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My Sleep Study 
18th-Mar-2008 04:02 pm
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I've always needed a lot of sleep. 13 hours is what I think I need. That's per night not per week. (This is not to say I get that very often. The last time I got enough sleep, waking rested, was in 2001. The time before that was 1996.)

When I was in high school, I know I was frequently late, and I seem to recall Rose, the crossing guard at my primary school scolding me for always running late.

Well, things have started to get worse -- I'm more tired -- and my spouse is referring to me as "solar powered" -- so I talked to my doc, who set me up with a Neurologist, who set me up with a sleep study last night, to be followed by a nap study today.



I left work with a couple of hours to spare. Spouse had told me that there was a Wendy's at "the" exit, but I didn't see it, so I went to the hospital and asked my GPS what was local. I "never" eat out unless it's with people other than fast food, but it mentioned Barnes Ribs, and I decided I'd give it a go. Heh. After it told me to turn down a dirt road, I had a bad feeling, and when that dirt road ended as someones driveway that feeling was confirmed. But I had seen some other things as I was driving, so I resolved to do one of them, ending up at the Chelsea Grille and ordering Chicken Marsala. The Tomato Basil soup was wonderful, the broccoli was yummy and the mashed potatoes were heavenly. Oh, and the chicken was okay too.

I got back to the hospital with about a half hour to spare, and managed to forget to bring in my overnight bag. *sigh* I rang the bell, like the sign said, and there was no acknowledgment. But someone else was waiting there, so I waited. After the 3rd person showed up I remembered my bag, still out in my car. Waited to see what they would want me to do -- should I be checked in then go get it, for example, but after the time of my appointment rolled around and I'd still seen neither hide nor hair of anyone other than patients, I said heck with it and went to get my bag.

When I got back, one of the other people was gone, so I was more comfortable waiting. The other guy was brought to his room, and then I was retrieved.

With no direction other than to get into my PJs, I put all of my stuff on the wooden chair, except my shoes, which I put under it. When the nurse came in, she had to move everything -- even the shoes. (Hmmm... I would have dressed (somewhat or) somewhere different(ly) had I realized then that the room was monitored -- I saw the camera later.)

She came in, talked to me, applied about two dozen electrodes and whatnot to various portions of my anatomy -- many of them on my head -- buried in my hair. Of course she first had to take measurements and write on my scalp with a pencil. She said several times that I am too skinny, I cannot have sleep apnea. I would not describe myself as skinny, but given the choice between large and small build, I would admit to having a smaller build. Then suddenly, a bit before 10pm (I'd been told that lights out was at 11pm) she came in and asked if I was ready for bed. Sure.

Then she hooked up a few more sensors, including two that went a little bit into my nose -- the tape for which on my upper lip was quite annoying.

Of course the fact that I could hear conversations (she told me in the morning I was the only quiet one), and I could hear bleed-through from the PA as she talked to others, and I could hear water running, and I itched under where the glue holding the electrodes on was placed, and my nose itched, and the tape on my upper lip was aggravating meant that I didn't sleep much. Or rather, I was awake much.

The next morning (they woke me at 6) I learned that just because she said it three times didn't make it true. I had told her that I don't snore. She said I did a bit -- the first time just audible breathing and the 2nd time a bit louder than that. Spouse has never heard me stop breathing, or gasp for air. I don't wake up with a headache. But, she said that I do seem to have apnea.

I guess I should take comfort from the fact that she didn't say "OMG we need to get you into a mask now or you're going to Diiiiiiie," but I found it very disheartening that it was apparently bad enough that she called the Neurologist to see about canceling the nap study -- because if I have apnea, that needs to be treated first. Guess the doctor overrode.

A bit after 7 they fed me one of the more uninteresting (ok, for hospital food it was probably pretty good) breakfasts I've ever had. At 8 I went down for a nap. I know I slept. Not sure I dreamt. At 10 I went down for a nap. Slept for sure. At 11 they gave me lunch -- I got a pesto pasta thing, and broccoli... that ... if that's the only broccoli a kid has ever had, I can support him hating broccoli. But the pasta was good. At noon I got another nap, and again slept. At 2pm, there were lots of noises -- conversations, rain, water running, and I was already starting to plan what I was going to do when I left, and I did not fall asleep. Each of these times they only left me down for 20 minutes.

