Can the CPAP community help me?

[sleepinow]

Hey everyone. So I haven't been here in a while, so let me just give you guys an update. I have been diagnosed with Obstructive Sleep Apnea, then Central sleep apnea, and now my newest sleep study does not include either of those two yet I wake up many times for no reason. Here is where I get a little aggravated....

So today I went to my polmonoligist Renuka Mapitagama located in Paramus, NJ. She has an overall high rating and I thought I should give her a try, and I did. So after completing my sleep study and getting it evaluated just today, it shows that most of the night I have arousals indexes hour.

Here are the pics of the study. All of it is in the link below (summary) If you would like for me to display it here, let me know please... (Sleep Latency test Included)

http://share.pho.to/7868j <<<<<<<<<


Anyways, she didn't really tell me something as to what is wrong with me. She told me to see a psychologist. I wondered why she would ask me to see a psychologist. I went to a sleep certified doctor to see why the hell I can't sleep not to go to some psychologist. She was talking about how the mind races and such. The problem is... my mind is barely ever racing and I am one very calm person and not impulsive at all. Like really? after four sleep studies a sleep latency test and NO diagnosis as to wth is wrong with me? I do not get it. I really don't. Wtf is the point of going to sleep studies if all the information contradicts one another (Now that I think about it the home study might have diagnosed me with Obstructive Sleep Apnea because I was sleeping supine). Here is a forum link that provides my previous studies

Here are the results for my home sleep study (Note the arousals on there 43 per hour)
viewtopic.php?f=1&t=94936&st=0&sk=t&sd=a&start=30

Here is the ASV Titration study AND the split night Diasnostic/CPAP titration study
http://imageupper.com/g/?S020001004E13975307271035045

Sorry for getting mad, but I make tons of decisions to try to improve my sleep and it seems as if I haven't progressed much. My sleep hygiene is excellent most likely better than most people. No drugs alcohol smoking.

I wake up tons of times during the night and FOR SOME REASON WHEN I EXERCISE (AS I KEEP MENTIONING IT TO EVERYONE AND NO ONE GIVES ME A CLEAR ANSWER) IT MAKES MY SLEEPING WORSE. I WAKE UP MORE TIMES. WHY? WHY! WHY!? phew... okay so. Please can anyone that can help me please do so. I am young and this is making me struggle because I keep anticipating that I will find out wth is wrong with me and I keep going to dead ends! I am going to request for my raw data soon.

RobySue, JohnBFisher, Sludge, Pugsy, and many others that I can't remember have tried helping me a lot so far, but it hasn't done too much(you all probably definitely do want to help me and I truly believe that but lets be realistic). I have followed the advice to get a full sleep study done all over. I did it, it states I do not have any sleep apnea (WHICH MEANS SOMEONE MESSED UP) my arousals seem to match my home sleep study. I had a split study that showed overwhelmingly a huge contrast compared to the other studies. Please can anyone like guide me to the best doctor in NYC or New Jersey area that might help me. I have a shitty UnitedHealthcare Community plan insurance, BUT I WILL PAY CASH TO FIND OUT WTH IS WRONG WITH ME IN REGARDS TO WAKING UP IN SLEEP MULTIPLE TIMES AND SLEEPING 10 HOURS AND 30 MINUTES TO FEEL RESTED WHEN I USE MY ASV MACHINE IN CONJUNCTION WITH A SHIT LOAD OF MELOTONIN EVERY NIGHT (50-80mg)

Oh heres another thing... why would I get sent to a psychologist when it is the unknown arousals that is causing my sleep problems. What would the psychologist do? Sleeping is completely unconscious (I believe) (unless your lucid dreaming or have a paralysis)
Please guys, my future looks bleak, depressing, and potentially poor and jobless.

I was crying to the doctor because I felt so hopeless... i am crying now because i feel hopeless... like seriously what can/should I do
And sorry if there is any bad grammar errors, I have not revised this too much

[mgaggie]

I was crying to the doctor because I felt so hopeless... i am crying now because i feel hopeless... like seriously what can/should I do
And sorry if there is any bad grammar errors, I have not revised this too much

Go and see a psychologist. What harm can it do?

[sleepinow]

I was crying to the doctor because I felt so hopeless... i am crying now because i feel hopeless... like seriously what can/should I do
And sorry if there is any bad grammar errors, I have not revised this too much

Go and see a psychologist. What harm can it do?

Thanks for your response! The reason why I do not know if I should see a psychologist is because I am attending school now and I do not want to potentially waste my time if there is most likely no point in seeing him/her
Could you provide an explanation for the reasoning of why I should get one other than because my doctor recommended it? Why not a neurologist?
Anyways, I will look for a psychologist over google right now and hopefully find a good one. I will hopefully try everything and see if it works because I have no other choice. Thanks

[mgaggie]

I am going to be a bit brutal here, but I think you need it.

You over think things. You are obsessing over this perceived problem you have. Have you ever thought that your problems could be psychological? Stress and anxiety can and does manifest itself in strange ways. Maybe there isn't an answer to why you wake up multiple times during the night, although you say you can't sleep, so what is it? Insomnia or multiple wake ups?

