I do not meet the minimum requirment for sleep apnea.

Barbara:

I'm not getting enough sleep. I've had sleep tests, but do not meet the minimum requirment for sleep apnea. Dr Shapira response:

This is a common problem in younger healthier patients and female patients in particular. When the original definitions for Sleep Apnea and Hypopnea were developed only old obese men were looked at. It is not uncommon for women to have UARS or upper airway resistance syndrome, or disturbed sleep from sleep disordered breathing that does not meet the definitions for sleep apnea.

This is frequently as little as 1/10 of 1 % of a drop in oxygen saturation. This may be why you "do not meet the minimum requirment for sleep apnea." There are many other possible scenarios for disturbed sleep as including restlesss legs, bruxism, sleep phase disorders and Alpha intrusion into Delta Sleep.

This is frequently an insurance problem, ie treatment of sleep disordered breathing with an oral appliance or CPAP might vastly improve your quality of life, health status, longevity and ability to function and enjoy life but you do not qualify for insurancce benefits.

I advise patients to follow thru with treatment to improve their life if they can budget it into their life.

Restless Legs and Celiac Disease

Below is an interesting abstract that ties restless legs to low serum feritin and restless legs to Celiac disease.. Sometimes restless legs is tied to UARS or RERA's other times it is due to low feritin levels or other problems.



Sleep Med. 2009 Aug;10(7):763-5. Epub 2009 Jan 12.
Celiac disease as a possible cause for low serum ferritin in patients with restless legs syndrome.
Manchanda S, Davies CR, Picchietti D.

University of Illinois at Urbana-Champaign, College of Medicine, 506 S. Mathews Avenue, Suite 190, Urbana, IL 61801, USA. smanchan@illinois.edu
OBJECTIVE: To describe celiac disease (CD) as a possible cause for low serum ferritin in patients with restless legs syndrome (RLS). BACKGROUND: Low iron stores have been found to be a risk factor for RLS with serum ferritin levels less than 45-50 ng/mL associated with increased severity of RLS. It has become routine clinical practice to test serum ferritin in the initial assessment of RLS. CD is a common genetic disorder that can cause iron deficiency. METHODS: Consecutive case series of four patients with RLS and serum ferritin below 25 ng/mL, who had positive screening tests for celiac disease. RESULTS: We report four patients who had serum ferritin < 12 ng/mL and positive screening tests for CD. All had CD confirmed by duodenal biopsy and response to a gluten-free diet. RLS symptoms improved in all four, with two able to discontinue RLS medication and two responding without medication. CONCLUSIONS: In patients with RLS and low serum ferritin who do not have an obvious cause for iron deficiency, we suggest looking for CD by simple, inexpensive serologic testing. Diagnosis and treatment of CD is likely to improve the outcome for RLS, as well as identify individuals who are at risk for the significant long-term complications of CD.

PMID: 19138881 [PubMed - indexed for MEDLINE]