Sleep Study -- Can someone translate these results?

[neicy57 0]

Any thoughts on the findings below would be greatly appreciated. I've inserted my thoughts on the recommendations at bottom. Thanks!

Position: The patient spent most of the night in the lateral position.

sleep Latency: The patient’s sleep onset latency after lights out was 27.5 minutes. The REM sleep latency from sleep onset was 178.0 minutes.

Total Sleep Time: The total time in bed was 363.0 minutes with a total sleep time of 219.0 minutes. Sleep efficiency was 60.3 %.

Sleep Architecture: The patient had 30.0 minutes of REM for 13.7% of TST, 55.0

minutes of Stage 1 for 25.1% of TST, 103.5 minutes of Stage 2 for 47.3% of TST, and 30.5 minutes of Stage 3 for 13.9% of TST. The arousal index was 51.2 per hour of sleep.

Respiratory: The patient was observed to have had a total number of 16 respiratory events with an AHI index of 4.4 per hour during total sleep time. The REM AHI index was 0.0. The normal AHI index is less than 5 per hour. There were 0 obstructive apneas, 0 mixed apneas, 0 central apneas, 16 hypopneas, and 108 RERA’s. The total RDI (A/H + RERA’s) was 33.97. Moderate to loud snoring was noted for 91.2% of TST.

Oxygenation: The patient had an average oxygen saturation of 95%. The minimum

oxygen level was 86%.

Cardiac: The average heart rate was 65.3 beats per minute. The patient had a

normal sinus rhythm with PAC’s noted.

Other/EMG: Patient had no evidence of periodic leg movements during sleep.

Diagnosis and Impressions:

This patient has evidence of mild obstructive sleep apnea syndrome independent of sleep stage. Although her total AHI was 4.4, her respiratory disturbance index was considered moderately elevated at 33.97. This indicates significantly elevated respiratory effort related arousals which contributes to significant daytime fatigue as a result of upper airway resistance. The patient was also noted to be snoring for 92% of the total study time. In addition she had evidence of oxygen desaturation events as low as 86%. The patient remained in sinus rhythm and had evidence of frequent atrial premature contractions. She did not have evidence of periodic limb movements.

Sleep architecture was markedly abnormal with extremely poor sleep efficiency of only 60.3%. She had difficulty falling asleep with a sleep latency of 27.5 minutes, delayed REM latency of 178 minutes, and decreased total REM of 13.7% of the study night. The total arousal index of 51.2/hour indicates severe sleep fragmentation in general.

Recommendation:

1) Based on the patient's history of daytime fatigue and evidence of significant respiratory effort related arousals, persistent snoring, and oxygen desaturation events, a CPAP trial is certainly warranted. (Scheduled)

2) weight loss efforts can help reduce the severity of sleep disordered breathing events. (evaluating lap-band procedure)

3) avoidance of alcohol and sedating medication is indicated as these can worsen sleep disordered breathing events. (rarely use alcohol; never use sedatives)

4) suggest avoidance of driving while sleepy. (rarely drive while sleepy)

5) would check TSH to rule out hypothyroidism if not already performed. (this is Greek to me):confused2:

6) if there is evidence of nasopharyngeal crowding, consider surgical evaluation.(this is Greek to me):confused2:

7) suggest improvements in sleep hygiene.(this is Greek to me):confused2:

8) if the patient continues to have significant daytime fatigue despite appropriate treatment of OSA syndrome, consider referral to a sleep specialist. (not sure what sleep specialists do but will get referral from my primary care physician).

9) consider cardiac evalution. (will get referral from my primary care physician)

[Nemesis 0]

Hi there

My experience is limited being a nurse... this is what I read;

5) would check TSH to rule out hypothyroidism if not already performed. *Hypothyroidism is an under active thyroid which can sometimes cause people to become overweight and in some studies can be responsible for sleep disturbances. TSH stands for thyroid stimulating hormone, and would be checked by drawing blood.

6) if there is evidence of nasopharyngeal crowding, consider surgical evaluation. *Since you snore and snoring disrupts sleep - they are suggesting you have a doctor rule out the possibility of there being a structural defect in your nose/throat area, such as crowding. If there is evidence of such crowding, a surgical consult to correct the issue is rec.

