Why the AHI result is often wrong! Learn to read your sleep study correctly.
ฝัง
- เผยแพร่เมื่อ 19 มิ.ย. 2024
- Don't trust your AHI, understand your sleep study report and take back control of your own health condition.
Sleep studies (also known as polysomnography studies), are very sophisticated and give a huge amount of data from each night. People are often only given a single AHI number as an overall marker of their disease severity. Personally I do NOT believe that a disease as complicated as sleep apnoea and UARS (upper airway resistance syndrome), can be defined by a single number. In this video I am going to help you understand sleep study reports so you understand what is actually going on with your own condition. You will learn about AHI, and what makes it a poor choice for understanding sleep apnoea by itself.
I fully appreciate that the TH-cam algorithm will hate this video because it is so long and technical, but I really think it will help some people out there. I think it will help people who are:
1. Trying to look for an alternative to CPAP
2. Understanding why they have been told they are normal when they still feel like they have a problem
3. diagnosis of OSA and UARS
4. just for general education of their health condition
I hope you found it useful, Thank you for watching!
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Chapters
0:00 Introduction
0:08 Why I made this video
0:45 Which sleep study I use - NoxT3
1:05 What is AHI / how to calculate it
1:52 Levels of AHI - Mild / Moderate / Severe OSA
2:56 Understanding a sleep study of a normal person / simple snorer
3:15 When AHI has an uneven ratio of apnoeas and hypopnoeas
3:45 Understanding oxygen levels
4:20 Understanding sleeping positions on the sleep study
5:21 Understanding snoring levels
5:56 Positional devices - SlumberBump
6:15 Mandibular advancement devices
6:24 Mild sleep apnoea patient report
7:01 The impact of position on the AHI
7:49 Why AHI isn't that useful
8:06 Looking out for traps in oxygen levels
9:10 Positional Sleep Apnoea - which looks like a normal sleep report
10:06 RIP Phase
10:29 Pulse Variability
10:55 Watching a wife elbow a husband
11:09 A very loud snorer report
11:43 Central sleep apnoea
12:15 Sleep apnoea makes snoring quieter?!
12:51 Severe Sleep Apnoea report
13:02 Oxygen Desaturation Index ODI
13:36 Upper Airway Resistance Syndrome report
14:17 Flow limitation
14:37 Paradoxical Breathing
15:12 Conclusion
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** Disclaimer - The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. ** - วิทยาศาสตร์และเทคโนโลยี
If only all doctors explained so well.
my pleasure
The discussion at 7:20, about AHI relative to sleep position, is so overlooked at yet so critical. It is great evidence for multiple night studies. Having data from a single night is like monitoring someones driving for one day and deciding they never speed because they happened to not drive anywhere that day.
Your videos are just fantastic. I’ve learnt so much from them. I think your delivery style is excellent: concise, clear, easy to understand and enjoyable. Thank you so much for providing them free for us to benefit from them.
Wonderful video. Truly. I'm going to ask my Dr for the raw data as he was seemingly only concerned with AHI. Clearly, that is not telling the story. I found your data breakdowns very easy to understand and follow. Great job, great video.
Thank you so much for posting this. My AHI was 67, now it's under 2, thanks to my CPAP. My sleep clinic has been unable to see me and explained this, due to covid. When face to face appointment resume, I'll have some insight, when this is explained to me. So thank you again.
You are a rarity person with great sensitivity and compassion, this information is so well explain and important for the user how most of the time can’t interpret all this medical graphics, thank you so much.
Oh my God, Thank you so much for this video. It's because of videos like this and people like you that internet is the treasure trove of knowledge that it is. You have no idea how much this video has helped me. 🙏 Thank you so much.
EXCELLENT!! After diligently (emphasis ) CPAPing for 5 years - I was ready THIS video. Thanks. Peace
Thank you, Dr. Veer. I wish all sleep medicine doctors took the time to explain sleep studies to their patients as thoroughly as you do.
I really appreciate Dr.Veer’s videos. I believe his approach is comprehensive and holistic. My one criticism is background music. I really don’t understand why so many utubers use so much overbearing and distracting background music, I wish somehow this annoying and increasing trend would stop.
