I've been having lots of health trouble attributed to chronic fatigue over the past 6 years, but I could never get anyone to do a sleep study. I recently switched to a new doctor(off at college), who didn't want to proceed with treatment without first ruling out a few things, one of which was sleep apnea. I have most of the common medical problems caused by sleep apnea, but have never shown any direct signs of it(my roommates have tended to be awake and in the same room as me while I'm asleep, and have never reported any sleep apnea like problems).
I recently took a turn for the worst, and life feels more like a hazy dream. I had to wait 3 grueling months from the ordering of the study to actually getting the data in my hand. But the data isn't clear. The pulmonary specialist who analyzed the study told me it *could* be sleep apnea, to try all the standard sleep hygiene and a huge list of medications, come back in 6 weeks, and she'd schedule another study. I've already tried about everything on the list multiple times in the past 6 years! I almost got in a shouting match trying to explain that to her. So that'd be 4.5 months of waiting before I can get the data back from the second study. At this rate...I don't know if I'll be alive by then
.
Study data follows:
Code:
Sleep Architecture:Total Time in Bed: 6.2hrs
Total Sleep Time: 4.4hrs
Sleep Efficiency Index: 71%
Wake Time: 110 minutes
Stage 1: 32 minutes (12% of total sleep time)
Stage 2: 166 minutes (63% of total sleep time)
Stage 3-4: 38 minutes (14% of total sleep time)
REM: 29 minutes (11% if total sleep time)
Wake time after sleep onset: 30 minutes
Latency to REM onset: 141 minutes
Number of REM period(s): 2
Arousal Index: 13/hr
The sleep stages chart is abnormal, with frequent spikes back up to full awakening. So I guess I have proof now that I actually don't sleep(I was surprised how hard it is to actually convince a general practitioner that you have trouble sleeping...now I have a pretty picture
).
Code:
Respiration:
Rate: 18-22 breaths per minute
Obstructive apenic events lasting 10-25 seconds together with snore arousals caused sleep disturbance and mild oxygen desaturations. These events occured more frequently during REM sleep (REM RDI = 21/hr).
Position: Supine, Lateral
Sleep Stage: REM, NREM
Baseline SaO2 saturaton: 96-98%
Minimum O2 saturation: 93%
Recorded Sleep Time: 4.4 hrs
RDI = 10
AHI = 5
Code:
Leg EMG: Periodic leg movements (13/hr) disturbed sleep at a rate of 3/hr.
The pulmonary specialist said that since I've taken klonopin for sleep, which is often used to treat leg twitching, without improvement, that she didn't think the leg twitching was causing my problem. I mentioned that I took a decongestant during the study since I had a cold(and seem to get sick a lot in general), so she now wants me to see an allergist(I've already tried allergy medication, nasal steroids, etc in the past, none of which helped my sleep). It doesn't seem like allergies to me, just when I'm having trouble sleeping, I seem to catch instantly whatever my roommates have at the time(cold or otherwise).
The leg movements and supposed obstructions always happened at the exact same time, so I can't really tell if one is causing the other, or if there's some other explanation for both.
So basically it comes down to that I have horrible sleep architecture, take lots of time to fall asleep, and wake up early. When I got the study done, the technician assured me he'd do a CPAP titration if he saw any need, but in the morning told me I didn't need it. Whether or not my problems are caused by sleep apnea, I have no clue. The pulmonary specialist seems like she's fishing for things that probably aren't, but could possibly be wrong.
I want to either rule out, or confirm the sleep apnea so I can get back to my chronic fatigue specialist for treatment(he won't proceed until he knows whether or not I have sleep apnea). Would that sleep study make me a good candidate to try out an auto CPAP machine at home, rather than waiting for a second sleep study? I'd probably have to go for an auto machine with as much logging as possible, so I could tell if there were any obstruction events in the first place, and if CPAP helps.
(Financial matters: The pulmonary specialist claims an insurance company probably wouldn't consider that study as indicative of sleep apnea, so they probably won't pay for further studies or CPAP. So buying an Auto CPAP outright looks like a good option; it's nothing compared to the money I'm leaking trying to combat secondary problems and illness arising from not sleeping, or paying for another sleep study.)
, and hope to try it out tonight. I actually got through to the doctor on the phone, and she faxed me a prescription. The only problem is my landlord seems to have accepted the package with the smartcard reader in it, and I haven't been able to find her all day. 
...which saved me some money on the machine if nothing else. I got a Respironics M-series Auto with A-Flex, and an Ultra Mirage Full Face Mask(I have mouth breathing trouble sometimes even without a CPAP).