Greetings all,

This is my first post. I have been exhausted for months -- sleeping for 13 hours a night just doesn't do a thing -- so I had a sleep study done 2 weeks ago. My doctor is going to meet with me and discuss them tomorrow, but until then I thought I'd post them here...it doesn't seem like I have apnea, so what on earth is my problem?

Without CPAP
Total Sleep Time: 3.3 hours

Respiratory Summary

Apneas: 0
Hypopneas: 10
AHI: 3
RERA's: 10
RDI: 6.0

Sleep staging and Scoring Times

Sleep Efficiency: 55.4
Sleep Maintenance Efficiency: 80.8
Stage REM Latency: 184.0

TST's:

Stage REM 5%
Stage 1: 4%
Stage 2: 76.4
Stage 3: 14.6
Stage 4: 0%

Oximetry Summary:

Baseline: 98.6
Average: 96.8
Minimum: 93.6

Cardiac Status:

Baseline (bpm): 80.5
Low heart rate (bpm): 46.8
Tachycardia (TST): 0 B
Bradycardia (TST): 59

No PLM

Snore Episodes: Total Sleep=1649
Index: NREM 519.4 REM 78 Total Sleep=497

Total Arousal Events

20 (18 Respiratory)

_____________________________________________

With CPAP (small nasal mask put on me around 2 A.M.)

Total Sleep Time: 2.6 hours

Respiratory Summary

Apneas: 0
Hypopneas: 0
AHI: 0
RERA's: 1
RDI: 3.5

Sleep staging and Scoring Times

Sleep Efficiency: 68.9
Sleep Maintenance Efficiency: 99.0
Stage REM Latency: 51.5

TST's:

Stage REM 24%
Stage 1: 2.3%
Stage 2: 58.9
Stage 3: 14.7
Stage 4: 0%

Oximetry Summary:

Baseline: 98.5
Average: 97.6
Minimum: 94.6

Cardiac Status:

Baseline (bpm): 75.5
Low heart rate (bpm): 48
Tachycardia (TST): 0
Bradycardia (TST): 35

No PLM

Snore Episodes: Total Sleep=276
Index: NREM 200 REM 76 Total Sleep=108

Total Arousal Events

9 (9 Respiratory, 0 Spontaneous)

I am not an expert on this. It does appear that your AHI is in the normal range (under 5). You have lots of snoring and a fair amount of arousals that may well be associated with the snoring. RERA stands for Respiratory Effort Related Arousal. These are arousals (abrupt transitions from a deeper stage of sleep to a shallower stage of sleep) that are related to problems with trying to maintain adequate air intake while you are asleep. You might want to read this FAQ about Upper Airway Resistance Syndrome here: http://sleepapneafaq.wikispaces.com/UARS+Upper+Airway+Resistance+Syndrome . Your doctor might be considering this diagnosis for you.

It looks like the first part of your sleep study shows somewhat reduced deep sleep (stage 3 and 4 sleep). Ideally, about 20% of your sleep should be deep sleep. You also had very impaired REM sleep (ideally about 20 to 25% of your sleep should be REM sleep). Your arousals are likely preventing you from getting enough REM sleep and deep sleep and this would account for your feeling all dragged out even with excessive sleep (since REM sleep and deep sleep seem to be the two stages of sleep most important to your body's well-being). It does look like CPAP helped reduce your levels of arousal and helped your REM sleep quite a bit. This is a good sign that CPAP is likely to be very helpful for you.

As for the slow heart rate, I know little about this but your doctor will be able to tell you what follow-up if any is needed wit respect to that.

I hope this helps. Do let us know how things go with the doctor.

Best wishes,
Bill

Well, I just got back from the doctor. He said he didn't think I had apnea. He said I probably had Idiopathic Hypersomnolence. He seemed a little bummed out that we don't know the cause; but then again, he didn't suggest any more tests, either, so I guess we're leaving it at that for now. He prescribed Provigil.

Hopefully it will work. My hope is that it will increase my energy so that I can exercise again, and as my fitness level improves, my health will improve and my sleep problem will stop. *fingers crossed*!!!

Hi sleepy.grrl,

Your doc wasn't concerned about your low heart rate?  Is he a family or Primary Care Physician?
It might not hurt seeing a cardiologist to rule out anything.

Yeah, I bet your doc was hoping it was sleep apnea, because if it was, it's very treatable.
Was both parts of the study (with and without cpap) done in one overnight sleep study?  From your description, I'm guessing yes.  I'm surprised they even tried the titration part of the study (with cpap).  


Linda


_________________
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Hi sleepy.grrl,

My AHI index came out very low - 8.8. But the doctors at Stanford think it could be worse than that, it just didn't show up in the sleep study. I have my titration & esophageal pressure measurement scheduled next week.

I read on the apnea forums that UARS(Upper Airway Resistance Syndrome) doesn't show up in normal studies. In your situation, I would see another doctor.

Hope you feel better soon.

Just received results for my first study
which my rera was 134
index  of 31.6 per hour
slept only 60& of the night

I only had an ahi of 4.7
but 18 hypopnea events which lasted total of 7.4 minutes through the night of the study and longest one was 50 seconds
and 154 respiratory events so my numbers were rather high
Did the Titration study last night and sleep like a baby