Love this more technical video. keep bring them on.
Great video. Was so good to be able to read my own sleep study 👍
Brilliant. This was THE BEST explanation!
I look forward to more of these technical videos on how to read the CPAP charts! THank you so much!!!!
A brilliant video as always Vik 👍
This level of information is exactly what needs to get out, because most doctors either keep this information away from us patients, or may not know everything themselves even.
Thank you so much, doctor. This is something even the specialist I went to has probably missed.
Loved the video! Great to be able to appreciate all the different parameters seen in the NOX T3 device and software program. Definitely more thorough than other HSAT devices.
I agree! not really necessary if all you want is CPAP, but kinda essential if you want to consider alternatives
Just amazingly clear and informative!!
Thank you very much for the technical insight, I hope to employ this analysis on a second sleep study soon. I had a sleep study done several years ago and relate very much to the last case you mentioned - having the symptoms of sleep apnea but being told there's no problem, and suspecting I have UARS at least.
Thank you for this video. In my new position at work I need to learn how to read a sleep study report. Thank you.
My O2 dropped to 46%. I don't know how I am not clinically brain dead after not knowing I had sleep apnea for years.
Thats tough. Hope you aRe doing better now
Holy cow, I’ve learned a lot as a health practitioner about sleep studies and have never seen someone desaturate to 46%. You’re right, you are lucky to be alive.
I just got my results and evidently I stopped breathing almost 500times and my oxygen went to 40
Me too around
40% was happening regularly for a long time for me
It got so bad for me
All my body was like in big trouble
It got to where I couldn’t sleep not even 15 minutes
I would sit up and dose without even sleeping for minutes at a time
That all the rest I would get
I think such a low value could be in error
Thank you very much for this, doctor. This is an excellent video.
Glad it was helpful!
Wow great video! So glad I am subscribed. I wish you were my sleep doctor.
Might be the most informative video on yt for real
Wow, thank you sir ! Fantastic video!
Fantastic and informative video. I hope sleep study administrators have your knowledge, but I'm affraid they may not, and perhaps mis-diagnosing the problem. I've requested my sleep study info so I can review it. thanks again.
Thank you so much
I am technician of sleep study from India🇮🇳
My first sleep study oxygen reading was 77%. Alarming! But I only had 9 events per hour. That was about 3 years ago. I was first given CPAP, then about 18 months later, BIPAP. Last year, I stopped using my machine for months. After that, a new sleep study by a new doctor: 15 events per hour, 95% oxygen. He put me back on CPAP. I honestly don’t notice a difference sleeping with the machine or without it. I am 68 years old and 20 pounds overweight, working on weight reduction. Last year, I lost 30+ pounds. Thank you for these great videos. Best wishes from Michigan, USA. Side note: I was sleeping in great pain for a couple of years due to osteoarthritis in both hips. I never got a good night’s sleep. I had my hips replaced last year and that has made a tremendous amount of difference in the quality of my sleep.
I had almost 500 episodes (over 100 a hr) and 40% oxygen. Made me sooooo scared for myself.. I'm only 26
Now you use cpap or not?
During my two sleep apnea studies I couldn't lie in bed as I normally would. I slept almost entirely on my back because I was tied down with massive numbers of data cables. I felt like Gulliver on the beach. Normally I sleep more on my sides because I find it easier to breath that way. The AHI of 80+ was certainly skewed because I was tied down onto my back.
Did you retake the sleep study?
That really sucks. Have you thought about checking out other places? Maybe you could talk to your Dr. about it. The hospital I went to let me sleep in the recliner in the room. I told them that’s how I sleep at home because I can’t lie on my back & sleep I feel like I’m suffocating. Found out I gotta have a bi pap with oxygen.
I had the same thing , old bed with broken springs I couldn't move position... my studies at home were better done. It's never fun in a lab anyway.
