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Monday, August 4, 2008

FINALLY - Sleep Study Results!

Here it is, the much awaited Sleep Study. Sorry to take SOOOO long, Aviva. Some technical difficulties way too boring to go into, but mostly my own procrastination.

First, in case anyone wants or needs a refresher on the first two parts of this post -

Part One: Sleep Study Last Night

Part Two: Chronic Monday: Sleep (Not!) - Some practical help in overcoming sleep disorders


And without further ado...




Click on the picture for the jumbo view.

First, for the sake of comparison, this is a nice chart of how the sleep cycle is supposed to go:


In Stage 1 sleep the brain transitions from alpha waves (waking) to theta waves (drowsy) and conscious awareness lowers. During Stage 2 or light sleep, muscular tone/activity lowers and conscious awareness disappears. It normally accounts for 45% to 55% of total sleep and is followed by delta waves, stage 3 slow-wave sleep and stage 4 deepest slow wave sleep.

Go here for another good description of the stages.

My sleep study showed that I never EVER went into delta/stage 3 & 4 sleep. This is not good. I'd go so far as to say this is very bad. And I had what is a good night's sleep, for me.

They didn't see fit to comment on the lack of delta sleep, but did suggest looking into family history of narcolepsy because I went into REM sleep after only 45 minutes. No history of narcolepsy in my family, but I seem to have a lot of the symptoms of narcolepsy, except for one major one: excessive daytime sleepiness. I do get some sleep, just not at the right time of day (night). And as long as I'm not working and can sleep whenever I'm able to, I don't feel too tired when I'm up. Seems like that might be a deal breaker on the whole narcolepsy theory to me, but what do I know?

When I talked to the P.A. at the rheumy's office about these test results, he said we should do the suggested Multi Sleep Latency Test (MSLT). Who am I to argue? I let them go ahead and schedule the test for me. Then I went home and did my internet research on the MSLT, then I called the Sleep Lab. I talked with the tech about my sleep problems and habits and she agreed that the MSLT would probably be useless for me, as I frequently don't go to sleep until 4:30 a.m. and if I went to the lab at 8:00 a.m. and they set me up to take naps all day, I WOULD take naps. We decided that that wouldn't be of much use, and that what I really needed to do was to talk with an actual sleep specialist type of doctor. Considering that, I'm unsure why I am still paying off the neurologist's $750 bill for reading the sleep study. Except that I don't want to have my credit record screwed up by him, of course.

THIS lady has narcolepsy: Open Your Eyes to Narcolepsy. I do not.

Fibromyalgia and Insomnia: Cause or Effect? from My Disability Blog (Emphasis added by me):
Patients with fibromyalgia usually have sleep disturbances during their most restful stage of sleep – the delta sleep stage. These disturbances keep them from feeling well-rested and psychologically healthy, in addition to interrupting critical tissue repair during the night. Studies have shown that insomnia in the night leads to more pain during the day and even less restful sleep the next night; a vicious cycle for fibromyalgia sufferers that is hard to end without pain medication and sleeping pills. Other studies have shown that when people without fibromyalgia were disrupted during their delta sleep stage, they developed symptoms such as achy joints and muscle pain, fatigue and sensitivities often associated with fibromyalgia. This information as left researchers wondering if insomnia is an effect or an actual cause of the disorder.
No mention of my Fibromyalgia by the $750 sleep-study-reading doctor.

