Opinions on partial night therapy

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Opinions on partial night therapy

Post by Pugsy » Tue May 05, 2015 11:05 am

What do you WANT to do?
Do you want to accept half a night therapy as being the best you can do?
Or do you want to maybe get some help in turning over some rocks to see if we can get you to the point that the cpap sleep seems worse than the non cpap sleep in terms of quality?

My first thought is that the mask/therapy is causing some low level arousals that you may or may not remember.
If you want to work at making it better....we will all try to help but you have to want to do it first. We can't make you want to do anything...that's something that has to come from you.

Do you own an overnight recording pulse oximeter?

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Liam1965
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Re: Opinions on partial night therapy

Post by Liam1965 » Tue May 05, 2015 12:18 pm

No, I don't have an oxymeter. And I don't know what I want to do. I'm not sure what to do. I'm doing the only thing I can think of to do, which is slowly acclimating to the machine while also getting some restful sleep without it, to keep me from completely collapsing.

I mostly just wanted to make sure there aren't some health risks that I'm not aware of associated with on-again/off-again use of the machine.

Liam, tired.

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Pugsy
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Re: Opinions on partial night therapy

Post by Pugsy » Tue May 05, 2015 12:25 pm

The really major health risk that comes to my mind is low oxygen levels.
That's why I asked if you had a recording pulse oximeter...that way you can see if or how much your oxygen levels are dropping during the time without the machine.
The other stuff is a risk too (stress hormones and all that) but low oxygen would be my first concern that I would want to check out to see for sure what might be happening.

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Re: Opinions on partial night therapy

Post by palerider » Tue May 05, 2015 1:07 pm

Liam1965 wrote:... then sleep for the remainder of the night. ... this seems to be something different, like somehow I'm falling into a coma-esque sleep that isn't including dreams. Of course, that's just one possible explanation, not a medical diagnosis, but....
Liam1965 wrote:...also getting some restful sleep without it,
here's a thing that you need to be aware of, well, a couple things.

MOST people with untreated sleep apnea THINK they're sleeping, and getting good restful sleep, because they don't remember what happens to them during the night, they don't remember the snoring, the gasping, the arousals.

as to your "coma-esque sleep that isn't including dreams", the prevailing wisdom is that if you don't wake up, or at least are disturbed from your sleep, your dreams fade completely away without any memory within a very short time.

if you're sleeping, and NOT remembering your dreams, you're most likely getting good sleep, if you remember all your dreams, you're most likely getting crappy sleep, and getting waked up during them.

when I was getting *horrible* sleep, I had dreams all the time, because my brain was so tired it was desperately snatching any instant it could to do the require dreaming.... and the same thing has been mentioned many times by others.

consider it.

one more thing, because I don't remember, if you are getting restful sleep and all without the cpap, why are you trying to use it?

as to getting accustomed to it, maybe you need to do what so many others have been advised to do, wear it when you're not sleeping, so your subconscious gets used to it...

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Re: Opinions on partial night therapy

Post by CanadaVoice » Tue May 05, 2015 1:23 pm

Liam,

I am new to the forum but not new to CPAP. A similar discussion was had on this topic (in another thread). It touched on this very thing, allowing the mask to be off (for whatever reason in the middle of the night) and sleep off without it for the remaining night vs. insisting to place the mask back on again and resume, thereby risking staying up all night fighting the mask (potentially).

Now, acclimating to CPAP is plain tricky for many people. And every situation is its own experience; so a general answer to your efforts might be a bad thing.

Now one thing, feel free to disagree with anything said. There is a risk in saying anything without knowing the entire story of your experience. So I am running with your current assessment. Please understand that some acclimation methods can work while others don't.

And before getting into any of them, questions must be offered to get to the bottom of it all for you.

Now that you have had some time and several nights to question many aspects of your sleep, you might have enough information to press ahead.

However, If someone walked into our clinic out here with this situation we'd additionally ask:

1) Are you experiencing any acute, noticeable mask discomfort? Or humidity issues?
2) Does your machine collect data to analyze the mask removal and overall sleep experience?
3) Do you have any claustrophobia or additional sleep struggles (insomnia, anxiety, etc.)?
4) Have there been any changes to your diet or medication?
5) Has there been a major life transition you have been dealing with?

We usually start with general (but specific questions like that) inquiries to hear everything out.