Very informative video. Thanks. I was just diagnosed with sleep apnea. I got the results of my sleep result today. Apparently I'm almost triple severe! My AHI was 85 with an average oxygen level of 85 as well. They just put in an order for my CPAP SO waiting for the call.
I was told my AHI was 85.2 and I had no idea what that meant. The first doctor I had when I asked for the info said I would not understand it anyway so he refused. My 2nd doctor at least is more into communication and working as a team with the patient. I am in Canada. Watching this video makes me want to learn how to read my chart as I really am as bad as the lady at the sleep clinic said I was wow!!!
I now understand my sleep study better thank you - I was going to give up on the cpap it’s been a frustrating journey however now appreciating how serious my Q2 dropping to 60% during my rem sleep I’m going to persevere in finding a mask I can wear all night
You have no idea how happy this comment made me. Thank you!
Incidentally REM OSA is often related to the tongue falling back. Try wearing a woodyknows backpack (see video on positional sleep apnoea), with a chin strap (see the Knightsbridge dual strap video on it), and a Philips dreamwear nasal cushions (it'll normally fit on any CPAP machine). Use all that and see if your O2 still drops after 3 weeks (takes time for you to get comfortable and to notice the benefit).
REM OSA also causes a lot of brain fog and that takes time to clear too.
With time you should be able to stop using the backpack and the chin strap (6 weeks or so?).
If you are still struggling consider a MAD with all of that and then see if you still have drops occurring. If not wait the 3 weeks for you to pay back your sleep debt and start removing things until you are just on the mask.
Sorry I can't explain it all to you, but ask your sleep lab and they will explain why it'll work and what order to stop using everything. They will be able to see from the sleep data to guide you.
Good luck.
@@VikVeerENTSurgeon you are a gift to all of us - thank you for your detailed response and recommendations- I have not been very happy with my sleep lab the after care has not been great so I saw a different sleep technician who was recommended to me by a friend - she explained my sleep report in detail - also adjusted the pressure level on my cpap machine from 4-6 to 5-9, changed the humidity level and provided me with a different hose that provides warm air and a Resmed nasal cushion mask. I told her I was a mouth breather she explained we often breathe through the mouth because we’re snoring - i trialled the nasal cushion last night without the chin strap I lasted 6 hours and I had 1.4 events per hour, which I think is pretty good as my AHI in the sleep study was 24 I typically sleep on my left side but appreciate I change positions throughout the night- i so wish I could have a consultation with you here in Sydney Australia :)
Learning so much have been using a APAP for over 20 years
Thank you very much for explaining all this.
Your channel is a treasure!
You are so kind
Very useful video. Thank you!
100%... I no longer use the resmed app or engage a sleep tech. I use sleep HQ to review my sleep data from my Airsense 10. I used an o2 ring to check my oxygen which was normal during sleep. I ended up needing a travel pillow because my jaw falls backwards when I sleep and now with APAP and the pillow my AHI is on average less than 1 and that's on my back. The reason I mention this is because my sleep study report had a lot of glaring omissions like 0 supine sleep data which I really needed in order to properly figure out the right treatment for me so it's definitely worth educating yourself and take ownership of your own therapy.
So informative. Thanks Vik.
Glad you enjoyed it!
So fascinating. I just looked at my trst results and realized I only had hypopnoeas, especially on my back. Im a week into CPAP and I am starting to feel better despite struggling to get used to the equipment.
This is gold
A young man close to me has recently got CPAP machine and has AHI at 105 per hour, which seems alarming when 30 is severe, and none of your examples were anywhere near this high. I'm pretty worried! His mean SPO2 = 92%, CT 90 =14% (don't know what that is?). I will suggest he obtains a full report of the sleep study, which was done at home over just one night a few months back. Thank you for this information and much more on your other videos. Very much appreciated
My AHI was 102, CPAP is working great for me :) Mean SPo2 is his average blood oxygen level. CT90 is the overall amount of time he spent under 90%. My figures were worse than this.
Super helpful. Thank you
I've got a sleep study tomorrow. I hope I get help after the study and not left to cope alone with my sleep problems.
