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Recent Sleep Study Results
#1
Recent Sleep Study Results
Hello,

For the last year or so my husband has been having extreme fatigue. So extreme that he had fallen asleep and wrecked his truck luckily with no major injuries or involving anyone else. Often daily he falls asleep randomly. It's very scary as his wife to see him like this and to know it happens at random times especially while he is driving but have no idea why.

I thought it was sleep apnea so I finally convinced him to go to a sleep doctor and get a sleep study done. He went back the other day for his results and it showed that he had 2.1 stoppages. The doctor never explained the other results. She gave him his paper, told him his AHI, said it was not enough for a cpap, that she wanted him to do a home sleep study and left the room. She left so many unexplained answers. It seems like she just wants to sell a machine. So I started looking over his results because to me it doesn't seem to be sleep apnea like we thought. His results show that he fell to sleep in a normal range but showed that he spent 83% of the time in Stage 2, 0% in stage 3 and 15% in REM. When. I look up the stages I get conflicting information regarding Stage 3 but it seems to me like he isn't getting enough Stage 3 sleep or REM sleep which might be the cause of his constant tiredness. We were also told that it could be narcolepsy. I am just looking for any input or ideas on what route we should take to get answers as to why this is happening. My husband is 38 years old, 6'2" and average weight. He isn't obese or an older age. We are a new family with a toddler so this is just scary to me and I need advice on what our next steps should be before we sink a ton of money into sleep studies that are not giving us answers. 

Thank you
Brittany
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#2
RE: Recent Sleep Study Results
Hi Brittany,
Ask for a copy of his sleep study, the entire report, not just the summary. You can post it here and someone will take a look at it. We may see something the doctor isn't explaining to you.
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Recent Sleep Study Results
I can only send his report in sections as it tells me the file is too big


Attached Files Thumbnail(s)
           
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#4
RE: Recent Sleep Study Results
The good thing is that the summary mentions RDI and Central Apnea with approximately 2 events per hour.

This is a summary report, though one of the better ones. You are missing the charts and tables that they draw their conclusions from. We like to see the full report simply because all too often the critical info is not contained in the summary.

What is in the summary does not coincide with your husband's symptoms. What he has, based on the summary (still want to see a full copy of the sleep study).

My suggestion is to see an ENT, and a pulmonologist (yes both) and at this time outside of a sleep specialty, And ask them to check all the "plumbing". Tell them he was checked for Sleep Apnea which sounded like a good bet, BUT the test came back negative and here is a copy of the FULL REPORT.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Recent Sleep Study Results
Here are the report snippets rotated for easy reading.

   
   
   
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#6
RE: Recent Sleep Study Results
I addition to Bonjour's suggestions, it might be worth exploring the snoring aspect. Although the number of apneas is low, the report specifically mentions that snoring is present and is leading to sleep fragmentation. It may be this fragmentation which is preventing your husband getting enough deep stage sleep. If this is the case, then treatment of the snoring might go part of the way to resolving the problem. This treatment could be via CPAP machine (even though not required for the low AHI), a mandibular advancement device (last resort), surgery (extreme last resort) or a soft cervical collar and a means of getting him off his back. If we can get him on his side with his chin up it's possible the snoring will reduce and the sleep disruptions will become less of a problem.

If you haven't already done so, you should get a comprehensive blood test to rule out any medical or hormonal issues. Anaemia, low testosterone, low thyroid function, Vitamin D deficiency are the usual suspects.

Good luck on getting this sorted - it must be a worrying situation for both of you.
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#7
RE: Recent Sleep Study Results
This is all great advice and so helpful. I just noticed that my husband always slept on his side before we had our daughter. Once we had her and she slept with us he started sleeping on his back then the issue started so we will try having his sleep on his side again to see if that helps. Do you think he should still try the home sleep study or go other routes like an ENT or bloodwork? We just don't have a lot of money to sink into studies that won't help or give us answers. I will also go back to the sleep doctor for a full report. 

Thank you for all your help. Yes it is very scary not understanding what's going on. I also forgot to mention that before all this started he was tested positive for mono. Which was what we thought caused it all but over a year later it has continued and gotten worse. My brother in law also has sleep apnea and said he too wasn't diagnosed with sleep apnea until after he had mono. Do you think that could be affecting it even though it's been over a year ago?

Thank you!
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#8
RE: Recent Sleep Study Results
I also want to mention that these phases of tiredness and fatigue comes in spurts. Like one week he will be totally fine and normal then suddenly for a week or 2 he will extremely tired and going to sleep. Then he will be ok then it will start over again. Like it comes in waves.
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#9
RE: Recent Sleep Study Results
Was the person he saw actually a sleep doctor or only a sleep therapist? If it was a sleep doctor he should have some opinions on the central apneas and sleep architecture rather than just pushing a home study which only really checks for sleep disordered breathing. The home study wouldn't hurt, especially since you said it seems to come and go it is possible that something is affecting him some nights more than others. If it was just a sleep therapist then they only convey info based on what is in the report and you aren't going to get much further with them right now. 

Seeing a pulmonologist that specializes in sleep would be a good path forward to discuss these results with(make sure they have a full report) and to try and dig further.

Does your husband use any prescription medication?
Are there any unexplained symptoms other than tiredness/fatigue?
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#10
RE: Recent Sleep Study Results
The problem with any sleep study is that it's only a snapshot in time. If the fatigue episodes are coming periodically then it's only a 50:50 chance that the study will find out what's wrong. Did the sleep test take place during one of his bad periods or a good period? It's possible something was missed. With a home test you might be able to time things so the test is definitely done during one of his fatigue periods.

Fatigue is one of the main symptoms of mononucleosis. Looking at the Mayo Clinic page on this illness it can (rarely) re-occur. Does he have any of the other symptoms? Are you in an area prone to mosquitoes? There are a lot of mosquito-borne viruses that have drowsiness or fatigue as a prime symptom, though usually associated with fevers, muscle pain etc.

It's probably a good idea to get the blood work done. Here in Oz pathology is covered by Medicare so it's effectively free. My GP is petty insistent I get it done every year (but I am somewhat older than your husband). Still a full workup can sometimes identify problems and identify potential health issues which aren't yet showing symptoms.

But in the meantime, correcting the sleep posture is something you can do right away and it costs nothing. That should probably be your first action.
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