But you have an advantage.

You have assessed your own situation as best you can despite being tired.

Kudos.

And your approach to slowly acclimating to the CPAP is a good thing.

There those on the forum who think going from zero to sixty as fast as possible is very important. I think so too, but with a dash of perspective thrown in. And you seem to understand perspective well enough. That means finding a method somewhere between too aggressive and too passive.

The thing about habits is a decent point, but even habits need refinement as you develop them.

So the trick for you is to measure longer and longer sleeps and gauge your sleep depth/quality accordingly. Is that right? Or are you digging for a method to get more acclimated? Or both? Or did I miss anything?

Because knowing just a little more might lead us to the answer.

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Re: Opinions on partial night therapy

Post by bwexler » Tue May 05, 2015 2:42 pm

You have not expressed a willingness to view or share any data from your machine.if you were to download Sleepyhead and review your data and post it here you might find some clues to improve your experience.
As for other problems OSA AFIB seems to go together. So if you don't already have AFIB or other heart problems they may come along with quitting therapy. I am sure there must be other health issues as well.
Just like an alcoholic, until you admit you have a problem and decide to do something about it, nothing we offer will matter.

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Re: Opinions on partial night therapy

Post by Bill44133 » Tue May 05, 2015 3:14 pm

Liam obviously you don't understand what is going on with you. If you understood this wouldn't be a question of not using the machine.

Please take 15 minutes and review this youtube video it will help you understand what is going on with with you when you don't use the machine:
https://www.youtube.com/watch?v=-gie2dhqP2c

This video put the whole thing in perspective for me. It should be required viewing for any one who is new.

I wish you well

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Liam1965
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Re: Opinions on partial night therapy

Post by Liam1965 » Tue May 05, 2015 3:38 pm

palerider wrote:as to your "coma-esque sleep that isn't including dreams", the prevailing wisdom is that if you don't wake up, or at least are disturbed from your sleep, your dreams fade completely away without any memory within a very short time.

if you're sleeping, and NOT remembering your dreams, you're most likely getting good sleep, if you remember all your dreams, you're most likely getting crappy sleep, and getting waked up during them.
It's all relative, and I'm not judging by the lack of dreams, I suggested that it was one possible cause. I rarely remember my dreams, so I have no reason to believe I am or am not dreaming, I just know dreaming is an important part of sleep, so therefore that might be part of the problem.

Also, my sleep without CPAP is not restful... only more so than WITH CPAP at this point, based solely on the outcome. If I sleep without it, I feel rested. Not rested enough, hence the problem I want to solve, but at least rested. When I sleep WITH the CPAP, I wake up feeling like I haven't slept, and while I've been told that some grogginess in the morning can be related to REM sleep after a long time without much of it, nevertheless that kind of groggy should wear off, while when I use the CPAP 100% of the time, I feel exhausted 100% of the time, it never wears off.

So when I call the non-CPAP sleep "restful" and the CPAP sleep "non-restful" they are by comparison to one another, and it is based on outcome not based on the quality of the sleep itself, which I recognize can be extremely hard to correctly gauge.

Liam, starting to regret starting this thread.

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Liam1965
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Re: Opinions on partial night therapy

Post by Liam1965 » Tue May 05, 2015 3:46 pm

bwexler wrote:You have not expressed a willingness to view or share any data from your machine.if you were to download Sleepyhead and review your data and post it here you might find some clues to improve your experience.
As for other problems OSA AFIB seems to go together. So if you don't already have AFIB or other heart problems they may come along with quitting therapy. I am sure there must be other health issues as well.
Just like an alcoholic, until you admit you have a problem and decide to do something about it, nothing we offer will matter.
I have not "not offered", I simply have no idea how to get that data, so therefore, sharing it is difficult.

I do not have any problems with my heart, I just had a complete workup on it last Wednesday due to a panic attack (due largely to the lack of restful sleep from the CPAP) and spent 7 hours in the ER having my heart checked from every angle. It passed with flying colors.

And I'm really getting sick of the back handed "help" in here. I swear, 10 years ago this group was nothing but supportive, now it seems like the first response to anyone new is to initially be suspicious of their motives and their knowledge and everything else, and only after they pass all of your f***ing tests will you grudgingly bestow your wisdom upon them.