From the Wikipedia definition of narcolepsy:
Four other "classic" symptoms of narcolepsy, which may not occur in all patients, are cataplexy, sleep paralysis, hypnogogic hallucinations, and automatic behavior. Cataplexy is an episodic condition featuring loss of muscle function, ranging from slight weakness (such as limpness at the neck or knees, sagging facial muscles, or inability to speak clearly) to complete body collapse. Episodes may be triggered by sudden emotional reactions such as laughter, anger, surprise, or fear, and may last from a few seconds to several minutes. The person remains conscious throughout the episode. Sleep paralysis is the temporary inability to talk or move when waking (or less often, falling asleep). It may last a few seconds to minutes. This is often frightening but is not dangerous. Hypnagogic hallucinations are vivid, often frightening, dreamlike experiences that occur while dozing, falling asleep and/or while awakening. Automatic behavior means that a person continues to function (talking, putting things away, etc.) during sleep episodes, but awakens with no memory of performing such activities. It is estimated that up to 40 percent of people with narcolepsy experience automatic behavior during sleep episodes. Daytime sleepiness, sleep paralysis, and hypnagogic hallucinations also occur in people who do not have narcolepsy, more frequently in people who are suffering from extreme lack of sleep. Cataplexy is generally considered to be unique to narcolepsy and is analogous to sleep paralysis in that the usually protective paralysis mechanism occurring during sleep is inappropriately activated. The opposite of this situation (failure to activate this protective paralysis) occurs in rapid eye movement behavior disorder.
I have experienced sleep paralysis and hypnagogic hallucination (phosphenes, the Tetris Effect and sounds). Sleep paralysis is actually a form of hypnagogic hallucination. It is by far the most disturbing form, to me. I have only had one episode in the last several years. I used to have them more often; I talked with a friend who was taking Psyc 101 at the time and she looked it up in her big book. I would really have thought they have at least mentioned the scientific explanation given on Wiki of sleep paralysis. But no, all they said was some people think the person is experiencing an out of body experience. If that idea wasn't already whizzing around in my little brain it started then, that something purely evil was trying to pull me away from my life, that if I did not wake up immediately, I would never wake up again. I guess that would be the "terrifying hallucinations" part that often accompanies sleep paralysis.

My experience with sleep paralysis was that I knew where my body was and who, if anyone, was around me, but I could not move or speak no matter how hard I tried. This compounded the terror.

This painting, "The Nightmare" by Henri Fuseli, is totally what I thought was happening to me: demonic visitation! I promise I've never consciously seen this work of art before.

The Nightmare, by Henry Fuseli (1781) is thought to be one of the classic depictions of sleep paralysis perceived as a demonic visitation.



A couple of other notes:

It seems like Tachycardia while sleeping might be something to be concerned about, too. It was also noted in my sleep study results.

MSLT -
SleepDeprivation.com

SleepNet.com

6 comments:

  1. Sherril,

    I have many illnesses that affect my sleep... Chief among them are sleep apnea and fibromyalgia.

    When I was diagnosed with sleep apnea, they told me I had NO restorative sleep stage whatsoever!! That would explain the fatigue!

    Anyway, I have plenty of other chronic illnesses where those two come from...

    I have learned how precious sleep really is.

    When I was younger, I took being able to get to sleep for granted. I never woke up feeling rested (even as a child) BUT never had too much trouble FALLING ASLEEP... until a few years ago.

    Now I truly realize how sleep deprivation can adversely affect health!

    Thanks for the great post!

    Jeanne

    ReplyDelete
  2. I've suffered from Sleep Paralysis for a long time now, and I understand how terrifying it can be. You have to learn how to control your episodes.

    Check out www.SleepParalysisMastery.com for more on this.

    ReplyDelete
  3. Hmmm. Interesting. Everyone, please be aware that the site mentioned above leads to one of those rather long info-mercials that doesn't really tell you anything, you have to buy the book for $24.95 for that. I don't know what's in the book; I apparently learned to master my sleep paralysis years ago, when a counselor asked me why I needed someone else to help me when I said I couldn't speak out to ask for help when I was in the throes of the "dream," why I couldn't help myself? That apparently pissed me off and I've never yet had another sleep paralysis dream.

    ReplyDelete
  4. Did you ever find any resolutions to all this? This page nearly exactly describes my situation. Plus, I'm on disability for the vaguely names sleep disorder, diagnosed with high functioning adult autism, and only about two years escaped from the psych drugs that put me in this situation (I'd had sleep problems all my life, but being coerced onto psych drugs nearly killed me; they ruined my life). I reject all drugs (like I used to before being coerced onto them). I'm losing my hope of ever living like a human being because my living situation is intolerable (noise, lack of peace, heating/cooling control problems, etc) and I've no money to throw at anything at all (plus, majority of healthcare is ignorant of the issues of sleep quality and if you don't have sleep apnea, they have no further interest in trying to work with you because they don't care or think about neurology).

    ReplyDelete
    Replies
    1. I take medication that's supposed to help me reach Delta level sleep, and I'm on a much more regular sleep schedule now than I was then. I now live much closer to a sleep specialist, but so much time has gone by that I would have to have a whole new sleep study done. If I could afford it, which I can't. So I just keep on keeping on and try to remember to be grateful for all the good in my life.

      I hope your living situation improves drastically, and soon! My thoughts are with you.

      Delete
  5. Losing weight, and eating clean is the best option.

    ReplyDelete

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