I do not understand my sleep study results. I was on cpap for a year and a half and I had gotten sooo sleepy during the day and the memory loss was driving my family and friends crazy. I had another sleep study done. The doctor called in a presription for a bipap machine even before I saw him for my results. The doctor told me that I have severe sleep apnea, and that he is surprised I am walking around! He stated that I had stopped breathing numerous times amounting from 10-45 seconds. He did explain the results...But I was so exhausted and zoning out and I did not ask him to explain the report all over again. I did however ask for a copy and thought that I would read it at home, no problem...But there was a problem. I don't understand what I am reading! Medical jargon? Please tell me what this all means and what the numbers mean compared to normal results.
Polysomnography report: during the initial half of the study the patient had a sleep efficiency of 87%. 11% of the total sleep time was spent in stage I sleep, and 77% stage ii sleep. The paitient has 214 obstructive events with 3 obstructive apnes, 1 mixed apnea, 1 central apnea, 209 hypopneas, for an index of 116.
Nadir sa02 with a respiratory event was 75%, seen during stage I sleep. Soft to loud snoring was noted. The ekg and the eeg channel from the polysomnogram were normal.
There were 357 periodic limb movements of sleep which caused 20 arrousals, resulting an index of 10. There were 23 unexplained arousals with total arousals of 216, and index of total arousals of 117. Alpha intrusion was not seen.
Cpap tritation study: the patient's awake sa02 on room air was 96%. Titration was begun at a continuous pressure of 12cm, and increased through 14, 16 cm, then switched to bilevel pressures of 18/16, 20/16, 22/16, and 24/18. At a pressure of 18/16, recorded for 38 minutes with 32 minutes spent in rem sleep, 6 minutes spent in non rem sleep, the patient had 3 hypopneas, resulting in an rdi of 5. Nadir sa02 at this setting of cpap was 92%. The patient also did well at a pressure of 20/16, which was recorded for 55 minutes with 6 minutes spent in rem sleep, and the patient had an rdi of 6.
Diagnosis: obstructive sleep apnea syndrome.
Summary and conclusions: this study demonstrated effective treatment of the patient's severe sleep apnea with bilevel pressures of 18/16 . The patient is to be fitted with a medium sized nasal mask with in-line humidification and ramp is to be set at 10 minutes.
The technician came to my home to demonstrate the bipap machine, which was exactly like the former cpap that I had. He said the ramp was set to 10, and the settings were 18/16.
So, what does the abrieviations mean? (sa02, rdi)?
214 obstructive events, as well as mixed apnea, central apnea, and 209 hypopneas? What does this translate to?
What are all the listed index numbers mean?
How do all these numbers compare to an acceptable report?
What contents of the report make me fall into a diagnosis of "severe" and
"obstructive sleep apnea syndrome."?
Why is this condition labeled a syndrome?
I would like help understanding the report, which was copied verbatim onto this post.
Thank you in advance! I cannot wait until there are answers/replies to read! Also, I got worse and needed the bipap machine. As I age does this condition worsen? (i am 41)
my parents are very concerned. I told them I will try to get information from the net. I think not knowing/understanding what the report means, people tend to think the worse of any given situation.
This might be late, but it may help someone in the future....
Sleep efficency is the amount of time spent in bed divided by the amount of time you are asleep. The sleep stages are as follows: stage one is twilight sleep, a light stage between full sleep and wakefulness; stage two sleep is a medium level, and should make up over half of your night's sleep; stages three and four are combined into 'slow wave sleep' and is your deep, restorative sleep. REM is dream sleep, and should make up about 20-25% of your sleep.
Apnea is divided into three categories: obstructive sleep apnea is when your airway actually closes and you have to make an effort to breath; central sleep apnea is where your body simply doesn't attempt to draw in air; mixed apnea is a combination of these two. All of these usually result in an arrousal, which is where you come out of stage two, three, or four sleep and into stage one sleep. Awakening is different from arrousal, and is where you are no longer in any stage of sleep, even if you don't remember it. Hypopnea is a partial decrease in airflow, like apnea, but doesn't involve the complete cessation of air. These can also be disruptive to your sleep and are sometimes measured by O2 stats. The index is the number of events divided by your total sleep, and indicates how severe your apnea is; which seems to be severe.
Lets see... you snore, but your heart rate and brain waves were normal (EKG and EEG, respectively). You also twitched or moved your limbs, arms or legs, which disturbed your sleep 20 times; but the index here is low because you moved your limbs hundreds of times but it interfered with your sleep only a few times. Other arousals are normal, as this happens to most people for no apparent reason and your number is fairly low.
As for the CPAP and BiPAP: continuous positive air pressure (CPAP) is where the mask blows air one-way into your nose/mouth. The numbers indicate the pressure that was blowing into your airway. The BiPAP is almost the same thing, except the air is blown into and sucked out of your airway, mimicing the process of breathing. The higher number indicates that more air was blown into your airway with a lesser force of air going the other direction.
SaO2 is your oxygen saturation (saturation of oxygen), while the rdi is respiratory disturbance index (RDI) refers to the total number of apneas and hypopneas divided by the total sleep. 214 obstructive events is the number of times you actually stopped breathing because your airway was closed and/or you simply stopped breathing on your own. 209 hypopneas refers to the numbere of times your breathing was decreased, but not completely stopped.
According to wikipedia, "In medicine and psychology, the term syndrome refers to the association of several clinically recognizable features, signs (observed by a physician), symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others." Thus, apnea has several features visible on a polysomnograph and symptoms that you experience.
I really hope this answers all your questions. I gathered this information from a combination of research sources because I, too, have just undergone a CPAP triation sleep study; and I also have obstructive sleep apnea (although mine is less severe than yours). I am categorized as having moderate OSA because I have fewer apnea/hypopnea events than you - although I don't know the cut-off scores for each category.
Thanks for the info... I am a newbie to all of this and the information that you gave was very helpful and answered many of my questions, as well. I am due to follow-up with my sleep doctor next week, but your comments helped me to clarify some questions to ask. THANK YOU!
For people who have severe apnea I wonder what the average severe is. Mine was a diagnosis of 327.23 obstructive sleep anpean events that night (times I stopped breathing) Avg. 78 times per hour. I was in near awake states 92 times per hour. Wonder how bad MOST people have it?
After memory problems, fogginess in the morning and a worsening of my mood disorder, I was diagnosed with sleep apnea in August of this year.I am following up with my sleep doctor, but just wanted you all to know that the information given in these blogs was helpful! Good luck to all!