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Oh Boy

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doctorlulu +0 points · over 2 years ago Original Poster

Dear Fellas,

Hey. Been a poor sleeper for a long time, since I can remember just about. Began wearing CPAP a little over a month ago. I'm pretty sure someone sneaks in at night and clobbers me right in the head with a sledge hammer. Anyway, the data collected by my little computer/sleep/breathing machine says I'm not getting 2 cycles of sleep over any 24 hour time period. My 02 is low and I was once diagnosed with restless legs. (Restless body is more like it.) My Apnea events are down from 38 on my back and 22 on my side to about 6 to 12. My question for you is this: how debilitating is it, if at all, for your average bear, not to sleep completing 2 cycles of sleep per 24 hours? IOW, is the fact that I feel like walking death, and have since way before starting my CPAP, possibly linked to getting and completing too few sleep cycles?

Thanks everyone. Sweet dreams

lulu

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

Hard to follow what you are asking. What is a a sleep cycle, as you define it. Why would someone have two per 24 hour period? Your apnea doesn't appear to be controlled by PAP therapy and the prescription you were given may need to be tweeked. How do you know your blood oxygen levels are low?

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

What sort of machine is telling you how many sleep cycles you are getting? Also, what do you mean when you say "sleep cycle"? I have never heard of any CPAP machine (or anything similar) that can monitor sleep cycles. To do so would require EEG data, so unless you are attaching electrodes your head every night I suspect that the sleep cycle info you are getting is wrong.

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doctorlulu +0 points · over 2 years ago Original Poster

Thanks for responding.

What is a sleep cycle? Good question. I didn't know either, so I looked on the net. Each cycle consists of reaching and going through the 5 stages of sleep from light sleeping through REM. Each cycle lasts about 90 minutes. Most people need about 7.5 to 8.5 hours a sleep per night which means they will get 4 to 5 complete cycles per night. I rarely sleep for 3 hours at a time max; Most often much less than that.

My sleep specialist at the hospital looked at a printout of my sleeping data downloaded to their computer from my DreamStation Auto CPAP. Apparently, it can tell how long I sleep minute by minute during a 24 hour period. It automatically adjusts air pressure depending on the type of sleep I'm experiencing, if I'm sleeping at all. She noted that I wasn't completing even 2 cycles for each 24 hour time span.

I am wiped out during the day and fall asleep occasionally throughout the morning, afternoon and evening, and my total sleep time is about 4 hours. My provider told me my 02 was low. She may have referred to the data from a home study I just did about a month and a half-ago where I was wired to a portable computer.

(If you knew my spouse, AKA World War III and Armageddon, you might be inclined to believe she was placing a refined powder of rat poison into the little reservoir/humidifier in my machine.)

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sleeptech +1 point · over 2 years ago Sleep Enthusiast

Your description of a sleep cycle is mostly correct. It does not necessarily consist of 5 different stages of sleep. Early in the night it will involve either 3 or 4 stages of sleep (largely depending upon whether you are using the current rules for classification of sleep) but later in the night a sleep cycle will often only contain 2 different sleep stages.

I can also tell you that the data from a DreamStation Auto cannot tell you which stages of sleep you have had. It also cannot tell whether you are asleep or awake. It is quite a stretch to claim that level of information based upon the data obtained from a DreamStation or any other PAP device, and it would be a rough guess at best.

It does sound like your treatment is not quite doing the job, based on your original post. This may be due to being set too low. Also, if your O2 was consistently low in your study, not just dipping when you have an event, you may have a secondary problem which requires more than just CPAP. A further complicating factor is the RLS. Limb movements are very often counted as respiratory events by a CPAP machine, so that may be another cause of your elevated AHI.

Having said all of that, it also sounds like you are simply not getting enough sleep. If you are only getting 2 sleep cycles, this would certainly be the case. The way to fix this is to work out what is disrupting your sleep (eg OSA), correct it (eg with CPAP) and then sleep long enough to get more sleep cycles.

Overall, it sounds like you need to have a discussion with your specialist about refining your treatment.

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doctorlulu +0 points · over 2 years ago Original Poster

"It also cannot tell whether you are asleep or awake."

