UARS just really bad snoring? Huh? Spontaneous Arousals

sleepsurfer wrote:socknitster,

check the report page on the encore pro software. there should be a a little blue squiggly icon next to the number of hours you slept that night. click on that and the waveform breathing report should come out.

I'll look but I was wrong about which version I have. It is 1.8.49 or something akin. I may not have that capability.

-SWS wrote:

socknitster wrote: At no time did the doctor mention UARS. I came up with this on another intense bout of research into causal agents of spontaneous arousals.

UARS arousals are supposed to be the type know as Respiratory Effort Related Arousals (also called RERAs). By contrast spontaneous arousals are supposed to be of non-respiratory origins.

That said, I'd sure be willing to bet techs sometimes score RERA's as if they were spontaneous arousals instead. Maybe lacking diagnostic equipment or lacking PSG scoring skills are to blame in those cases.

Good luck getting to the bottom of your spontaneous arousals, Jen. I suspect people who score high on this HSP screening questionnaire might be more sleep-arousal inclined. I think arousals can also be related to certain other comorbid conditions such as pain, depression, etc.

Interesting post, SWS and thanks for commenting. My sleep report does not include RERAs, despite the fact that they put the belts on my chest/abdomen and the tech was very fastidious about putting them on carefully, going to the control room to check and coming back to adjust until they were perfect. I am certain the techinician had the best of intentions as she seemed to care very much about getting it right, however many things are pointing towards this is not the best facility to have this done. The report not showing a scoring of RERAs is only one thing. My bipap prescription of 11/4 is another. That kind of spread is so uncomfortable to breathe with it is a little insane that anyone with brains would think it is ok to prescribe it if they had ever experienced it (doubtful). Also, their primary way of measuring O2 sats is thru blood gas which I stubbornly refused to do and they put a pulse ox on me. There were other little things as well.

This is the third sleep study I have attended (2 of my own, 1 with my son) and so far NONE of them have lived up to the standards I would truly consider acceptable. My first one had walls so thin that every time the tech spoke to the other patient I was awakened and I had to share a bathroom with HIM. My son's. They left a heart monitor in the room beeping loudly with every single heartbeat and they left the lights on at bedtime! When I complained, they turned off the lights but said the heart monitor had to stay. I can't imagine anyone could sleep well with that kind of distraction. And then this one. Just ridiculous. What do I have to do to find a good one? This last one was the only one in my area that is even ACCREDITED. It just doesn't seem like these labs are held to any kind of standard. We pay SO MUCH for these tests and our lives are on the line and they just refuse to provide the best quality of care and diagnostics. It is disgusting.

Going now to check out the questionaire you posted.

socknitster wrote:We pay SO MUCH for these tests and our lives are on the line and they just refuse to provide the best quality of care and diagnostics. It is disgusting.

So very true for some sleep labs. During one of my sleep tests, maintenance was banging on the pipes running through the walls of my room, presumably on the floor below. It was making a rather large racket in my room. I mentioned it to the sleep tech, that it was keeping me from sleeping.

Her answer? "They're not supposed to do that." Did she go do something about it? No, just told me that it wasn't supposed to be happening.


Sigh.

Muse-Inc wrote:Gee, I just scored 20 on that test. Interesting that I am more rattled than I used to be. Could be that I am returning to the more senstive child I used to be

Interesting, when I arrived at the test sight, I realized I recognized it. I took this questionaire probably 4 years ago. I scored slightly higher this time as a 24. Personally I don't think this is ALL due to personality. I think some of this is a symptom that something is not quite right. For example, startling easily is a symptom of adrenal problems. Being very sensitive to sound is a symptom of chronic fatigue syndrome/fibromyalgia and probably of other conditions. These are just the ones I am aware of. I would LOVE to score a little lower on that test! I have always been a very sensitive person but I am moreso now than ever. I wouldn't give up the rich inner life aspect though. I am very happy being by myself (in fact that is when I'm happiest--or simply when everyone is quietly getting along). I always have rich, complex thoughts and self-conversation. THAT is part of my essential being.

Being such a sensitive person is really hard in a house with two little boys and a husband. They step all over my feelings daily. It is a daily struggle to not be hurt and to shake it off. And when I'm feeling my worste, it becomes impossible. I would say that my worste problem in my life right now is irritibity. I have been struggling with this for 3 years. It is intense and brought on and exacerbated by these external stimuli mentioned in the test. Little boys are noisy. That makes life very hard for me. And it wil be a long time until they outgrow the worste of it. My doctor thinks the irritibilty is brought on by anxiety and I have to say I think he is right. That is where I hope the lyrica can help me. It helping in 3 ways. It is known to increase slow wave sleep. It helps with pain (which the chronic fatigue syndrome gives me plenty of) and in the EU it is approved as an anxiolitic and is undergoing research for that purpose here. I just have to get the dose right. I"m on 1/2 the fibromyalgia dose now and am feeling better, but there is more room for improvement.

Now I'm off to examine the test for children. One of my sons is very sensitive. The other, completely oblivious! LOL!

