Well, Morbius must admit to having difficulty understanding the previous PSG report, his "Adds and Subtracts" failing him.
embryopathy wrote:
Sleep Parameters Report:
Lights out at 9:34 p.m.
Tot. Recording Time (minutes) 446.8
Tot. Sleep Time 306.0
Sleep Latency 114.9
Time Awake After Sleep Onset 26.0
Sleep Efficiency 58.5%
Study ended at 5:01 a.m.
If "Study Ended" corresponds to "Lights On", then Total Recording Time (TRT) = Total Sleep Period (TSP).
This would seem to be correct, cause if TSP - [Sleep Latency (SL) + Wake After Sleep Onset (WASO)] = TST, then TST = 446.8 - (114.9 + 26.0) = 306.0 minutes.
However, if Sleep Efficiency (SE) = TST/TSP, then 306.0 minutes / 446.6 minutes = 68.5%, not 58.5%.
Not that 68.5% is all that great either. As a matter of fact, it's more in the "awful" category.
Anyway, another good way to generate REM in MSLT naps is to go in sleep-deprived. So if Sleep Efficiency turns out to be the same in the PSG prior to the MSLT as it was in the initial PSG, and the test appears positive (2 or more REM naps), then you say "Gee, do you think that the reason there was REM in the naps was because the sleep efficiency was only 58.5 [or whatever] percent?!"
BTW, insomnia is a relatively common (28%) side effect of Zoloft. Why give it to him at 8:00 PM? Better yet, why give it to him at all?
the doc just called.....lab is behind & he still doesn't have report but he looked at some preliminary info....sleep apnea did NOT show up, AGAIN! I can't believe it! $1400 for the 2 studies and they don't show his breathing problems! The dr. said he still cannot rule out cheyne-stokes based on my observations but because my son does not tolerate the sleep study wires well, he thinks it would be futile to try cpap. He says we could try O2 cannula, but I know he will not tolerate the cannula (been there done that). Dr says cpap mask is worse coz of straps & larger area of face covered. Dr said he is the one who said to cancel the MSLT because the tech called him and said my son kept pulling off the wires, and wasn't sleeping, so the mslt is "inconclusive". I wish that meant it was free! Doc said if he would tolerate it he would order 1 wk trial cpap, and see what happened and then try to get insurance to pay for one but he doesn't think my son will tolerate it at all. I've always known it would be a long shot, but am willing to give it a try. I think the doc will if I push it, but he wants to try a med change first.
He wants him off the trazadone (which I agree) coz we have established that decreasing/increasing it improves/worsens his daytime sleepiness. Before (years ago) going on traz. we tried ambien 5mg and it didn't work, so we are going to try 12mg of the continuous release and hope it doesn't make him too sleepy during the day....if it does we'll try the 6 mg. If that doesn't work, I don't know what we'll do.....get used to 3-5 hr sleep/night? I can't do it. continue to live sleepy all day & night?
Anyway, I asked him to go back & look specifically at the time of 1-1:45 am because that is when I noticed his abnormal breathing. He agreed to do so. I pray something shows up! I really want a diagnosis, even if we can't treat it.
RE the 'episode' of him going pale and falling forward, he said "I really don't know what to make of that". That was it. I'm going to have to follow up on that w/his internist I guess.
Its probably time that you state why you are qualified to answer a lot of the threads. I am not disagreeing with the information that you post because at times it is pasted out of a text, but as far as I know, you could be a custodian that likes to read. Some people are putting a lot of weight on your words, so it seems appropriate that you would shed some light on how became so "knowledgeable". Its just an idea. Its their decision to take your posts as fact, but some people may not have thought to ask for your credentials.
Doc said if he would tolerate it he would order 1 wk trial cpap, and see what happened and then try to get insurance to pay for one but he doesn't think my son will tolerate it at all. I've always known it would be a long shot, but am willing to give it a try.
You really should check out that pCO2 level. If it is elevated, then he may in fact qualify for a BiPAP, which he may find to be a little more tolerable that plain ol' CPAP.
Further, if he in fact has significant central apnea, plain ol' CPAP probably won't do anything anyway.
Its probably time that you state why you are qualified to answer a lot of the threads. I am not disagreeing with the information that you post because at times it is pasted out of a text, but as far as I know, you could be a custodian that likes to read. Some people are putting a lot of weight on your words, so it seems appropriate that you would shed some light on how became so "knowledgeable". Its just an idea. Its their decision to take your posts as fact, but some people may not have thought to ask for your credentials.
I am a presently unemployed Kamikaze Pilot. BTW, my COBRA Payments are a bear.