Brilliant Video Dr Veer thank you
Hi Dr. Veer - I'm wondering if you have an opinion about the various Home Sleep Test devices currently available. It seems like there is a trend toward smaller / disposable devices (like WatchPat and NightOwl) which rely more on complex tech / algorithms to "estimate" apnea events and sleep architecture. Do you think the Nox T3 (now T3s) is a better device to collect the kind of data necessary to diagnose UARS, for example?
I have 2 sleep reports with NoxT3s - one before and one after throat surgery.. What are the chances you can view these and comment.. My snoring went down but AHI increased after surgery.... love your videos btw - so good to have someone explain these things!
Very good explanation 👍 I wonder why the doctor that analyzed the data, did not mention that I have almost zero obstructive apneas (1.2/h) when I am on non-supine positions 🤔
This is why I try to sleep on my stomach....of course that produces other stuff (back problems)!
Hi Dr, thanks again for a very helpful vid. So one assumes the NoxT3 software only works with the initial test results and not with the Resmed Airsense 11 software? Im using Oscar to read this software and under Flow rate it often has multiple clear airways.....can I ask what is clear airways?
you are a star. Oh just found another one of your Vid and am I talking about UARS?
Excellent
THANK YOU!!!!!!!
Very good video
Thank you for these insights. Could you share some information on how these polygraphs technically work? Reason of asking is that the sot polygraph records 6h of sleep while im almost certain i slept significantly less. How does the device register i am sleeping and how accurate is this?
I have extreme sleep apnea but before i got tested i had recorded my snoring, The recordings show clearly the apneas where I do not breath for a bit then load snoring when I do, but when it gives an overall rating for the snoring it says it is not very loud, and that is because it basically averages the whole night, and if I spend 50% of the night not breathing(yes it was that severe) then that 50 of the night I am not making any noise.
My sleep study says in the non supine position, I have an AHI of 16.4 but only in that position 14.3 percent of the time. In the supine position, I have an AHI of 7.0 for 83.1 percent of the time. I think I sleep on my side more because I was conscious of the sleep study gear that I was wearing making me sleep on my back more. My question what device would help in this situation? Would an oral appliance such as Mandibular advancement device or a tongue holding device help? I cant seem to tolerate a CPAP machine. Thank you
wondering about this: I have a heart rate / 02 monitor on my watch. It sometimes shows a steep drop - sometimes down to 70 but then right back up to normal a couple minutes later. Would this be more of a central rather than obstructive? Also separate of that - I sometimes wake up because while I can breathe in through my nose, I can not breathe out through nose and have to exhale through mouth. This is only occasional but worrisome.
I have tried two at home sleep studies and I couldn’t sleep either time, I tried for a week straight with both and my dr said there almost no data on my sleep and would have to do it again. Not sure what to do but try and get a referral for an ent and hope they have some answers, I am so completely wiped out almost every day!
Doing gods work
Dr. how do we know which test is accurate for sleep apnea if each night can give you a different results ? How do I know if my fatigue is cause by sleep apnea or long covid or something else?
Dr.Vik ,I need your help. Please kindly assessed my situation.
Great video! My sleep studies have no RIP Phase or Flow Limitations data :(. My severe sleep apnea seemed 'fixed' after some surgeries because the AHI was around 5. But the RDI was around 15 and oxygen levels dropped to less than 88% for about 32 mins. I still feel very tired and this has a toll on my mental health but some doctors just dismiss it seeing the AHI alone. Would you say that the RDI and oxygen levels I mentioned explain what I feel? If only my sleep study had RIP Phase and Flow limitation data!
It sounds very plausible. Do speak to someone who will look at it properly for you. - have a look at this video which I think might help you. - th-cam.com/video/sa9zNYpTWlM/w-d-xo.html
Thank you very much for the video. Would it be possible for you to do one focused solemnly on Central Sleep Apnea with the analysis of the sleep study? It would be important to also learn about the different types of apneas, beyond the obstructive.
I'd appreciate a central sleep apnea video as well.
I wonder if he could do that since he’s a surgeon. Centrally mediated sleep apnoea probably has no surgical solutions or treatments
Typically what is the difference between central and obstructive?