I'm trying the best I can to make this work, because I need to sleep better. CPAP isn't doing it, and I asked a simple question about whether there were real problems with doing a slow ramp-up to getting used to the machine rather than diving in head first with both feet, or whatever twisted metaphor you prefer. I wasn't asking if it was OK to do long term, or if you personally thought that it was a bad habit to break, I was asking if there were any real health risks involved in sleeping half the night with CPAP and half the night without, not real health risks as compared to sleeping 100% with CPAP, but compared to sleeping WITHOUT it, because that's the likely alternative to this partial-night thing I've been doing lately: giving up entirely.

For those who have offered honest help and guidance, I thank you. For those who seem more interested in telling me how I'm wrong and how I'm not admitting to my problem or whatever, just ... don't help. If you aren't able to help, just don't.

Liam. Heaven save me from my friends.

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Re: Opinions on partial night therapy

Post by OkyDoky » Tue May 05, 2015 3:53 pm

Liam, If you would like to learn how to get your data here is a good resource to learn how. https://sleep.tnet.com/resources/sleepyhead
Many here will help you to do that and maybe something can be found to help you get the therapy a little better.
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Re: Opinions on partial night therapy

Post by SleepDisturbed » Tue May 05, 2015 5:30 pm

I'm trying the best I can to make this work
No, you are not. You are obviously an intelligent person, and seem perfectly capable of getting Sleepyhead set up, capturing your data, and sharing with the very experienced and knowledgeable people here, like Robysue and Pugsy. With that information they might very well be able to help you. All the instructions are available and help is just a post away.

So go ahead and do that. Then you will begin doing what almost all of the rest of us have done. THEN you can say that you are trying your best. Right now you are just running in circles, and making wild guesses about what is going on with your therapy.

Please. The health consequences of untreated apnea are very real, and very serious. Despite differences of style, approach, and tact, no one hangs around here for long for any reason other than to try and help folks like you.

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Re: Opinions on partial night therapy

Post by Morbius » Tue May 05, 2015 5:36 pm

http://www.ersj.org.uk/content/10/5/973.full.pdf
We conclude that there is an improvement in severity of obstructive sleep apnoea syndrome after only 4 h of nasal continuous positive airway pressure. This carryover effect could explain why a number of patients with obstructive sleep apnoea syndrome apply nasal continuous positive airway pressure for only part of the night or not every night.
Eur Respir J 1997; 10: 973–976

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Morbius
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Re: Opinions on partial night therapy

Post by Morbius » Tue May 05, 2015 6:24 pm

http://www.sleepreviewmag.com/2001/04/c ... d-fiction/
CPAP has a residual or carry-over effect, which can decrease the severity of OSAS for the rest of the night after only 4 hours of use.60 Two studies47,61 have confirmed a benefit in cognitive function, daytime sleepiness, snoring, mood, and quality of life when CPAP is used 3 and 3.4 hours per night, respectively. However, these residual effects of CPAP last only for 3 to 4 hours and are lost if it is not used every night.62

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Morbius
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Re: Opinions on partial night therapy

Post by Morbius » Tue May 05, 2015 6:36 pm

Now, you could even blow a whole night off, but that doesn't work quite as well:

http://www.ncbi.nlm.nih.gov/pubmed/8484 ... t=Abstract

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Re: Opinions on partial night therapy

Post by kaiasgram » Tue May 05, 2015 6:53 pm

Hey Liam, I get your dilemma and the only reason I don't have the same dilemma is that I happen to sleep straight through most nights. But my sleep quality is poor and more often than not I wake up feeling pretty close to what you describe. Before CPAP I would get at least a few nights of what felt like truly restorative sleep even with my severe apnea.

CPAP therapy changes the external and internal environment of our sleep and I suspect that for some those changes compromise sleep quality to some degree, even at the same time the therapy is successfully controlling apnea. I also suspect that for perhaps a minority of people this does not get significantly better over time.

I have no answers but FWIW I also have no judgments about you or your situation or how you're currently dealing with it. I use my CPAP faithfully because the desats scare me. It's pretty much a fear-based choice. I don't know what my choice would be if I was waking regularly at the 4-5 hour mark. I'd like to think I would soldier on with the mask but humility dictates that I acknowledge I don't know.

I'm not trying to support the idea of going back to sleep without the mask. I'm just trying to say that you're not as alone as you may feel in the face of the feedback you're receiving.

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