Ep 11: Teenage sleep study review story

In this episode we have a continuation of the previous episode and are reviewing the sleep study of a teenage girl who’s having her first sleep study . 

Transcript

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Imagine finding yourself in a world quite much never heard of before, and getting the real opportunity to get a first-hand experience of some of the things happening in real time as a satisfaction to your curiosity built overnight. This is the story of a young lady whom I'm given the name Nia, who got to do her internship for her school work in a sleep lab. A one too familiar yet also new to her. Nia got to do her first sleep study on the very first night of her internship, which was quite a coincidence or an adventure because um of the patients booked in for the night, one of them cancelled last minute, and so there was um an empty room or a bed that um the lab director gladly offered Nia to do her first sleep study or or to experience what goes on in the night. And so we're going to see how this turns out an inside-out look on an experience in a sleep lab. Hello everyone, and welcome back to another episode of the Sleep Lab Stories. This is a continuation of the previous episode, which already covered, I already given a summary of what was going on. If you're new here, thanks for choosing to spend this time with me. And if you've been here before, I thank you again for the continuous support and consistency in showing up and or tuning in. I welcome every kind of interaction, feedback on any of the topics or things we talk about here. And yeah, you can reach out to me through my email or also just comment in any of the episodes from whichever platform that you're listening from. So, as uh from the previous episode and also from um the short introduction of I've done, Nia had spent the night in the lab and had her own sleep study done. So, today we are going to review the overnight sleep study of uh from Nia and um which was uh I mean recorded through the night, and in in like in many labs, this uh recording was stopped around 6, which is a more or less organizational reason. It's not like the time the patients are woken up. Some labs do wake up patients at this time, but uh from the lab where Nia is, the studies are just stopped because the shifts changes most of this time, and uh and uh the night shift gets to go home while the new the morning shifts come in at this moment to take over. So Nia continued was able to continue to sleep, and um for some patients, depending on the reason for admission, the time can be extended, which is known as the extended sleep study, to the time where the patient will uh voluntarily wake up. So, for this case, Nia woke up around 7 a.m. after the study was uh stopped. She got time to freshen up and change from her pyjamas and take breakfast comfortably before heading out of the room to review the sleep study with the physician, who usually comes in around 8. By this time, the technician has had already prepared and uh done preliminary reports from the automated analysis, from which thanks to some of the programs or tools that are available nowadays. This is uh it can be done within just a few minutes if not seconds. The scoring is done uh with the tools that are made. So, some of the tools used to analyze sleep are um thankfully quite fast enough. So um Nia gets to look at her study that has been done the previous night, and after the usual niceties with the doctor, um asking how the night was, she responded with a mixed facial expression. This being a new environment, it took her, of course, longer than usual to fall asleep. And other than that, the discomfort at the beginning due to the devices attached to her, the cables caused her a bit of disturbance, which again made her stay um awake a bit longer than usual. After the initial struggle through the the first I mean experience or the experience after being um cabled, near reports though that she managed to eventually fall asleep and actually surprisingly had what she describes as deep sleep than what she's had in a in a long while. Of course, this made the doctor curious and on inquiring why she thought she had a deeper sleep for this night, she says that probably the fact that she had put her phone away and was not doing um the usual cheat chat uh late-night chats with her friends, she was more intentional um to have the entire sleep recorded and so actually got immediately in bed and um fell asleep. So the recording must have been the reason why or the motivation as to why this sleep got a bit more uh uh deeper or more intentional, and also the fact that she was also curious to see how her sleep looks like uninterrupted. After this nice summary from her subject uh subjective summary, now uh the physician turns to the screen to show her the summary of her sleep from the recording of the previous night and also from uh this uh what the technician has prepared and to confirm if what Nia perceives is actually a reality or not. On the screen, there is too much information and signals and numbers, which are a bit confusing, especially for someone like Nia. We're seeing this for literally the first time, and the physician, however, tries to break this down in simple and easier terms for Nia to understand. The kind of test Nia did the previous night is called a polysomography, simply put, a recording of multiple body functions during sleep to evaluate sleep quality, sleep stages, breathing movement, and heart activity. More can actually be derived from some of these channels or some of these parameters depending on the intention of the sleep study. Sometimes for research purposes, there are other parameters, but we are not going to go into that today. The physician explains some of the parameters that are