Sleep Study Results - Hmmm...

[Madalot]

Looks like I'm being told to stay off my back. Here's the summary. I have a graph or two, but they sent them in TIF format and I need to separate them out from the Word document, then save them in jpg. I'll do it if anybody asks, but unless someone wants to see them, I'm not going to bother.

RESULTS
CPAP / BILEVEL STUDY Start Time 10:08:29 PM End Time 5:46:33 AM
The study began with AVAPS settings IPAP 13, EPAP 6 rate 7 and O2 at 2L/min. During the first part of the study she slept on left and right sides and slept well without events, including during REM sleep. The IPAP when asleep increased to 14-15. Later in study patient was positioned supine and had sustained sleep. At this point she had possible obstructive vs hypoventilatory events with oxyhemoglobin desaturation to EPAP was increased to 12 and rate to 9 with some improvement. Once most of the appeared gone the tv was increased slightly to 440 to allow the IPAP more room to assist with increasing pressures. However, patient did not fall back to sleep in supine position. She did return to her Left side for the remainder of the night and had no further events. She did enter REM sleep again and at this time the IPAP increased to 16-19 with EPAP at 12.

IMPRESSION
Nocturnal hypoventilation secondary to neuromuscular disease. IPAP at 13 cm H2O and EPAP at 6 cm H2O maintained oxyhemoglobin while sleeping on her side. However, residual events were seen when she was on her back. These improved with increase in EPAP. EPAP at 10-12 cm H2O eliminated desaturations.

RECOMMENDATION
Since she appeared to have adequate nocturnal ventilation when on her side positional measures may be sufficient to maintain sleep and adequate oxygenation. A simple method is to place a tennis ball in a sock and pin to back of nightgown. This makes it uncomfortable to sleep on the back and trains patient to sleep on the side. If this is not effective would increase the EPAP to 10-12 cm H2O.

For now, my doctor is recommending that we leave the equipment and all the settings as is and that I do the tennis ball thing, which would be fine except there isn't a nightgown/pj to sew it into...if you get my drift.

I still don't think we've addressed my awakenings, but they seem to be focused on the back sleeping as the culprit, even though I really don't sleep on my back that much (but probably more than I realize I guess).

I am going to assume (yeah, I know, I'm an ass) is that the increased pressure does wake me up sometimes, but I'm going to have to live with it.

[Emilia]

Sans nightgown or pj's....you could get yourself a child size backpack or purse that wears like a backpack and stuff it tightly with towels. Wear that and I doubt you'll roll onto your back as it would be quite uncomfortable, I would think.

Best of luck..... I hope this resolves your problem!

[Rebecca R]

Your doc must work holidays. Are you relieved to have the results? I wonder what the tech was surprised about???

[Madalot]

Sans nightgown or pj's....you could get yourself a child size backpack or purse that wears like a backpack and stuff it tightly with towels. Wear that and I doubt you'll roll onto your back as it would be quite uncomfortable, I would think.

Best of luck..... I hope this resolves your problem!

No matter what I do, this is not great for me because being disabled with a neuromuscular disease, turning over in bed is difficult, thus why I sometimes pause on my back to rest. I try really hard not to stay there, but sometimes the effort it takes just to get that far has me totally exhausted (physically). Turning over has always been difficult, but I can't imagine trying to do that with something on my back. I have to be on my back at least for a moment or two to get from left to right side.

I would be perfectly content to remain on my left side all night where all my breathing difficulties are well controlled, but it causes me horrendous muscle pain in my left leg to stay on it all night.

Your doc must work holidays. Are you relieved to have the results. I wonder what the tech was surprised about???

Probably surprised that things went as smoothly, all things considered, than he envisioned.

[Rebecca R]

Avoiding back sleeping:

viewtopic.php?f=1&t=50240&p=461529&hili ... ak#p461529

[Madalot]

Avoiding back sleeping:

viewtopic.php?f=1&t=50240&p=461529&hili ... ak#p461529

I'm trying to envision doing this, knowing that I must get on my back to get turned over. I physically cannot go the other way (stomach) and even doing it upwards (flipping to my back before turning the rest of the way) is difficult for me at best. I also cannot stay on one side all night because of pain.

