Sleep study results

[SleepyMcgee]

Got my sleep study results back. on my back my AHI is 30+. On my sides its <2.

I slept on my back ~20% of the time...Would fatigue be THIS noticeable after such a short time on my back? Anything else you guys see?

Honestly if this is about sleeping on my back I'll just do tennis balls....

Thoughts?

[Sylvia54]

Hi there, Using tennis balls does not really work.
Search the internet for a belt that you can wear around your chest, that will work much better.
i.e. "Slumber Bump Belt".
Ask your sleep doctor about something like that.

[LSAT]

What was the reason for the sleep study...why was it recommended?

[SleepyMcgee]

What was the reason for the sleep study...why was it recommended?

I'd been having fatigue come and go for a couple years (I'm 41). Got to a point where fatigue was persistent and getting worse. Primary care ordered it.


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[Julie]

Why didnt you go back to your orig. thread with this so people can know whats been happening until now? Its confusing this way with no history here.

[SleepyMcgee]

Why didnt you go back to your orig. thread with this so people can know whats been happening until now? Its confusing this way with no history here.

Fair point. There wasnt much data in that thread so I started net new but here is a link for folks interested. Thanks

viewtopic.php?f=1&t=114979&p=1114363#p1114363

[SleepyMcgee]

I guess what I'm looking for is this...People here always say 'there's much more to a good night sleep other than AHI' to which I completely agree and its why I pushed HARD for 6+ months to get a sleep study done. I had been using a CPAP on the hunch that I had SA and was able to control my AHI to under 5 EVERY night for >3 months...But my symptoms (fatigue, out of body feeling, sometimes dizziness, brain fog) didnt subside as much as I had hoped. I have been consciously trying to sleep on my side and I feel as good (sometimes better) than I did with CPAP...

So I'm curious, from the study results, does anyone see things that would point to other sleep issues or am I barking up the wrong tree?

Thanks again for all of the help.

[Pugsy]

On this report alone the one thing that stand out to me for a possible cause of the fatigue (and stress the possible because it is not a certain) is the long REM latency and the decreased time in slow wave sleep along with decreased time in REM.
It takes you longer to get to REM than normal and you don't get as much REM.

The body needs the "normal" progression of sleep stages along with the "normal" amount of time spent in each sleep stage for optimal restorative powers of sleep.

Now why you don't get as much deep sleep or why it takes longer...that's the million dollar question. When people have OSA we assume that the sleep apnea events are causing arousals and breaking the cycle of normal progression of all the sleep stages. So we try to "fix" the apnea events with cpap and assume that fixes the problem but sleep apnea alone isn't always the problem and if sleep apnea isn't the lone culprit then cpap can't fix the problem. CPAP fixes sleep apnea but unfortunately it can't fix "bad sleep" if the bad sleep is caused by something other than sleep apnea.
And there's a long list of potential culprits for "bad sleep" besides just sleep apnea.

All this assumes that "bad sleep" is the cause of your fatigue and it might or might not be the cause of your fatigue.

So we go back to "do we really need cpap if we can stay on our side". IMHO it might not be technically needed assuming a person can really totally stay on their side which I personally have found that it is not always so easy to do despite wanting to but I would probably continue trying cpap if I found that sometimes I felt better on cpap even if it wasn't all the time.
Sometimes feeling better is sure better than never feeling better IMHO.
There may be more than one thing going on here and while cpap can't necessarily fix everything....it can sure fix at least one thing.

Have you gone without cpap for a period of time now to see if you still get the "feel better some of the time" thing and can for sure with absolute 100% certainty stay off your back totally?
If you can't get "feel better some of the time" at all without cpap then I think you have your answer there. It might not be what you wanted as an answer but it's there. CPAP helps...just not as much as you hoped.

[SleepyMcgee]

Have you gone without cpap for a period of time now to see if you still get the "feel better some of the time" thing and can for sure with absolute 100% certainty stay off your back totally?
If you can't get "feel better some of the time" at all without cpap then I think you have your answer there. It might not be what you wanted as an answer but it's there. CPAP helps...just not as much as you hoped.

Yes. I've been off it for a month and have just as many 'good/great' days without it as I did with it. It seems completely random. But perhaps its some nights I sleep almost entirely on my side and others not.