mainly um looked into while analyzing the let me see the basic function of sleep. And the first is the overall sleep architecture that shows how sleep is organized. This sometimes is summarized in a graphic that's called hypnogram and shows just the cycling, the repeating cycle of the different sleep stages, and also the total duration of the sleep. A teenager had to sleep for about eight to ten hours. The percentage of time in bed, which is the sleep efficiency, should be greater than 95%. I mean should be greater than 85%, and for Nia's case she had about 95%. And uh after spending a total of nine hours in bed, and which about um about uh a I mean normally about uh that's an example. If one spent about nine hours in bed and eight of them asleep, this usually brings about 95% of sleep efficiency. Nia took um a bit long to fall asleep, which uh we already reviewed at the beginning and some of the reasons. Normally, of course, she spends more time in bed before falling asleep, but when she actually wants to fall asleep at home, she usually she says spends about 20 to 15. I mean 10 to 15 minutes, which again, if we consider this, is normal. Near sleep stages showed a cycling through light sleep, deep sleep, and the dreams uh reach sleep stage. These stages were recorded by the electrodes that were placed on the head, which capture the brain waves. No abnormalities in terms of seizures or electrical charges were observed. Next channel that there was reviewed was the uh breathing uh parameters. Breathing in sleep is assessed by a parameter known as the EHI, which is uh the abbreviation apno hypnoindex, and basically summarizes the breathing interruptions per hour. From here, there were less than one event per hour, which indicated that she had a pretty normal breathing. Oxygen levels were also reviewed next, and these were captured via the pulse oximetry and an average of 95% through the night recorded, and a minimum value for NIA's sleep was at 94%. The heart activities showed a regular rhythm with no abnormal activations at any point during the study. These are usually also recorded through a 2.03 point EKG electrodes placed on the chest. Body movements, specifically the legs, were monitored also using sensors capturing the leg muscle activity, and only showed a few occasional movements which uh Nia cannot really remember. There were also uh quite some movements which were during um changing of sleep positions. These are several per night. Again, this she cannot remember because they're usually quite brief, and also in between changing of sleep stages, and most people don't remember this. And the changing of position between backside or stomach, or I mean sides left or right, are quite normal, and unless like someone wakes up or stands or sits up and they don't remember those, those are like the abnormal occurrences during sleep when it comes to movement that when observed should be considered as such, but for this case they were none. There were also brief awakenings in between caused by brain activations lasting just a few seconds. These are usually called arousals, and they are also normal. The microphone, which was meant to capture the breathing sounds or snoring sounds, showed no regular or loud sounds or breathing. There was no snoring or any no, like barely any uh sounds made during breathing. So, in conclusion, here had a normal sleep architecture and excellent sleep efficiency, sleep stages appropriately represented, including the REM, which is the dream rich sleep stage, and the deep sleep. Um, it's important also to know that dreaming actually can happen in any stages of sleep, and this the REM stage is usually just one that is considered to have like more likelihood of dreaming. There were no significant respiratory events observed, oxygen saturation remained within normal limits, cardiac rhythm was normal, no significant limb movement or abnormal movement noted, meaning the overall findings are consistent with a normal healthy sleep for a teenager. Of course, near reports that at times she, if if she were not like excited or anything, she would have probably extended her sleep, like mostly she does at home when she's at home to probably 9. And the doctor assures her that this is normal, and especially for teenagers, her age, due to the growth hormones and uh the several changes in the bodies, they do actually need more sleep. And other than the sleep onset, that took a bit of a time or during this uh study in the lab, due to the whole and uh novelty of the environment and everything that was attached to her. Nia was excited about the whole experience, and we likely let us look deeper and into some of our experiences in the lab in the next couple of series or episodes. I'd be very excited to report directly from this point of view on some of the unusual experiences, some of the stories on from this perspective, and also to to get to see what um or rather to to experience with her some of these events in the lab from the point of view of someone who actually didn't know anything about sleep before or rather about sleep lab before. Thank you for joining us for today's episode and also for spending this time. If you've listened this far, I hope you've learned a couple of things. If it's not for you, I hope this can be in something useful for someone else. So feel free to share with a teenager, a mom, a teenager, or a dad to a teenager, or a sibling to a teenager who might need to hear this or to know about this. And as we also get to experience one-on-one events in the lab about the different things, I think we'll probably have a QA or some episodes might go into the extreme, maybe some of the weirdest moments or something like that. So I'm really excited for those, and I hope you join in next. And um, yeah, take care until next time!