I would love for someone to please give me their imput on my results.
2008
Sleep latency was 2 minutes which is reduced implying an increased pressure to sleep. Total sleep time was 420 minutes with total time in bed of 435 minutes giving sleep efficiency of 97% which is elevated.
Stage 1 8%; Stage II 81%; Stage III 6%: 5% REM with a REM latency of 237 minutes which is prolonged.
There were only 15 events seen throughout the night across all pressures. All of them were hypopneas. The mean duration was 17 seconds, max duration was 25 sec.
Overall for the evening across all pressures the apnea/hypopnea was 2 events per hour. CPAp was started off at 4cm and increased to a final pressure of 8. At 8 cm the patient spent about 1 hour with 17% of the time being spent in REM sleep, the index was 1 event per hour. The patient spent 4 hours at 7cm where the index was 2 events per hour.
Nadir oxygen saturation at 8cm was 93%
The entire study was spent supine.
The patient did seem to have occational spontaneous arousals more than I would expect by they were not caused by leg movements or definive repiratory events. I didn't see any evidence for RERA's.
IMPRESSION: Successful CPAP titration.
RECOMMENDATIONS:
Continue at 8 and see how she does from a clinical standpoint. It does not sound, however, like she is getting tremendous amount of relief from the CPAP. She scores 21 out of 24 on the Epworth Sleepiness Scale. Her increased sleep effiency decreased sleep latency would also suggest some component of sleep deprivation versus medication effect. She does have spontaneous arousals noted thoughout the night and this could be contributing to her lack of consistent sleep. I didn't see any definte bruxism and the technicians did seem to see some mild bruxism scattered throughout the night. There was only minimal snoring noted by the technican.
May need to consider alternative diagnoses. Idiopathic hypersomnolence is also a possibility and can coexist with sleep apnea, albeit in rate cases.
Weight reduction and avoidance of sedative and alcohol at bedtime, if clinically appropriate.
Avoid driving while fatigued.
Rule out hypothyroidism
Clinical correlation is advised
I had a complete workout done before going for my titration because I knew that they would want one done.
Thyroid- normal
Cortisol- normal
Hormones-normal
Since being diagnosed in 2006 I have gained 30lbs and my cholesterol is very high, but I have low blood pressure and persistant low body temperature.
What would help my REM sleep?
Thanks
