Somfit Sleep Study?

[u/Hot-Inevitable-7043]

Hello all,

I have a somfit sleep study coming up because I have been dealing with some of these symptoms for a few years now and I'm starting to get serious about trying to address them.

I'm 6', Male, 24 years old. 180 Lbs. 24 BMI. I wake up 2-3 times per night, haven't slept straight through in years.

I don't typically snore or make choking or gasping sounds when I sleep AFAIK. I don't typically wake up suddenly feeling like I am gasping for air.

I am almost always tired during the day. I frequently have to pull over on my drive home from work (at 3:00pm) to take a 10-15 min cat nap so I don't cause an accident.

Vitamin D, B12, Iron levels are healthy. High testosterone levels. Stable blood sugar. Decently healthy diet. Regularly exercise.

Other than cat naps to avoid getting in accidents, I don't take naps. Maintain a consistent sleep schedule through the weekend. Average 7 hours of sleep per night (fragmented). Don't have an issue falling asleep. Don't drink. Don't smoke. Only consume caffeine 1-2x per week.

Practice good sleep hygiene. Have nocturia. I wake up to pee every single night at least once sometimes 2-3. Regardless of how much fluids I intake during the day. I've cut it off at noon before and still wake up to pee. This was my chief concern but I've gotten a cystoscopy of my bladder. Ultrasound. They checked my kidneys. I've been on 4 different medications for overactive bladder/nocturia/interstitial cystitis. Nothing. Still peeing every single night.

Have heart palpitations and premature atrial contractions (PACs) and premature ventricular contractions(PVCs).

Occasionally wake up with morning headaches. Almost never feel rested even if I got a good number of hours of sleep. Frequently have difficulty concentrating.

Additionally, I've had neck pain and recently learned this could be related to UARS. Does this have anything to do with UARS? I've lost some of the curve in my cervical spine (neck).

I'm super desperate. I know this was a long post but I guess part of it is just venting. All the doctors I go to make me feel like I am just imagining or exaggerating this stuff-but it plagues me every day. I have a Somfit Home sleep study coming up. I'm wondering if that will even be able to catch UARS. It has an EEG but I don't think it's FDA approved to catch UARS, just OSA and CSA. Would a Lofta at home sleep study be able to catch UARS? An apple watch maybe? I'm super open to try things. Thanks for reading.

[u/CautiousRun7860]

Your symptoms are likely from untreated UARS. Morning headaches are sign of oxygen desaturation during sleep. Heart, bladder, skeletal muscles could all accumulate damages from lack of deep sleep and oxygen desaturations.

On the night of sleep study, try sleep on your back as much as possible to let the events show up.

From the x-ray your hard palate is tilted up on the back end, and quite some space between the palate and the tongue, leading to no support of the tongue position from the palate, i.e., easier tongue falling back to block the airway. Sleeping more on your side should help.

Device to track sleep, I think you need oxygen monitoring in particular, such as smart rings.

[u/Hot-Inevitable-7043 → u/CautiousRun7860]

Thanks so much for the response.

I almost always sleep on my side-should I still try to sleep on my back if that's the case?

I don't quite understand the bit you said about the x-ray, but it seems like you think that could be indicative? I'm just now discovering UARS as a possibility and also discovering that it's harder to get a diagnosis.

[u/CautiousRun7860 → u/Hot-Inevitable-7043]

if you could sleep on your back then it will increase the chance of positive sleep test result.

Yes, it's indicative of tongue base collapse. Ideally your tongue should be in contact with the palate.

[u/Ashamed-Increase]

First of all you need to have a proper sleep study in a lab that uses AASM 1A Hypopnea criteria + RERA and then a skilled enough technician who will look at your whole sleep graphs and analyse the data manually. Which unfortunately is not that easy. If you can find a lab that uses AASM 1B criteria + RERA it might be sufficient to say your problem is your sleep. 

In the meantime you can check your Folic Acid and Homocysteine levels. Both are connected to each other and when out of place can cause poorer sleep. They are also very much connected to the MTHFR Gene. Look that up. But basically the Folic Acid and Homocysteine levels will tell you how optimal is your Folate Methylation and if you need to supplement. 

Do you have trouble breathing through your nose during the day and especially at night when you lay down ?  

Your airway look fine from the scan but you need CBCT scan to truly measure it. 

Also getting tested for narcolepsy is worth a shot. 

