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Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 8:37 am
by Rubicon
The MSLT indicates you are objectively not sleepy. Need to keep that in mind.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 8:43 am
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 8:19 am
Need long report to quantify arousals and awakenings and look at the histogram.
"Nonspecific sleep architectural impairment" huh? I guess that sounds a little flashier than TWA.
You have the long report for the original diagnostic?
IMO you need to decide if a better approach might be taking a long-acting sleep-oriented medication rather than a sleep-friendly ADM and cut out the middle man. Run it by Grewal since you're paying her all this money.
I second what Pugsy said! What medication would that even be? Thanks!
And these are the only documents I have in my “MyChart” app.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 8:49 am
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 8:37 am
The MSLT indicates you are objectively not sleepy. Need to keep that in mind.
That was a big takeaway for me as well. I am fatigued, and I am tired. But I am not sleepy.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 10:44 am
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 8:37 am
The MSLT indicates you are objectively not sleepy. Need to keep that in mind.
This was the response I got about sleep medication:
https://www.dropbox.com/s/uflur1lv1uqdo ... M.png?dl=0
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 11:05 am
by Pugsy
So what do they want to call it when you aren't sleeping in a normal way when in your own bed?
Duh.....
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 11:21 am
by Rubicon
That makes NFS.
"Normal" patients routinely have sleep efficiencies of 90+% in the laboratory setting.
In your own bed it was already shown that you have TWA. The NPSG showed exactly what it was predicted to show.
Really need the detailed report re: arousals, awakenings and histogram to make the case.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 11:33 am
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 11:21 am
That makes NFS.
"Normal" patients routinely have sleep efficiencies of 90+% in the laboratory setting.
In your own bed it was already shown that you have TWA. The NPSG showed exactly what it was predicted to show.
Really need the detailed report re: arousals, awakenings and histogram to make the case.
I get the sense that they don’t look at my CPAP data at all.
I don’t understand what else I can do. This is an extremely experienced doctor at Jefferson University. If she’s not taking me seriously then who would?
How would I get the detailed reports?
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 12:16 pm
by Rubicon
Billymadison420 wrote: ↑Tue Sep 06, 2022 11:33 am
I get the sense that they don’t look at my CPAP data at all.
How was your sleep quality in the laboratory compared to a typical night at home?
Did they ask you that specific question in the AM after the NPSG?
How would I get the detailed reports?
Ask them for it.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 12:21 pm
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 12:16 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 11:33 am
I get the sense that they don’t look at my CPAP data at all.
How was your sleep quality in the laboratory compared to a typical night at home?
Did they ask you that specific question in the AM after the NPSG?
How would I get the detailed reports?
Ask them for it.
I would say that my sleep quality was worse than at home. But regardless I still feel incredible fatigue weather at home or whether in a lab.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 12:23 pm
by Rubicon
Billymadison420 wrote: ↑Tue Sep 06, 2022 11:33 am
This is an extremely experienced doctor at Jefferson University.
What does that mean? She's been around a long time?
She's not boarded in Sleep Medicine.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 12:24 pm
by Rubicon
Billymadison420 wrote: ↑Tue Sep 06, 2022 12:21 pm
Rubicon wrote: ↑Tue Sep 06, 2022 12:16 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 11:33 am
I get the sense that they don’t look at my CPAP data at all.
How was your sleep quality in the laboratory compared to a typical night at home?
Did they ask you that specific question in the AM after the NPSG?
How would I get the detailed reports?
Ask them for it.
I would say that my sleep quality was worse than at home. But regardless I still feel incredibly fatigue weather at home or whether in a lab.
There were 2 parts to that question.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 12:25 pm
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 12:24 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 12:21 pm
Rubicon wrote: ↑Tue Sep 06, 2022 12:16 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 11:33 am
I get the sense that they don’t look at my CPAP data at all.
How was your sleep quality in the laboratory compared to a typical night at home?
Did they ask you that specific question in the AM after the NPSG?
How would I get the detailed reports?
Ask them for it.
I would say that my sleep quality was worse than at home. But regardless I still feel incredibly fatigue weather at home or whether in a lab.
There were 2 parts to that question.
My apologies. Yes they did ask.
Can my sleep doctor infer the disordered breathing, that you all referred to as sleep/wake/Junk, from the CPAP machine data just the same as you can?
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 1:01 pm
by Rubicon
Billymadison420 wrote: ↑Tue Sep 06, 2022 12:25 pm
Can my sleep doctor infer the disordered breathing, that you all referred to as sleep/wake/Junk, from the CPAP machine data just the same as you can?
Why would she want to? She has a sparkly new NPSG to look at.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 1:08 pm
by Billymadison420
Rubicon wrote: ↑Tue Sep 06, 2022 1:01 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 12:25 pm
Can my sleep doctor infer the disordered breathing, that you all referred to as sleep/wake/Junk, from the CPAP machine data just the same as you can?
Why would she want to? She has a sparkly new NPSG to look at.
I guess because my CPAP is at home. It seems she is disregarding in lab results because of the wires and such.
Re: How to determine Good Sleep?
Posted: Tue Sep 06, 2022 1:41 pm
by Rubicon
Billymadison420 wrote: ↑Tue Sep 06, 2022 1:08 pm
Rubicon wrote: ↑Tue Sep 06, 2022 1:01 pm
Billymadison420 wrote: ↑Tue Sep 06, 2022 12:25 pm
Can my sleep doctor infer the disordered breathing, that you all referred to as sleep/wake/Junk, from the CPAP machine data just the same as you can?
Why would she want to? She has a sparkly new NPSG to look at.
I guess because my CPAP is at home. It seems she is disregarding in lab results because of the wires and such.
What is she disregarding? I don't understand your point. You got 7.76 hours of sleep @ 85.9% (a little low as far as efficiency goes, but told them you sleep better at home) and a normal MSLT, so IMO she thinks you're fine there.
However, sleep disruption is there, they said it's there. You need those values if you want to make a case for anything. And I'm talking about >100 arousals, a bunch of awakenings (number will vary based on length, and we only got 71 minutes of WASO to work with).
