Hi everyone. I am new to the forum. I have been in the Navy for 18 years now and recently had a sleep study done this month. I received the results from the Tech a few days ago. I dont have the Doctors results yet. Those should be in a few days or so. I have been reading alot about this disorder to the point where i am totaly confused. Here is a little history about me. For as long as i can remember, i have never awoke in the morning feeling refeshed. Friends and family would always comment on how red my eyes were and how swollen my face was. As i am getting older, i wake up in the morning ready to chew on a bag of nails. I basically feel RAGE in the morning for no reason at all. My chest gets tight and i just cant seem to wake up out this FOG im in. I had sinus surgery back in March 09 for Polyps. I felt great for about three days after the surgery even with the blood running out of the nose. My wife said i was sleeping like a baby. Well anyway, things have steadily gone downhill from that point. I am drained all day long, my weight goes up and down like a yo-yo, mood swings, periods of i dont want to eat anything to periods of i feel like im starving to death. It has affected my carrer and family life. I have anxiety of going to bed because i know what im going to feel like when i wake the next day and i already know what my day is going to be like. There is nothing exciting about knowing that your next day is going to suck just as bad as the day you had today! Im babbling!! It just feels good to talk about it. Here are my results.
Time in bed 438.1
Total sleep time 299.0
WASO 95.0
Sleep Onset 39.5
Stage 1 39.5
Stage 2 75.5
Stage Delta 0
REM Latency 188.5
Sleep Efficiency 68.4%
Stage1 130.5 23.4%
Stage2 115.0 28.3%
Stage3 0 0%
Stage4 0 0%
REM 48.5 11.9%
Respiratory Events Summary
Obstructive 1
Hypopnea 24
Apnea+Hypopnea 25 Index/Hr 5.1
Respiratory events by position
Supine
Apnea Hypopnea Apnea+Hypopnia
Number 1 20 21
Index 1.1 21.4 22.5
Right side
Number 0 4 4
Index 0 1.3 1.3
No events happened in other sleeping positions
REM Min O2 81.4%
NREM Min O2 90.3%
Number of Desaturations: 27
Average duration of desaturation: 30.2
Total duration of desaturation: 816.6 ???? I dont know what that means
Number of arousals: 52
Arousal Index: 10.4
Number of awakenings: 10
Snoring Events: 852
Snore Index: 173.9
How important is this Delta wave sleep that i am not getting? From all the reading that i have done, it looks like i am not repairing when i am sleepin and when i am getting good sleep like i am supposed to with the REM sleep, i start having Hypopnea events and desaturation which cant be good for me. Another thing also, i was sleeping in an unfamiliar environment. Is that why i stayed in stage 1 and 2 for the most of the night? Do you think i would have had more Apnea and Hypopnea episodes if i would have been more relaxed and comfortable in my environment? Thanks for looking. Any help would be greatly appreciated so i can be prepared to ask the Doc the right questions when i see him. I am tired of being tired and want to get my life back. I feel like i am going insane.
Last edited by 53driver on Wed Sep 23, 2009 8:26 pm; edited 1 time in total
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| Naval Aviator going insane! Please help with sleep study. | |
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53driver
Joined: 22 Sep 2009 Posts: 6 
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 Naval Aviator going insane! Please help with sleep study. |
| Tue Sep 22, 2009 5:14 pm | |
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Daniel Moderator
Joined: 25 Jun 2005 Posts: 4165 Location: Ireland
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Re: Naval Aviator going insane! Please help with sleep study
In brief.....(I can't see an AHI figure), I think you have mild apnoea, but are very symptomatic. Your sleep architecture is disrupted with no Delta Wave Sleep (Stage N3) and what appears to be reduced REM Sleep. The lack of Delta Wave Sleep usually results in Excessive Daytime Sleepiness. Your O2 desats are not good. You are a heavy snorer. Your sleep efficiency is not good...........but that is normal enough during a sleep study. Your REM latency is very extended at 188.5 minutes.........in a perfect world about 90/110 minutes.
Delta Wave Sleep is your most resful/restorative sleep......your not getting any. In a perfect world you should be getting about 20% of your sleep time in Delta Wave. REm Sleep is also reduced.............typically about 20%.
More likely the apnoeas/hypopnoeas are shunting you back to Stage 2 of Non REM Sleep. I don't see any mention of limb movements.........was anything said to you ?
As you are aware, sleep deprivation is a form of torture............and you are being tortured (LOL). The quality of your sleep is not good and you should make sure that your sleep doctor explains this to you, fully. Your desats also need attention. Get your doctor to go through the sleep study report with you, in detail. Bring your wife with you. From a support point of view it is important that she is familar with your condition. Daniel. _________________ The untreated Sleep Apnoea sufferer died quietly in his sleep....... Unlike his three passengers who died screaming !!!!!! (Anon) |
| Tue Sep 22, 2009 8:19 pm | |
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53driver
Joined: 22 Sep 2009 Posts: 6
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Dan, thanks for the reply. Here are the limb movements.