Its probably time that you state why you are qualified to answer a lot of the threads. I am not disagreeing with the information that you post because at times it is pasted out of a text, but as far as I know, you could be a custodian that likes to read. Some people are putting a lot of weight on your words, so it seems appropriate that you would shed some light on how became so "knowledgeable". Its just an idea. Its their decision to take your posts as fact, but some people may not have thought to ask for your credentials.
I am a presently unemployed Kamikaze Pilot. BTW, my COBRA Payments are a bear.
M.
Nicely done. Very original.
It seems odd that you find yourself confident to answer questions that directly impact the lives of others, but you are not willing to list your credentials and expertise. Oh well. Its up to others whether or not to take you seriously.
I read something today that said if a sleep study does not indicate any slow wave sleep, it is not a valid study (because most apnea occurs during delta sleep). What do you think of this statement?
My hypothesis is that my son's apnea only occurs during deep sleep, and he didn't get any the first study....don't know about the 2nd yet. This would also explain why it does not occur every night at home---because some nights he has too many arousals to ever get into deep sleep (he awakens VERY easily all night long). I read today that cheyne-stokes occurs mainly in the first 3 stages of sleep and NOT in REM.
I read something today that said if a sleep study does not indicate any slow wave sleep, it is not a valid study (because most apnea occurs during delta sleep).
Its probably time that you state why you are qualified to answer a lot of the threads. I am not disagreeing with the information that you post because at times it is pasted out of a text, but as far as I know, you could be a custodian that likes to read. Some people are putting a lot of weight on your words, so it seems appropriate that you would shed some light on how became so "knowledgeable". Its just an idea. Its their decision to take your posts as fact, but some people may not have thought to ask for your credentials.
I am a presently unemployed Kamikaze Pilot. BTW, my COBRA Payments are a bear.
M.
Nicely done. Very original.
It seems odd that you find yourself confident to answer questions that directly impact the lives of others, but you are not willing to list your credentials and expertise. Oh well. Its up to others whether or not to take you seriously.
Serious? Why, of course I'm serious! I was even going to become a "Registered" Kamikaze Pilot! I passed the "written" part of the exam, but after looking at the requirements for the "practical" portion of the test, it seemed kinda pointless.
I just got a call from the pulmo. dr.,....he went over every epoch of my son's sleep study and said there is a significant amount of CSA and the time period that I observed the typical abnormal breathing (do u follow me there----what i see at home) he was having cheyne-stokes.
He wants him to be on oxygen but since he wont tolerate anything in his nose we are going to try cpap at a fixed pressure of 10. dr says insur will not pay for vpap without trying cpap first and that cpap can be effective w/csa.
He also wants his heart checked and is ordering a echocardiagram (something i have been wanting for yrs).
He had some bradycardia (dr said 'as would be expected') but he didn't see any arythmias.
He said he had some desats, not as significant as would be expected w/osa, but he didn't remember exactly---he thinks it got down to mid-80's.
The final report will be done in a couple days.
WOW!!!! sounds like we are FINALLY getting a diagnosis!!!!!!!!!!!!!!!!! I am so happy about that!
but of course, a litte nervous about it as well.
He said if he won't tolerate the cpap, we will try medication to stimulate breathing....anybody have info about that?
I just got a call from the pulmo. dr.,....he went over every epoch of my son's sleep study and said there is a significant amount of CSA and the time period that I observed the typical abnormal breathing (do u follow me there----what i see at home) he was having cheyne-stokes.
He wants him to be on oxygen but since he wont tolerate anything in his nose we are going to try cpap at a fixed pressure of 10. dr says insur will not pay for vpap without trying cpap first and that cpap can be effective w/csa.
He also wants his heart checked and is ordering a echocardiagram (something i have been wanting for yrs).
He had some bradycardia (dr said 'as would be expected') but he didn't see any arythmias.
He said he had some desats, not as significant as would be expected w/osa, but he didn't remember exactly---he thinks it got down to mid-80's.
The final report will be done in a couple days.
WOW!!!! sounds like we are FINALLY getting a diagnosis!!!!!!!!!!!!!!!!! I am so happy about that!
but of course, a litte nervous about it as well.
He said if he won't tolerate the cpap, we will try medication to stimulate breathing....anybody have info about that?
wow.....again....
\
Did all of his sleep reports show the CS breathing or just the latest one at the time when you heard the unusal breathing?
Did all of his sleep reports show the CS breathing or just the latest one at the time when you heard the unusal breathing?
I'm not certain; possibly just during the time I observed. (I didn't observe any the 1st study, this was the 2nd) hoping to recieve the report this week. Why--what would that imply?
just got a call from the cpap place to schedule a fitting. they said the AHI is 57 with significant desats and heart rate changes.
sure hope i get my ccopy of the report today!
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