What it knows is when it is turned on and blowing air. The only time I have it on and blowing air is when I try to sleep. I could be sleeping less than the recorded time it shows it is blowing but not more.

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doctorlulu +0 points · over 2 years ago Original Poster

Thanks for the detailed response. You've confirmed my worst nightmares. I am one disturbed pup. If I could sleep like a normal human being and keep my grey matter soaked in oxygen, I might be able to have a rational thought or two during what little time I have left. Wouldn't that be something? At least it would be a nice change.

Our astronauts sleep 300 miles above the earth. I can't climb 3 steps on a ladder w/o getting dizzy. How do people sleep when they are under pressure? If something's bugging me, I get even less sleep.

"DreamStation Auto cannot tell you which stages of sleep you have had." Right. I didn't mean to imply it did. I believe my doctor meant that based on how little I sleep, there isn't sufficient time to go through the stages to complete 2 cycles. I am under the impression that this particular unit can sense resistance and adjusts itself accordingly, with resistance increasing as an apnea event occurs during sleep?

It's a good thing I'm not a real doctor. It's a good thing I try not to take my advice.

Pleasant dreams!

Thanks again

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doctorlulu +0 points · over 2 years ago Original Poster

I'm still almost completely exhausted every day. Been using CPAP since February and am nearly as wiped out as I was before I started. Had a complete sleep test about a month ago in hospital. The chart showed my sleep apnea as an almost uninterrupted dark line. They applied a CPAP to me at three thirty am and the apnea decreased markedly. At 6:30am I hit REM for a few minutes before they woke me up. No REM other than that. Doctor has increased the flow pressure to 14.

Does feeling tired lead to hunger? Weight gain is often symptomatic of OSA, and for me I think I may overeat to a degree to compensate for feelings of exhaustion. The idea is that eating more food will yield more energy or the feeling of more wakefulness.

Which reminds me, has anyone been on Modafinil? It is used in certain people to increase wakefulness.

I have signed up for by-pass bariatric surgery. In my case, there are many pre-surgery steps that must be taken before surgery is performed. It requires, among other things, numerous trips --35 to-50-- to the hospital, which is about an hour away. Surgery is at least 6 months away due to all the requisites. Just learned that this type of procedure may negatively impact the gallbladder requiring its removal. (Another fine mess I've got myself into, Ollie!)

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

The prescription is usually done in two stages. First the sleep study where they determine the degree of OSA. Then a titration study to determine which type of PAP therapy and at what pressure(s) is most efficient. Is your doc a sleep specialist?

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doctorlulu +0 points · over 2 years ago Original Poster

Yes. He's a sleep specialist. There is a large department in the hospital designated specifically for sleep disorders and I go there.

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doctorlulu +0 points · over 2 years ago Original Poster

Just got copies of my sleep study results. No N3 sleep period. No REM in diagnostic phase of 217 minutes.

During pressure titration period of 204 minutes REM = 35 minutes.

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Marshastin +0 points · over 2 years ago

if you would like to compare with a person that has experienced these symptoms...i just used the cpap therapy for the first time - for six weeks of the past 2 months. i experienced fatigue for a year before i started it and developed insomnia so that really skewed the results of the sleep tests. So i started a diary for that and was surprised at my whole sleep pattern - was not good. After seeing the Dr @ the sleep center, i took a daily nap but needed to try to limit that actual sleep to about a half an hour, no longer; i could rest for a while during the time i laid down, too, but have to limit the sleep time. Then i tried to go to sleep approx. same time every nite, etc - all the advice in dealing with insomnia and my sleep pattern has gotten better with minimal problems. I am dealing with a different problem right now in a different topic here (i see you have replied to it). i was kind of surprised the sleep center didn't have much advise to give me, but i think they are waiting to see if i resolve the insomnia problem and giving me more time to get used to the whole therapy, too. i was told the therapy takes 90 days for us to adjust to, so i think you and i are both fairly new to this whole thing! (i can't take any meds for insomnia anyway and i only use 5 mg melatonin every night now). Good luck and/or good therapy, whichever works for you!

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doctorlulu +0 points · over 2 years ago Original Poster

Hey, hey, hey. Nice to hear from you. Good thoughts that will help me. I hate going to bed at a regular time!

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