7) suggest improvements in sleep hygiene. *Sleep habits are called "hygiene"... for example going to bed too early or too late, watching TV before bed, using drugs or alcohol to help us sleep... etc. They suggest improving your sleep habits so your sleep disturbances will diminish.

I hope this helps.

[Choromom 0]

Any thoughts on the findings below would be greatly appreciated. I've inserted my thoughts on the recommendations at bottom. Thanks!

Position: The patient spent most of the night in the lateral position.

sleep Latency: The patient’s sleep onset latency after lights out was 27.5 minutes. The REM sleep latency from sleep onset was 178.0 minutes.

Total Sleep Time:

The total time in bed was 363.0 minutes with a total sleep time of 219.0 minutes. Sleep efficiency was 60.3 %.

Sleep Architecture:

The patient had 30.0 minutes of REM for 13.7% of TST, 55.0

minutes of Stage 1 for 25.1% of TST, 103.5 minutes of Stage 2 for 47.3% of TST, and 30.5 minutes of Stage 3 for 13.9% of TST. The arousal index was 51.2 per hour of sleep.

Respiratory:

The patient was observed to have had a total number of 16 respiratory events with an AHI index of 4.4 per hour during total sleep time. The REM AHI index was 0.0. The normal AHI index is less than 5 per hour. There were 0 obstructive apneas, 0 mixed apneas, 0 central apneas, 16 hypopneas, and 108 RERA’s. The total RDI (A/H + RERA’s) was 33.97. Moderate to loud snoring was noted for 91.2% of TST.

Oxygenation:

The patient had an average oxygen saturation of 95%. The minimum

oxygen level was 86%.

Cardiac: The average heart rate was 65.3 beats per minute. The patient had a

normal sinus rhythm with PAC’s noted.

Other/EMG: Patient had no evidence of periodic leg movements during sleep.

Diagnosis and Impressions:

This patient has evidence of mild obstructive sleep apnea syndrome independent of sleep stage. Although her total AHI was 4.4, her respiratory disturbance index was considered moderately elevated at 33.97. This indicates significantly elevated respiratory effort related arousals which contributes to significant daytime fatigue as a result of upper airway resistance. The patient was also noted to be snoring for 92% of the total study time. In addition she had evidence of oxygen desaturation events as low as 86%. The patient remained in sinus rhythm and had evidence of frequent atrial premature contractions. She did not have evidence of periodic limb movements.

Sleep architecture was markedly abnormal with extremely poor sleep efficiency of only 60.3%. She had difficulty falling asleep with a sleep latency of 27.5 minutes, delayed REM latency of 178 minutes, and decreased total REM of 13.7% of the study night. The total arousal index of 51.2/hour indicates severe sleep fragmentation in general.

Recommendation:

1) Based on the patient's history of daytime fatigue and evidence of significant respiratory effort related arousals, persistent snoring, and oxygen desaturation events, a CPAP trial is certainly warranted. (Scheduled)

2) weight loss efforts can help reduce the severity of sleep disordered breathing events. (evaluating lap-band procedure)

3) avoidance of alcohol and sedating medication is indicated as these can worsen sleep disordered breathing events. (rarely use alcohol; never use sedatives)

4) suggest avoidance of driving while sleepy. (rarely drive while sleepy)

5) would check TSH to rule out hypothyroidism if not already performed. (this is Greek to me):confused2:

6) if there is evidence of nasopharyngeal crowding, consider surgical evaluation.(this is Greek to me):confused2:

7) suggest improvements in sleep hygiene.(this is Greek to me):confused2:

8) if the patient continues to have significant daytime fatigue despite appropriate treatment of OSA syndrome, consider referral to a sleep specialist. (not sure what sleep specialists do but will get referral from my primary care physician).

9) consider cardiac evalution. (will get referral from my primary care physician)

I'm certainly not a medical expert, but this says that you do have apnea, obstructive only apparently. You do not have restless leg syndrome.

TSH testing is your thyroid - sometimes if that is out of whack you don't sleep well, or get restorative sleep. Hypothyroidism would mean that your thyroid is not producing enough of whatever it is it produces.

