I need some help understanding my sleep study. I have been perusing this site for a few weeks prior to getting my results from my dr., but I'm still confused. I had my first study and then they called back to say they needed more sleep time on my back and wanted to try me on CPAP. These are the results from my first study.

Total Bed time: 357 min
Latency to sleep onset: 85 min
Total wake time: 202 min
WASO: 116 min
Total sleep time: 156 min
Sleep efficiency: 44%

Stage 1: 30 min - 19%
Stage 2: 76 min - 49%
Stage 3: 45 min - 29%
REM: 6 min - 4%
Latency to Stage REM 1: 133 min
Overall arousal index: 17/hr

Respiratory Disturbances:
Back -                             15 min total sleep time;               0/hr RDI;            0 min total REM;                    0/hr arousal index;                           0 number of events
Side -                              141 min total sleep time;              5/hr RDI;            6 min total REM;                     5/hr arousal index;                            11 number of events

REM -                              6 min total sleep time;                30/hr RDI;                                       30/hr arousal index
NREM -                            150 min total sleep time;              3/hr RDI;                                       3/hr arousal index

Total respiratory events recorded:
RERA                              -                                         8
Hypopneas                               -                                         2
Obstructive apneas                  -                                         0
Mixed apneas                           -                                         1
Central apneas                         -                                         0

Respiratory disturbances ranged from 10 to 26 seconds; lowest recorded SpO2 90%

Discussion: Patient had poorly fragmented sleep. Sleep architecture shows significantly reduced REM sleep of only 4%. The overall respiratory disturbance index was 4/hr, however during REM sleep was 30/hr. Overall arousal index was 17/hr. The EEG showed during REM sleep there was significant alpha intrusion.

I don't have all the data from the 2nd study where I did a split night. I know I did sleep longer - 276 min. The final comments were:

Sleep study did show her sleep efficiency significantly improved to 67% on titration and she did achieve positive airway pressure of 6 cm. of water pressure with REM sleep of about 7 minutes with 0 respiratory disturbance index at this level. She did have 3% REM and also 3% slow wave sleep though most of her sleep was in light sleep. The alpha intrusion noted in the earlier poysomnography was not present on application of CPAP. Her best respiratory disturbance index at this point was 6 per hour. 8 cm was tolerated well, however no REM was achieved at this time. The final impression is underlying obstructive sleep apnea with severley reduced sleep efficiency and abnormal architecture with alpha intrusion. This seems to have improved with application of positive airway pressure and titration was noted to be good. Conclusion: Obstructive sleep apnea during REM. Improved with CPAP of 8 cm of water pressure. Possible fibromyalgia.

Any comments would be greatly appreciated. My dr. never mentioned the alpha intrusion or the possible fibromyalgia. I didn't discover this until I had gotten home and read the report. Now I'm really confused. I'm going to ask for the full report and follow-up with my dr, but I kind of feel like you guys know more than she does.

Hi,
do you have insomnia?  I've never seen a sleep efficiency score that low!  Are you always awake that much during the night, or do you think it was just because of the study?

I think the alpha intrusions indicate that your brain kept trying to go into a lighter stage of sleep.  Which would mean, not only did you have very little REM, but what you got was disrupted.

The cpap brought down your arousals and it looks like your apnea as well.  You slept a little more, but still had a significantly low sleep efficiency score.  I don't know, but MAYBE this is why they suggested fibromalaysia....I would think if you had fibro. aches & pains could keep you awake...meaning apnea is only part of the reason you have poor sleep.   I would think the fibro diagnosis would have to involve consultation with you & your dr, and probably some blood tests.  Maybe they (sleep people) just meant to clarify if you have it as a possibile explanation for your poor sleep efficiency/lack of deep sleep....  I wouldn't think they would have info/expertise for anything else.

Vette the SA potion doesn't look that bad but I agree with  embryopathy your sleep efficiency is unbelievably low and as is your Rem. You might want to have RAM_Sleep look at your stats see what he thinks, he is a SA guy so he might be able to help you! Good Luck to You.


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

Vette-
I am not a sleep professional or a medical professional. But I have done some reading on alpha intrusions. My understanding is that these show up as intrusions of alpha brain wave activity during deeper stages of sleep (usually during stages 3 &4- aka slow wave or delta sleep, or during REM sleep). These alpha intrusions can disrupt the deeper stages of sleep that are especially important to your body's functioning.

There appears to be some research that indicates that people with fibromyalgia may be particularly prone to alpha intrusions and I have read that alpha intrusions have been noted in other people who have chronic pain syndromes (such as rheumatoid arthritis). I would not think that, in the absence of other symptoms of fibromyalgia, that alpha intrusions alone would be diagnostic of fibromyalgia.

In addition to the points made by Embryopathy and White Beard, I wold also wonder how you felt about your expereince in the sleep lab and whether you feel you slept as well as you normally do or whether you felt particularly bothered by the testing conditions.  Some people seem to respond particularly poorly to their sleep studies (and I have read of some dreadful sleep lab situations) and this may interfere with sleep during the study.

I would encourage you to ask for copies of the full sleep study reports for both your first and second studies and to look at what they have to say about your arousals, especially what they show about spontaneous arousals (arousals not related to periodic limb movements or to respiratory problems).

Hope this helps. Keep us posted on how things are going for you.

Best wishes,
Bill

Thanks for the responses everyone. I don't think I have fibromyalgia, but I'm curious as to what is causing the alpha intrusions and why I get so little REM sleep. I did have trouble falling asleep during the first study I'm sure because of the unfamiliar surroundings. I did sleep a lot longer for the second test, but still had very little Stage 3 or REM sleep. The second study was more indicative of how I sleep at home. I'm quick to fall asleep because I'm dead tired, but I wake up many times during the night. I'm also a very light sleeper - I hear every little thing. The 2nd study seemed to indicate that I did not have any alpha intrusions once I started using the CPAP. Still very confused by all of this. I'm going to continue to do my own research since my dr. isn't very forthcoming with much information. She seems like she just does sleep medicine on the side. I should have copies of the full report soon and I should also have my CPAP machine within the next week, so I'm going to give it a whirl and hope for the best.