She removed the electrodes and told me to shower and then I could leave. Their water pressure left something to be desired, but the temperature was good, and I eventually got, I think, all of the glue out of my hair.

Yes, in case you're wondering, I'm yawning as I type this.

But it's time to run off for food and class.

And then wait 3.5 weeks to talk to the Neurologist and learn what's up.
Comments 
18th-Mar-2008 08:40 pm (UTC) - Sleep apnea
I'm glad you were comfortable writing all this up. I tend to suspect that people who believe they need 13 hours of sleep usually are getting very poor sleep when they are lying down, which is why they need to get more hours. I spent some years feeling I needed 11 or 12, finally cut down to a solid 9 (when I can count on it) and then found out I had sleep apnea (having already been told: "You have sleep disturbance, profound.") I am now sleeping 8 1/2 to 9 1/2 hours per night and feeling quite good, though it did take me at least a month to get used to the mask. In any event, please keep us posted.

Nate
19th-Mar-2008 04:14 am (UTC) - Re: Sleep apnea
I will keep all posted. I had/have always thought that I sleep very well. I certainly usually stay down once I get there, and I usually get there quite quickly. (Glad you're taking care of your issues, and that the mask has helped.)
18th-Mar-2008 09:37 pm (UTC)
Sounds exhausting, but interesting! At least, I find medically stuff fascinating. Thanks for sharing.

I hope they found enough data to get you feeling better. *hug!*
19th-Mar-2008 04:15 am (UTC)
Me too! :-) Guess I'll know in 3.5 weeks.
18th-Mar-2008 09:45 pm (UTC)
Ooo, good luck. My partner used to be a good solid 12-hr-a-night kind of guy (when he could get it, which was rare, so he was always tired) and the mask changed his life. I hope you find a solution that works well for you.
19th-Mar-2008 04:16 am (UTC)
Thanks. I'm hoping the mask isn't the answer -- I know some people take to them better than others, and some people they cause sickness in ... and... I don't know -- I think my life is complicated enough without adding that level of complexity... But if that is the recommended answer, I'll at least give it my best shot.
19th-Mar-2008 10:12 pm (UTC)
I hear ya. Three more weeks (and a fraction maybe)? Good luck...
19th-Mar-2008 11:40 pm (UTC)
Thanks.
18th-Mar-2008 09:53 pm (UTC)
The Wendy's is off the main drag. It's down the frontage road (properly named Brown Drive, but I'm not sure anyone in town calls it that), west of M52. If you'd turned left at the light -just- after you turned onto M52 (it's almost a U-turn, but not quite), it's down that road, just past the Comfort Inn and before you get to the propane dealer.

My sister and I have had lunch quite a few times at the Chelsea Grille. It's good food. Not as foodie as the Common Grill (nor as expensive), but good basic food.

It's hard to do broccoli well in a cafeteria/large kitchen setting. I thought the food at CCH was at least as good as the food at UMs Women's & Children's, and it served at something much closer to proper serving temperature.
19th-Mar-2008 04:22 am (UTC)
Not sure I was on M52. The Garmin took me in exit 162 -- down Old US 12. If M52 is the street that the hospital is on, I was only on it for what, 0.2 miles, and only between the hospital and old 12. Wrong exit I'm guessing. There was something (Stivers?) at the exit the Garmin took me down, but I didn't know what it was, so I didn't try. Wonder if the Common Grill (which I didn't find) is the place that was recommended... but is probably closed on Mondays so never mind... The wait-staff was wearing flashing-but-subdued green, and there was good fiddle music being played. But that's all the St. Patty's day madness that hit there. Oh, and the cigarette smoke that came over the wall from the 3 smoking seats, but while noticeable, it wasn't terrible. (Can't compare CCH to Women's, but I'll take your word on it.)
20th-Mar-2008 02:35 am (UTC)
You're right -- different exit. I didn't know you were navigating by GPS -- the Fletcher Rd exit (162) is probably a little more direct to CCH's south entrance, but not to the west entrance (which is the one off M52). Stiver's is, afaik, your standard small town EAT at the exit. Food is decent, but it's mostly a local's place now. The Common Grill is downtown, past the hospital (and yes, it is closed on Mondays).
18th-Mar-2008 09:54 pm (UTC)
Ooh great idea, let's conduct a sleep study in a noisy room - that'll give good representative results, won't it?

