No Stage 3 Sleep

newpapper · Post by **newpapper** » Mon Jan 13, 2014 8:27 am

Hello,
I had my sleep study but not my titration yet. My study showed zero stage 3 sleep. The Sleep Dr. did not mention it (only that I have moderate apnea and oxygen desaturation and did I want CPAP) and I discovered it later reading my study. I am very concerned about it as I understand that 3 is the restorative phase of sleep. Is this common for disrupted sleep and can CPAP help get stage 3 sleep back?
Thanks for your thoughts!

Sheriff Buford · Post by **Sheriff Buford** » Mon Jan 13, 2014 8:30 am

You betcha... treating sleep apnea restored my deep sleep... you may also dream more which is a good indication of "better" sleep.

Sheriff

newpapper · Post by **newpapper** » Mon Jan 13, 2014 8:32 am

Thanks Sheriff.

kteague · Post by **kteague** » Mon Jan 13, 2014 1:19 pm

Yes, it's common. How much REM sleep did you get and was there any REM sleep while supine? It is not unusual for this to be a "worst case scenario" and if not captured in a study, can cause test results to not be fully reflective of the degree of a problem. On your titration, this should happen also. But sometimes it doesn't - it's just one night and it's hard to cover every possibility in one compromised night's sleep. My sleep doc reported these tests to be "technically suboptimal". Part of why getting a machine that records treatment data is so important. And yes, CPAP should help your sleep stages normalize. There can be other contributors, but getting therapy right may totally resolve things.

newpapper · Post by **newpapper** » Tue Jan 14, 2014 6:55 am

Thank you kteague for reassuring me that it should get better. To answer you questions - I had 18% (1.1 hours) REM sleep and none of it was supine. I never seem to sleep on my back and was never on my back in the sleep study. My worst case scenario may be on my sides. I do have other contributors as Periodic Limb Movement of Sleep was also diagnosed. I have requested a machine that records treatment data and will do so again at the titration. Thanks again, I do appreciate your thoughts.

Sludge · Post by **Sludge** » Tue Jan 14, 2014 7:47 am

newpapper wrote:Is this common for disrupted sleep and can CPAP help get stage 3 sleep back?

Not necessarily to both questions.

NREM3 can also decrease as a function of age and due to a technical scoring "glitch". In those cases CPAP probably won't make a difference.

Also, while NREM3 may be lacking in horrid OSA (with subsequent rebound after application of CPAP), you appear to have more of an UARS thing. In that case, NREM3, being very airway-stable friendly, may be normal.

newpapper · Post by **newpapper** » Tue Jan 14, 2014 8:10 am

Thanks Sludge. I had about 18 obstructive hypopneas for each apnea. I hope that the titration will help and show some stage 3 sleep!

Thewino · Post by **Thewino** » Tue Jan 14, 2014 10:51 am

Newpapper,

I was in a similar situation. My first sleep study showed that I spent 97% of my sleep in Stages I and II because of so many apneic events. Therefore, during sleep, I would only spend 3% in Stage III and REM sleep. This is obviously a big problem as I wasn't getting any restorative sleep.

To answer your question: Yes, CPAP can restore your missing Stage III phase of sleep.

CPAP help me significantly with this very problem. And, I am remembering dreams now.

Good Luck and sleep well,
TheWino

newpapper · Post by **newpapper** » Tue Jan 14, 2014 11:12 am

Thanks TheWino. It's good to hear success stories. Go Gators.

kteague · Post by **kteague** » Tue Jan 14, 2014 8:04 pm

Do stay in tune to if your PLMD changes significantly from your diagnostic study to the titration study or after starting CPAP. Not something to be concerned about at this point, just be mindful of your diagnosis in case the subject needs revisited later. Hopefully that will not prove necessary.

Sludge · Post by **Sludge** » Wed Jan 15, 2014 6:16 am

newpapper wrote:I hope that the titration will help and show some stage 3 sleep!

Even if it doesn't, if you get a lot really solid NREM2 (EEG waves not tall enough, but are pretty wide)(research "Why The 75 µV Rule Is Stupid") that would still be very good news.

BTW, how old are you (whisper if the answer is uncomfortable for you).

newpapper · Post by **newpapper** » Wed Jan 15, 2014 9:23 am

Thank you kteague and Sludge. I had my titration last night. The plan is to try to improve the sleep first and then see how the PLMD is. I am a 60 year old male.

Sludge · Post by **Sludge** » Thu Jan 16, 2014 5:36 am

newpapper wrote:I am a 60 year old male.

OK, so that's kind of a tweener area, so we'll see what the results show and go from there.

Sludge · Post by **Sludge** » Thu Jan 16, 2014 5:52 am

From Feinberg (1983), as one gets older, the height of the delta waves diminishes, and if the height is <75 uV, then they can't be called "delta waves" anymore ("The Glitch"):

newpapper · Post by **newpapper** » Thu Jan 16, 2014 6:29 am

Thanks Sludge. I see I am just at the age where they go below 75.

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