Periodic Movements Types Total Index Isolated LM's 24 4.9 Indepen LM's 10 2.0 Iso LM's with arousal 3 .6 PLM's with arousal 2 .4 PLM's with apnea 0 0 Iso LM's w/respiratory 2 .4 I watched a Youtube segment about Rosey Odonnel on the View. The sleep doctor on the show said that body has a hard time getting into deep wave sleep and REM sleep because it knows its going to be in distress if it goes into those stages. Call it "Fight or Flight" syndrome if you will. I think that kind of hits the nail on the head with me. My body is in protective mode by not allowing itself to get to the important stages of sleep because it knows that as soon as it does, my body will relax to the point where i am not breathing anymore and the distress begins. In a weird way, i am excited that i have this problem because now i really have some answers to some if not all of my health issues i have right now. And most importantly, there is a major cure for these issues with the use of a CPAP. Starting to get excited now. Thanks for your help! Sammy "I never saw a wild thing sorry for itself. A small bird will drop frozen dead from a bough without ever having felt sorry for itself" |
| Wed Sep 23, 2009 3:22 pm | |
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Daniel Moderator
Joined: 25 Jun 2005 Posts: 4165 Location: Ireland
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Limb movements are not significant. I disagree with the 'protection mode' regarding deep sleep. Depending on the length of time we sleep, we have between 4 and 6 sleep cycles (these comprise your sleep architecture), each lasting about 90/110 minutes. Typically, in the first cycle you start from Stage 1 to Stage 2 to Stage N3 (Delta Wave), back to Stage 2 and then to REM. First stage of REM usually occurs after 85/90 minutes and might last up to 5 minutes.............therafter we spend more and more time in REM sleep as the cycles progress. Depending on age and other health factors we may spend less time in REM. It is quite structured, and anything that upsets this structure really messes up the effects of quality sleep.......restful sleep. Apnoeas and Hypopnoeas disrupt our sleep cycles and push back the progression of our sleep. Your extended REM latency is an example of this. Also, during REm Sleep our bodies go into a type of paralysis.........some say to stop us acting out our dreams (you can also dream during Non REM Sleep, but these dreams are not as vivid as in REM Sleep)..........during REM Sleep we are inclined to have more Apnoeas and Hypopnoeas than during Non REM Sleep. IMHO, if you get your sleep architecture sorted.......you should see some massive improvements. Typically with OSA sufferers, once we eliminate the Apnoeas and Hypopnoeas the sleep architecture gets back in order. Best of luck. Daniel. _________________ The untreated Sleep Apnoea sufferer died quietly in his sleep....... Unlike his three passengers who died screaming !!!!!! (Anon) |
| Wed Sep 23, 2009 7:45 pm | |
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53driver
Joined: 22 Sep 2009 Posts: 6
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Dan, i understand now. The arousals or the snoring is shunting my REM and Delta sleep. Here is my graph timeline with all the info. Maybe it will shed a little more light for ya.
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| Wed Sep 23, 2009 9:07 pm | |
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ApexAZ
Joined: 24 Jun 2009 Posts: 372
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I think the 'fight or flight' analogy is probably better explained like this:
Your muscles relax while you sleep and cause a collapse of tissue in your throat which blocks airflow. Your oxygen levels (most cases, not all) drop as a result of this which triggers this fight or flight response in your brain that tells your body to wake up (arousal) so that your muscles tighten up to open the airway and allow you to start breating again. Although I don't know if fight or flight response is the appropriate term to use because flight isn't really an option for survival? So what's happening is you are getting enough apneas/hypopneas in stage 1/2 sleep (and partly REM) that you are waking up before ever making it to stage 3/4. You're not breathing, so you aren't staying asleep long enough to get any real rest, basically. _________________ Brian Severe OSA 19 cmH2O Respironics M Series Plus F&P Forma Full Face Mask |
| Thu Sep 24, 2009 2:07 pm | |
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53driver
Joined: 22 Sep 2009 Posts: 6
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Sleep Study Results are in
This read i have from the Doctor does seem a little sketchy. You dont speak with the Doctor that grades your sleep study at this clinic. I think he is out of state. When i called the sleep study clinic yesterday, they said that they recieved the audio from him and had to send it to a transcriptionist to be transfered to paper. Here are some of the things he said.
