Taking the Chute

We went to the sleep doctor yesterday for the results of Justin’s sleep study.  It was another afternoon appointment which required nap adjustment.  That always makes for a tougher day no matter how hard we try to make it better.

The appointment was for 3 pm and we didn’t see the doctor until 4:15.  That just makes me mad right at the beginning.  I had to take Travis with me so both boys had been waiting for over an hour and they were getting antsy.  They start to pick at each other and that makes it hard to listen to the doctor.  He started off by asking how the study went and I still feel like the execution was very good, but I had no idea how the results would read.  He jumped right in with the discouraging news:  Justin had no respiratory events the entire night, no matter what the CPAP setting.  No central apneas, no obstructive apneas, no RERAS, no snoring, nothing.  But given the results of the March study he still will call his diagnosis mild sleep apnea, and continue to treat with a low CPAP setting.

That being said, the big issue that the study revealed was the huge number of arousals Justin experienced per hour of sleep.  They say any more than 5 per hour is noteworthy and Justin averaged more than 20.  ( Remember, arousals are not wakings, but shifting in levels of sleep, either deeper or lighter.)  And then tracking his REM sleep (dream sleep) he only gets about 12% of his night’s sleep at that level.  That’s not enough, but I am not sure what a good percentage is.  I just know that he needs more.  The doctor said that some sleep issues can be treated with medicine, but medicine is more effective in issues falling asleep or staying asleep.  Justin’s issue does not respond to medicine, and it causes other problems making the trade off undesirable.

His solution?

Give him more sleep. 

Put him to bed earlier and let him sleep later.  If he sleeps longer he will have more opportunity to get more REM sleep.  That should decrease the sleepiness.  It has been my goal since they were born to get the boys to sleep more and so far I have been a failure.  Justin already goes to bed at 7:30 and I have yet to figure out how to make my children sleep longer in the morning.  He told me not to wake him up.  I have never woken my kids up!  Ever!  That’s almost humorous.  You can lead a horse to water but you cannot make him drink.  That is both my children and sleep.  He wants me to offer incentives to make Justin sleep later.  Incentives don’t even work for potty training when I am right there to remind him and it is daytime.  Somehow during the night when he wakes early he is supposed to know that he needs to go back to sleep to get some reward.  I am okay with putting Justin to bed earlier, but the doctor doesn’t want his night pattern varied more than once a week.  That kind of messes with our limited social life, especially since we don't have a lot of time together anyway. 

So down we go.  Back to the beginning to start over and try to figure out where to go this time.  How do we try to implement the doctor's suggestions?  I really want to be open to his suggestions without being antagonizing or ignoring them without true effort.  We are making headway in the constipation area, and now tackling this feels daunting.  We have three months until we go back to report the results of our efforts so we need a strategy and hopefully we can make some progress.  I am trying to be optimistic, but I feel discouraged.  I suppose that's how it feels to be back at the beginning.