[split] New member - Analysis Request PLM, limb movement arousals

[Eddi3p]

Hello all,

I’m new to the website and I recently got a sleep study done. The sleep specialist advised me that my study was normal and have no sleep apnea. I wanted to see if someone could interpret my results. If you could help It would be greatly appreciated appreciated. Thanks 

EEG 
Stade 1, stage 2, stage 3 and REM sleep  has been reached. EEG was unremarkable. No epiletiform discharges were seen.

Sleep Architecture
The patient slept 414.1 minutes , the patient recorded for 493.1 minutes. 
Sleep efficiency: 84 %, sleep latency was 19.5 minutes. 

The patient ‘s latency to REM was also prolonged to 277minutes from sleep onset, duration was 8.8
 % of TST which is also reduced.  Short episode of SWS  was seen.


ECG analysis
The average  heart rate Based on pulse rate channel was 54.6 bpm/ minutes, the highest heart rate during sleep  was 93 , Cardiac Arythmies : None

Respiratory event analysis
The study showed a total of 16 episodes of hypopneas. The mean duration of this hypopnea was 32.5 seconds. 
The patient had 2 episodes of apnea the mean duration of this apnea was 11.8  seconds. 

Apnea/ Hypopnea index (#/H TST) : 2.2
Loud snoring Episodes seen : 35   prominent with the suppine position,   8.4% of TST

Airflow is maintained by compensatory respiratory effort, pulse oximetry showed saturation mean 
SPO2% : 96  lowest   SPO2% : 92

 PLMs arousals within normal limit. 2.1 (#/H TST)

Summary and Conclusions 
The above interpretion was based on an epoch-by-epoch  review of polysomnography, scored sleep report and digital photography of the patient sleep.  Sleep pattern showed highly fragmentated associated with  relative hypoventillation episodes

[Crimson Nape]

Hi Eddi3p! -
To avoid hijacking another member's thread, I have split your post off into its own thread. I will be following this up with a PM to you with the same message.

[Sleeprider]

Results show a high level of arousal associated with limb or leg movements, labeled PLM (periodic leg movement). With an index of just over 21 per hour, this is a significant sleep disorder that is not related to respiratory problems. Your sleep doctor is probably only familiar with positive air pressure therapy for respiratory event related arousals and should have suggested you discuss this with your doctor to address with prescriptions that can settle PLM and related arousals from limb movements or restlessness. We have some members on the forum that are more familiar with this issue than I am, but your test indicates that you don't need CPAP, but you do have a significant problem as it relates to sleep integrity.

[Eddi3p]

Thanks for your insight. I was surprised when the doctor called to say everything was ok. Because I definitely don’t feel like I get a good nights tests or don’t wake up feeling rested

---

Thank you! Sorry I didn’t noticed I was responding to another members post

[Sleeprider]

Well, when you're a hammer, everything looks like a nail, and your sleep doctor seems to have only one trick, and it has to do with CPAP. I hope you will take your results to your regular doctor and discuss the limb movements and arousals that arouse your level of sleep more than every 3-minutes all night. That is intolerable for your health and well-being, and can be treated. He may have suggestions or a referral, but you clearly need some help. I revised the title of the thread to hopefully attract some more help form members familiar with this.

[Howardoo]

The math on the arousals appears to be all over the place. I can't tell which number is the correct number when it comes to leg movements, etc.

[Rubicon]

51.6% Stage 1?

246.5 minutes to REM?

Total train wreck sleep architecture!

[kappa]

I agree that the leg movement numbers are all over the place... we have 146 leg movement associated arousals + awakenings, but somehow only 51 total leg movements in the subsequent section??? Then 47 of the leg movements are classified as PLMs but there are only 10 PLM Arousals?

Do you experience restless legs when awake (research "RLS"), noticed limb twitches when half asleep?

[Eddi3p]

Not really to be honest. The test shows that my oxygen is fine. But the fragmentation and arousals is a cause for concern to me. I think I may be leaning towards UARS rather than Sleep Apnea. I never feel like I had a restful night

---

It did take me a while to fall asleep lol. I felt like I didn't fall asleep for a good hour or two. Didnt feel like I slept much at all

[Geer1]

99% of that sleep study indicates no breathing issues either apnea or uars unless they did not score RERAs and breathing arousals only accounts for apnea/hypopnea. There is one contradictory statement that I dont understand. "Sleep pattern showed highly fragmentated associated with relative hypoventillation episodes". I would ask doctor to clarify what that statement means since O2 levels appear good and next to no breathing related arousals were scored so not sure how hypoventilation and associated fragmented sleep are related.

As others have already mentioned the leg movement data makes no sense and requires clarification as well. 51 leg movements, 47 of which were PLM with 10 associated arousals but supposedly there were 146 arousals/awakenings in total so the other 4 leg movements caused 136 arousals???

In short it appears you have elevated arousals but they appear to have failed at interpreting what is the cause and report/conclusions don't seem to be consistent.