[sleepinow]

I am going to be a bit brutal here, but I think you need it.

You over think things. You are obsessing over this perceived problem you have. Have you ever thought that your problems could be psychological? Stress and anxiety can and does manifest itself in strange ways. Maybe there isn't an answer to why you wake up multiple times during the night, although you say you can't sleep, so what is it? Insomnia or multiple wake ups?

Thanks again for your response

What makes you think that I over think things?

I have absolutely zero anxiety as far as I believe because I do not panic at anything unless probably something bad happens like a bad car accident or something. Stress, I do not think I am stressed? How can I tell? serious question. I truly do not think I am stressed because idk I just don't feel it. Many people consider me a calm individual and easygoing. I remember I used to have stress and anxiety but that went all away after I quit my video gaming addiction, stopped doing drugs(I didn't them alot either), improved my school performance greatly, stopped drinking caffeine, successfully practiced meditation multiple times, I can't be stressed now, I just don't feel it

I understand that stress may be a good reason to see a psychologist but what way can I show you that I am not stressed. Like isn't it easy to distinguish whether someone is stressed or not?

Yes my problem CAN be psychological but what is the chance of that when I do not display any psychological abnormalities that I am aware of. I should note that I do not know exactly what psychologists will examine me on, but if someone who has gotten their sleep fixed who did not have any stress or anxiety and saw a psychologist then count me in.

And to answer your last question, I guess it is both. I get multiple wake ups and those multiple wakeups causes me not want to fall back asleep because of the wakeups. I do fall asleep pretty fast though

[49er]

I am going to be a bit brutal here, but I think you need it.

You over think things. You are obsessing over this perceived problem you have. Have you ever thought that your problems could be psychological? Stress and anxiety can and does manifest itself in strange ways. Maybe there isn't an answer to why you wake up multiple times during the night, although you say you can't sleep, so what is it? Insomnia or multiple wake ups?

mgaggie,

Your response would make more sense if sleepinnow's sleep studies had consistently shown the same results. But since they haven't and he still feels horrible with no answers, his reactions are perfectly understandable in light of the circumstances. Unfortunately, when doctors don't have any answers, they pass off the problem as psychological because that is easier instead of trying to help patients with difficult cases solve their problems.

sleepinnow, since you are in the New Jersey area, have you considered going to see Dr. Stephen Park, an ENT/Sleep Specialist in NYC, particularly if your problems may be due to ENT issues? Hang in there and don't give up.

[sleepinow]

I am going to be a bit brutal here, but I think you need it.

You over think things. You are obsessing over this perceived problem you have. Have you ever thought that your problems could be psychological? Stress and anxiety can and does manifest itself in strange ways. Maybe there isn't an answer to why you wake up multiple times during the night, although you say you can't sleep, so what is it? Insomnia or multiple wake ups?

mgaggie,

Your response would make more sense if sleepinnow's sleep studies had consistently shown the same results. But since they haven't and he still feels horrible with no answers, his reactions are perfectly understandable in light of the circumstances. Unfortunately, when doctors don't have any answers, they pass off the problem as psychological because that is easier instead of trying to help patients with difficult cases solve their problems.

sleepinnow, since you are in the New Jersey area, have you considered going to see Dr. Stephen Park, an ENT/Sleep Specialist in NYC, particularly if your problems may be due to ENT issues? Hang in there and don't give up.

Thanks for replying

I have considered seeing Stephen Park and might actually go there. I was reluctant to go there because of the driving distance and just the pure chaos that goes on in the cities.I also wanted something local so that it wouldn't be an inconvenience to get there. I over exaggerated the chaos part but yeah there is just too much too much going on in the city.

See I think I should first see the raw data myself and see if I had breathing cessations that did not last 10 seconds to be an apnea but rather check and see if my arousals could possibly been happening after I stopped breathing lets say four seconds. How do I check for arousals anyway? Would it be a transition from a sleep stage to a wake stage? And would it be considered upper airway resistance syndrome?

I think that part of it may be ENT issues and part of it something else like my brain causing me to wake up for some reason that just doesn't make sense to me. That is just my guess though. Better to have an idea about something

[Sludge]

...Sludge... (has) tried helping me a lot so far, but it hasn't done too much...

How ya figure?

I told you forget about the OSA, you have a spontaneous arousal problem:

viewtopic.php?f=1&t=94936&p=879818&hili ... ge#p879818

so now the objective data supports precisely what I said...

How is that not helpful?

[kaiasgram]

sleepinow -- I looked at your report and saw that the diagnosis after this sleep study was Hypersomnia. Hypersomnia can be a symptom of depression and I'm guessing that's behind the recommendation to see a psychologist. Depression can mess up sleep continuity and I've read that it can cause spontaneous arousals during sleep. So I wouldn't assume that this is just a case of a doctor passing off a patient to a psychologist because it's easier than trying to help someone with a complicated, puzzling case. I can tell you anecdotally that my clients who deal with depression, even low-grade depression (aka dysthymia) almost always report difficulties with staying asleep at night.