Thanks!
that was ever so kind of you. many thanks.
I just wanna thank you, for all information. God bless you.
You are so welcome
Thanks
Great video! Can someone tell me why my Alice One at home sleep study device results were mild apnea and mild snoring in the "upright " position when In realty I was in bed lying flat on my back sleeping. My dentist disregarded the upright position and told me I need to sleep with an oral appliance forever that he sells for $4000. Do you think I should get a second position?
Mr Veer . I have mild positional sleep apnoea. Can you please review electronic positional device .Thanks
Which sleep study is this taken from. I used a watchpat one. What’s your opinion on one of these ?
Hi Dr Vik, I have a deviated septum and severely blocked nose most of the time leading me to mouth breathe as I physically cannot through my nose, can this contribute the sleep apnea?
Sort of... Nasal obstruction makes sleep apnoea harder to treat, but doesn't cause sleep apnoea on its own. Sorry for being vague - it's actually quite complicated.
So my oximeter only recorded my spo2 which minimum was at 79% and at an average of 83% and my bpm which was like of all over the place it got at low as 53 and as high as 147 and I have no idea what any of it means. Any thoughts?
Where was this guy when my doctor was insisting that I needed a CPAP and couldn't understand why it was making my sleep worse.
So how can one get a graph like this? I can't go for sleep study to the hospital all the time. They gave me a study kit for home use for one night and i got a cpap machine. But is there another device which can give me more details of my sleep?
This is fantastic, thanks! Unfortunately, my sleep study was less detailed than the examples you looked at. It didn't break out apneas versus hypopneas, for example, and didn't show what body positions were associated with which apneas/hypopneas. Maybe this is because I did the sleep study at home with WatchPAT?
Daniel Jackson, they all show this, they might not have shown you the data, ask your dr for the full report.
Oh sorry now I see you said watchpat. Watchpat got approved on a wink and a nod. Do it again with a good lab. I high cpap reviw channel covered how they were approved and why it shouldn't have been
I can't tell you how valuable this video was for me - thank you so much! I've been suffering from feeling like I haven't slept for years. After watching your video, I asked for my sleep study after they only gave me a single number AHI of 13.6. They then sent some summary information but did not include the graphs. I have interpreted the information based on the guidance you gave. Could you please tell me if I'm on the right track. The data they provided was TST=4h 42min, AHI=13.6, 2 obstructive apneas, 3 central apneas, 8 mixed apneas, 8 RERA events, 51 hypopneas, minimum O2 88%, less than 90% for 28min, mean O2 95.9%, 30% TST in supine position AHI=29.1, 70% TST non-supine AHI=7, RDI=15.3. I believe it indicates that I should stop sleeping on my back, and that should substantially help my sleep apnea. The study also indicated mild to moderate snoring but I don't have the graphs to correlate with sleeping position - I will be asking for the graphs. Am I on the right track? A slumber bumper will probably help me correct? What should I make of the 8 RERA and 15.3 RDI? Not sure what they mean. I've also started your exercises. Thanks again for this amazing video!
BTW, the only thing the sleep doctor told me was my AHI was 13.6 and I could probably benefit from CPAP. I tried and could not tolerate it because my nose is always congested. I wish she would have gone through my study as you took us through the samples. Would have saved me a lot of aggravation!!
Really hard for me to give you advice based on this, but my guess is that you have OSA when sleeping on your back, and then UARS (see video on this), when sleeping on your side. I would say that sleeping on your side (slumberbump is a good product - but i'm yet to review it), is a good idea. Also think about a Mandibular Advancement Device (trying to do that video too). Sorry I can't be any less vague. I hope it helps anyway.
Thank you Dr. Veer. Could I ask what part of the data makes you guess that UARS could also be involved?
It's OK, I got the answer by watching your UARS video. I see that it's tied to RERA. Thanks again!
Possible to do a video on interpreting a RBD report?
Are these O2 levels averages? So for example you would be worried if O2 dropped below 88% on the report. Does this mean dropping below 88% at any point in tome? Or the average dropping below 88%?