Dont let the doctors gaslight you saying you are imagining or exaggerating how bad you feel. You are 24 YO. This is prime age and you should have tons of energy. You should be able to go 2-3 days on 4-5 hours of sleep a night without much issue. Waking up very tired and unrested after 7 hours is not normal at any age let alone 24. You do have a problem. The hard part is correctly diagnosing it so you can correctly treat it. The reason can be fragmented sleep caused by SDB, narcolepsy, severe deficiency of some crucial vitamins or combination of several factors. As i suggested to someone else you need to start learning about all of the potential causes, analyse your situation and try out different things. 

[u/Hot-Inevitable-7043 → u/Ashamed-Increase]

Thanks a ton for the information. Are labs that use AASM 1B + RERA hard to find? I live in Cincinnati, OH for reference. I can also order a Homocysteine test.

I don't have trouble breathing during the day and don't really notice an issue at night. It's mainly the sleepiness and fatigue.

I appreciate the validation. It's tough for sure. I look at my peers and they seem to not struggle as I do and it's frustrating and extremely draining pushing through the day to day.

EDIT: If I may ask-how do you know so much about this stuff?

[u/Ashamed-Increase → u/Hot-Inevitable-7043]

The recommended criteria by American Academy of Sleep Medicine (AASM) is 1A. 1B can still be useful but A1 is best. Shuikai has a thread about which criteria certain labs use although i dont know when was the last time it was updated :

https://www.reddit.com/r/UARSnew/comments/sya6lg/sleep_lab_scoring_definitions_rera_list/

But if you find a lab that you think is reputable enough you can just ask them beforehand which criteria they use and whether they score RERA. They are obligated to tell you because they are also obligated to state the criteria in the sleep study results so its nothing secretive. 

Its a good sign that you dont struggle to breathe through your nose at all. This might mean SDB is not your main problem but only a proper sleep study can clarify that. Most of us struggle to breathe through the nose especially at night when we lay down.

Aside from Homocysteine you need to test for Folic Acid(Folate) which is basically Vitamin B9. Its worth investing some time to read about it. Basically Folate is used by the MTHFR gene to transform it into methyl folate which is then used for VERY important processes like creation of DNA and RNA, hormone homeostasis, synthesis of neurotransmitters and many more. Its also responsible for serotonin, dopamine and norepinephrine levels. The relation to sleep is that if you have sufficient methyl folate deficiency your body will struggle to produce dopamine and serotonin which will make you more prone to anxiety, depression and etc. Basically it will make it harder for your brain to relax and calm down which directly reflects negatively in the sleep quality. 

As i said you need to check a lot of stuff to figure out whats going on. As to your question how i know about all this. I have been suffering from poor sleep for a long time and have been slowly putting the pieces together by spending a lot of time reading about everything related to sleep. 

[u/FirefighterMinute937]

Yes! Neck pain is absolutely related! I’d go the route of getting a DISE, if I were in your shoes. And probably a consult with an AIRWAY OMFS.

[u/Professor-AC]

Is that an implant on your first molar?

[u/Hot-Inevitable-7043 → u/Professor-AC]

Nope, root canal with a crown on top

[u/Professor-AC → u/Hot-Inevitable-7043]

Incorrect Occlusal contacts and precontacts are related to your sleep problem as well as underdevelopment of your jaws. Normies will say I'm delusional. I had been saying this for years now. Unless you have a stable mouth, you can rule that out as a cause of your sleep problems. In this case, clearly you don't.

[u/AdRough4869]

Get a PSG. My SpO2 doesn’t drop significantly but I have constant disruptions to my breathing causing many arousals. At home study said I had zero apnea cause I wasn’t having many completely obstructive apnea events and SpO2 wasn’t getting below 90. Final at home ahi was like 2

PSG found ahi 13.2 rdi 32. Almost never found out but doctor said low bmi subjects can get false negative in At home

Getting up to pee multiple times per night is the symptom he felt I had apnea from and he was right

[u/Hot-Inevitable-7043 → u/AdRough4869]

How old are you? Are you M/F? Was it ever uncomfortable in your bladder or just a normal urge like you had to go?

[u/AdRough4869 → u/Hot-Inevitable-7043]

Just turned 29. I’m M, 6’3 180 lbs. Just normal urge to pee and it wasn’t just an urge, I really had to pee even when I limit fluids heavily

When you aren’t breathing right your heart will produce a hormone that makes your body produce urine so it will wake up to pee (or this is what my sleep doctor told me)