I've entered a new chapter it seems.

[Noctuary]

Relax. When things seem overwhelming just attack the problem one small piece at a time.

All of the below are simple sleep hygiene items that from my own experience helped me.

Do you use your computer/iPad/cell phone within 2 hours of bedtime? Try not doing that.

Do you check your computer/iPad/cell phone when you wake up in the middle of the night? Don't. REALLY!

I get home now at 2 am. I would basically have to go to bed then if I don't websurf or do something. I'm always wound up at the end of the night because of my job, which is stressful. If I'm not asleep by 4 am I might have to deal with the great big light in the sky.

I'd suggest finding something to do other than websurf. Reading a real book (not a kindle or nook or ipad) comes to mind. Or reading a real newspaper. Listen to some music while working on a crossword puzzle that is printed on paper. Play a game of solitare with real cards. Take a shower. Do a really good job of flossing your teeth.

Yeah, none of these things are as easy as websurfing is to just plop down and do, but the blue light from our electronic gadgets is bad for the melatonin cycle.

These things are literally the only life I have. Thank you for your help though.

[Noctuary]

I guess I'll give you all a break; what else is there to look at or to say?

Maybe I can find a better pill than Provigil.

[palerider]

Reading a real book (not a kindle or nook or ipad) comes to mind.

I have to offer a disagreement on the kindle/nook comment, because the ereaders that use eink displays are effectively the same as a book, they don't create their own light and shine it into your eyes with a heavy blue contingent, they rely on reflected light, just like printed paper does. I read a lot on my nook simple touch before falling to sleep.

the ipad, however, is out.

[archangle]

Post a copy of your SD cardon dropbox if you're comfortable with that idea.

[Noctuary]

The last time you used your ResMed AutoSet...
was last night (on Monday, May 04, 2015)
You had an AHI of 2.36, which is considered reasonably good
You machine was on for 8 hours, 55 minutes and 1 seconds.
You had no major mask leaks (maximum was 8.40 L/min).
Your pressure was under 11.38cmH2O for 95% of the time.

[Noctuary]

I still can't figure out how to move the various charts around; so here's another screen shot from further down the 'head.

[Noctuary]

And one more:

[Pugsy]

Those extra graphs don't really tell us much and there's no need to go to the work to post them.
All we need is
The usual stuff on the left side
and on the right side these graphs (you can turn off the unneeded graphs in Preferences/graphs)
Events
Flow rate
Pressure (either mask pressure or regular pressure but not both)
Leak
Flow limitation

Your flow limitation graph appears to be more active than I would want to see. I don't know if the flow limitations are part of your issue or not but it's worth trying to reduce the flow limitations to see if it helps or not.
More minimum pressure is usually what we suggest trying for reducing flow limitations.
Based on the pressure graphs and statistics...maybe 9 or 10 minimum pressure...probably 10.

Again...I don't know that the flow limitations are a factor or not in how you feel but it's at least something to try.

[RogerSC]

Speaking of the blue light from computer monitors, with my Windows 8.1 desktop computer I use a free program called "f.lux". It automatically changes my monitor's light "temperature" at "sunset" to night time levels (less blue light), and then puts it back in the morning to daytime (sunlight) levels. I find it more relaxing to my eyes during my pre-sleep web surfing, if nothing else. If the blue light affecting sleep theory is actually valid, then it helps in that area, as well. I think it has been of some help in my sleep, but it's hard to tell. I think that they have a Mac version as well, but I don't have a Mac, so I haven't had to actually use it. For something like an iPad, you'd need to actually put a blue light filter over the screen if you wanted to try that out.

I usually go and use my desktop computer for a while before I go to bed, as well, and find the reduced lighting from f.lux to be nice and cozy *smile*.

Thought I'd mention this, since you seemed to be running out of options. Just curious, also, if you've tried melatonin? Like .3mg at night before you go to bed?

[chunkyfrog]

It could be something else, an infection, allergy, accidental exposure to a toxin.
Stuff happens all the time. Most of the time it passes.
Sometimes we need to call in the experts (gasp--doctors).

