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Wednesday, April 23, 2014
Sleep Apnea Readings
I am trying to have the readings from my polysomnograhpy test explained:
Epworth Sleepiness Score: 19 Sleep Efficiency: 80% Sleep Latency: 12 minutes REM Sleep Latency: 78 minutes Stage 1: 6% Stage 2: 79% Stage 3: 3% REM: 12% Arousal Index: 8.5 AHI: 6.1 AHI REM: 14 Oxygen Saturation: 87% Loud snoring present during study
Does this mean I have sleep apnea? I fall asleep constantly during the day while sitting at my office, while driving, watching television, etc. This has been going on for years. I am not overweight and I exercise regularly.
Interpretation and clinical correlation of the sleep study should ideally be done by a certified sleep specialist who knows the patient and their medical history. The sleep specialist can correlate the symptoms with the findings of the sleep study and recommend the plan. The data you provide are only a small portion of the overall information available in a typical sleep study. Having said that, I can offer some interpretation of the data you provide.
Your study results suggest that you may have some degree of sleep deprivation, because it did not take you long to fall asleep and go into the REM stage. The Epworth sleepiness scale indicates also that you have significant degree of sleepiness. Your breathing disturbance numbers indicate you have what is considered a mild degree of obstructive sleep apnea (an AHI between 5-15) that is predominant in REM sleep. In the presence of significant sleepiness, as in your case, it is often recommended that the patient receive treatment for sleep apnea. This may be a conservative intervention, surgery, dental appliance or CPAP. The treatment choice is dependent on a number of factors, including your upper airway examination and your treatment preference. Given that you are not overweight, you may have an anatomic abnormality that could be corrected with surgery.
It is also possible that you may have another disorder that causes sleepiness other than sleep apnea that may not have been picked up on a single night sleep study. This could include narcolepsy, a condition called idiopathic hypersomnia, or a variety of medical and mode disorders. It is sometimes as simple as sleep restriction (lack of adequate sleep on a regular basis). Many individuals do not obtain enough sleep time on a night-to-night basis, which may be 8-9 hours in some cases. The average sleep time in adults has decreased over the past decades and is resulting in sleep restriction and sleepiness in a large segment of the population.
It is critical that you consult with a sleep physician. The sleep specialist will consider all the other causes of sleepiness and most likely would recommend a trial of CPAP (the treatment of sleep apnea). If your symptoms improve with CPAP, then the sleepiness is probably due to sleep apnea. Surgery or an oral appliance may also be an option for you, depending on your airway examination. In the meantime, the interview and physical exam, along with a review of you medications, sleep history, and medical history, may uncover other causes of sleepiness. Please keep in mind that the degree of sleepiness you have is not normal but should be completely treatable by the sleep physician. In the time you are waiting to get sleep evaluation please review the sleep hygiene recommendations on our website and make sure you are getting at least 8 hours of sleep. This will help rule out sleep restriction as a cause of your sleepiness.
Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University