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Interesting chat w/sleep lab people

Posted by permagrin on January 24, 2003 at 16:19:26:

Mike had another very rough night last night and woke up around midnight convinced that I had put a very heavy load of chocolate chip cookie dough on his feet! This really got him agitated. (ROFL!) He woke up saying, "I didn't mean to accuse you of anything while you were making the cookies." Heh. There was no reasoning with him and that was obvious, so I let him cool off for about an hour, during which he accused me several times of calling him "stupid" when I tried to explain to him that he was confused and had apparently been dreaming, and that I do NOT make cookies at midnight. Not no way, not no how, and not for anyone. Thank God I was blessed with a good sense of humor... Anyway, mostly I was just pleased as punch to know he had been dreaming. (Yes, I ended up sleeping in the living room after getting him hooked up to CPAP.) I figured I was in for a rough day with him because I figured he'd remove the mask and not get any decent sleep, but I also figured at least one of us should have some sleep. I was so pleasantly surprised when he called me into the bedroom to help him get his clothes this morning, and he had strap marks still on his face!

I decided to try to get to the bottom of what was going on with him, and since his doctor stil hasn't returned my request for a phone call, I decided to try to reach someone at the sleep lab that did his PSG. I spoke with one tech who sounded mystified, but postulated that he might be having medication conflicts, so I was all over that and wanting more info. She said they have a guy there who reads, interprets and makes recomendations on the PSGs that they do, he is a PhD, but not an MD, and she would have him call me. A couple of hours later, he actually did! He was a wonderful guy who spent almost an hour talking with me and getting info about Mike, making suggestions and brainstorming with me. His theory is that Mike has some anxiety issues, based mainly on the anxiety questionaire that Mike filled out for them prior to his PSG. He said that probably prompts the restlessness and wakefulness, and explained to me how anxiety produces alpha waves that intrude into delta waves during sleep and disrupts it. It made perfect sense in that regard. He said he really thought Mike needs to address this high anxiety state, probably first through meds and eventually with some good counseling therapy. The agitation is the manifestation of this pent-up anxiety.

He also pointed out that exercise, in Mike's situation is absolutely essential because all he does is sit around. Mike had been walking three-quarters of a mile on a treadmill before the holidays, but as his condition worsened over the holidays, we let it lapse, mainly out of concern for his safety and stability. This guy said it isn't negotiable. Mike is excited about getting back into the routine of exercising as he was an athlete earlier in his life. This afternoon, he went almost a quarter mile before he started to falter.

Lastly, this nice man suggested getting Mike in to have an ENT look at him to see if there's chance of a surgical intervention or if surgery might improve his ability to tolerate CPAP and possibly lower his pressure requirement. I'm working on getting him a referral for that, and I have a call in to his psychiatrist to see if he will prescribe pamelar, which is what the sleep guy recommended for anxiety.

So that's where it sits this afternoon.

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