I'm wondering if something like the nightshift device makes sense...I always try to stay off my back but honestly, once i'm asleep...All bets are off lol

thanks

[Sylvia54]

I guess what I'm looking for is this...People here always say 'there's much more to a good night sleep other than AHI' to which I completely agree and its why I pushed HARD for 6+ months to get a sleep study done. I had been using a CPAP on the hunch that I had SA and was able to control my AHI to under 5 EVERY night for >3 months...But my symptoms (fatigue, out of body feeling, sometimes dizziness, brain fog) didnt subside as much as I had hoped. I have been consciously trying to sleep on my side and I feel as good (sometimes better) than I did with CPAP...

So I'm curious, from the study results, does anyone see things that would point to other sleep issues or am I barking up the wrong tree?

Thanks again for all of the help.

Other sleep issues.
Okay, when you say "out of body feeling", I remember reading about that being a symptom of narcolepsy.

[Pugsy]

I'm wondering if something like the nightshift device makes sense...I always try to stay off my back but honestly, once i'm asleep...All bets are off lol

I dunno. I am like you...I prefer side sleeping (back and pelvis pain issues) but I will wake up hurting like the devil and being on my back. Since my OSA is strictly worse in REM no matter which position I just never really put forth a lot of effort staying on my side. It's easier said than done and unless there is some really good reason to put forth the effort I am not inclined to put into effort into it.

Worth trying I suppose but my thoughts about using something to try to make sure I stay on my side are this...
I see no sense in doing the tennis ball thing...think about it...you want to sleep without waking and having tennis balls wake you up when you rollover onto your back seems kinda stupid to me. Multiple tennis ball wakenings is going to be worse IMHO than just being on your back and sleeping. Anything that causes awakenings is unwanted so why add discomfort into the mix?
Now I did try using a wall that was comfortable in an effort to stay on my side back when I was trying to figure out if my pressure needs in REM changed any when I was on my back. It's hard to build a wall that won't move that is comfortable but I managed to get it done by using a buckwheat pillow up against my back. It might move a little but not nearly as much as regular pillows plus it felt good against my back in terms of comfort and support.
I did it for about a month and determined that my pressure needs were still high in REM and didn't matter if I was on my side or back...so I gave up trying to force side sleeping at least for pressure needs experimentation.

If you want to try something to reduce the chance of you ending up on your back...pick something that is comfortable and not likely to cause discomfort because discomfort will cause awakenings which are the last thing you want.

While you are doing all this...continue looking for other potential causes of fatigue unrelated to sleep apnea or even sleep in general. In my case I have at least one known culprit which is pain (the back and pelvis) so I have had to try to address that issue separately. I would have that issue even if I didn't have OSA.
It's a war I never really win and I just accept it and do the best I can.
I always tell people that I don't really have that "cpap miracle" waking up feeling like I am ready to run a marathon but at least I don't wake up feeling like I just ran the marathon and got run over by a bus at the end of it.
I have "good" nights and "bad" nights and the days go along with however the night went. CPAP does it's part in helping out but it can't do a damn thing about my back or pelvis. It took me probably 3 years into CPAP to come to this realization...I get the miracle (what you probably think of as a good day) maybe once a month. I am grateful that I at least get that but I spent probably 3 years getting to that point where I accepted that cpap simply couldn't fix everything.

[SleepyMcgee]

I'm wondering if something like the nightshift device makes sense...I always try to stay off my back but honestly, once i'm asleep...All bets are off lol

I dunno. I am like you...I prefer side sleeping (back and pelvis pain issues) but I will wake up hurting like the devil and being on my back. Since my OSA is strictly worse in REM no matter which position I just never really put forth a lot of effort staying on my side. It's easier said than done and unless there is some really good reason to put forth the effort I am not inclined to put into effort into it.

Worth trying I suppose but my thoughts about using something to try to make sure I stay on my side are this...
I see no sense in doing the tennis ball thing...think about it...you want to sleep without waking and having tennis balls wake you up when you rollover onto your back seems kinda stupid to me. Multiple tennis ball wakenings is going to be worse IMHO than just being on your back and sleeping. Anything that causes awakenings is unwanted so why add discomfort into the mix?
Now I did try using a wall that was comfortable in an effort to stay on my side back when I was trying to figure out if my pressure needs in REM changed any when I was on my back. It's hard to build a wall that won't move that is comfortable but I managed to get it done by using a buckwheat pillow up against my back. It might move a little but not nearly as much as regular pillows plus it felt good against my back in terms of comfort and support.
I did it for about a month and determined that my pressure needs were still high in REM and didn't matter if I was on my side or back...so I gave up trying to force side sleeping at least for pressure needs experimentation.