[robysue]

Noctuary,

On the day that you posted the data for, the largest component of your events (by far) are machine-scored CAs. And many of those CAs just happen to be scored during times when the machine is playing around with the pressure:



It is possible that you happen to be some what sensitive to the changing pressures and sometimes when the machine is doing its thing, the pressure changes are causing you to arouse. Maybe not enough to actually remember waking up, but an excess of "spontaneous arousals" can be enough to make you feel wiped out the next day. And those CAs are nothing more than normal post-arousal CAs as you get back to sleep.

You might want to tighten your APAP range. Since you spend 50% of the night at or above 10cm, you might sleep better if the APAP range were narrowed to 10-12. That would lead to a "smoother" pressure curve, and the more constant pressure may help you sleep better.

[Noctuary]

It could be something else, an infection, allergy, accidental exposure to a toxin.
Stuff happens all the time. Most of the time it passes.
Sometimes we need to call in the experts (gasp--doctors).

Explain. My ailment came on overnight, at least the change in my sleep. Before I slept beautifully; overnight that changed. This was a couple of days after visiting the hospital for pains in my neck and shoulders (not a heart attack). I've wondered if I caught something there.

I can tell you now my GP would not have a clue about the things you mentioned; he's very conservative and belongs to a medical group; they're not going out on a limb for something like that.

[Noctuary]

t is possible that you happen to be some what sensitive to the changing pressures and sometimes when the machine is doing its thing, the pressure changes are causing you to arouse. Maybe not enough to actually remember waking up, but an excess of "spontaneous arousals" can be enough to make you feel wiped out the next day. And those CAs are nothing more than normal post-arousal CAs as you get back to sleep.

You might want to tighten your APAP range. Since you spend 50% of the night at or above 10cm, you might sleep better if the APAP range were narrowed to 10-12. That would lead to a "smoother" pressure curve, and the more constant pressure may help you sleep better.

I can try that. Last night I spent two hours reading my tablet. I slept okay and I feel far better than yesterday. I knew this would happen as well. Tomorrow I will feel like crap.

This is the basic cycle of my sleep. There has been some deviation now and then, but not often.

[Noctuary]

Those extra graphs don't really tell us much and there's no need to go to the work to post them.
All we need is
The usual stuff on the left side
and on the right side these graphs (you can turn off the unneeded graphs in Preferences/graphs)
Events
Flow rate
Pressure (either mask pressure or regular pressure but not both)
Leak
Flow limitation

Your flow limitation graph appears to be more active than I would want to see. I don't know if the flow limitations are part of your issue or not but it's worth trying to reduce the flow limitations to see if it helps or not.
More minimum pressure is usually what we suggest trying for reducing flow limitations.
Based on the pressure graphs and statistics...maybe 9 or 10 minimum pressure...probably 10.

Again...I don't know that the flow limitations are a factor or not in how you feel but it's at least something to try.

Thanks.

[robysue]

So to follow up on my previous post:

Noctuary,

It looks to me like sleep fragmentation is at least part of your problem. But then the questions becomes:

• Is there something causing the sleep fragmentation?
• Is there a way of minimizing the sleep fragmentation?

All kinds of things can cause sleep fragmentation. Medicine, eating too close to bedtime, stress, depression, infection/illnesses, are some of them. Sometimes it's a physical environment problem: The bedroom/sleeping environment is too hot, too humid, too cold, too dry, too light, too noisy, too quiet (if you have tinnitus) can all be a factor in fragmented sleep.

If a cause for the fragmented sleep can be identified, then addressing the cause usually helps to minimize the sleep fragmentation. But sometimes there just is no obvious cause for it. In that case, really stringent adherence to some parts of good sleep hygiene can help minimize sleep fragmentation. For some people, the judicious use of prescription sleeping pills under the advice and supervision of a doctor can help minimize sleep fragmentation.

Which brings us back to the late night web browsing. Yes, I understand, it's a major part of your life and you're not willing to give it up. But----are you willing to install a program like f.lux on your computer or tablet that you do the web browsing on? I do use that on my Mac laptop and iPad and it does make a bit of a difference. To install in on an iPad means that you have to "hack" the iPad and unlock it. I've done that, but it does require following instructions (that you can find on the web) very, very carefully.