was that it was cycling faster and shallower than I wanted to breathe.  That was really hard to re-sync with because after the machine switched to low pressure so I could exhale, it would return to high pressure about two seconds later. If I took a deep breath, I ended up still exhaling into the high pressure and then consequently not getting a full breath the next time.   What a long night that was!  To top it all off, they said they didn't get good enough data and I had to do it all over again!  I *never* want to be on a ventillator in a hospital!!

The second titration study was much better, but I was a nervous wreck.  The doctor had prescribed Ambien to help me sleep. I was really scared that was going to render me helpless with a machine that was not going to let me breathe normally.  I fell asleep and didn't wake up until the next morning. They said they used bi-pap and got good data.  I felt really sleepy the next day because of the Ambien (I think).

I just got a call today from the DME company. They're ordering me a bi-pap machine and my pressures will be 13 and 9.  The doctor had told me I have "moderate" apnea but didn't give me specific numbers or oxygen level data.  I know that I often awake with a headache that I can tell is from oxygen deprivation.  Hopefully that will now be a thing of the past.

The mask I tried was a Swift with nasal pillows.  I too have a beard and mustache.  The first mask they were going to try on me also had nasal pillows but fit over my whole nose. The straps tied behind my head somewhere in two places and I felt really claustrophobic and later quite terrified when I realized that the fit was so tight that I couldn't pull it away from my nose after the air flow started.  I switched to something that more resembled a snorkel and that I could easily pull away from my nostrils if I needed to take a short break.  I think I could get used to the other mask over time, but this was the first time I had experienced CPAP and it freaked me out a little.

I'm looking forward to getting my own machine.  Hopefully I'll get used to it quickly and won't have any more episodes where I feel like it's robbing me of my air.

Well, before you let them deliver your bi-level, find out which one they are ordering for you. Since you found you way here and will be educating yourself about xPAP therapy I can guarantee you you are NOT going to be satisfied w/a bi-level that is not fully data capable.

Check out the various bi-level devices available. Respironics' proprietary name for their bi-levels is Bi-PAP and Resmed's proprietary name for their bi-levels is VPAP.

The Resmed VPAP Auto and the Resmed VPAP Auto 25, also called Resmed S8 II VPAP Auto and Resmed S8 II VPAP Auto 25 are fully data capable as are the Respironics RemStar Bi-PAP Auto w/Bi-Flex and Respironics RemStar M Series Bi-PAP Auto w/Bi-Flex and the Respironics RemStar Bi-PAP Pro w/Bi-Flex. Do NOT accept ANY Respironics w/Plus in the name. NONE of the Plus models are fully data capable. All of the above are reimbursed for at the SAME RATE by insurance companies. some models do cost the DME supplier more or less than others, BUT they contract with the insurance company at the exact same reimbursement rate - so - many DME suppliers will protect their profit margin by providing a less than fully data capable device at the expense of your and your doctor's access to the data.

As far as the Swift nasal pillows mask: there is the original Swift where the hose is attached to one side or the other - not very convenient, there is the Swift II and I'm not sure of what "improvements" they made w/it, then there is the latest, the Swift LT which is the best of the three, the hose is attached in the middle (it or the II might allow for either side or the middle). Insist on the Swift LT.


_________________
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 & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

CrohnieToo wrote:

Well, before you let them deliver your bi-level, find out which one they are ordering for you. Since you found you way here and will be educating yourself about xPAP therapy I can guarantee you you are NOT going to be satisfied w/a bi-level that is not fully data capable.

Check out the various bi-level devices available. Respironics' proprietary name for their bi-levels is Bi-PAP and Resmed's proprietary name for their bi-levels is VPAP.

The Resmed VPAP Auto and the Resmed VPAP Auto 25, also called Resmed S8 II VPAP Auto and Resmed S8 II VPAP Auto 25 are fully data capable as are the Respironics RemStar Bi-PAP Auto w/Bi-Flex and Respironics RemStar M Series Bi-PAP Auto w/Bi-Flex and the Respironics RemStar Bi-PAP Pro w/Bi-Flex. Do NOT accept ANY Respironics w/Plus in the name. NONE of the Plus models are fully data capable. All of the above are reimbursed for at the SAME RATE by insurance companies. some models do cost the DME supplier more or less than others, BUT they contract with the insurance company at the exact same reimbursement rate - so - many DME suppliers will protect their profit margin by providing a less than fully data capable device at the expense of your and your doctor's access to the data.

As far as the Swift nasal pillows mask: there is the original Swift where the hose is attached to one side or the other - not very convenient, there is the Swift II and I'm not sure of what "improvements" they made w/it, then there is the latest, the Swift LT which is the best of the three, the hose is attached in the middle (it or the II might allow for either side or the middle). Insist on the Swift LT.

Thanks for this information!  I'll call the DME company today and discuss this with them.

You might also want to call your insurance company to ask what local DME CPAP suppliers they are contracted with. Hopefully, you will have the option of more than one. That gives you some bargaining/negotiating room. Iif one doesn't want to provide a fully data capable bi-level another more than likely will just to get your business. A lenient mask exchange policy is another important issue w/local DME supplier selection.


_________________
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 & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.