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Looking For Insight About Results From Second Titration
I'd appreciate any insights you may have regarding my latest sleep study:

Thanks in advance to all who reply:

Most important parts:

13 awakenings

Sleep latency to N1-3.5 minutes (used ambien)
Sleep latency to N2-19.0 minutes
Sleep latency to N3 (SWS)-39.0 minutes
Stage R Latency from Sleep Onset: 80.5 minutes

Minutes N1-51.5
N2-223.0
N3-4.0 (almost no N3 sleep-even though I had mask on)

% of test N1-15.5% % of Sleep Period-11.5%
% of test N2-67.3% % of sleep period-50.0%
% of test N3-1.2% % of sleep period-0.9%
% of test R(Rem)-16.0% % of sleep period-11.9%

Summary Graph: (OF GREAT INTEREST TO ME)

The Central showed two lines at the beginning of my sleep period and no other centrals throughout the night. I've been having trouble falling asleep since last March, I haven't been breathing at sleep onset and have been waking up. Only Ambien has gotten me to fall asleep.

The two lines were under 30 seconds, first line of graph showed a central of around 15 seconds, second line of perhaps 20-25 seconds............I was first told that I had sleep apnea in July 07 (wasn't aware of any trouble before then) by a woman I slept with as she noted that I had been gasping, choking, not breathing at sleep onset. She was medically trained, she said i had the signs of sleep apnea.....

Obstructive showed up right at same time as centrals, there were three lines close to same period as centrals, each under 30 seconds but between 15 and 25 seconds, followed quickly by four more lines, two of which lasted just over 30 seconds and then three more lines, each under 30 seconds...............................There was only one large cluster of obstructive events, these were about two hours later (between 1 to 2 AM) followed by one solitary line between 4 and 5 AM and a three line cluster between 5 and 6 AM.........

Two Hypopneas around 11:30 PM, both of which were inbetween the Obstructive cluster of that time, then a large cluster of Hypopneas between 1 and 2 AM, these began during the latter part of the Obstructive events of that time and these Hypopneas kept going after the Obstructives ended. Then another cluster of Hypopneas between 4 and 5 AM (the single Obstructive event was in between the occurance of the Hypopneas, it started as a cluster of Hypopneas, the Hypopneas ended then I had the one Obstructive event followed by one Hypopnea event and then the chart shows two single Hyponeas between 5 and 6 AM, first Hypopnea taking place just before the single obstructive event.

Pressure originally was at 6, it went up to 8, went over 10 (to around 11) during 1-2 AM events, stayed around 13 till around 3:30 AM (was woken around that time, in fact I did stay awake at one period around then for over an hour, used ambien to get back to sleep). Pressure dipped at 3:30 AM to around 6 went back up to 12 , showed dips between back to 6 and back up to chart to 12 or 14? during period between 4:30 and 5:30 but I had been awake between 4:30 to after 5 AM.........Chart shows I went back to N2 after 5AM and that pressure stayed steady around 12 or 14 during this period (I was being titrated while on my back at that time).

No Mixed events, no Autonomic events.........Sp02% (oxygen?) was mostly just under 100 but with a few dips to under 90% until the 1-2 AM period where there was a large cluster of lines dropping to low 90's or right at 90% and a good sized number of lines falling under the 90% level. After that, lines stayed in the mid 90's but with several dips under 90 during the latter Hypopnea events between 4 and 5 AM.

21 LM Arousals
38 Respiratory Arousals
28 Spontaneous Arousals
4 RERA

Longest Obstructive Apnea-42.6 seconds
Mean-27.1 seconds
31 Obstructive-A or H/h-5.6
Longest Central-23.0
Mean-19.3
2 Central-A or H/h-0.4
Longest Hypopnea-48.9
Mean-32.2
34 Hypopneas-A or H/h-6.2

All were supine.

Normal Breath-Total 3046 Supine 1469 Non Supine 1577
Breath with flow limitation-874 Supine 681 Non Supine 193
No snore-Total 869 Supine 676 Non supine 193
Snore-Total 5 Supine 5

RMI
Events
Supine 91 Duration 40.6 minutes RMI Index 28.2
Prone 0
Left 3 Duration 0.4 minutes RMI Index 4.0
Right 6 Duration 0.7 RMI Index 3.9

CPAP Statistics (I was tested on an Xpap)
Pressure Duration TST CA OA MA Hyp AHI Desat Lowest Oxygen
4 3.4 2.0 2 1 - - 90.0 - 95.0
6 8.4 5.9 - 6 - - 61.1 1 90.0
8 136.2 99.7 - 6 - 2 4.8 1 94.0
10 15.7 10.2 - 6 - 5 64.8 4 83.0
12 17.9 14.9 - - - 5 52.3 10 86.0
14 132.2 111.9 - - - 11 5.9 5 88.0
16/12.0 50.5 32.6 - 3 - 10 23.9 3 92.0

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Welcome, BP! You'll find a lot of support and good people here. It's a little difficult to decipher all this, at least for me (maybe our doctors and other professionals will have an easier time), but i was wondering whether you can upload the summary graph so that we can all see things easier. Of course, feel free to redact your name, other info.. . I just thinkjwe have the ability to upload our charts here.
Thank you Mike,

No, I don't have a printer, I wish I could but I'm not able to post a summary graph.

