Sleep problems for which there is no diagnosis, please help

There is a lot of information there, none of it especially worrisome to me, a non-professional in medicine.

First, we should keep in mind that a polysomnography is a standardized assessment in a standardized setting, but not for the patient him/herself. It's very much strained and artificial, and much worse than having to stay in a motel room. Ideally, the patient will get enough sleep going through all the stages of sleep at least once, ideally three times or even four. You spent a long time in bed trying to sleep or 'zoned out' between actual sleep. In that time, they got just enough of real sleep that they feel they can peg you with the stats you see.

One that jumps out for me, again with no professional training at all, is that you spent very little time in REM sleep. This might be indicative of a sleep disorder, mood disorder, endocrine disorder....and that's only if your sleep that night was fairly representative of a typical night for you. And, I don't claim that your paucity of REM that night IS a disorder or that it is pathological....just that it seems low to me. Typically, a healthy person has between 15-25% REM.

Another that seems excessive is the sleep latency. You took over half an hour to fall asleep (that's A,...) and B, you took longer than the typical/statistically 'normal' time to enter REM (usually near the 90 minute mark for most people). However, even in the report they say that it could just be the artificial setting and you being wound up over the entire experience. You're by no means the only patient to report that it was almost impossible to relax with wires, noises, knowing a CCTV camera was watching you all night to check for turnings, limb movements, vocalizations, etc.

Further, your O2 sat, or oxygen saturation, apparently never got below the mid-90's, which tells me the few apnea/hypopnea events recorded when you were being observed were not sufficiently long to cause your body to deplete your blood oxygen severely. If you need more of a frame of reference, I am treated excellently by my CPAP machine with a month-over-month average, running seven years in total now, AHI of an astoundingly great 0.4 events per hour. The medical and insuring communities feel that anything less than 5.0 events per hour is 'treated'. BTW, AHI stands for 'Apnea/Hypopnea Index). They total all events that your machine says were problematic enough to record, and then they divide that total by the total numbers of hours of sleep. But, with my excellent AHI of a paltry 0.4, I still get desats running down into the mid-80's. This means I go for 20+ seconds at a time before I commence breathing again. Your 93% means your events last only 12-14 seconds long. Not bad.

On last puzzle that a sleep specialist might/should want to take a close look at: the report says that the durations of one or more of the stages of sleep are 'prolonged'. Your hypopneas and 'respiration effort-related arousals' or RERAs. are not noteworthy, nor is your leg/arm movement numerous and possibly interfering with your transition to the various stages of sleep.

Your sat levels of O2 don't seem to warrant a visit to a pulmonologist. You have minimal limb movement. But your stages of sleep and your transition to each of them seems odd to the people looking at your results. If you are not on mood-altering medications, or those that affect endocrine function, if you don't have untreated GERD, aren't rising two/three times each night to void, don't have a barking dog next door, or people on shiftwork entering or leaving the house while you're abed, I have nothing else coming to mind except a sleep disorder specialist.

Check your diet? I have ALS and wish I could get 4 hrs solid sleep!

There is a lot of information there, none of it especially worrisome to me, a non-professional in medicine.

First, we should keep in mind that a polysomnography is a standardized assessment in a standardized setting, but not for the patient him/herself. It's very much strained and artificial, and much worse than having to stay in a motel room. Ideally, the patient will get enough sleep going through all the stages of sleep at least once, ideally three times or even four. You spent a long time in bed trying to sleep or 'zoned out' between actual sleep. In that time, they got just enough of real sleep that they feel they can peg you with the stats you see.

One that jumps out for me, again with no professional training at all, is that you spent very little time in REM sleep. This might be indicative of a sleep disorder, mood disorder, endocrine disorder....and that's only if your sleep that night was fairly representative of a typical night for you. And, I don't claim that your paucity of REM that night IS a disorder or that it is pathological....just that it seems low to me. Typically, a healthy person has between 15-25% REM.

Another that seems excessive is the sleep latency. You took over half an hour to fall asleep (that's A,...) and B, you took longer than the typical/statistically 'normal' time to enter REM (usually near the 90 minute mark for most people). However, even in the report they say that it could just be the artificial setting and you being wound up over the entire experience. You're by no means the only patient to report that it was almost impossible to relax with wires, noises, knowing a CCTV camera was watching you all night to check for turnings, limb movements, vocalizations, etc.

Further, your O2 sat, or oxygen saturation, apparently never got below the mid-90's, which tells me the few apnea/hypopnea events recorded when you were being observed were not sufficiently long to cause your body to deplete your blood oxygen severely. If you need more of a frame of reference, I am treated excellently by my CPAP machine with a month-over-month average, running seven years in total now, AHI of an astoundingly great 0.4 events per hour. The medical and insuring communities feel that anything less than 5.0 events per hour is 'treated'. BTW, AHI stands for 'Apnea/Hypopnea Index). They total all events that your machine says were problematic enough to record, and then they divide that total by the total numbers of hours of sleep. But, with my excellent AHI of a paltry 0.4, I still get desats running down into the mid-80's. This means I go for 20+ seconds at a time before I commence breathing again. Your 93% means your events last only 12-14 seconds long. Not bad.

On last puzzle that a sleep specialist might/should want to take a close look at: the report says that the durations of one or more of the stages of sleep are 'prolonged'. Your hypopneas and 'respiration effort-related arousals' or RERAs. are not noteworthy, nor is your leg/arm movement numerous and possibly interfering with your transition to the various stages of sleep.

Your sat levels of O2 don't seem to warrant a visit to a pulmonologist. You have minimal limb movement. But your stages of sleep and your transition to each of them seems odd to the people looking at your results. If you are not on mood-altering medications, or those that affect endocrine function, if you don't have untreated GERD, aren't rising two/three times each night to void, don't have a barking dog next door, or people on shiftwork entering or leaving the house while you're abed, I have nothing else coming to mind except a sleep disorder specialist.

@vladimir19982
Are you under a lot of stress and anxiety? Do you take any medication? Do you drink coffee or have a lot of caffeine? What is your sleep environment like? Is it dark, quiet, do you use white noise/air filter/soft music? Have you tried meditating? Have you tried taking melatonin or Calm magnesium at night? Have you tried drinking warm milk or take tryptophan supplements?

It may be good to see a neurologist for nervous system evaluation and have full blood panels done to check your iron, oxygen, thyroid, vitamin deficiencies or toxicities, heart, liver and kidney function, etc.

How is your diet? Are you vegetarian or vegan?

@vladimir19982
How is your exercise level? Do you get regular exercise?

Do you drink alcohol, smoke, vape, or do drugs? That can affect health and sleep.

Do you drink water and stay hydrated ?

Do you play video games and are you on screens throughout the day? Do you stop at least an hour before sleep?

Have you ever worked with a psychologist who specializes in sleep issues? Have you tried massage, acupuncture, yoga, etc.?