Understanding My Sleep Study Results: Zero Spontaneous Arousals
Subject Information: 28 years old, female, height 5'4", weight 160 lbs. Medications: I am currently taking Adderall, various vitamins, and occasionally propranolol for anxiety. On the day of the test, I refrained from all medications, including foregoing Adderall for two weeks before the study. I also avoided caffeine on the day of testing. Approximately four hours before the polysomnography (PSG) test, I took a regular 500 mg Tylenol for a headache; it was not Tylenol PM or any sleep-altering medication. Additional Medical Background: Aside from the conditions mentioned previously, my only other significant medical history is the gastric sleeve surgery I underwent on November 13, 2024. I had childhood asthma triggered by exercise and allergens but have since outgrown it. There’s also some history related to mental health, which may have been misdiagnoses of narcolepsy. Greetings! I recently underwent a PSG and MSLT, which confirmed a positive diagnosis for narcolepsy. However, I was under the impression that narcolepsy often leads to highly fragmented sleep patterns. Additionally, I have sleep apnea, now identified as treatment-emergent central sleep apnea (CSA). During the study, I recorded ten central apneas and three obstructive apneas, alongside four occurrences of limb movement arousals, yet reported an astonishing total of zero spontaneous arousals. Can this be accurate? The total number of arousal events noted was 36, but the figures cited pertain only to those involving desaturation. All noted events were linked to respiratory issues and limb movements. Interestingly, my average sleep latency was recorded at just 2 minutes, with REM sleep occurring in 3.5 minutes during the PSG and 7 minutes during the initial nap. To my surprise, I had thought I remained awake throughout each nap, but it turns out I was asleep the entire duration. The absence of any spontaneous arousals strikes me as extremely unusual; I’ve been unable to locate any articles or discussions online from others experiencing a complete lack of such arousals. Could the accuracy of the study be in question? What factors could lead to these findings? Additionally, I've noticed significant cognitive challenges that have progressively worsened over the last few years, coupled with severe excessive daytime sleepiness (EDS). An intriguing observation I made using an app called Welltory indicated that my body was considerably relaxed, suggesting a dominant parasympathetic nervous system, with little interference from the sympathetic nervous system affecting my heart function. Could this finding be connected? Or might it simply be an unreliable method that I shouldn't prioritize? Thank you so much for taking the time to share your thoughts and insights with me!
Answers (1)
6/23/2025, 12:50:56 PM
OpenHealth AI
Thank you for sharing your detailed sleep study experiences and results. It’s understandable to have concerns about the unexpected findings, especially when navigating a complex condition like narcolepsy alongside sleep apnea and cognitive challenges.
Main Points:
- Lack of Spontaneous Arousals: The absence of spontaneous arousals during your sleep study can be unusual but may still be accurate depending on your specific sleep patterns and medical conditions.
- Significance of Study Results: The presence of central and obstructive apneas with limb movement arousals indicates sleep disturbances that likely contribute to your excessive daytime sleepiness (EDS).
- Connection with Cognitive Challenges: Your experience with cognitive issues may relate to the overall quality of sleep disrupted by your conditions, including narcolepsy and sleep apnea.
Explanation:
Narcolepsy is characterized not only by EDS but also by potentially fragmented sleep patterns due to sudden sleep attacks and disturbed nighttime sleep. It’s not uncommon for people with narcolepsy to experience very brief or no spontaneous arousals, especially if other sleep architecture elements are affected, like in your case with significant apnea events. However, continuous monitoring and follow-up with healthcare providers who understand these complexities can provide clarity.
The finding of your body being more relaxed, as indicated by the Welltory app, suggests a possible dominance of the parasympathetic nervous system, which may also correlate with your sleep patterns and overall fatigue. The app's data should be viewed as supplementary and not definitive, while your actual medical tests should take precedence.
Next Steps:
-
Review Sleep Study with a Specialist:
- Schedule a follow-up appointment with your sleep specialist to discuss the findings in detail. Bring up your concerns about the lack of spontaneous arousals and discuss the implications for your treatment plan.
-
Monitor and Document Symptoms:
- Keep a detailed log of your daily symptoms, including cognitive challenges and daytime sleepiness levels. This may help your healthcare provider assess your condition more effectively.
-
Explore Treatment Options:
- Discuss potential treatments for both narcolepsy and sleep apnea. Treatment for sleep apnea (like CPAP therapy) could be crucial in improving your overall sleep quality and reducing EDS.
-
Consider Cognitive Assessment:
- If cognitive challenges are significant, a formal assessment might help clarify this aspect of your health and evaluate potential interventions.
-
Lifestyle Modifications:
- Maintain a regular sleep schedule, practice good sleep hygiene, and address any overtiredness. This may include strategies like reducing screen time before bed, creating a restful sleep environment, and managing stress levels.
Please remember that ongoing communication with your healthcare providers is key as you navigate these complexities in your health. You're taking proactive steps by seeking information and clarification, and that is truly commendable. Feel free to reach out if you have further questions or need more support.
Related Questions
Mass on the Glottis
Patient Details: 63-year-old male, height 165 cm, weight 66 kg, Asian descent. Lifestyle Factors: No history of smoking or alcohol consumption. Medical History: Diagnosed with asthma and angina. Current Medications: Uses a Symbicort inhaler and takes Concor tablets. Main Concern: A mass was detected during a gastroendoscopy carried out a year ago. There is no report of pain, but the patient experiences mild hoarseness. What might be the diagnosis?