Of course our definition of "noisy" and some other people's might not coincide, but generally in an experiment one tries to get rid of variables which might affect the results! (Actually, I'd have expected them to ask whether you normally sleep in a quiet or noisy environment and then try to replicate that so that what they saw was representative of your normal sleeping arrangements.

Hope it manages to produce some useful results anyway!
19th-Mar-2008 04:25 am (UTC)
To be fair, it wasn't _terribly_ noisy, but _I_ could hear the receptionist talking on the phone and other whatnot, and it caught my attention. Agree with your 2nd and third paragraphs completely. Thanks.
18th-Mar-2008 10:17 pm (UTC)
In the winter I find that if I wear really warm stuff to bed (sweats) I get lots better sleep. If I don't, I wind up waking a dozen times and being a wreck, and pretty stiff, the next day.
19th-Mar-2008 04:29 am (UTC)
Heh. At home I have the sheet, the comforter, the quilt, and then the blanket folded in half on my side of the bed. And sometimes a few other things strewn atop. I usually wear a flannel nightgown. Was warned to bring a 2-piece here, so I had flannel PJs. AND I kept my socks on. I looked at the sheet and the flimsy blanket-thing and said I really hoped they had something else, and she came in with a heavy duty blanket that kept me warm all night long. I like wearing warm stuff, but having enough blanket-matter is even more critical to my sleep, I think. (I think the heat was up to 80 or 85 on the dial -- don't know what that was for real -- but that's warmer than even I want it, and I had no problems -- and she told me that if I sweat she'd come in and turn it down... and she didn't come in.)
18th-Mar-2008 10:18 pm (UTC)
If they haven't already, have them check your vitamin D level. Our doctor is finding a strong correlation between vitamin D levels, sleep issues and depression. He put me on fairly massive doses (6000 IU per day) because my level was very low. He also believes that the acceptable levels are much lower than they should be. On whatever scale they use for the test, he says that he considers 65 to be the low end of acceptable.
18th-Mar-2008 10:28 pm (UTC)
The sleep study is quite specific. They don't just watch and listen while you sleep. All those electrodes capture information and stream it to the console. There are other bands, etc. that measure when you do or do not breathe, and for how long, and the oxygen level in your blood. They actually see what sleep level you get to, when, for how long.

If they say you stopped breathing in your sleep - however little there was of it -- then you stopped. While it is true that sleep apnea correlates strongly to obesity, there are people with sleep apnea who are just fine or underweight.

All I can tell you is this: When they told me I needed a CPAP machine, I cried out loud, tears flowing. When I went back (if you end up diagnosed with sleep apena, you go back a second time to try out the different "dosages" to determine the settings for your machine) I couldn't stop crying. I told the technician (a very nice young Brit who eventually calmed me down in a skillful but gentle way) that I felt I was being punished for being fat.

Now that I've been using one for a year, I went to my physical with my doctor, and *begged* that she refill the order for my CPAP. They will get it from me only over my dead body -- unless I really do get over the condition.

I had no idea what a difference it makes. Not just that you get enough rest. You also have less physical stress -- sleep apnea is dangerous to the heart. My night sweats have gone away.

Keep us posted. If you need to talk, you know where to find me.
19th-Mar-2008 04:36 am (UTC)
Thanks. I'm looking forward (kind of) to learning how often I stopped breathing, and low my blood oxygen went (according to the glowing thing on my middle finger) and everything else that they know. Or will know within the next 3.5 weeks.

I don't think I'd be doing the "denial" and the "anger" thing as much now if the only contraindication were my weight -- but dangit -- I don't snore like any of the famous folks we know who learned of their apnea -- nobody's noticed me stopping breathing -- I don't gasp -- I don't wake up with headaches -- the only "symptom" I have is being on the edge of the bell curve as far as how much sleep I need, and I've been there since I was quite young.