Nasopharangeal crowding would be that your nasal and sinus passages are not big enough to allow enough air to get through, and/or the tissue at the back of your throat is obstructing breathing. Sometimes surgery is indicated to correct that.

Improvements in sleep hygiene would mean establishing a routine...doing the same thing every evening to prepare for sleep, to get your mind and body ready for rest. It would be things like the lighting, or the noise level in your bedroom, whether or not you take a long bath or a shower before bed...the kinds of things that make it easier to 'turn off' the day's demands and get ready for sleep.

The snoring can be indicative of the obstructive airway...like the commercials on TV that show the blocking of the airway. You do have episodes where you are not getting enough oxygen...saturation should stay above 90%

A sleep specialist would evaluate all of these things and recommend possible solutions: surgery, weight loss (that ALWAYS gets included, doesn't it!) using a CPAP, medication....whatever might help.

I believe that having "16 respiratory events" means that you stopped breathing that many times. The delayed REM means that you did not get deep sleep...the kind our bodies need to restore themselves. And, if the 51.2/hour means what I think it does, that indicates that you average 51 times each hour where your sleep is disrupted.

Now, remember, I am not medically trained. I just have sleep apnea and so does my husband.

[cranberry31 0]

Hi,

I am a CCU nurse and have assisted with sleep studies in the past so willl try to interprete for you

basically you snore when you sleep, when you snore your oxygen saturation drops, this is the level of oxygen in your body, they are wondering if you need to be evaluated for surgery to make sure you don't have a structural abnormality in your nose or your throat that blocks your airway when you sleep.

the quality of your sleep is poor, only 60%, which means you are basically exhausted the next day, you take too long to go to sleep, there are different stages of sleep and you don't spend enough time in the good stage, all of this is basically very common in people who are very overweight, usually if you retuen to a normal weight your sleep pattern will improve dramatically, ask them to sit down and explain it all to you in plain english, hope this helps a little.

[mickeymammoth 0]

I'm not an expert, but your AHI number was under 5 events per hour, which means you're "normal." However, since you snored and had 16 hypopneas (those are where you don't stop breathing, but you breathe shallowly), and your oxygen sat got a little low, they must think there's room for improvement.

Frankly, your numbers aren't that bad. I'm surprised they even diagnosed you with sleep apnea. I recommend you post your results on cpaptalk.com where people with more knowledge can tell if it's worth you trying CPAP or not. I have much worse sleep apnea, and my CPAP is my savior. I can actually sleep! But it's kind of a trial getting used to wearing a mask.

[singledad167 0]

There's another site that would be better for answering all you questions. When I was going through the sleep study process they helped me emmensly. There are even sleep docs that post there that can break everyting down for you, help you get the right equipment. Repost this on

Sleep Apnea Support Forum Index

Good luck and keep us posted...

[Northwest_Nance 0]

I had sleep study done a few months ago and I found this website really helpful when it came to interpreting results and answering questions about cpap and bipap machines, etc... they really helped me get through all my questions and the first few difficult weeks adjusting to my bipap machine... Sleep Apnea Support Forum Index

It's amazing once you learn all the detrimental affects to your health that come from having sleep apnea.... including a slowing of your metabolism. Some people lose 10-20 pounds without changing their diet, after getting their cpap or bipap machine, because their metabolism wakes up!

EDIT: Oops just noticed someone else already recommended the sleep apnea support forum to you.... my bad!

[globetrotter 0]

I'm not an expert, but your AHI number was under 5 events per hour, which means you're "normal." However, since you snored and had 16 hypopneas (those are where you don't stop breathing, but you breathe shallowly), and your oxygen sat got a little low, they must think there's room for improvement.

Frankly, your numbers aren't that bad. I'm surprised they even diagnosed you with sleep apnea. I recommend you post your results on cpaptalk.com where people with more knowledge can tell if it's worth you trying CPAP or not. I have much worse sleep apnea, and my CPAP is my savior. I can actually sleep! But it's kind of a trial getting used to wearing a mask.

+1

you have sleep apnea, but it isn't that bad.

[maguirre67 0]

sounds like you have sleep apnea didnt your dr tell you