If you want to try something to reduce the chance of you ending up on your back...pick something that is comfortable and not likely to cause discomfort because discomfort will cause awakenings which are the last thing you want.

While you are doing all this...continue looking for other potential causes of fatigue unrelated to sleep apnea or even sleep in general. In my case I have at least one known culprit which is pain (the back and pelvis) so I have had to try to address that issue separately. I would have that issue even if I didn't have OSA.
It's a war I never really win and I just accept it and do the best I can.
I always tell people that I don't really have that "cpap miracle" waking up feeling like I am ready to run a marathon but at least I don't wake up feeling like I just ran the marathon and got run over by a bus at the end of it.
I have "good" nights and "bad" nights and the days go along with however the night went. CPAP does it's part in helping out but it can't do a damn thing about my back or pelvis. It took me probably 3 years into CPAP to come to this realization...I get the miracle (what you probably think of as a good day) maybe once a month. I am grateful that I at least get that but I spent probably 3 years getting to that point where I accepted that cpap simply couldn't fix everything.

Thanks, good feedback.

I have no health issues (that I'm aware of) and no pain etc that keep me from sleeping in any particular location. I'm in reasonably good shape (bike or run 3-4X week).

When I look at the sleep data it looks like my ONLY REM sleep (if I'm reading it right) was on my side. If thats the case, it seems using something that gets me off of my back and to my side could be the way to go since I'm getting no restorative sleep on my back anyway?

I'm speaking with my DR later this week and am trying to figure out where I go from here. Do I ask for more tests? Do I ask him if prescribing the nightshift is a good idea? Trying to get some good next steps and questions lined up.

Thanks

[Pugsy]

You know it is possible you didn't get much (if any) REM sleep when on your back because it's possible the worse on your back sleep apnea events prevented progressing into the deeper sleep stages.
If that's the case the we would assume that cpap fixed that problem.
If that is the case then we would then assume that if it was the lack of good sleep that was the cause of the fatigue...then the fatigue should be improved...and if it doesn't improve then we assume the fatigue is caused by something else.
A lot of assuming going on.

Did you ever get a sleep study with the machine or did they just give you the machine and bypass the titration study....I forget?

[SleepyMcgee]

You know it is possible you didn't get much (if any) REM sleep when on your back because it's possible the worse on your back sleep apnea events prevented progressing into the deeper sleep stages.
If that's the case the we would assume that cpap fixed that problem.
If that is the case then we would then assume that if it was the lack of good sleep that was the cause of the fatigue...then the fatigue should be improved...and if it doesn't improve then we assume the fatigue is caused by something else.
A lot of assuming going on.

Did you ever get a sleep study with the machine or did they just give you the machine and bypass the titration study....I forget?

It was not a split study. We COULD, based on the intial results, go for a split study to do the titration...

When I used my CPAP I was always under 5AHI but fatigue was no better than without it...Perhaps because it caused other sleep issues....

[Pugsy]

There's no guarantee that doing a sleep study with cpap would shed any more light on things except maybe see if your REM and deep sleep issues improved or not...and then if they did or didn't might not explain the "why" of either it did or didn't in a manner that would point you to answering the main question which is "why do I have good and bad days/nights".

A lot to talk over with your doctor about. Most docs don't dig deep into the "why" when we don't feel as good as we want. It's a lot of work with no guarantee of results. They tend to look at the AHI and maybe leaks and hours of use and if all those are okay then they shrug their shoulders.
Maybe your doc will be different and more willing to think outside the box and work with you on trying to figure out what might be the real cause of your fatigue and what to do about it.

Good luck to you. All I know is that this feeling rested thing is sometimes a very difficult goal to achieve for some people.
Probably for any number or reasons and also probably because of a combination of reasons to boot.
Those people who hook up to cpap and feel the miracle ...don't know just how lucky they are. I always turn a little bit green with envy when I read about them. It just means that sleep apnea was the lone culprit and it was fixed easily. Most of us have more than one thing going on and figuring out what the culprits are can be really difficult.