Sleep study shows 14+ fragmentations per hour. What to do?

Question

Hi doctor,

I am a 46 year old female, who weighs 170 lbs and is 5.4 feet tall. I have symptoms of chronic fatigue. I had a sleep study recently that showed I have intrusion in every stage of sleep, and I have sleep fragmentation that occurs 14+ times an hour. My sleep doctor did not seem to think this would make me tired. He said the body has a way of recovering from that and getting enough sleep. I was diagnosed with idiopathic hypersomnia without known cause to my fatigue.

I have been tracking my sleep with a fitness watch. When I fall asleep, which does not take long, I enter stage 3, that is, slow wave sleep, within 5 to 10 minutes. Can going into a deep sleep that quickly indicates a problem or contributes to fatigue? I also will fully wake up during the night (go to the bathroom) but go back to sleep and hit REM within five minutes. I heard that is normal during the night, right?

Answer 1

Hello,

Welcome to icliniq.com.

Sleep itself is a complex phenomenon, which is regulated by multiple mechanisms. As per your sleep study records, which have pointed out fragmentation of your sleep cycle, yes, these fragmentations do have an effect on your physical and mental health.

Fragmented sleep results in a disturbance in physical and mental health. Physically you feel exhausted, low in energy levels, and fatigued with trivial efforts. Besides, you can have anxiety symptoms, irritable behavior, loss of interest in work, difficulty in concentrating and at time difficulty in recalling things from recent events.

Though the body has a tendency to overcome these symptoms if the sleep issues persists for a longer duration, the natural mechanism also fails. Sleep cycle is predominantly divided into NREM and REM phase. Out of which, the majority is constituted by NREM. If REM phase increases in duration, then it can contribute to above mentioned symptoms.

The total sleep is divided into 3 to 4 cycles of 90 to 120 minutes, out of which, 3/4th is constituted by NREM and REM is only 1/4th. REM sleep is characterised by high brain activity state.

Hence, if you are having a higher duration of REM sleep, then your brain will not be able to get ample rest, as it would be in an activated state for a longer duration of time. So, you would be fatigued easily while awake. You have a sleep disturbance, which needs to be corrected to improve the symptoms that you are having, or else it is going to contribute in comorbid physical and psychiatric disturbances.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

SWS or slow-wave sleep is part of the sleep cycle. It constitutes the stage 3 and 4 of the sleep cycle, which is considered to be a deep sleep. Currently, it is regarded as an N3 stage of sleep cycle by new classification of the sleep cycle.

SWS or deep sleep is an important part of the sleep cycle. This marks complete disengagement from the environment. This phase of sleep is important in cerebral restoration and recovery in humans. Deep sleep occurs in the initial parts of the night and gradually is replaced by light sleep as the night passes.

Deep sleep prevents the sleep drive that builds up steadily over the course of day time. It regulates the release of growth hormone. If you get deep sleep very quickly during your sleep cycle, then it is no harm, as it will help in replenishing your body and mind. But if your SWS is interrupted by frequent arousals, then you may feel sluggishness and daytime drowsiness.

One drug called Gamma-hydroxybutyrate causes increased deep sleep. However, due to its high abuse potential, it is under schedule X and is dispensed only on prescriptions for narcolepsy treatment. Besides this meditation, deep breathing relaxation techniques, stress-free lifestyle, and sleep hygiene measures can also promote this healthy sleep phase.

Thank you.