I have more ahi events in the non supine position than the supine. Is this unusual?
Thank you so much for this video! I was diagnosed with mild REM related OSA and mild positional apnea. Oxygen dropped to 85% at one point, and pulse rose to 120 bpm but in both of those instances the report says “excluded periods” for respiratory periods. So I don’t know what to make of them. Total AHI is 5 and total RDI is 28. It was a home study so I don’t have some of the other useful data. Could this point to UARS if I’m experiencing gasping events regularly on my back and yet numbers seem too low for OSA? Would a mandibular device be a good start? They want me on a cpap but I am unsure.
it is pointing to UARS - but that report sounds like it came from a WatchPat device? Might be worth doing a more complete study like on a NoxT3. I think a Mandibular Advancement Device would be a great idea.
I have mild sleep apnea. Pretty much a zombie with pseudo arthritis when left untreated so the term mild is pretty bullshit to me but that's another story. Anyway, mandibular works well for mild. I just graduated engineering and couldn't have done it without my mandibular. The cpap didn't give me the same energy boost the mandibular did.
Hi Mr Veer,
Just a quick question to pick your brain if I may! What would you say that constitutes 'normal' or non sleep apnea metrics on a sleep study? Is it a certain AHI, say 5, in the most vulnerable sleep position for OSA, or stability of oxygenation etc Many thanks if you can assist.
Matt b, 5 and under is considered normal for ahi but watch lanky lefty's videos, he says you shouldn't go by the ahi number. (Mine was 5.9 with a mandibular device they told me it was minimal but I was having spo2 at 82-85% for 2 hrs a night - def not ok).
Thanks very much for posting this doctor. I had a sleep study performed a few months back on the N.H.S, but have still not heard anything because of some sort of backlog. I might try asking them to send me the results in the meantime. Are the results something that would be produced immediately? And so am I just waiting for interpretation? Thanks.
No, it needs to be validated, sorry.
@@VikVeerENTSurgeon Thanks for reply Doctor 👍
I just purchased a Sleep O2 ring which measures sleeping O2 and heart rate from Sleep HQ which I can upload with my Cpap data. It aligns with the data. It's not cheap - requires premium membership- but I'm fed up trying to get data/analysis from the doctor. Cannot get my Fitbit which measures these to connect to the Fitbit app- very frustrating. Hoping I can plan better management. I think sleep medicine is easy money for many docs. The techs don't even tell you the data can be obtained from your machine when asked.
hi doc, can I send you my sleep study results and you take a look at them? I'd like to have your opinion and could pay for the consultation. Let me know
Pretty hard to roll on side when all wired up!
Dr. Veer, can you get RERA's in a sleep study from a chronically blocked nose?
Errrr.... I guess. It depends on the equipment and how blocked you are. It isn't meant to pick this up, but it can confuse the readings if you have a blocked nose. vague answer I know, but it's quite complicated. Sorry!
I have a lot of hypopneas myself. That's how my AHI got so high. And also, I can't sleep on my back cause of hypopneas and RERA. 😅😅
They told me I was in normal range with 3.8 stop breathing each hour and oxygen levels at 86 I didn't get my report just what they told me on the phone I was normal still have insomnia and sleeplessness and headaches what can I do to get them to look at my results better I know something is going on. Thank you please let me know if I should do another one thank you
Hey man if you see this it would mean the world… Do you think it would be possible for someone to be mis diagnosed with Narcolepsy type 2 but instead have UARS? I had a sleep study done that was normal with apnea’s but never truly aligned myself with the symptoms of narcolepsy. God bless
I guess it's possible, but it would be odd for a sleep doctor to get them mixed up. get someone to video you whilst sleeping - if you are breathing really heavily, it might be worth looking into it again.
@@VikVeerENTSurgeon tysm man, during my sleep study they recorded me but my father slept in the same room because I was a minor at the time. He snores pretty loudly so Idk how they would of noticed my noises over his.. Appreciate it so much. Thinking of doing another one now that i’m older to be sure.