Experiencing Heart Palpitations Following Chest Impact
I'm a 17-year-old female who has struggled with tachycardia for several years, having been diagnosed with postural tachycardia syndrome (POTS) about five years ago, although I haven't pursued further testing because I haven't completely lost consciousness. Recently, over the past month or two, I've started to experience sensations of my heart skipping beats, accompanied by difficulty in breathing during these episodes. These occurrences have become significantly more frequent, even when I'm at rest. Five years ago, I underwent a Holter monitor test, which indicated primarily tachycardia with occasional premature ventricular contractions (PVCs), but nothing alarming was found. In early December, I was struck hard in the chest by an elbow while in a mosh pit, which resulted in some pain when taking deep breaths for a few days. My sternum became bruised and slightly swollen, and it remained tender to touch for about two weeks, but this discomfort was manageable. I still feel some soreness when stretching, although it’s not severe. Additionally, I have diagnoses of Crohn’s disease and hypermobile Ehlers-Danlos syndrome (HEDS), and I am currently on immunosuppressants. Given these circumstances, would it be advisable for me to seek medical evaluation, or could these symptoms be considered typical?
Post-Gallbladder Surgery Concerns: Potential Infection Three Weeks Later?
Subject's Age: 35 Gender: Female Height: 5 feet 4 inches Weight: 160 pounds Ethnicity: Asian Duration of Symptoms: Last Three Weeks Geographic Location: United States Relevant Medical History: Almost three weeks ago, I underwent gallbladder removal surgery. In the last few days, I have observed a small amount of cloudy discharge emerging from my incision site. Recently, I noticed what appears to be pus leaking from the area. While there is no significant pain, I do feel a mild soreness when I touch or move the site. I have not experienced any fever or chills, and there’s no unpleasant odor coming from the wound. Should I continue to clean the area with soap and water, or is it advisable to seek medical attention at the emergency room for further evaluation?
Understanding My Experiences with Dissociation and Physical Symptoms
Hello everyone! I'm 15 years old and I’ve been grappling with intense feelings of dissociation recently. About two years back, I experienced what I now refer to as a "silent seizure" for the first time. It happened around 2 PM while I was at school in the band hall. Suddenly, I found myself zoning out completely; I was just sitting there, disassociated from reality, until it dawned on me that I couldn’t seem to reconnect with my surroundings. Feeling lost, I turned to a friend and anxiously asked, "Where am I?" She chuckled, unaware of the seriousness of my situation, but I stood up and wandered out of the classroom, aimlessly walking towards the bathrooms. The sensation was akin to being in a dream—you know you’re somewhere, yet you can’t fully engage with the moment for what felt like 5 to 10 minutes. Strangely, I even had the feeling of observing myself from above as I moved through the halls, like a scene from a dream. In a state of panic, I contacted my mom. By the time I managed to leave school, my mind was clearing. She took me to her workplace where a colleague checked my blood sugar levels, revealing it was low. I had eaten that day, so this was unexpected (especially since my mother also faces issues with low blood sugar). This occurrence was unprecedented for me; thankfully, I haven’t faced such low levels since then. In the following weeks, I experienced intermittent dissociative episodes, prompting me to visit a doctor. I underwent blood tests, an electrocardiogram (EKG), and a routine examination. Everything appeared normal, except I was diagnosed with anemia—something my mother and sister also deal with. I walked away from that appointment without any real explanations, and after a while, the episodes subsided—thankfully, a relief. FAST FORWARD TO NOW: (15 years old) (Potentially relevant context) Recently, I’ve been enduring severe heart and chest discomfort. I’ve been noticing irregular heartbeats, sporadic strong pulsations, and sharp pain localized in my heart region and upper right chest. Lying on my side can be quite painful, and sometimes I struggle to take deep breaths. I make it a priority to get a full eight hours of sleep each night, I take daily vitamins, and I’m actively involved in competitive cheerleading, maintaining a healthy fitness level for my height and weight. We sought medical advice again, underwent numerous tests, and, once more, everything checked out fine. My heart was deemed healthy, and all other measurements were satisfactory. Initially, we suspected anxiety might be a factor, but my mom is hesitant to consider antidepressants, believing that my age may limit treatment options. She has recommended that I hydrate more and practice breathing exercises (which is somewhat ironic since I struggle to breathe when these pains occur, yet I don’t argue). UPDATE: During practice today, I unexpectedly experienced my first "silent seizure" episode in two years. It was more disconcerting than I recalled. I lost track of my location again and couldn’t re-engage with reality. It felt as if I was observing those around me from a dream-like vantage point. This realization frightened me, thinking that I had moved past these episodes. It took about ten minutes for me to regain my awareness of my environment. Additionally, this week, I noticed moments of dissociation, albeit not as intense as previous episodes. I found myself vacantly staring, and my vision felt oddly lazy, frequently. It's worth noting that I do not have a lazy eye. I plan to document these occurrences meticulously, and if they persist, I will consult my doctor again. Meanwhile, if anyone has suggestions about what might be happening to me, I would greatly appreciate it. Is this potentially linked to anxiety? I’m genuinely confused about my condition!
Identifying a Mysterious Brown Circle on My Scalp
Age: 21 Gender: Female Height: 5'4" Weight: 175 lbs Ethnicity: White (Scottish/Irish) Location: California Current Medication: Testosterone injection administered subcutaneously in the thigh While I was having my hair dyed blue, my girlfriend noticed a perfectly circular brown mark on my scalp. It resembles a circle that appears to have been made with a brown marker. The size of the ring is similar to my thumb’s tip and contrasts sharply with the lighter shade of my scalp. There is no evidence of hair thinning or loss around this circle; we only discovered it because we were parting my hair. I’m curious if this could be connected to the brain fog or headaches I’ve been experiencing lately. I looked online, and while ringworm was suggested, it doesn’t match my symptoms since there are no bald patches or flaky skin. I’m open to answering any additional questions to help clarify this situation, as it's causing me some concern.