I have a sleep problem where I will typically wake up 1-2 times per night and have trouble falling back to sleep. I’ve gone to the sleep doctor and they want me to do a sleep study, but it would be $600 out-of-pocket because my insurance doesn’t cover it. I know that apnea is a common cause of sleep problems, but I doubt if that’s what I have based on the symptoms. My weight is fine, I don’t snore, and I feel like I sleep soundly until I wake up. It’s just that when I wake up, it may take 1-2 hours to fall back asleep.
It seems that the end result of a sleep study is generally is a CPAP machine for apnea. But if you don’t have apnea, what else would a sleep study be able to diagnose that could be treated?
I had a sleep study and was diagnosed with hypersomnia, which is a form of narcolepsy, so sleep studies aren’t just for apnea or prescribing a CPAP. In your case they would want to rule out an underlying physical cause for your insomnia before recommending a course of treatment. Maybe you don’t snore but you stop breathing, which wakes you up. Maybe you have disturbed sleep cycles. Maybe a lot of other reasons. It’s worth getting checked out.
A friend did a sleep study and was diagnosed with Restless Leg Syndrome. She’s on medication for that and says she is sleeping better so far. So, yeah, other things. I had heard that a lot of sleep studies are done by people affiliated with CPAP manufacturers. Don’t know how accurate that is, but if so that would account for the bias toward apnea in some places.
I can’t help but wonder why your insurance won’t pay for the study. Also, $600 seems high (although everything medical seems high to me really).
I have a high-deductible plan. Simple visits have a co-pay, but other services go towards the deductible. If my deductible was met, they would pay for it.
My concern is doing the sleep study and the result is, ‘Yes, you wake up and have trouble falling back asleep. No, it’s not apnea. Here’s a prescription for sleeping pills. Leave the $600 at the desk.’ I already have a prescription for the pills, so it’d be like throwing away $600 for nothing.
My wife says she doesn’t notice anything before I wake up (trouble breathing, snoring, twitching, etc). It’s like I’m sleeping and then I’m awake. That’s kind of how I feel as well. When I initially wake up, I almost feel like I’m in a dream state and then I rapidly become fully awake.
There’s a wide range of indications for polysomnography, including suspected obstructive sleep apnea, central sleep apnea, hypersomnia, hypoventilation syndrome, REM sleep behavior disorders, epilepsy, evaluation of paroxysmal nocturnal disorders, periodic limb movement disorders, and various types of insomnia.
The test could well uncover the cause of your sleep disturbances, thus giving the possibility of a definitive treatment beyond using sleep meds, which become notoriously ineffective over time.
You might want to look at this article in Wikipedia about segmented sleep.
I sleep in pretty much the same pattern as you. I’m not thrilled with it, but I find that the main problem is getting back to sleep. Once I read about this theory, I became a little more accepting about my sleep habits and got back to sleep sooner.
You might be able to train yourself to sleep through the night by enrolling in a program of Cognitive Behavior Therapy for Insomnia. Basically, this consists of two parts;
[ol]
[li]Sleep Hygiene. You don’t do anything in your bed but sleep and have sex. No tv, no reading, no video games. Try to wind down before bedtime. No liquor within 3 hours of bedtime. [/li][li]Sleep Deprivation. They put you on a strict schedule of sleep with no naps allowed. If you go for a week with only five hours a night of sleep, you will likely be cured of waking up. This is very hard and many people can’t (won’t) do it.[/li][/ol]
I have likely oversimplified this approach, but you get the idea. Hereis the wiki article on it.
After you have the sleep study, they will likely steer you in this direction anyway. As Qadgop (an actual doctor) notes, there are pathologies that might be responsible and some of these might require a specific treatment. IANAD, just a wandering stranger on the Internet dispensing half truths and vague assertions.
If you are worried that, each night, you arise as though in a trance and wander the streets murdering every unfortunate soul who crosses your path, a sleep study would be the smart thing to do.
Hypersomnia wouldn’t be diagnosed with just a regular nighttime sleep study, usually - I mean, with just a nighttime study, they’d let you “sleep” at night and send you on your way without ever knowing you fell asleep in the elevator on the way to your car.
If that were suspected, you’d probably have a daytime sleep latency test which involves much the same wiring as a nighttime study, but the way it works is they have you lie down for 20 minutes at a time, 4-5 times over the course of a day, and measure how long it takes you to fall asleep. If it’s less than a certain average (10 minutes? mine was 5 years ago so I’ve forgotten) you might have some degree of hypersomnia or narcolepsy.
Ideally such a test would be in conjunction with an overnight study - yeah, 24 hours in the place - but that way they can be sure you really got “enough” sleep the night before, and you’re not stressed and extra-alert because of the hassle of getting there during rush hour. I actually left a former sleep practice in part because the doctor ordered the daytime study, but not a confirming nighttime study as well.
kayT mentions have a friend diagnosed with Restless Legs Syndrome as part of a study - actually RLS is usually not diagnosed that way, the diagnosis relies more on patient reports. Because with RLS, you really don’t fall asleep. Periodic Limb Movement Disorder (PLMS or PLMD) is something that does show up on the sleep study. Someone with one very often has the other, however, so if you do have RLS, it’s worth getting a feel for the degree of accompanying PLMD.
All that said: if your frequent waking is an issue, you can certainly try behavioral modification as a low expense option and see what that does for you. I personally used to have a lot of trouble with waking for a bathroom break, then my mind would rev up and make it hard to fall back asleep. I manage that by using an iPod to play something my mind can half focus on instead of glomming onto whatever daily problems I’m dealing with.