@@VikVeerENTSurgeon even if Rdi and Ahi was normal?
I had an apnea while lying down awake is that even possible?
Hi doc! Thanx for this video. If paradoxical breathing is at 85, 8%, flow limitation at 27%, and snore at 37%, but AHI normal (1.3), what would that indicate? UARS?
hahaha, very hard to tell from just that, but yes it does point to UARS. there is definitely something going on with all that paradoxical breathing. get someone to look at it closely for you
@@VikVeerENTSurgeon thank you! I am super confuesd, and is just trying to learn as much as possible. Your video really helped. The sleep technician has marked the study "normal respiration", and they can't help due to norml AHI. Did recommend med to seek private help though, so that's next on the list. Again, thank you
Thank you for another excellent video! I have a question about my sleep apnea that my dr never explained to me. I have observed from my sleep oximeter without wearing CPAP that my oxygen dropped to 84% and stayed at that low level for 45 minutes out of about 3 hours. I also have the normal sleep apnea where the oxygen comes back quickly after a short moments of not breathing. Even with wearing CPAP I observed on the sleep oximeter that I can have and stay at low level oxygen about 90-91% for close to an hour. I asked my sleep dr and the heart dr ( I got PAH from sleep apnea) they both didn’t explain to me as why I sleep and stay at low oxygen level. Do you think this could be a combination or obstructive sleep apnea and central sleep apnea? Thank you 🙏
CC, my ENT sent me to a pulmonologist before he did anything else and that dr sent for a lung test to make sure it wasn't unrelated (I have hours at 82-85% spo2). Thankfully my lungs were fine and then they started the sleep apnea treatment. Go see a pulmonologist. If your lungs are fine then your cpap treatment is probably not effective. Did you export your data to Oscar?
I was never shown a report, just told I has severe aponea 42 times an hour and told in 3 months id get a cpap. Not much faith in the NHS
I dont see how under 5 AHI is good. Mine is usually 1-2 AHI on an APAP 2nd week in and I only feel more tired in another way.
Is flow limitation the same as the Desaturation Index ?
No, very different
Hi Vik, is it possible to have UARS and OSA together?
It's the most common thing I see. also a lot of people have OSA on their backs and UARS on their side.
@@VikVeerENTSurgeon why is UARS common on side?
I requested my full report with data and they said it is not available to be given out. hmmmmm
Hi Dr. Veer, for apnea/hypopnea, do u know why they decided on the number 10 seconds as the magical number? For ex, what if a patient had events that were like 7-9 seconds, wouldn't they still be significant? However, they would not be counted because the event was not over 10 seconds....
you are right, it's a bit rubbish. most of us just look for arousals and dips in oxygen / effort in breathing. we don't count the seconds. that's why you need a good sleep study equipment. otherwise you are likely to get an unrepresentative result.
@@VikVeerENTSurgeon Ahh i see, makes sense. Thanks for your reply.
@@VikVeerENTSurgeon Also, a general question for you if u don't mind. Do sleep doctors account for the fact that patient's don't sleep well or like they normally do at home for in-lab studies? Like the first night effect, i feel sleep inlabs is not as "bad" as it would be for patients at home due to sort of being more alert in a new environment.
The reason i am asking is because I know for my in-lab, i feel my sleep was not representative of my sleep at home at all. I had such a hard time falling asleep, possibly due to new environment/setting/wires/ being nervous/anxious or something. And then i also woke up in the middle and again had trouble sleeping. This is never the case for me. I'm usually out cold around 11-12 and up at 7-8 AM. And sleep the whole way thru. I actually feel like i barely slept for my inlab study. I recall being awake/alert for a large part of the study, which became increasingly frustrating mentally as i knew this was very important for me diagnostically.
I feel my in lab study resulted in data that was falsely lower than it would have been had i slept like I normally do. I also had less reduced REM sleep (most of my events were in REM sleep), also making me think had I had more REM sleep my AHI would have been higher. I had an AHI of 6.5 but my sleep doc says i'm fine and don't need tx, despite complaints of classical symptoms such as morning headaches, brain fog/cognitive issues, poor unrefreshing sleep.
