Posted by meffect on August 5, 2015, at 19:21:56
In reply to Re: Can mediation imitate early signs of Narcolepsy? » meffect, posted by phidippus on August 5, 2015, at 11:09:33
I know what you mean about the benzos. I wish my doctor never prescribed them to me. I never asked for them. I would stop taking them but I get major insomnia without them. I tried quitting before, i went 4 days with very little sleep and then I had to go to work the next day so I had to start taking them again. I hate benzos with a passion, the worst drug on the planet. A drug a person can never stop taking because the addiction is the worst of any drug on the planet? Given to me without even asking or telling me the risks. Wish the stupid government would do something about this. Like, I literally probably need 30 days off work just to get past the insomnia. Who knows what other side effects i'll have. Yes government, I want you to create a program that gives me the ability to take 30+ days off work overcome an addiction that you allowed me to get so easily. I feel like my life is ruined and is slowly being stipped away from me from these god damn benzos. I am noticing myself to be a much more forgetful person lately as i've been taking benzos for at least 5 years now. I want to quit before its too late. i hate this whole situation i and many other people are in
I'm not sure if I have sleep apnea or not... i guess maybe I do? I kind of got the impression that I went to a CPAP salesman because they really pushed the CPAP there. I told them many times that the CPAP was not working out for me and that I would like to try a dental appliance. But they instead pushed that I need to try different CPAP masks. I did that, but I still cant stand the darn thing. It makes my insomnia worse and also falls off my face in the middle of the night 95% of the time. I have a couple full face mask because I'm a mouth breather. I haven't tried the chin strap with a nasal mask yet. Not sure if it would make it any more tolerable
Here's my study, sorry if there are any errors, I had to scan a crappy copy of it and then do an OCR on it. I fixed a lot of errors in the OCR already but I might have missed some
My Sleep Study Says
Indication:
[My Name] is a 30 (I'm 31 now) year old male with a BMI of 23.4 and a medical history of mood disorder complaining of symptoms of snoring, fatigue, and excessive daytime sleepiness with an increased Epworth Sleepiness Scale score of 18.
The above patient underwent an attended Polysomnogram using standard sleep apnea montage. The sleep staging was assessed with 17.EG channels F4-MI, C4-M1, 02-MI, LOC, ROC, and chin EMG. Limb muscle activity was assessed with electromyogram of bilateral anterior tibialis muscle. Modified precordial lead was used to monitor electrocardiogram. Laryngeal sound recording was obtained from microphone placed on the anterior neck. Air movement was recorded with a nasal-oral How thermistor. The respiratory pattern was assessed with both abdominal and thoracic inductance plethysmography. Continuous oxygen saturation was measured using digital pulse oximeter. Apnea was defined as the cessation of airflow for at least 10 seconds. Hypopnea was defined as an abnormal respiratory event lasting at least 10 seconds associated with at least a 30% reduction in thoracic abdominal movement or airflow as compared to the baseline, and with at least a 3% decrease in oxygen saturation or if the event is associated with an arousal. RERA was defined as a sequence of breaths lasting at least 10 seconds characterized by increasing respiratory effort or flattening of the nasal pressure waveform leading to an arousal from sleep when the sequence of breaths does not meet criteria for an apnea or hypopnea. The apnea hypopnea index (Al 11) was defined as the number of apnea and hypopnea events per hour of sleep. The respiratory disturbance index (RDI) was defined as the number of apnea, hypopnea, and RRRA events per hour of sleep. The protocol and definitions used for this study were based on the American Academy of Sleep Medicine (AASM) established guidelines.
Sleep Analysis:
Baseline sleep architecture revealed that the patient slept a total of 354.5 minutes, out of the 445.1 minutes recorded. This gave a sleep efficiency of 79.6%, which was mildly reduced. Sleep latency was 86.0 minutes, which was increased. Stage R sleep latency was 75.0 minutes, which was reduced. The amount of Stage R sleep was reduced and the amount of Stage N3 sleep was normal. A total of 42 stage shifts and 5 awakenings were noted. The amount of wake after sleep onset (WASO) was 4.6 minutes
Cardiac Analysis:
Significant arrhythmias were not seen.
Leg Movement/Abnormal Behaviours Analysis:
Significant periodic leg movements were not seen. No abnormal parasomnia like behaviour was noted.
noted.Respiratory Analysis:
Respiratory analysis revealed mild to moderate snoring. In addition, a total of 9 obstructive apneas, 1 central apnea, 2 mixed apneas, and 20 hypopneas were noted. The longest apneic event was 26.6 seconds in duration. The longest hypopnea was 37.2 seconds in duration. The lowest oxygen desaturation was 89.0%. The apnea/hypopnea index (AHI) and respiratory disturbance index (RDI, which is the combination of AMI and RERA index) was 5.4. This indicated a mild form of obstructive sleep apnea syndrome. It should be noted that the patient had increased events while in the supine position and during Stage R sleep with a supine AMI of 7.9 and a Stage R AHI of 11.9.
CPAP/BPAP Analysis:
CPAP was not initiated because the patient did not meet the AASM required criteria for obstructive sleep apnea within the first two hours of the study, based on the severity of obstructive events or reduced sleep efficiency or both.
IMPRESSION:
1. Mild obstructive sleep apnea syndrome with AHI and RDI of 5.4 and lowest oxygen desaturation of 89.0%. Increased supine and Stage R related OSA with a supine AHI of 7.9 and a Stage R AHIof 11.9.
2. Mild to moderate degree of snoring was noted.
3. Abnormal sleep architecture characterized by reduced sleep efficiency, increased sleep latency, reduced Stage R latency, and a reduced amount of Stage R sleep.
RECOMMENDATION:
1. Treatment options include CPAP/BPAP, surgical options, mandibular advancement devices, hypoglossal nerve stimulator, and Winx oral negative pressure therapy. If the patient is agreeable to trying CPAP therapy, start CPAP at a pressure of 6.0 cm for outpatient acclimation and then schedule the patient for a full night CPAP titration to document the best pressure requirement.
2. Educate regarding the importance of good sleep hygiene and adequate duration of 6-8 hours per night.
3. In view of higher risks associated with surgery and general anesthesia, notify surgeon and anesthesiologist about OSA diagnosis prior to any surgeries.
poster:meffect
thread:1080722
URL: http://www.dr-bob.org/babble/20150629/msgs/1081056.html