Confused about sleep study/OPO results

[rz2014]

Hello! I'm a 28-year-old male, about five months ago I noticed that I was having a lot of trouble staying awake during the day, especially at home. Feeling like my brain was in a fog. I frequently was taking 2-3 hour naps on my days off work, and was routinely sleeping for 11-12 hours a night, and still not being well rested. My primary physician recommended I take a sleep study and MSLT, so I did (to the tune of $800 ).

---

My results (this was in mid-August) were:

No apneas, no hypopneas, "infrequent" irregular airflow. Oxygen never dipped below 92%.

My sleep, on the other hand, was quite restless. While I fell asleep quickly (8.0 minute sleep onset), out of 437 minutes in bed, I was only asleep for 276.5 of them (a pitiful 63.3% sleep efficiency). I was in Stage 1 for 63 min (23%), Stage 2 for 149 min (54%), Stage 3 for 63 min (23%), and spent only 1.5 minutes in REM sleep (which is odd, because I recalled at least three dreams that night). They measured 71(!) spontaneous arousals/awakenings, 31 of which they attributed to "limb movements". The sleep study put my Limb Movement Arousal Index at a moderate 6.73, and Limb Movement without Arousal was 4.34.

The MSLT was pretty normal, fell asleep on 3 out of 4 naps, average latency was 13 minutes, so nothing too concerning. My doctor's diagnosis was Periodic Limb Movement Disorder, and his recommendation was to take Ambien, something I was (and am) reluctant to do because of the numerous side effects. He also recommended that since I didn't exactly get a great night's sleep, that I take an Oxygen Pulse Oximetry test (the finger one) at home.

---

Instead of taking Ambien, my therapist recommended I try melatonin first, I did, and my sleep quality slightly improved. My 11-12 hours sleeps have become 8-10 hours, and my naps are much more infrequent (just 1 long nap in the past month). Most importantly, I'm somewhat more alert while awake (though while at home, I still feel groggy/drowsy/"brain foggy" especially in the evening).

But the home OPO I took a week ago is what worries me; the nurse said it registered "cyclical" results, with my oxygen dipping as low as 83% at times. She recommended that I take a home sleep study (yay, more money), something I can't do for another three weeks because of a chaotic work schedule up ahead, and lack of transport to and from the sleep center.

---

Given all this information, what do y'all recommend? Should I take days off work to do the sleep study? Could it be apnea? Could something at my house be causing my sleep issues? Anyone been in a similar bind before?

I appreciate any and all answers, and thank you very much for reading

[Sheffey]

My doctor's diagnosis was Periodic Limb Movement Disorder, and his recommendation was to take Ambien

my therapist recommended I try melatonin

What kind of people are you dealing with?

Neither one of these recommendations is appropriate for PLMD. My sleep doctor would scream if she knew this was being recommended.

[rz2014]

Oh geez, that's not comforting, what are the usual treatments then?

But yes, my report has this under "Recommendation", and echoes what the nurse told me post-study: "I recommend treating him for Periodic Limb Movement Disorder. Ambien may control his leg movements and increase his REM sleep.".

[ChicagoGranny]

Sheffey may have dropped out because there has been trouble with the website's server today.

Right away you should have your serum ferritin level checked.

Stop all caffeine, including that in chocolate. Antihistamines also cause PLMD to be worse in some people.

Wikipedia has a good article --> https://en.wikipedia.org/wiki/Periodic_ ... t_disorder

The first line of drugs to try are dopaminergic agents - Mirapex and Requip. You do need a doctor who is knowledgeable and will work with you to find the right drug. It varies by patient, and the side effects can be bad. You have to find one that is effective and has minimal side effects.