Polysomnography: One Tool in Helping in the Diagnosis and Treatment of FibromyalgiaWritten by Shirise J. Wilson, BA, CRT, NREMT, RPSGT
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I meticulously place each EEG electrode on her scalp making sure I properly prep and measure each site. I attached two effort belts, one on her chest, other on her abdomen. Leads where placed near her eyes and chin. Leads where places on her legs, and EKG leads where placed on her chest. A thermistor airfow was placed at her nares and a pulse oximeter probe on her finger. The setup procedure took about an hour, to pass time away she and I “chatted” about our families and recent news events Once in bed client was hooked up to EEG machine and monitor. She was allowed to watch a little television around 10:30 PM she started getting sleepy. She lets out one big yawn and shuffled between covers. On computer screen I notice LT is drifting in and out of sleep (microsleep). She’s not totally asleep yet, but her body is relaxing and preparing itself for sleep. It is during this time that her body temperature drops, and her pineal gland at base of her skull is slowly releasing melatonin in her bloodstream, signaling to her brain that it’s time to make that wonderful transition into sleep. Now this is where fun for me as a sleep technologist begins. On a computer screen I get to observe all wonderful electrical activities of brain. When she was awake I observed those fast, low-voltage type of brain waves called beta waves. But as she closed her eyes, waves change to a slow-high voltage brain rhythm called alpha waves. Alpha waves danced across screen for several more minutes, then suddenly right before my eyes alpha waves were quickly replaced by a new wave pattern called theta. Her mind is no longer thinking about her day, LT has now drifted from a state of conscious wakefulness to that wonderful abyss called stage 1 sleep. Stage 1 sleep is lightest stage of sleep. Considered transitional sleep, stage 1 will move LT into a deeper and rewarding sleep state. Her eyes began to roll slightly from side to side, she no longer hear sounds of cars and trucks passing her window. Or mild humming noise coming from fan. But yet if I where to enter her room and lightly touch her arm, she would be easily aroused and not have a sense that she had been sleeping at all. After 5-7 minutes in stage 1 sleep, LT slowly enters stage 2, during this stage of sleep two identifiable sleep-specific wave forms pop on screen. Sleep spindles and K-complexes, these are two beautiful wave forms floating across polygragh. I love vintage cars so every time I look at a sleep spindle, I am reminded of old spoke tires on a ford Model T. K-complexes are quite different then a sleep spindle, it is a super large wave form that appears seconds before a sleep spindle, and looks like QRS complex on a EKG tracing, with a well delineated negative upward spike which is immediately followed by a positive downward spike. Both of these wave forms appear and disappear across screen in seconds. LT‘s legs begins to twitched several times. She now is definitely showing signs of PLM. 15 minutes later she falls into stage 3 sleep or deep sleep. In stage 3 sleep she is not easily aroused. In this stage of sleep between 20-50 percent of waves are transformed into delta waves. Over size slow tee-pee shape waves ripple across EEG computer and appear again and again. When all of a sudden (out of blue) delta waves are constantly being bombarded by alpha waves. Until finally for every delta wave seen an alpha wave intrudes on its territory. LT is no longer asleep, alpha-delta intrusion causes her eyes to pop open. After twenty minutes staring at ceiling, she then takes her first bathroom break, why not, her restful sleep has been interrupted. Once in bed, her sleep debt built up from her arousal causes her to fall quickly back into stage 1 sleep again. Throughout night she will repeatedly travel up and down stages of sleep, never reaching stage 4 or REM sleep because of alpha-delta intrusion and PLM. This constant interruption in her sleep can hamper proper release of serotonin, (which is necessary for activation of an important immune system cell called “natural killer cells“)# and growth hormones that aide in rebuilding damage cells. LT’s sleep test ends at 6:00 AM, she had several complaints from being tired, to increase pain, to being unhappy. these are all typical complaints of a FM sufferer. A trained and experienced polysomnographic technologist then analyzed and scored LT’s sleep data. The report indicated she had frequent leg movements in stage 1 and 2 sleep, consistent with disorder premature leg movement (PLM), along with frequent arousals and alpha-delta intrusion. A month later, a follow-up phone call was conducted by sleep center. Therapy for LT included low dose anti-depressant, physical fitness training and benzodiazepines such as clonazepam which help in promoting better sleep, by relaxing skeletal muscles and reducing her premature leg movements. Every fibromyalgia patient is different and may require a different individualized treatment, (some patients may suffer from sleep apnea or bruxism.) But, for LT these combination of treatment seemed to help and she was happy with outcome. Conclusion I hope this small glimpse into fibromyalgia will help explain why patients need and will benefit from a sleep center. Precise diagnosis is essential to establish existence of fibromyalgia and distinguish this disease from other sleep disorders. Once diagnosis is made, a multifaceted approach is then required to ensure healing and restful sleep. The consequences of fibromyalgia can be significant for those affected as well as bed partners and family members. Although many patients try to self-manage their lack of sleep, most will eventually seek treatment if symptoms are progressive and/or unrelenting. I extend this one challenge to every doctor and that is to ask their fibromyalgia patient one question, “How are you sleeping?”
Shirise J. Wilson is a health professional and founder of cpapcompare.com, where you can find great information on snoring and sleep apnea products. Her newest ebook is FREE! This eBook Could Save Your LIFE!!!! Discover the Insider Secrets of How to Stop Your Snoring in the Privacy and Comfort of Your Own Home...The ebook is FREE. http://cpapcompare.com/STOPSNORING!!.html
| | Relaxation Couldn't Be SimplerWritten by Kim Beardsmore
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6.Feel how your body feels 7.Don't try to alter your breathing, it will change naturally as you sink deeper into experience 8.If thoughts slip into your mind, gently bring your awareness back to your breathing This is all you need to do to relax your body and mind. It's THAT simple. To really benefit you need to practise this 'breathwork' on a daily basis. After a few days of using this simple technique, you should begin to feel rejuvenating powers of true relaxation. After a few months - broader benefits will become apparent - improved health, improved relationships, better concentration and memory. But don't stop there! With practice, it is possible to achieve this feeling of peace and calm at any time, enabling you to remain focused and composed even under pressure. Staying calm in a stressful situation is like having night vision when lights go out - you have a great advantage! (c) Copyright Kim Beardsmore
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