LoQ wrote:

socknitster wrote:We pay SO MUCH for these tests and our lives are on the line and they just refuse to provide the best quality of care and diagnostics. It is disgusting.

So very true for some sleep labs. During one of my sleep tests, maintenance was banging on the pipes running through the walls of my room, presumably on the floor below. It was making a rather large racket in my room. I mentioned it to the sleep tech, that it was keeping me from sleeping.

Her answer? "They're not supposed to do that." Did she go do something about it? No, just told me that it wasn't supposed to be happening.


Sigh.

Sadly, that is so typical and not surprising at all. Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening! If they couldn't get that problem solved, they should have sent you home to return with no charge at a later date.

jen, i agree with your sensitivity comment. while i am overly sesnsitive anyway, i have noticed a definite reduction in sensitivity after starting cpap but especially after starting the thyroid meds (and i must add, also by reducing stress and fatigue by leaving my previous job). i too would look for a biological/physical cause for the over-sensitivity. I bet the adrenals ARE the key.

socknitster wrote:

LoQ wrote:

socknitster wrote:We pay SO MUCH for these tests and our lives are on the line and they just refuse to provide the best quality of care and diagnostics. It is disgusting.

So very true for some sleep labs. During one of my sleep tests, maintenance was banging on the pipes running through the walls of my room, presumably on the floor below. It was making a rather large racket in my room. I mentioned it to the sleep tech, that it was keeping me from sleeping.

Her answer? "They're not supposed to do that." Did she go do something about it? No, just told me that it wasn't supposed to be happening.


Sigh.

Sadly, that is so typical and not surprising at all. Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening! If they couldn't get that problem solved, they should have sent you home to return with no charge at a later date.

Do you mean the Brandon Harris case?

NotMuffy wrote:

socknitster wrote:Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening!

Do you mean the Brandon Harris case?

Although Brandon Harris occurred just this past January.

What the heck was that one where they didn't have video running...

NotMuffy wrote:

NotMuffy wrote:

socknitster wrote:Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening!

Do you mean the Brandon Harris case?

Although Brandon Harris occurred just this past January.

What the heck was that one where they didn't have video running...

NM, that was something else...

NotMuffy wrote:

NotMuffy wrote:

socknitster wrote:Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening!

Do you mean the Brandon Harris case?

Although Brandon Harris occurred just this past January.

What the heck was that one where they didn't have video running...

Yes, that is the one I was thinking of. Was it just last January? Time goes slow when you aren't feeling well. Regardless, my point was that many of the technicians are not properly trained (varies by state) and frequently there are things going on in and around the sleep lab environment that are not conducive to sleep. We need better regulation and certification in this industry. Hopefully it will come in time.

socknitster wrote:

NotMuffy wrote:

NotMuffy wrote:

socknitster wrote:Hell, just a few years ago the news was all over someone DYING during a sleep study and no one did a damn thing. It is sickening!

Do you mean the Brandon Harris case?

Although Brandon Harris occurred just this past January.

What the heck was that one where they didn't have video running...

Yes, that is the one I was thinking of. Was it just last January? Time goes slow when you aren't feeling well. Regardless, my point was that many of the technicians are not properly trained (varies by state) and frequently there are things going on in and around the sleep lab environment that are not conducive to sleep. We need better regulation and certification in this industry. Hopefully it will come in time.

In the Harris case:

the tape showed Harris waving seven times over 40 minutes apparently to draw someone's attention but no one responded

a nurse responded when Harris removed sensors from his body

Harris walked to a nearby restroom and the nurse left, and he returned to the room and to bed

Three nurses later entered the room and Harris appeared to be in discomfort. He tried to get up, lost his balance and fell, bringing emergency personnel, the uncle said.

From the available data then, it is suggested that:

It may have been nurses rather than technicians (although that could easily be an error in reporting);
They weren't watching the video;
Since he went directly to the bathroom, the catastrophic event had yet to begin, and he only really needed to "go to the bathroom";
During the 40 minute period of waving, key parameters were still being monitored (although the EKG was probably a rudimentary Lead II). Even if the HCPs were not familiar with the subtleties of EKG interpretation, it would be a safe bet that everybody and their grandmother looked at that record afterwards with a microscope for signs of impending doom, but didn't see anything;
One of whom was also undoubtedly the coroner;
The event happened upon return to the room;
At that point, proper response occurred; and
The coroner's report says that it was not a slow-developing event, but "sudden cardiac arrest". Anything developing over a period of 40 minutes would have left a sign that should have been picked up on post.

So while they may be guilty of poor performance by not letting him get to the bathroom for 40 minutes, proving negligence is going to be tough. If the PSG showed no evidence of untoward events during the 40 minute period prior to Harris removing the sensors, then this will (and apparently has been) treated as simply an unfortunate event.

There was somebody here who said they went to Emory, perhaps they can weigh in if they have additional news.

http://www.ajc.com/news/dekalb/coroner- ... 93531.html

http://blackpoliticalthought.blogspot.c ... sleep.html

http://www.mlnlaw.com/Articles/Emory-Sl ... ersy.shtml

https://www.youtube.com/watch?v=wcKUgcelWKs