And even the tennis ball could be a problem because sometimes the effort it takes simply to get turned that much leaves me weak, exhausted and out of breath, forcing me to try to rest a moment on my back before continuing the journey to my other side (and I sometimes fall asleep before completing the move).

Yeah..I'm screwed.

[rested gal]

Your doc must work holidays. Are you relieved to have the results. I wonder what the tech was surprised about???

Probably surprised that things went as smoothly, all things considered, than he envisioned.

Probably so. And probably a bit surprised that Maddie's SDB (sleep disordered breathing) was so strongly sleep position related.

[-SWS]

Madalot, I'm glad your PSG yielded some useful data. Regarding the challenge of turning over in bed...

I wonder if something like this might help compensate for the tennis ball or Zzoma solution:
http://www.google.com/search?hl=en&clie ... 72&bih=596

[msradar65]

For many years I slept on a hybrid waterbed. It looked like a regular bed but had tubes of water in it. Maybe a different mattress will help you stay comfortable on your side. Just a thought. Glad to hear you got some useful data from the study.

[HoseCrusher]

On a positive note...

It looks like you enter REM sleep both on your side and on your back. I believe REM sleep is important.

As far as back sleeping goes, I would suggest that when you wake up in the middle of the night, you make a conscious effort to see if you are on your back, and if so, roll over.

[welki]

Good news, Mad ... but tell me where that sleep tech is! Lemme at 'er! I want to punch her in the nose for making you worry.

(Nah, you're not screwed, just another PITA to deal with.)

Was nice "talking" with you last night,
welki

[Madalot]

On a positive note...

It looks like you enter REM sleep both on your side and on your back. I believe REM sleep is important.

As far as back sleeping goes, I would suggest that when you wake up in the middle of the night, you make a conscious effort to see if you are on your back, and if so, roll over.

Actually, the graph I'm looking at shows NO REM sleep on my back. The best I did on my back was N2. I flipped on my back, on my own at first, around 11:45 - 12:00 and according to their chart, made it to N1. I turned onto my right side around 12:15 or so and then slept on my right side from then until about 2:45 - 3:00. The REM sleep began around 2:15. I woke up around 3:00 and tried to move to my left side again, when he stopped me and asked me to stay on my back.

I went down to sleep around 10:08 and the first REM sleep I got was around 2:15 or so. The REM I got at the end of the study only last a few minutes as I woke up, probably because the pressure was around 19.

Honestly, I try NOT to sleep on my back and if I wake up that way, I always turn over.

[HoseCrusher]

Oops, I misread the report.

Do you remember when you wake up a night if you are on your back?

[Madalot]

Oops, I misread the report.

Do you remember when you wake up a night if you are on your back?

This is just it. I really DON'T sleep on my back much. My husband and I have talked about this at great length because my doctor had already mentioned back sleeping as being problematic. *IF* I'm on my back and my husband sees it, he wakes me up. But he rarely wakes me up and I almost NEVER wake up on my back. I wake up a lot, but I am almost always on my side.

The only reason I turned over on my back at all during the study is that I couldn't sleep, probably because the backup rate was faster than I am accustomed to and bothered me. I only stayed on my back for a short time, apparently making it to N1 during about a 15-20 minute period, then turned on my side to stay there.

I guess it's irritating me a bit because the results of this study now say positional apnea when I really do not sleep on my back that much. If not for him forcing me on my back, I probably wouldn't have been there much at all (I was on my way to my left side again when he stopped me and MADE me sleep on my back for a while).

So yeah -- they found I have serious problems on my back, but since I rarely sleep on my back, it really doesn't answer the other questions about why I wake up so much and feel so tired and unrested during the day. They're assuming it's from sleeping on my back, yet I can't really convince them it's not something I do that often.

[snuginarug]

So yeah -- they found I have serious problems on my back, but since I rarely sleep on my back, it really doesn't answer the other questions about why I wake up so much and feel so tired and unrested during the day. They're assuming it's from sleeping on my back, yet I can't really convince them it's not something I do that often.

Oh no. This is not the kind of answer you wanted. How frustrating and disheartening. I don't know what to say. I really hate this for you.