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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10065
Experience:  14 years as clinician in the field of Family Practice
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Hi, I recently had a sleep study done and it came back saying patient�

Customer Question


I recently had a sleep study done and it came back saying:

"patient's latency to sleep onset was normal at 16 minutes. Latency to REM onset was severely premature at 18 minutes (normally 90 min). Sleep effeciency (total sleep time / total time in bed) was normal at 93%. Stydy demostrated a pattern of light to moderate, periodic and non-positional snoring. There was no significant evidence of obstructive apnea or hypoapenea. Oxyegen saturation remained above 97%." She told me that i had a "REM sleep disorder" and that i basically woke up every 8-18 min in stage 4 sleep or something like that and instead of going into REM at 90 min i went in at 18min. Then woke up and rinse and repeat.

This is really effecting my life my immune system is getting weak and my brain is not functioning as it should. Like brain fog or an abnormal brain state or something. I cant do work, have conversations, body is extremely fatiuged, lost girlfriend and friends.... Def need some help.
Submitted: 6 years ago.
Category: Health
Expert:  Anthony Bray, MD replied 6 years ago.



It sounds that you had basically a normal sleep study except for some variation in sleep architecture. I don't think that this explains your symptoms. REM sleep is actually not the deepest stage of sleep contrary to popular belief. Stage 4 is the deepest stage of sleep. Stage 3 and 4 are the most restorative stages and would impact your memory and mental acuity the most. as you did not have apnea or hypopnea evnts tken I think it is doubtful that sleep is the issue. Your oxygen saturation remaining good through the night is also reassuiring. If you had significant drops in your oxygen saturation then this too could adversely affect your memory and mental sharpness. The architecture anomaly is the brief time from stage 4 to REM (REM is actually back to a shallow stage of sleep) If your total time in stage 3 and 4 is reduced then perhaps this could have some adverse effect. This is going to tend to vary from night to night. This finging is what I would call a "soft" finding as some variable such as a noise could have altered your archtecture of sleep(time spent in each successive stage) on that particular night. Certain medicications may alter the sleep architecture. From your study results I suspect that your symptoms likely stem from a different source than a problem with sleep.Dfferent factors could give you the symptoms that you experience. The list might include certain viral infections such as mononucleosis, depression, thyroid dysfunction, deficiency of B-12 or thiamine, and many other potential causes. I would recommend that you pursue further evaluation per your medical doctor or neurologist with regard to these symptoms. (I realize that you may disagree with my assesment of your sleep study results but you will have an official reading for this from an interpreting doctor) The report will probably then be forwarded to your medical doctor and then you will get the official interpretation (this is the usual coarse but you might be seeing the sleep specialist which is often a pulmonologist).


I hope this information is helpful. If you have further questions then let me know. I'll be glad to get back with you. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button. Thank you and Best Regards,


Anthony Bray MD

Customer: replied 6 years ago.
Im in the military, when i was younger i had the same problem stuttered, very anti social, no gf, no life basically and no connections not even with parents. I went into basic training and something happened idk what it was but seemed like through all the training and running the veil came off my eyes and i could speak, sleep, talk professionally, think straight and i started to communicate with people and things only got better.

Then i got to my new base, and before i went over seas i started to feel as though my sleep wasnt the same, and i started to seclude myself, and stutter again, and some anxiety. When i came back from over seas (going over there wasnt the problem) i was a mess. I went to neurologist, cardiologist, gastrologist,endocrologist, numerous blood tests on base from b-12, to thyroid, to testosterone. Was diagnosed with depression given prescriptions but only made me worse. Cause in my opinion i wasnt really depression just wasnt getting recharged from sleep. Then i did a sleep study and these results came back. All those other docs i went to said everything was fine. 100% So i have spent a year checking everything else out and this is my last resort and i really need some help how to fix it cause these docs here have no freakin idea what so ever.....they wanna put me on add meds... I wasnt diagnosed they just want to just because it seems like.
Expert:  Anthony Bray, MD replied 6 years ago.

Hello again!


One possible difference could be that you had an enormous increase in your exercise when you went into basic training. Exercise is a natural anti-depressant. A lot of exercise causes the release of endorphins in the brain and enhances one's sense of well being. It sounds like some aspect of the basic training did you a tremendous amount of good. I doubt that it was enhanced sleep. At least I've never had the impression that basic training would be conducive to good sleep quality but just the opposite. The characteristics that you describe sound like you were introverted and anxious perhaps as much as anything.


On a separate note the clinical definition of depression is different than most people have a sense of. It does not necessarily mean that you feel sad all the time or cry often although these can be characteristics. Depression (in the medical definition) is a combination of characteristics that define negative feelings. These may include anger, self-doubt, pessimism. You might feel a lack of enjoyment of things. People who are depressed are less likely to engage in interactions with others.I don't know how well these characteristics may fit you or not. The medications available for the treatment of depression are a tool that can be helpful. Some people will benefit to a greater degree than others. Some people will respond to a certain class of medicine versus another. The response to this type of medicine becomes very individualized. It takes several weeks typically for a medicine to reach its maximum benefit. By about six weeks you pretty much know what a certain medicine at a certain dose is going to do for a patient. The most common medicine that is started for depression is the SSRI class. This class increases the neurotransmitter serotonin. this helps many people but others do not respond so well. Still others may give up and quit to early. treatment of depression is a gradual process. There are medicines that act more on norepinephrine and/or dopamine neurotransmitters which if you should be depressed might be of more help. Depression has a typical interference with sleep. The most common pattern of sleep disturbance due to depression is early awakening and being unable to get back to sleep.


The fatigue that you mentioned can be a symptom of depression but can be a very difficult symptom by itself to nail down the cause. People always get tired and the first question is when does the fatigue cross over from the normal into something pathologic. It is not such an easy question to answer. Here again the exercise tends to help many of the causes of fatigue and I would think may be of significant help to you.


Other characteristics that you describe sound to me that you are an introverted person. There is nothing wrong with that. Being introverted can serve you well in some respects but hurt you in others. The history of stuttering is a developmental thing that many kids grow up with and this tends to improve as you mature. It to me is somewhat suggestive of some association with anxiety. The cause and effect is hard to say. Kids whom grow up with a stutter tend to have some increase in their social anxiety. I would bet that you hate public speaking.


It sounds to me that the experience of basic training helped you. perhaps it was the exercise. Perhaps the structure and discipline helped you. It may have been that the experience boosted your self esteem. I would suggest that you look back on this experience and try to recapture at least some of the properties of this period of time. Perhaps this will help you to feel better.


I think that it might be possible that medication of some type might hold benefit for you but I recognize that you seem quite cynical at this point of this approach. Certainly I'm not suggesting that you retry what did not help in the past. It sounds that you have had a good thorough work up to search for medical factors which might cause fatigue and brain fog. It would possibly help your sense of energy to take a vitamin B complex and CoQ10.(The latter is a supplement that is over the counter and is a substance that is related our bodies use of energy) The B vitamins are also related to our bodies use of energy. These supplements plus a more vigorous exercise program may help with the fatigue.


I hope this helps you out somewhat. If you have further questions or points of discussion then I'll be glad to get back with you. Good Luck to You,


Anthony Bray MD

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