It has been quite a while since my last post! If you remember, I took a sleep test a few months ago (Sleep Study — Part 1). I met with the RN to discuss my results, but first, I want to tell you a little more about the test itself and what it was like to have a sleep test.
I arrived at the Sleep Center at 8pm to check in and to give the techs time to hook me up to all the wires before bedtime. I loved that the rooms were set up like hotel rooms and not hospital rooms so it didn’t feel so clinical. My sleep test, also called a polysomnography (PSG), was set up to measure brain function (EEG), eye movements (EOG), muscle movements (EMG), heart rhythm (EKG), pulse and mouth and nose airflow.
Luckily, after you’re hooked up to all of the wires, you’re not strapped in for the night. The other end of the wires are connected to a box that they loop around your neck so you can walk around before bed. There was a little lounge at the end of the hallway with some couches, magazines and a TV where you can relax before bed. I had the lounge to myself and I spotted only two other patients the whole time I was there.
I hung out in the lounge for a bit trying to relax. This was not easy to do since I was covered in wires and I was also watching the Red Sox lose… again. But, I did what I could. I went back into my room around 10:30 to read in bed for a little and at 11:00 I called the tech in to tuck me in. And by tuck me in, I mean, hook my wires up to get set for sleep monitoring!
After the wires were plugged into the monitoring equipment, the tech shut the lights off and wished me good night. But before I could fall asleep, she had to test the connections from the other room to make sure everything was set up correctly. She had me move my legs and arms, blink and take deep breaths – every movement was either seen from the closed circuit camera or monitored through the wires.
When I’m home, I can usually fall asleep within 5 or 10 minutes of hitting the pillow and I really tried to make the sleep test experience as close to feeling like home as possible. But there’s only so much you can do when you feel like a combination of Bane, Darth Vader and (masked) Hannibal Lecter as you’re trying to sleep.
While I’m sleeping, I move around a lot, switching from my stomach, to my back or flipping side to side, but as I’m falling asleep I like to be on my left side. This proved difficult during the sleep test since the wires were hooked up behind the nightstand to the right of the bed (if you were standing at the foot of the bed looking at the head of the bed) so as I lay on my left side, the wires were under my head.
I managed to stuff the pillow between the wires and my head which actually helped but my brain was going crazy – I couldn’t shut it off! She’s watching me, am I doing it right, is everything ok, why can’t I sleep, did that wire just come unhooked, what if I can’t fall asleep, why am I not falling asleep?? I tried to shut everything out and relax and after about 30 minutes, I fell asleep.
Sleep tests are frequently done to test for sleep apnea, a sleep disorder where you repeatedly stop breathing in your sleep – sometimes hundreds of times in one night and each time could be longer than a minute. And you may be thinking, wouldn’t someone know if they stop breathing during the night? Maybe, but in a lot of cases, people don’t wake up completely, so they are unaware that their sleep is disrupted throughout the night. The best way to determine if you have sleep apnea is to have a sleep study done, but some common symptoms include snoring, persistent daytime sleepiness, waking up out of breath during the night and waking up in the morning with a dry mouth or a headache.
I was pretty sure I didn’t have sleep apnea, but I it couldn’t hurt to check it out and eliminate it from the diagnosis list. I do talk in my sleep a lot, but I didn’t think I stopped breathing.
Once I finally fell asleep, the test went ok. I do remember the tech coming into the room in the middle of the night because I was kicking my legs around so much that she thought one of the wires became disconnected. After she made sure it was still attached to my boisterous leg, I fell right back asleep.
She came in to wake me at 6:30, which is earlier than I normally wake up, but it gave me plenty of time to wash the goop from the wires out of my hair. Since my REM cycle was monitored, she could tell when I was coming out of the cycle to know the best time to wake me.
A few weeks later, I met with the RN to go over my results. I was in bed for 453 minutes (7.5 hours – not too bad) but I slept for 388 minutes (6.5 hours – not my best night). Remember how I said it took me a really long time to fall asleep? I took me precisely 22 minutes. That doesn’t usually happen. Even though my sleep efficiency was considered good at 85% – 6.5 hours of sleep has not been nearly enough for me, so I was a little sleepy when I woke up and I felt sleepy that day.
There are normally two stages of sleep: rapid eye movement (REM) and non-rapid eye movement (NREM). As you begin to fall asleep, your body enters stage 1 of NREM – this stage can last 5 to 10 minutes. Stage 2 of NREM is still considered light sleep because you could be easily awakened but your heart rate slows and your body temperature decreases as your body prepares for deep sleep. My light NREM sleep was 10% of my overall sleep time, which is considered normal.
Stage 3 of NREM is a deep sleep, but it is not REM sleep. Dreaming is common in Stage 3 – although not as common as dreaming during REM – and the dreams are usually less memorable. My deep NREM sleep was 81 minutes (21%) of total sleep time, also within the normal limits.
REM sleep is the time of night when you can have intense dreaming due to heightened brain activity, but your major voluntary muscle groups are paralyzed. Your body usually enters REM sleep after about 90 minutes of sleep and you could have 4 or 5 periods of REM sleep each night. As you sleep, each REM cycle is longer, so while the first one may last 10 minutes, the final cycle may be an hour, so your total REM sleep may be between 90-120 minutes. The night of my test, it took me 86 minutes to hit my first REM cycle (normal!) and my total REM sleep was 79 minutes, still considered normal, but I probably could have used one more cycle!
The time I spent sleeping and all of my sleep cycles were fairly normal. The part of the sleep test that was slightly less than normal (although still considered normal for science) was my legs. I mentioned above that at one point the tech thought I kicked the wire on my leg off because I was so active while I was sleeping. Well, that wasn’t the only time. I had 117 periodic leg movements during sleep and 8 of them woke me up. Overall, this is a pretty good average as waking up 10 times or less per hour is still considered normal. But, wow, I really do kick a lot!
In addition to kicking, I move around a lot in my sleep. I spent 14% of the night on my back and I know I flip from side to side and onto my stomach all night.
The good news from the test is that I don’t have sleep apnea – I had zero obstructive, mixed, central apneas and my oxygen levels were between 93-95%.
So, the test told me a lot about how I sleep – but not about why I’m still sleepy. The RN went over my results and gave me a homework assignment – every day, I have to keep track of how much sleep I got the night before. In a few weeks, I’ll come back and the doctor will look for a pattern to see how my sleep looks over time.
Stay tuned for Part III – how I’m tracking my own sleep!
Have any of you ever done a sleep test? Do you keep track of how much sleep you get each night?
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