Hi,

Below are the results of my sleep study. My follow-up appt. is schedule for two months out.  She is the only "Sleep Specialist" physician who is board certified in my area; hence the long wait to see her.  Any feedback would be greatly appreciated.  I never feel rested, irregardless of the length of time I spend sleeping.


Time in bed:  378
Slept for     : 315
Sleep latency was prolonged at 46 minutes
REM latency was prolonged at 123 minutes

Stage 1 sleep:  5%
Stage 2 sleep: 71% (noted as increased)
Stage 3 and 4 sleep:  2% (noted as a reduction)
REM sleep     : 23%

6 apnea/hypoapnea events per hour
mean O2 Sat 97%  lowest 90%
84 periodic leg movements, 15 per hour, 8 associated with arousal.

Thanks in advance!
Sinus bradycardia was noted

Stage 2 sleep is really the first stage of real sleep. Stage 1 is just that dozing in and out. But Stage 2 sleep is a light sleep and we are easily aroused from Stage 2. Stages 3 & 4 are also called Delta or slow wave sleep and is the restful, restorative sleep. REM sleep is rapid eye movement sleep which is when our muscles are pretty much paralyzed so that we can't act out our dreams, it is when most of our dreams occur and is when our brain sorts thru and files our memories of the day.

Even tho only 8 leg movements caused arousal that was still almost 2 arousals per hour of sleep and the apneas/hypopneas averaged 1 every 10 minutes all night. Still wonder why you are so tired?

It would appear you have mild sleep apnea. An AHI of 5-15 is considered mild OSA, 15-30 moderate OSA and over 30 severe OSA.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

How significant is the apparent low amount of stages 3 & 4 sleep I am getting?

I am wondering if that is the biggest culprit due to the amount of apneas and leg movements being fairly low.

Thank you again.

Quite likely could be. Like I say they are the stages of restful, restorative sleep.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

I am new to this, but from what my (son's) dr said, my interpretation of your study would be that your fatigue is probably caused by the lack of enough stage 3 & 4 but that is probably caused by the apnea and the arousals and the arousals are probably caused by the periodic leg movements.  Perhaps a med could help with the leg movements (like for restless leg syndrome), and cpap for the apnea and then maybe you could get some deep, restorative sleep!?

I had to wait 3 months after the study to talk w/the dr.  It's frustrating I know, but i became familiar w/the issues on this forum and then was better able to understand and converse w/the dr....so while you wait--read up!

slpy4ever wrote:

Hi,

Below are the results of my sleep study. My follow-up appt. is schedule for two months out.  She is the only "Sleep Specialist" physician who is board certified in my area; hence the long wait to see her.  Any feedback would be greatly appreciated.  I never feel rested, irregardless of the length of time I spend sleeping.


Time in bed:  378
Slept for     : 315
Sleep latency was prolonged at 46 minutes
REM latency was prolonged at 123 minutes

Stage 1 sleep:  5%
Stage 2 sleep: 71% (noted as increased)
Stage 3 and 4 sleep:  2% (noted as a reduction)
REM sleep     : 23%

6 apnea/hypoapnea events per hour
mean O2 Sat 97%  lowest 90%
84 periodic leg movements, 15 per hour, 8 associated with arousal.

Thanks in advance!
Sinus bradycardia was noted

While there is a lot of information in here, a few more items would be helpful.

How many spontaneous arousals did you have?
What is your age?
Taking any medications (for possible SWS depression)?
What was your baseline heartrate?
What was your supine AHI?
REM AHI?
NREM AHI?

---

As for fatigue, I was reading a study a few nights ago regarding sleep cycles. The article suggested that those individuals zipping through 6 (SIX!!) sleep cycles felt more rested than those with 4 or even 5.

Normal is around 4-5, however its mostly dependent on how much a person sleeps.

Lets say that your cycle takes 100 minutes (for easy math). Six cycles will consume 600 minutes, or 10 hours in bed. Its not realistic. Plus, I have read other studies that show 8 hours as being optimal. Haha. We are dogs chasing our tails when it comes to sleep!

I also have a long wait until my next appointment.  Two days ago I called the doctors office and told them I was worried because of the severe OSA and is there anything they can do about getting me an appointment sooner.  They couldn't but what they did do was get the doctor to prescribe me an APAP machine in the interim so I can get some sort of treatment.   So maybe you can call and ask about that sort of thing for yourself.  Though in your case, it looks like the legs are what are causing you trouble (though, I am not great at reading these things yet).

crossfit wrote:

I also have a long wait until my next appointment.  Two days ago I called the doctors office and told them I was worried because of the severe OSA and is there anything they can do about getting me an appointment sooner.  They couldn't but what they did do was get the doctor to prescribe me an APAP machine in the interim so I can get some sort of treatment.   So maybe you can call and ask about that sort of thing for yourself.  Though in your case, it looks like the legs are what are causing you trouble (though, I am not great at reading these things yet).

While the legs are moving, 8 of the 84 are causing arousal. It may be something that gets treated, but they do not seem to be causing stage shifts. They appear to be, essentially, benign.

PLMs are also a tricky topic. I have read that some physicians feel as though PLMs may indicate the presence or UARS and that EEG arousals could be so subtle that they are a result of the patient arousing. Some of those same phyisicians feel as though medicating a patient for PLMD is irresponsible and that the etiology of those PLMs need to be established prior to medicating the patient.

It really depends on which camp your doctor is in.

There isnt enough information posted, to get a good feel for the study.

Hi,

Thanks for your replies.  

RAM,

My age is 43.  (small frame, normal weight)
I do take 2 mg. Clonazepam which was prescribed for insomnia 2 yrs ago. (not anxiety)  Other sleep meds did not help.  I do question the long term use of it and have tried to wean off it ... difficult to accomplish ... comes with some bad side effects.

I am not sure what my baseline HR was at the time but I believe my resting heart rate is around 72-75.  

What is AHI?  I do not see that listed on the report.  


Thanks. "sleepy"

slpy4ever wrote:

Hi,

Thanks for your replies.  

RAM,

My age is 43.  (small frame, normal weight)
I do take 2 mg. Clonazepam which was prescribed for insomnia 2 yrs ago. (not anxiety)  Other sleep meds did not help.  I do question the long term use of it and have tried to wean off it ... difficult to accomplish ... comes with some bad side effects.

I am not sure what my baseline HR was at the time but I believe my resting heart rate is around 72-75.  

What is AHI?  I do not see that listed on the report.  


Thanks. "sleepy"

Clonazepam could be the key here, however it will usually reduce your latency significantly. It did not seem to factor in because your latecny was increased at 46 minutes. When did you take it on the night of your study? At bedtime, or prior to hookup?

Keep in mind that Clonazepam can markedly lower your SWS percentages.

Also, Clonazepam is known for morning sedation.

Finally, Clonazepam is known for reducing limb movements, so it is possible that the drug is masking the severity of your PLMs. It could be that it is not helping with OSA (AHI of 6).

Its too bad that you cant get off of that med and then see how your sleep pans out.