I also saw your video on UARS. I'm just a person trying to get proper good quality sleep. And not have horrible morning headaches. I'm assuming due to my results, they feel i'm on the lower side and don't really need a cpap machine. I feel it doesn't hurt to try, perhaps it would resolve my symptoms. Maybe there are better ways to navigate this, but as a patient and layman, it's hard to know what to do. Any thoughts would be appreciated. thanks again.
If you are worried about a sleep disorder then an in hospital PSG is required. if you are just worried about a breathing disorder (like OSA or UARS etc), then a home study I think is superior. you can do everything at home except have the video on you but we aren't interested in epilepsy or sleep walking etc. I would have a PSG at home.
@@VikVeerENTSurgeon ahh i see. Thank you for response. Also, if you don't mind, what's your thoughts on cpap treatment for mild sleep apnea or UARS. I read varying things, some sources state benefit isn't so great unless one has closer to moderate or severe apnea. For me, the biggest thing is the horrible morning headaches, cognitive issues, and somewhat feeling drowsy. I think its mostly a breathing issue but I feel i'm on the milder side or a case of UARS. Wondering if cpap can still provide benefit.
I wonder if I could email you the results of 3 sleep studies of mine
I have an AHI of 83. After several sleep studies and seeing multiple doctors my sleep apnea symptoms are not going away. Still wake up feeling tired. Also throughout night my pulse rate remains high and often jumps to 100-115 bpm. I don't know who to consult with for my sleep apnea. Any advice?
I would see a sleep centre and get checked out by a team. This is not a disease that one person can fix.
What is unclassified tachycardia?
Everyone who sleeps on their back during a sleep study will have apnea. The test is designed for supine sleeping, isn't it? And the study can tell how long you are sleeping and in what position?
I didn't know anyone is actually allowed to sit up. I was almost strapped to the bed in such a way as to not be able to move from a supine position. My report said to sleep on my back less. I don't sleep on my back nor did I sleep as long as they said. I literally slept about 2 hours if that long. It was 3 or 3:30 am when I finally slept and they woke me up about 4:30 or 5. Never got to see the report, didn't talk to the doctor before or after. Someone even marked out the doctor's remarks about me having minimal snoring. And what gets me is there is always a magic rabbit pulled out of the hat when someone does not have apnea bad enough to use Cpap. Oh, yeah, a number somewhere on that report can be used to justify it. AHI, ODI, etc. "Oh, your oxygen dipped for ten minutes during 7 hours of sleep. You need a CPAP stat."
Do y'all have no conscience? Being a sleep doctor must be very lucrative. How many doctors do you compete with? How many hours does someone have to actually sleep for the study to be correctly interpreted? How about that? I was told the amount of time I slept was enough. Two hours of fitful sleeping is enough to diagnose someone? When they are waking up because they don't want to sleep? Because they don't want to sleep in a strange place with electrodes taped to them and lights on?
Are y'all serious?
just for the record, we conduct over 95% of our sleep studies at home, and so people are in their own beds. We provide all the care for free on the NHS, and we ask people to sleep in any position they want.
If that was your experience, you ought to go somewhere else. My job on the NHS is to help people come off CPAP, not get on it.
sounds like you had a terrible time, I don't want you to name and shame the place. just find somewhere different. Good luck, and I hope you get your thing sorted.
@@VikVeerENTSurgeon Not all allow home studies. I was told my case is too complicated
@@VikVeerENTSurgeon I live in Arkansas. Not too many in rural areas and they all want you to go to same sleep doctor. I had to insist on another full study because they just wanted to do the titration again. Yes, it seems like a racket around here. I know what my problem is and getting a doctor to at least check it has been a problem. Doctors here dont like to be questioned especially if they dont know whats going on with a patient.
Brain waves don't lie. They know exactly how long you were asleep & awake. Sleep misconception is very common & people often think they slept a lot less than they actually did. And enough with the sleep field being a racket. People can die from apnea.
@@litwriter1468 can't you go to a private doctor?