National (U.S.) Sleep Clinic Recommendations

[deltadave]

Yes I do need an alarm clock (and usually an elbow from the wife) in order to wake up. I often wake with that hangover type fog/headache even though I don't drink.

Looking ahead, after the Sleep Debt is paid off, it must be determined if you are an Advanced Sleep Phase, Delayed Sleep Phase, or Normal ("lark", "owl" or... IDK what they call "normal"-- I guess "normal"). Because of your job, it would be advantageous to turn you into a "lark" (given the above comment, you're probably "normal").

Using the aforementioned Two-Process Sleep Model (where only Process S was presented to isolate Nap Effect), you could be fighting Circadian Rhythm (Process C in the model):



Red box represents your general sleep area, blue box bedtime (inconsistency = bad. Follow all Sleep Hygiene Rules) and you are rising before you're ready (which should be the intersection of Process S and Process C).

[deltadave]

"lark", "owl" or... IDK what they call "normal"--

"Hummingbird".

Isn't that precious.

[Tom W]

Yes I do need an alarm clock (and usually an elbow from the wife) in order to wake up. I often wake with that hangover type fog/headache even though I don't drink.

Looking ahead, after the Sleep Debt is paid off, it must be determined if you are an Advanced Sleep Phase, Delayed Sleep Phase, or Normal ("lark", "owl" or... IDK what they call "normal"-- I guess "normal"). Because of your job, it would be advantageous to turn you into a "lark" (given the above comment, you're probably "normal").

Using the aforementioned Two-Process Sleep Model (where only Process S was presented to isolate Nap Effect), you could be fighting Circadian Rhythm (Process C in the model):



Red box represents your general sleep area, blue box bedtime (inconsistency = bad. Follow all Sleep Hygiene Rules) and you are rising before you're ready (which should be the intersection of Process S and Process C).

I had a doctor's appointment yesterday so I got to sleep in until 6:00 and even though I only got 7:58 hours of sleep I felt pretty good most of the day and even though I crashed by late afternoon I didn't have the need for a nap.

I'm sure some of it had to do with getting an extra 45 minutes of sleep but I thing getting up at 6:00 instead of my usual 4:25 had some impact as well.

I was in bed by 9:00 last night and will make every attempt to be asleep by then for the next several weeks to see if (and how much) it helps.

Thanks again for all the info/advice.

[jnk]

http://www.dormivigilia.com/wp-content/ ... icle-2.pdf

[deltadave]

I was in bed by 9:00 last night and will make every attempt to be asleep by then for the next several weeks to see if (and how much) it helps.

OK, cool.

After you stabilize "Process S", then maybe we can FW "Process C" to get a good matchup (for instance, if you're on the West Coast of Florida, daylight there looks to start about 50 minutes later than Normal Time (DST, or DUMBO Standard Time)). Perhaps starting some Bright Light Therapy might not be a bad idea.

Still wondering why I think a place that has been sending out reports with the wrong time on them for 10 weeks is a problem?

[deltadave]

http://www.cet-surveys.org/Dialogix/ser ... TIVE=START

[robysue]

http://www.cet-surveys.org/Dialogix/ser ... TIVE=START

Very interesting survey

[SleepingUgly]

I took the test, and it wants me to do light therapy at 7:15am! Blech!! I couldn't answer some of the questions accurately, as there is NO time of day that I reliably feel most alert, so I was kind of making up answers to questions like those.

[Tom W]

My latest sleep study report....

[Tom W]

So it's been exactly two weeks since the DME called and said that they've contacted my insurance company for approval for my newly prescribed ASV machine.

I have to admit that after 12 years of PAP therapy I'm really excited about getting an ASV machine even though I know there will be a possibly long adjustment period.

The morning/day after the ASV titration reminded me of my first CPAP titration. The one where you wake up and say, "Oh, so that's what sleep is". I thought it was all in my head until I got the results of the study which confirmed that I had a decent night's sleep.

0 events, 3 periods of REM, and a lot less PLM's than any of my previous studies.

In the mean time I keep dragging myself through each day with an average AHI of 13.5 on Bi-PAP waiting for the DME's number to show up in my caller ID every time the phone rings.

[SleepingUgly]

Why don't you call your DME instead of waiting for them to call you?

[Tom W]

It's been this long of process for each of the previous machines that I've gotten from them give or take.

The first one (straight CPAP with recording capabilities) took more than 3 months because the insurance company didn't want to purchase another machine for me. They had purchased my first machine 10 years prior and felt that if it was still working that they shouldn't be responsible for replacing it just because the doctor wanted the 'unnecessary' feature of full compliance downloads.

I'm certain it will all work out in time.

[Tom W]

So after the somewhat promising results during my ASV titration my first 12 days of ASV have been a little disappointing.

CAI: 3.3
OAI: 10.8
HI: 2.7

AHI: 16.8

I was hoping that the ASV would be able to resolve some of the issues I had been experiencing with clusters of apneas where I appear to be holding my breath but it hasn't.



At this point it looks like I need to once again start looking for a Clinic that can test for 'things' above and beyond what local sleep labs can.

Any suggestions?

[Xney]

Wow, I'd probably try a higher minimum pressure if you're still getting OAs.

[Tom W]

I'm scheduled to see the doctor on Monday so I'll see what he suggests but I've been on BiPAP with pressures as high as 18/15 with no reduction in Obstructives.

Oddly during my ASV titration I had zero OA's which leads me to believe that the machine is incorrectly labeling the events as I've never had a night with zero OA's in the 17 months I've had machines with data capabilities but we'll see what he thinks after I show him the data.

It might be difficult to see but all of these apneas end with an exhale so in a way it doesn't seem logic to keep trying to push air in when the only thing that clears the blockage is air moving out.