Much appreciation.
19th-Mar-2008 02:43 pm (UTC)
I didn't have the other symptoms, either. (I thought the night sweats were due to my age, not the sleep apnea, as did my doctor.) I've never been a snorer, but lately I started breathing more heavily. As for needing more sleep when you were young -- yeah, that's actually normal. Seriously.

I'm not saying you do have the sleep apnea. That's for the study to reveal. I'm just saying that, if you do, dont' fight the CPAP and go for it. It's worth the trouble.

You're welcome. As I said, you know where to find me.
19th-Mar-2008 06:45 pm (UTC)
I needed more sleep then my classmates as a child. And I seem to need more now than I did then. And it's getting worse and I'm getting (more) worried.

I won't fight it if they prescribe it.
19th-Mar-2008 04:29 am (UTC)
I will keep that in mind -- thanks. As far as I know that test has not been done.
18th-Mar-2008 10:58 pm (UTC)
Your experience sounds very similar to filker0's from the beginning of this year. His sleep study and MSLT were to confirm the previous diagnosis of narcolepsy (so the insurance company would pay for some of the meds the neurologist wants to have him try). Along the way, they determined that he had not full-blown apnea, but hypopnea - only when sleeping on his back (his pulse ox dropped down to about 80% or so). He had a second overnight study to try out a CPAP, which didn't go so well. He's currently on a home trial with a BiPAP, and has yet to get thru a full night with it. He sees the doc for a followup on April 1.

And we got a copy of the sleep study in the mail before we had his followup appointment from the first study, so had a pretty good idea of what was going on.
19th-Mar-2008 04:39 am (UTC)
Hope I get results in the mail too, but, heh, I'll not hold my breath.

ASO and Narcolepsy were the 2 things they were investigating me for. Hope filker0 finds the correct Whatever-he-needs to make it all right.
19th-Mar-2008 02:46 pm (UTC)
If you went to the university, the report will go to your doc, and that's where I got my copy.

It's an interesting read. Turned out I stopped breathing every 8 minutes, or so. Scary. Never made it to stage 4, mostly went between 1 and 2, with most time spent in 1. No wonder I was so tired!

Not all, but some of my depression was from lack of sleep. As I said, you'll be amazed at what a difference good sleep can make.
19th-Mar-2008 12:23 am (UTC)
My sleep study was done at home using a much simpler machine, but it correctly diagnosed my sleep apnea. I'm down from needing 7-9 hours' sleep to more like 5-6, and I'm not keeping Colleen awake with my snoring.

They can pry my facehugger off of my cold, dead face when I'm done using it.
19th-Mar-2008 04:43 am (UTC)
I've never been told I snore except, very occasionally, when I have a cold, and then it's usually "but not really badly".

I would dearly love to be able to get enough sleep within 5 hours. (I feel like I'm always busy, and that I'm always falling behind.) Of course at this point, I'd probably cheer for 7-9.

For me, other than the sting of "everything you know/believe is wrong", the "now wait for most of a month" is what's going to be getting to me.

And just _what_ am I doing up at getting on 1 am? Typing into my LJ... why?
19th-Mar-2008 03:03 am (UTC)
I've often thought about doing a sleep study. I can sleep at least as many hours every night if I let myself. But I pretty much know what the causes are. Part of it is constant nasal congestion. I have yet to find something I can afford that will actually open up my sinuses. And something to keep my throat open.
19th-Mar-2008 04:49 am (UTC)
I just learned that a friend has apnea (he didn't tell me but his wife showed me his apparatus) -- and the solution for him was to wear a funky hingey thing in his mouth that adjusts his jaw to keep his throat more open, I guess. I am curious about this approach, since I'm a SERIOUS grinder -- I wear a bite splint (which made the TMJ go away, but doesn't stop the grinding), and they noticed me grinding my teeth often overnight -- so that's a semi-familiar solution.

