No REM Sleep? Please help!

First I'd like to say that I am new to this forum but I have been reading it for some time. I had my first sleep study last night and am concerned. It was a split-study. I went to sleep at 10 and was awaken at 2. The technician said that I had had no REM sleep at all. I understood this to mean that the data would be inconclusive because I would have to go back. I felt like I slept normally. I woke up with the same tiredness and the same headache. It's seriously starting to kill me. Why would it have to be measure during REM sleep only? Please help!

Welcome -- you're saying it was a split study but you didn't say whether you were put on cpap when the tech came in at 2:00. Can you clarify for us?

Please do clarify what happened the rest of the night. It could be that the tech was commenting on the extent to which you really need help. Sleep can be so fragmented by breathing difficulties that you can't reach REM.

She told me that I had to sleep for two hours and show at least 5 episodes of (apnea I guess) before she could do the titration portion. Since I didn't enter REM she never put a mask on me. She said that was part of the criteria that had to be met. Does that make sense? That's the way I understood it.

rockncountry101 wrote:She told me that I had to sleep for two hours and show at least 5 episodes of (apnea I guess) before she could do the titration portion. Since I didn't enter REM she never put a mask on me. She said that was part of the criteria that had to be met. Does that make sense? That's the way I understood it.

Those criteria (for starting the titration) make sense, but then why did the tech come in and wake you up at 2:00 if you hadn't met the criteria? Please tell me they didn't kick you out and send you home at that time?!

No. But I didn't go back to sleep neither. I might have produced REM sleep if I had been given a little longer. It seems my best sleep comes right before morning. However, it was a split study and I was told that from the beginning. They are going to let me come back at another date to try it again at no charge, but I'm not sure I even want to. It is just very stressful.

It is not uncommon for someone to have no REM sleep during the first part of the test. That is one of the indicators that would then be checked during the titration portion to see if there was an improvement when using the mask.

Concerned you either didn't get the correct info, or they perhaps are not doing the test right?

When do you expect to get the results of what they did record? The tech normally won't tell you any details, but the report will.

In my both of my studies, I had 0 REM sleep during the first part of the test.

Krelvin wrote:It is not uncommon for someone to have no REM sleep during the first part of the test. That is one of the indicators that would then be checked during the titration portion to see if there was an improvement when using the mask.

Concerned you either didn't get the correct info, or they perhaps are not doing the test right?

When do you expect to get the results of what they did record? The tech normally won't tell you any details, but the report will.

In my both of my studies, I had 0 REM sleep during the first part of the test.

The information will be complied and sent to my ENT who ordered the test within a week or two. I think that when I go back (if I do) I'll be too scared to try to get to sleep. (Sorta like this time.) What happened in your case? Did you get fitted for a mask and how has it worked out for you?

rockncountry101 wrote:No. But I didn't go back to sleep neither. I might have produced REM sleep if I had been given a little longer. It seems my best sleep comes right before morning. However, it was a split study and I was told that from the beginning. They are going to let me come back at another date to try it again at no charge, but I'm not sure I even want to. It is just very stressful.

It is stressful, but do go back -- especially since they're offering to repeat the study at no charge. Sleep apnea has not been ruled out yet.

Your symptoms sound suspicious and your doc referred you for a sleep study for a reason. Get as complete a copy of this first study as you can.

rockncountry101 wrote:The information will be complied and sent to my ENT who ordered the test within a week or two. I think that when I go back (if I do) I'll be too scared to try to get to sleep. (Sorta like this time.) What happened in your case? Did you get fitted for a mask and how has it worked out for you?

It is a test. Some tests are not pleasant, I can think of many over the years that I would have preferred to opt out on. The goal of the test is to find out if you OSA. If you don't take the test, you won't find out.

In both of my studies, 1/2 through, I was put on a mask, I slept pretty good after that and I got good tests. I got a machine that I use every day anytime I lie down without fail. It helps me, has help correct my OSA and made me feel better. That has helped me with other parts of my life. I can't imagine not using it now, ever.

Never said it was pleasant, but you do what you gotta do to move forward.

Bring a teddy bear? Favorite blanket? to make you feel better, but take the test with a positive attitude. After it is over, it is over.

Thanks everyone for the advice. I just wonder what happens next time if I don't get any REM sleep. I slept a solid four hours. At least I thought I did. I took my usual medication plus a sleeping pill, which I was told was fine. Wouldn't failing to get REM sleep be a sleep disorder itself?

rockncountry101 wrote:Thanks everyone for the advice. I just wonder what happens next time if I don't get any REM sleep. I slept a solid four hours. At least I thought I did. I took my usual medication plus a sleeping pill, which I was told was fine. Wouldn't failing to get REM sleep be a sleep disorder itself?

As mentioned before. You don't fail the first part of the test if you don't get REM sleep. That is not what would stop going to the second part of the test.

If you don't get REM sleep during the second part, you still completed the test, but it may indicate other issues. But the test would be over.

Krelvin, do you happen to know if it's general policy at sleep labs to only start titration if those apnea-event criteria are met in time? I was wondering if significant flow limitation with arousals would be sufficient for starting titration -- or not. RERAs could certainly keep a person from getting into REM and ultimately would need treatment with PAP therapy, but my impression is that RERAs (with no apnea events) don't count as criteria for titration.

Actually don't know. I do know they needed x amount of sleep (however broken it was) before they could move to the next step and that you had to have events high enough to move forward. But if you are scheduled for a split test, it would have to be pretty inconclusive for them to not do that part.

No REM sleep is an indicator of issues, but not something that would hold back going to the next test.

I just wish I knew the answer to that. I can't believe that everyone that goes into a lab study reaches REM sleep. Like I said, what if my problem at home is that I DON'T reach REM sleep often. Hopefully someone will clear that up for me soon. I'll let you guys know when I find out just what the reasoning behind that is.