Doctor: Oxygen desaturation data, no signifigant desaturation was seen. Me: Ok, so 27 desaturations with the lowest sat being 81.4% is not considered signifigant. Doctor: The patient had 852 snoring events with an index of 173.9 suggestive of severe snoring. Me: I agree with that Doctor: Respirotory Summary--- The patient had 1 obstructive and 24 hypopneas with AHI of 5.1 which was pretty much within normal limits but it was slightly worse in REM sleep where the AHI was 17.3 and NREM sleep was 2.7. Me: Why do they just use the average of the entire night to get the AHI. He recognized i had moderate Apnea during my REM sleep, which only happened once the whole night and that was around 4AM once i finally got settled down enough to get into that stage. Why isnt there any consideration for my intense snoring at the first half of the night thats giving me a large number for REM latency. I guess im kinda pissed off about these results because they dont read like i feel during the day. Minimul this and mild that BLAH BLAH BLAH!!!! Doctor: Conclusion: Minimal OSA Poor sleep efficiency (Which is typical for a sleep study) Mild sleep fragmentation (No delta sleep at all and half the REM i need and he calls it mild, is that correct??) Mild desaturation (????) Was this guy smokin crack!! Severe snoring Doctor: Suggestions Patient should lose weight Avoid sedation or alcohol Suggest checking TSH Patient should undergo instruction in sleep hygene technique suggest patient sleeps in the side position Would consider CPAP trial or repeating the study the above measures fail to resolve the patients symptoms Clinical correlation is advised Me: Ive had hell losing weight for years because my sleep sucks and im exhausted all the time. I dont drink alcohol or take pills to sleep. Both of those are addictive and i stay away from them. Is a TSH study for thyroid????? If it is, i already had that done. Came back negative. He suggest i sleep on my side. Really!! I snored like a bear in all positions!!!! Any comments or views on this? Should i have the study done again or should i schedule a CPAP titration and see how that works out. In my mind, i have moderate sleep apnea. |
| Fri Sep 25, 2009 1:55 pm | |
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Vicki Moderator
Joined: 31 May 2005 Posts: 4528 Location: Southern California
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You should find another sleep doctor for a, hopefully better, second opinion. You can find an accreditied sleep doc. near you at www.abms.org.
Vicki _________________ Being defeated is often a temporary condition. Giving up is what makes it permanent. Marilyn Von Savant That which does not kill you makes you stronger-Friedrich Nietzsche Friedrich must of had apnea. |
| Fri Sep 25, 2009 7:16 pm | |
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53driver
Joined: 22 Sep 2009 Posts: 6
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Vicki, thank you for the advice. Do you agree or disagree with the doctors findings?
Sammy |
| Fri Sep 25, 2009 7:43 pm | |
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Vicki Moderator
Joined: 31 May 2005 Posts: 4528 Location: Southern California
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We aren't professionals and aren't here to interpet results but I will say that I agree with your observations. You have moderate OSA in REM, you desat. to significant levels. Additionally, untreated OSA causes weight gain for several physiological reasons, therefore, it is hard to lose weight unless you are treated. TSH stands for Thyroid Stimulating Hormone, so yes it is a thyroid test. He is just CYA to make sure you don't have some other issues going on, but you said you have already had your thyroid levels checked.
I think that if you got a second opinion from a respected sleep doc., you might see a different assessment and different recommendations. Vicki _________________ Being defeated is often a temporary condition. Giving up is what makes it permanent. Marilyn Von Savant That which does not kill you makes you stronger-Friedrich Nietzsche Friedrich must of had apnea. |
| Fri Sep 25, 2009 8:17 pm | |
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53driver
Joined: 22 Sep 2009 Posts: 6
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Vicki
Thank you for the further insight. I appreciate you taking time out to respond once again. I have one more question. If i have mild OSA or moderate OSA, does it really matter? If i go in for the titration study, dont they just keep cranking up the pressure until the hypopneas go away or are drastically reduced. Does a XPAP reduce snoring or eliminate it all together? Seeing that my snoring is severe. When i started this journey, i thought it would be pretty straight forward. What i have found out is that it is pretty complex. Thank you for the input once again. Sammy |
| Fri Sep 25, 2009 9:16 pm | |
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Daniel Moderator
Joined: 25 Jun 2005 Posts: 4165 Location: Ireland
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I agree with Vicki. You need to see another sleep doctor. Whether you have mild or moderate apnoea is really immaterial, because of your symptoms. It needs to be addressed. Properly titrated XPAP will clear up the snoring issue. Daniel. _________________ The untreated Sleep Apnoea sufferer died quietly in his sleep....... Unlike his three passengers who died screaming !!!!!! (Anon) |
| Sat Sep 26, 2009 3:45 am | |
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truckerdad57
Joined: 22 May 2008 Posts: 143
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ditto what Daniel and Vicki said
ditto what Daniel and Vicki said
Another issue you need to look at in your OSA treatment and looking at this sleep study is being an aviator you may also need to deal with adminsitrative issues. FAA has requirements for all civilian pilots to be under "current and effective treatment". FAA flight surgeons have specific AHI cut points that if your sleep study exceeds you are medically disqualified until treated. Even if your sleep doctor feels you do not need a CPAP.. as an aviator you may have to... There is an entire thread about dealing with OSA in the military in the general information forum. Good Luck _________________ Just a truck driver with sleep apnea |
| Sun Oct 04, 2009 9:06 pm | |
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