Keeping the throat open seems to be a mechanical sort of thing, but opening the sinuses... Does peppermint work for you. If so, would one of those systems that puts moisture in the air and can add essential oils to it work for you?
19th-Mar-2008 03:42 pm (UTC)
I am teeth clencher. I've worn bite splints for years, although I've clenched so hard I've broken 3 dentist made ones & have been wearing a plain athletics bite guard for a couple years. I saw that hingey thing a while ago but then forgot about it. It seems awfully expensive. I didn't want to spend the money on it unless I knew it worked (catch-22 there, I guess).

I do have a humidifier running all the time (which sits right outside my bedroom doorway) so I haven't considered trying a vaporizer. I have tried the Sudafed plug-ins & they work for a few nights, then it seems I get congested all over again. I've also coupled it with breathe-rite strips.
19th-Mar-2008 06:49 pm (UTC)
I can't push for the funky jaw thing -- I only just learned of their existence the other day -- and the wife said that one of them causes him to need to massage his jaw for 10 minutes in the morning in order to relax enough to go about his day, and the other one takes him half an hour to recover from ... but I figured this was a YMMV item, and if you didn't know about it I wanted to mention it.
21st-Mar-2008 08:32 pm (UTC)
You can get teeth guards at any sport store. You heat it in hot water, mold it to your teeth, and then dip in cold water to set. No hinge.

Won't work to keep the throat open, but I'm told it helps with teeth grinding. Husband tried one years ago with great success. It's a lot cheaper than the dental apparatus you get from a dentist.
21st-Mar-2008 09:01 pm (UTC)
(I have a bite splint from my dentist -- and while it keeps me from destroying my teeth quite so fast, I still grind.)
19th-Mar-2008 05:27 am (UTC)
Have you tried nasal irrigation for the congestion? Roughly the equivalent of timed-release sudafed *plus* claritin, at least for me. YMMV, of course, but salt is as cheap as it gets.
19th-Mar-2008 02:47 pm (UTC)
I second this recommendation. I do this daily. When I skip, I have trouble.
19th-Mar-2008 03:48 pm (UTC)
I never even think about it when I am at the store. More people are saying it works, so I will make it a point to buy it & use it.
19th-Mar-2008 03:47 pm (UTC)
Hmmm. I've never tried the nasal irrigation, but I am hearing that it works. I guess I will have to try it.

Usually I take Sudafed & it works some of the time. I tried Claritin years ago when it was still a prescription with no luck.
20th-Mar-2008 03:44 am (UTC)
Claritin seemed to help a little, but not as much as sudafed. The combination worked a little better.

All I'm taking now is flonase, after I water my nose. I can actually smell the flonase now.
20th-Mar-2008 04:01 am (UTC)
I can imagine what flonase smells like. I tried that years ago too, it only gave me bloody noses. I was using nasacort for a while, but I am currently unemployed and can no longer afford it--or much else for that matter. But I will get the nasal irrigation thingy.
20th-Mar-2008 04:29 am (UTC)
That's the great thing about nasal irrigation. Kosher salt is about $1/pound.
19th-Mar-2008 12:14 pm (UTC) - Sleep Studies
I've gone through that incredibly annoying procedure twice.

The first time was in a facility that took some effort to make sure the bed was comfortable and the facility quiet. That was annoying, but not too bad.

The second was in a hospital with lots of ambient noise and a crappy bed. I don't think I slept a wink.

Wick
19th-Mar-2008 06:43 pm (UTC) - Re: Sleep Studies
*sigh* I hope at least you/they learned something from these experiences (other than where to avoid).
19th-Mar-2008 09:43 pm (UTC)
I wouldn't have pegged you as a candidate for sleep apnea, but you never know with some people. You just have to go against the grain don't you?

Hopefully they can find some other solution than the mask, but I do know at least one person whose life has been changed by the mask. It's a goofy thing. He wears the one that wraps around his face and stuffs a tube up each nostril. It took him a while to get used to it, but he can actually sleep now.`
19th-Mar-2008 11:39 pm (UTC)
*g* I wouldn't have pegged me either. I like your explanation.

I'll know more in 3.5 weeks when I can talk with the Neurologist and get my results.
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