Forum · Doctors contradict my polysomnography results

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[-] InventivePurpleHerring7613 +0 points · 8 months ago

Hi there,

I just feel like I need advice.

I never had actual insomnia or serious nocturnal awakenings in my life until last year. Up until last year I had a normal sleeping pattern where I would typically sleep around 7 hours per night without interruption. It started very suddenly. At the time I was very fit and training for track and road races (distance running!) and weighed 142 lbs w/a height of around 5'11''. One night in late May last year I started waking up exactly after 4 hours of sleeping, not being able to fall back asleep. Upon waking up in the middle of the night, I felt extremely awake, as though I could hypothetically do a workout at 3 AM.

As time passed I went to several doctors. At first it was suggested I should "exercised more" to help my sleep. I tried making it obvious that I already was exercising a great deal, but I was desperate to take up any advice. As I continued my intense training schedule, my sleep pattern deteriorated further, going from 4 hours straight to 2 hours, awakening, followed by 2 more hours of sleep for a total of 4. It was only after a great deal of running that I noticed, on days I ran significantly longer than unusual, my sleep fragmentation became more severe. The worst point was a week during which the typical run was over 10 miles--my marathoner friends would tell me, oh, you're gonna sleep like a baby after this---it was on those days when my sleep actually deteriorated to waking up after only 30 minutes--followed by another 30 minutes of sleep. I was basically waking up every half an hour for a total of less than 100 minutes of sleep in a night. I had reason to believe that my disturbed sleep pattern had something to do with running.

So I got a sleep study done last August. My results were as follows: Sleep efficiency 53.8% (pretty much the same sleep efficiency now, little has changed). Sleep onset was 17.9 min. REM latency 275 min. Apnea Hypopnea Index (AHI) was 3.1; 10 apneas and 2 hypopneas. All the apneas were central apneas. There were 37 RERAs which resulted in a Respiratory Disturbance Index (RDI) of 12.7. The RDI during REM sleep was 0.0, and the RDI supine was 14.7 vs non-supine RDI of 5.76. Overall average SaO2 was 96% and the lowest was 90%. Tracheal microphone recorded infrequent mild snoring. Cardiac rhythm was "unremarkable" (sic). Diagnosis: Mild Obstructive Sleep Apnea.

Now here's why I'm posting this thread here: I vividly remember the person from the sleep clinic which did my sleep study telling me for some reason that they wouldn't request a CPAP for me. I remember them telling me something about how my apnea was "very" mild and that insurance would not approve me getting CPAP. I clearly remember the same person telling me it would be okay for me to use sleeping aids as an alternative to apnea-specific treatment.

So I went back to my previous general physician, to whom I showed the polysomnography results. She agreed with the sleep clinic doctor in their dismissal of CPAP or other sleep apnea treatment, and simply prescribed me trazodone. For several months, I did not think much of my sleep study results. Yet my sleep did not improve. The trazodone only made me very sluggish and tired but did not stop my insomnia. Melatonin only helps marginally. I decided to stop running for four months, because I was convinced that running had something to do with my sleep problem. But after four months of not running, I gained 18 lbs (now I weigh 160) and my sleep did not improve much if at all. I started running again a few weeks ago but I'm taking it easy.

Today I showed these same polysomnography results to a second doctor, and he seemed very surprised when I told him the sleep clinic did not give me a CPAP. He said "it's not true" that I don't qualify for a CPAP, and that I should try a CPAP. So I agreed on a CPAP trial a month from now. How did the first two doctors see my results and deny a need for CPAP?! Do my results really mean I should try it? My mom has a CPAP machine and told me some scary things about it. She got upset and confused when I told her my new doctor wants me to try CPAP--she says that her machine makes her lungs and chest hurt and that she developed a dependency on it, and that I'm "too young" for CPAP (age 24). However from what I've read there are some very young people and even athletic people who have sleep apnea. I feel like I have no choice but to try.

What do you think about my polysomnography results? Alex

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