Depression may not be at all relevant in your case but I can imagine that the doc you saw noted the possible red flags and thought it an appropriate next step.

I also think that your question about whether subclinical respiratory events (not meeting criteria for scoring an apnea, hypopnea, etc.) could be part of the explanation for all the spontaneous arousals is an interesting question.

Hang in there, I hope you find some answers and some relief soon.

[49er]

sleepinow -- I looked at your report and saw that the diagnosis after this sleep study was Hypersomnia. Hypersomnia can be a symptom of depression and I'm guessing that's behind the recommendation to see a psychologist. Depression can mess up sleep continuity and I've read that it can cause spontaneous arousals during sleep. So I wouldn't assume that this is just a case of a doctor passing off a patient to a psychologist because it's easier than trying to help someone with a complicated, puzzling case. I can tell you anecdotally that my clients who deal with depression, even low-grade depression (aka dysthymia) almost always report difficulties with staying asleep at night.

Depression may not be at all relevant in your case but I can imagine that the doc you saw noted the possible red flags and thought it an appropriate next step.

I also think that your question about whether subclinical respiratory events (not meeting criteria for scoring an apnea, hypopnea, etc.) could be part of the explanation for all the spontaneous arousals is an interesting question.

Hang in there, I hope you find some answers and some relief soon.

Kaisgram,

I reread the report and perhaps I am missing something. But it seemed like it was automatically linking excessive sleepiness which can be due to many causes to hypersomnia as a general diagnosis without being specific. It also mentioned possible narcolepsy although I wasn't totally clear on how strong a possibility that was.

It just seemed like to me there were still too many questions to be referring someone to a psychologist. That was the reason why I said what I did.

Sorry, I don't mean to make generalizations but sadly many people who have complex cases have experienced that with medical providers.

49er

[sleepinow]

...Sludge... (has) tried helping me a lot so far, but it hasn't done too much...

How ya figure?

I told you forget about the OSA, you have a spontaneous arousal problem:

viewtopic.php?f=1&t=94936&p=879818&hili ... ge#p879818

so now the objective data supports precisely what I said...

How is that not helpful?

lol why did you edit the quote?

Okay to explain the helping portion, there are things people have suggested that I do, that I did do, that hasn't helped me at all. My memory isn't the best so I may be wrong. Now the question is, what shall I do next?

[Sludge]

I also think that your question about whether subclinical respiratory events (not meeting criteria for scoring an apnea, hypopnea, etc.) could be part of the explanation for all the spontaneous arousals is an interesting question.

If a subtle respiratory event generates an arousal (and this is easy enough to see) it would have been scored as a RERA instead of a spontaneous.

If it's so subtle that it can't be seen, then "IMHO" it would be easier to change arousal threshold.

[sleepinow]

sleepinow -- I looked at your report and saw that the diagnosis after this sleep study was Hypersomnia. Hypersomnia can be a symptom of depression and I'm guessing that's behind the recommendation to see a psychologist. Depression can mess up sleep continuity and I've read that it can cause spontaneous arousals during sleep. So I wouldn't assume that this is just a case of a doctor passing off a patient to a psychologist because it's easier than trying to help someone with a complicated, puzzling case. I can tell you anecdotally that my clients who deal with depression, even low-grade depression (aka dysthymia) almost always report difficulties with staying asleep at night.

Depression may not be at all relevant in your case but I can imagine that the doc you saw noted the possible red flags and thought it an appropriate next step.

I also think that your question about whether subclinical respiratory events (not meeting criteria for scoring an apnea, hypopnea, etc.) could be part of the explanation for all the spontaneous arousals is an interesting question.

Hang in there, I hope you find some answers and some relief soon.

Thanks for your information, I would just like to know what would be best next step for me to take. I might consider a psychologist but I am sure more people here can give me advice either to support seeing a psychologist or using their own brain power to find a possibly better path. Maybe I am depressed, but I think it probably has more to do because I sleep like crap, idk, on the days I do sleep well I feel good. Also I have had no exercising and that too would probably reduce depression. But as far as I can tell I don't know if I am depressed if that makes sense. Any why would depression wake someone up?

[Sludge]

lol why did you edit the quote?

For grammatical reasons (change "have" to "has") and/consequently exclude the other folks (Sludge is only responsible for Sludge).

[49er]

...Sludge... (has) tried helping me a lot so far, but it hasn't done too much...

How ya figure?

I told you forget about the OSA, you have a spontaneous arousal problem:

viewtopic.php?f=1&t=94936&p=879818&hili ... ge#p879818

so now the objective data supports precisely what I said...

How is that not helpful?

lol why did you edit the quote?

Okay to explain the helping portion, there are things people have suggested that I do, that I did do, that hasn't helped me at all. My memory isn't the best so I may be wrong. Now the question is, what shall I do next?

sleepinnow,

I reread the report again and my question is what did this doctor suggest regarding following up on possible narcolepsy if anything? Perhaps you want to see a neurologist regarding this issue? And if you feel you have ENT issues that are interfering with sleep, perhaps you want to see Dr. Park?

49er