Saturday, November 22, 2008

Sleep Treatment

My sleep study treatment was last night. I was all hooked up with the wires by 9:30 and just lay in bed watching TV until I got tired which was about 10:30. Lisa, the tech came in to fit me with my CPAP mask. I had several to choose from. My first choice was one that resembled the tubes that go with an oxygen mask/tank. Instead of the two narrow prongs that fit up inside your nose, this one had two oval 'pad's that fit right under your nostrils. I thought it might be the best one for me since I'm a side sleeper. I had a half hour of getting used to it and I wasn't at all sure I liked it. I felt like I had cotton stuffing up my nose and it bugged me. I switched to the mask where it covered my nose only instead of the full face mask. It has straps with velcro that fits across the forehead, and has a chin strap and other straps that run down the side of the face. It was about 11:15 when I settled in for the night. I woke up shortly afterwards to use the bathroom and when Lisa came in the room to unhook me from the CPAP machine she commented that I was halfway done. I asked her the time and she said it was 3:30. I was very surprised, as I thought I'd only been asleep for about an hour. She said I was into a deep sleep within 5 minutes of closing my eyes. I did have a hard time falling back to sleep but I eventually did. Once again I needed to use the bathroom and Lisa said 'good, you're all done, it's time to get up'. It was 6:30. Fastest night of sleep I've had in a long time.
After Lisa removed the mask and all the wires, she gave me a copy of my Sleep Study Interpretation.

There are five stages of sleep:

1st stage:
is light sleep where you drift in and out of sleep and can be awakened easily. In this stage, the eyes move slowly and muscle activity slows. During this stage, many people experience sudden muscle contractions preceded by a sensation of falling.

In stage 2, eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.

When a person enters stage 3, extremely slow brain waves called delta waves are interspersed with smaller, faster waves.

In stage 4, the brain produces delta waves almost exclusively. Stages 3 and 4 are referred to as deep sleep, and it is very difficult to wake someone from them. In deep sleep, there is no eye movement or muscle activity. This is when some children experience bed wetting, sleepwalking or night terrors.

The fifth stage is the Rem period, breathing becomes more rapid, irregular and shallow, eyes jerk rapidly and limb muscles are temporarily paralyzed. Brain waves during this stage increase to levels experienced when a person is awake. Also, heart rate increases, blood pressure rises, and the body loses some of the ability to regulate it's temperature. This is the time when most dreams occur, and, if awoken during REM sleep, a person can remember the dreams. Most people experience three to five intervals of REM sleep each night.

My first study shows that I have an abnormal sleep architecture. Onset of sleep was at 5.5 minutes and the REM latency was unachieved all night. Lisa explained that I went from stage 1 to stage 2 and stayed there all night. She says it's no wonder I am always so tired and have no energy. Last night she says I was in all 5 stages but went into deep sleep ( stage 4) within 5 minutes of closing my eyes. She said I experienced several REMs during the night which means I had been dreaming.

My first study shows that I experienced a total of 86 apneas (stopped breathing) and hypopneas ( shallow breathing / low respiratory rate) which is about 15.4 an hour. A total of 12 obstructive apneas were recorded.
Last night with the CPAP I experienced no apneas or hypopneas.

I am definitely going to be getting a CPAP. Lisa said I'll probably have it after Thanksgiving. I'll have to go back in January for a followup to make sure the CPAP is working properly and some data from it will be downloaded.
I'll be seen by a Respiratory Therapist who will review my equipment and resolve any issues I might have had since receiving the CPAP. I'll also be examined by a doctor who specializes in sleep disorders.

I feel pretty good today, the most rested I've felt in many months.

The mask will take some getting used to. The machine makes a humming sound but it didn't really bother me. I hope it won't bother Tom too much. Lisa gave me a paper on troubleshooting if I experience things like mask leaks, skin irritation, pressures sores, nasal congestion, chest discomfort. The last one on the sheet was 'bed partner intolerance' Possible cause: noise, anxiety Correction: promote education of the patient and bed partner, recommend attending a patient support group. In other words 'suck it up bed partner and deal with it'!!

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