Any insight to my titration would be greatly appreciated.
Because it is hard to decipher what all you have written due to its length and since no graphs are available to us I would suggest you make an appointment with your doctor and have him go over your test results with you.

If you have had your appointment and you still have questions, make a follow-up visit.

Have you been prescribed a machine? If so which one? What is your pressure setting on it?
I read the thread about DMEs and neglegent doctors that was posted on this forum, my DME and doctor especially fit...which is why I'm asking people (who probably know a lot more about apnea and titration results than DMEs or some of these doctors) for their feedback.

My next appt with my NEW doctor is in Feb and my old doctor was an even worse doctor. This new doctor never even read my titration results, just downloaded, printed, gave them to me when I saw the doctor six weeks after the titration. The new doctor had said thar he would read the results over the phone to me as soon as the results came in (because I couldn't get a follow up visit until Dec) but how quickly that promise was forgotten (or claimed to have never been made).

I have a Respironics BiPap w Auto, my pressure is now set to 18/14 because of the latest titration but I still get apneas although I think only after I fall asleep (as the titration showed) and 18/14 doesn't stop the apneas.
Summary Graph: (OF GREAT INTEREST TO ME)

The Central showed two lines at the beginning of my sleep period and no other centrals throughout the night. I've been having trouble falling asleep since last March, I haven't been breathing at sleep onset and have been waking up. Only Ambien has gotten me to fall asleep.

This is not uncommon. Many people have sleep onset central apneas. It is when our bodies are transitioning from being fully awake to fully asleep. Sleep aides may intensify sleep apnea and make it worse. I realize that there are some that need to take a sleep aid -- but good sleep hygiene, melatonin, and others should be tried and sleep aides used as a last resort.

The two lines were under 30 seconds, first line of graph showed a central of around 15 seconds, second line of perhaps 20-25 seconds............I was first told that I had sleep apnea in July 07 (wasn't aware of any trouble before then) by a woman I slept with as she noted that I had been gasping, choking, not breathing at sleep onset. She was medically trained, she said i had the signs of sleep apnea.....

Obstructive showed up right at same time as centrals, there were three lines close to same period as centrals, each under 30 seconds but between 15 and 25 seconds, followed quickly by four more lines, two of which lasted just over 30 seconds and then three more lines, each under 30 seconds...............................There was only one large cluster of obstructive events, these were about two hours later (between 1 to 2 AM) followed by one solitary line between 4 and 5 AM and a three line cluster between 5 and 6 AM.........

This section is hard to follow since we can't actually see the graph. At what interval were they? We need to be able to see the actual events and when they actually occurred in order to make informed comments.

Two Hypopneas around 11:30 PM, both of which were inbetween the Obstructive cluster of that time, then a large cluster of Hypopneas between 1 and 2 AM, these began during the latter part of the Obstructive events of that time and these Hypopneas kept going after the Obstructives ended. Then another cluster of Hypopneas between 4 and 5 AM (the single Obstructive event was in between the occurance of the Hypopneas, it started as a cluster of Hypopneas, the Hypopneas ended then I had the one Obstructive event followed by one Hypopnea event and then the chart shows two single Hyponeas between 5 and 6 AM, first Hypopnea taking place just before the single obstructive event.

Pressure originally was at 6, it went up to 8, went over 10 (to around 11) during 1-2 AM events, stayed around 13 till around 3:30 AM (was woken around that time, in fact I did stay awake at one period around then for over an hour, used ambien to get back to sleep). Pressure dipped at 3:30 AM to around 6 went back up to 12 , showed dips between back to 6 and back up to chart to 12 or 14? during period between 4:30 and 5:30 but I had been awake between 4:30 to after 5 AM.........Chart shows I went back to N2 after 5AM and that pressure stayed steady around 12 or 14 during this period (I was being titrated while on my back at that time).

No Mixed events, no Autonomic events.........Sp02% (oxygen?) was mostly just under 100 but with a few dips to under 90% until the 1-2 AM period where there was a large cluster of lines dropping to low 90's or right at 90% and a good sized number of lines falling under the 90% level. After that, lines stayed in the mid 90's but with several dips under 90 during the latter Hypopnea events between 4 and 5 AM.


I am assuming that you have a hard copy of your results and no way of putting the graphs on due to lack of a scanner. Do you have a digital camera? It might be possible to take a picture of it and upload the picture. I have done it that way in the past.
I don't have a digital camera, in fact I have an old computer and I'm technologically totally unsavvy.

I have centrals at sleep onset but the real problem is that I can't fall asleep at sleep onset, I wake up because I can't breathe and only ambien puts me to sleep. This has been going on since last April or actually the last day in March 08...I also use L tryptophan.

I'm looking at the graph again............I fell asleep at 10:30 PM, the interval for the first group of obstructive apneas (which came right after the centrals and I had used ambien) were between 10:40 and 11:00 with one line around 11:10.

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