I’ll try to watch my language, but reading the sleep study report – I am pissed.
What a waste of money and time and resources.
My complaint regarding sleep had nothing to do with what people usually mention: I have no trouble falling asleep, and while I often wake up fairly easily, I have no trouble going back to sleep if I do wake up. I have slept through thunderstorms. I don’t snore, my legs don’t twitch, I don’t grind my teeth. We have a good mattress, my pillow is supportive, and I have found the kind of combination of blankets that allows me to throw the top one off when I get too warm (early morning) and pull it back over me when I have cooled down.
No (use of) screens in the bedroom – other than phone on the night stand: no TV, not even radio. I don’t drink much caffeine anyway and hardly ever after about 4 p.m., I don’t drink alcohol (ever). I go to bed and get up in the morning at roughly the same time every day, weekend included, but not dogmatically so. Every once in a while there is a late night, or an early bedtime, and it doesn’t seem to throw me off too much.
My complaint, and the reason I do not wake up refreshed even after eight hours of sleep, is that for the second half of the night (or so, I don’t look at the time) I dream. Vivid, often disturbing dreams. It feels like I dream instead of sleep. I feel trapped in dreams. Mark has learned to wake me up and gently insist (upon my request) that I stay awake – instead of drifting back to sleep.
Even before I received the phone call from the sleep lab to schedule the study, I had second thoughts about it: no matter how perfect the sleep center room / bed / everything would be – it would be different enough to affect my sleep.
After speaking with Bonnie from the sleep lab who explained details of the sleep study I had even more reservations: she mentioned the type of study: a split night polysomnogram, meaning they were going to look for sleep apnea. I was surprised and explained that sleep apnea was the least of my concerns.
As for the sleep study itself, first the good: both technicians were excellent in their respect for me. There was never any indication that Mark was anything but welcome there to stay with me until I was going to sleep. Both technicians, instead of loudly knocking on the door, tapped lightly with their fingers, opened the door an inch and said my name, then waited for me to acknowledge them. They answered questions and were intent on making sure that I was comfortable.
Unfortunately, the temperature in the room was freezing all night long even though one of the technicians adjusted the thermostat when I said that I was cold. He offered a second blanket but it was a cotton blanket that added only weight, no warmth. The bed was massively uncomfortable: the mattress hard enough to make my hips and left knee scream sooner or later no matter how I lay, and it felt like it was covered in plastic: my back was covered in (cold) sweat.
The sensors attached to my scalp had tiny points that felt like there was a little pebble on the pillow, digging into my head. Since there were at least six (Mark thinks he remembers a dozen) sensors attached to my scalp and face there was no way for me to lie that didn’t make at least one of them dig into my head. The only thing I could change was which one of them would dig …
In order to get the best reading, I was told to give them “as much back sleep as possible”. Normally, I sleep on my side, changing throughout the night. Being a first-born I tend to do as I am told so I tried to sleep on my back.
I was uncomfortable but did go to sleep. After I don’t know how long I kept waking up because I just couldn’t get comfortable enough. I thought about saying “This isn’t working, I am going home” but being a first-born I don’t do that kind of thing.
In the early morning, being half-awake, bored and frustrated, I listened to several instances of running water – probably the other sleep study patient, using the bathroom, maybe taking a shower. Soft voices, sneezing, morning sounds.
At around 6:15 there was a light tap on the door: time to take the sensors and belts off. One of the technicians then shared some of his findings with me.
No surprise to me, there was no sleep apnea, just a couple of instances of “hypopneas”. He did say that those happened when I was on my back, in REM sleep. His suggestion? Try sleeping on your side.
He thought he might have heard me snore, lightly, for a bit, but he wasn’t sure.
He noted that my REM sleep was less than normal, and that my sleep efficiency was only 76% (normal is at least 90%).
Since the physician who would write up the report was a pulmonary specialist, the data collected and used focused on respiratory disturbances (of which there were few). I would be much more interested in a neurologist’s take on the data.
Today I received a copy of the report in the mail. More details, numbers – “21 respiratory, 3 limb movement and 166 spontaneous arousals” etc. -, impression and recommendations.
“Impression: sleep stage disturbance, hypersomnia, obstructive sleep apnea, snoring, insufficient sleep”.
???
Hypersomnia is “prolonged nighttime sleep” and/or daytime fatigue (how would he know, the data being from a SLEEP study?) – ??
Earlier in the report it says, “snoring very light and sporadic” and “1 obstructive apneas, 0 central apneas, 0 mixed and 9 hypopneas”. How that yields an impression of “obstructive sleep apnea” and “snoring” I don’t know,
His “Recommendation: consider ENT consult for airway evaluation related to snoring; instruct the patient on proper sleep hygiene to improve sleep quality; avoidance of alcohol at bedtime, due to its negative consequence on sleep quality; follow up in 2-4 weeks with PCP for further discussion.”
The alcohol bit gets me the most I think: the papers I had to fill out prior to the study specifically asked about caffeine and alcohol consumption. To me, avoiding alcohol at bedtime would be part of “proper sleep hygiene”, in the same vein as avoiding strenuous exercise, heavy meals right before bed, etc. = nothing that has to be mentioned separately unless it is a known issue.
Both the “Impressions” and the “Recommendations” sound like canned responses that have little to do with the actual data.
What a waste.
I would add that nothing about the test environment was representative of how Sibylle normally spends her nights. Not the room, not the bed, certainly not all the wires and devices she had glued and strapped to her body, not the starting or ending times, and not the fact that we slept apart. Any data gleaned from such an abnormal situation, even “adjusted” for the situation has to be taken with a large grain of salt.
Her primary concern, the issue that drove the test, was (and still is) persistent vivid dreaming that leaves her feeling like she didn’t sleep restfully. That the sleep study is primarily aimed at identifying sleep apnea or related issues means that it was at odds with her goal. The canned language of the report leads both of us to believe that that study was ill-equiped to address her questions.
I agree with Sibylle that the test was largely a waste – a well-conducted but ultimately meaningless waste. One that’s produced a report she’ll have to refute with her primary care physician. Fortunately we have a good primary care doctor, who I hope will agree with Sibylle that the results of this test shed no light on her original complaint — “why do I feel trapped in vivid dreams night after night?”