Here are the results from two sleep studies taken 11 years apart. It reads a little different and I believe is skewed to reflect apnea to get me on the Cpap because the snoring is so disruptive. PLMD and RLS do not go away and there is no cure. I am on the cpap machine now set at 11. What do you think in comparison of these to study's?
RESULTS OF SECOND SLEEP STUDY 05/05/2008
TECHNICAL COMMENTS:
Lots of wake scored throughout study to include a bout of out of bed for stretching legs. Moderate events scored meeting Medicares desat criteria were later in the study. Desats worse during REM and while supine. Numerous events were noted with 1-3% desats as well. No delta, spontaneous arousals, ectopy, or PLMS. Any PLMS noted were eliminated by a scored and unscorable respiratory events.
SLEEP ARCHITECTURE:
Sleep efficiency was measured at 57.7% for 466.5 minutes in bed and 269.2 minutes of sleep. It Initially took 47.8 minutes to fall asleep, which is significantly increased. There was moderate sleep fragmentation with 127 stage shifts and 18 awakenings during the night. Deep sleep was absent with reduced REM. Latency to REM sleep was prolonged.
DISTURBANCES OF SLEEP:
The patient had a total of 99 Medicare criteria respiratory events for apnea hypopnea index of 22.1 (Of these, there were 7 obstructive apneas, 1 central apnea, 0 mixed apneas, and 91 hypopneas) Snoring of moderately loud volume was reported. This occurred in all positions.
SLEEP POSITION:
The apnea hypopnea index in the supine position was 41.1; non-supine was 7.8. The patient was supine for roughly 20% of the night.
OXYGEN SATURATION ..
The mean oxygen saturation was 96%; the lowest saturation was 77.0%. Time spent below 90% was 5% of the record.
CARDIOVASCULAR EVENTS:
The ECG revealed normal sinus rhythm.
OVERALL AROUSAL SUMMARY:
The patient had 0 periodic limb movements, 99 respiratory arousals, and 0 cortical arousals.
IMPRESSION:
This recording is consistent with moderate obstructive sleep apnea syndrome supine predominant and moderate sleep fragmentation and low sleep efficiency. This patient had sufficient respiratory events to qualify for CPAP treatment, but failed to show sufficient events in the first half of the night to qualify for a CPAP trial on this study.
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Monday, June 09, 2008
RESULTS OF FIRST SLEEP STUDY DATED 06/04/97
1. Sleep latency markedly increased at 101 minutes. Some of the difficulty initiating sleep did appear to be due to Restless Leg as well as sensitivity to noise in the environment until ear plugs were used. Once asleep, REM latency was slightly increased at 183 minutes (normal 90-120)
2. When asleep, there were 79 transient arousals and 17 wakings generally due to snoring and some Periodic Limb Movements disrupting sleep. There was an 1-1/2 hour arousal at 0440 with some problems with Restless Legs and so was given Sinemet 10/100. Patient was able to return to sleep. Overall sleep efficiency was very low at 62%. There was a 15% stage I which is increased over the normal 5%, a decrease in deep sleep to 9% with normal for age expected 12% to 15%, and a decrease in REM to 9% with normal for age 15% to 18%.
3. Snoring was documented in all positions, but appeared worse supine where it caused the most arousals. No significant obstructive apnea. Apnea-Hypopnea Index a normal 2 or less, with normal 5-7 or less. All events obstructive, hypopneas more frequent than apneas, events more frequent in REM than non-REM, and on back than sides, and she did spend one-third of the night supine. Typical event lasted 21 seconds.
4. Mean sleeping saturation 96%, and she reached a low of 93 in REM and 90 in non-REM.
5. Mean sleeping heart rate 66 with a very rare premature ventricular contractions and no evidence of morning hypertension.
6. Periodic Limb Movements were noted in spite of Sinemet at 0440. She averaged 15 Periodic Limb Movements per hour, 12 of which caused arousals across the night, significantly fragmenting sleep. Restless legs were noted to interfere with sleep onset, but are not counted in the PLM index.
7. In the morning, the patent described her sleep as worse than usual estimating two hours to fall asleep which is close to the actual measured sleep time, estimated awakening three times, and sleep a total of six hours, slightly overestimating the actual measured sleep time. She indicates she sleeps like this maybe once per week.
Impression:
1. Restless Leg Syndrome interfering with sleep onset.
2. Periodic Limb Movement Disorder, mild to moderate, with 15 Periodic Limb Movements per hour, 12 of which caused arousals per hour in spite of Sinemet during the night.
3. Borderline Upper Airway Resistance Syndrome, variant of obstructive sleep apnea with snoring in all positions causing arousals, but a normal Apnea-Hypopnea Index and no significant desaturations.
