Noctuary wrote:1) What is your work schedule? (I know from previous posts you work evenings or nights, but I need it clarified.) Do you enjoy your job? Do you get any satisfaction out of your job?
I hate my job. Too many people now; its like working days.
A job that you hate can add to depression. And also sap you of what ever energy you happen to have.
2) Given your work schedule, what is your idea of the ideal sleep schedule for you? In other words, if everything was wonderful and you were feeling great, when would you go to bed? When would you get up? And could you keep that sleep schedule in place on your days off as well as the days that you work?
Nothing would change. I would keep to the same schedule that worked for me nineteen years.
My question is: What is that schedule? I know you think you've made it clear, but I really don't know when your work hours are or when you have been sleeping (or trying to sleep) during the last 19 years. So can you clarify:
What are your ideal and current bedtimes?
What are your ideal and current wake up times? And by wake up time I mean the time you actually want to
get out of bed and start your day.
3) What exactly needs to change in terms of how you feel during your regular "wake hours"? Try to separate this out from the fact that you think the lousy sleep is the root cause for now.
Getting enough sleep is the only thing that needs to change. And lousy sleep is the root cause.
Like many others, I suspect that you are blaming all your problems on "lack of sleep" when there are likely other causes. Read through the comments about your 1000 calorie/day diet.
Also seriously consider what Jay Aitchsee says in
his response to your thread. Consulting a mental health therapist is a good idea.
The idea of PLMD first brought up by kteague is also worth pursuing. Although that may mean another trip back to the sleep lab. (Which might not be such a bad idea.)
And finally seriously consider what Julie says in
her response. Her suggestion to investigate cardiac issues is spot on. As are her comments about the toll that shift work can take over the long run. I think she's hit the mark when she writes, "I think you've lost perspective on what's happening, want to blame it all on sleep, but need to get some professional help."
A) Right now are you dealing with way too much fatigue during your wake hours? In other words, are you dragging around because you're physically tired, but you are not overly sleepy? When fatigue is the problem, you typically don't fall asleep when you're sitting quietly, but you also don't have much energy to get up and do things that require some physical activity---such as housework, laundry, yard work, exercise, whatever.
B) Or are you dealing with way too much sleepiness during your wake hours? In other words, do you find yourself dozing off when you want to be awake? Do you find it hard to stay awake during a tv show or movie that you want to watch? Are you afraid of falling asleep while driving? Are you yawning all the time? Is it hard to concentrate on mental tasks because of brain fog and feeling like you're not fully awake?
Its sleepiness now. It was fatigue before. Mostly a lot of yawning. I have no trouble staying awake.
This seems contradictory. If the problem is
excessive sleepiness then you would have
a lot of trouble staying awake. But you say that you have
no trouble staying awake.
C) Or are you dealing with too much moodiness (for lack of a better word)? In other words, are you down, sad, blue, and/or depressed most of the time you are awake? Are there things you used to enjoy doing that you no longer find any pleasure in doing? Do you feel hopeless most of the time? Is it hard to find things to feel happy about? Is it hard to do things you need to do because there's a part of your mind that keeps asking, "What's the point? It's not going to make any difference anyway?"
I've always been depressed; but for most of my life I slept well anyway.
If you've always been depressed, then you absolutely have to consider the fact that many of your problems with the lack of energy, fatigue, and overall "feeling bad" may be due to the depression and not the OSA, which is now being managed quite well.
Now it seems the flesh in my throat chokes off air; that is the only difference now.
The data says otherwise: Your CPAP is preventing almost all of your obstructive sleep apnea events. There are no clusters of events to speak of---except at times when you say you were awake anyway. Moreover, "the flesh chokes off air" is not the same complaint as "I wake up too early and cant' get back to sleep so I'm not getting enough sleep." And most of your threads have focused on the fact that you are waking up and not being able to get back to sleep.
4) What factors other than lack of sleep might play a role in making you feel lousy during the day? Do often have headaches? allergy problems? muscle soreness? other pain issues? Do you have other known medical issues even if they're minor? How's your weight? How's your diet? How's your social life in a broad sense? In other words, do you have at least a small network of family or friends that can provide you with some emotional support and a chance to have some fun?
Its only the sleep thing. I have lost at least 12 lbs. the past few weeks, and I intend to lose more. No real social life; I'm not a people person (shocking).
I'll reiterate my comments from above: There are a number of other factors that others have identified as possible reasons for your feeling lousy during the daytime that go well beyond the lack of sleep. You need to investigate those causes rather than dismissing them.
In particular, I strongly suspect that the depression is playing a much larger role in all this than you want to admit.
It's good that you are losing weight. But severe dieting (1000 cal/day) of any sort also takes its toll on the body. You may not think that severely restricting your calories is leading to a decrease in how well you feel and an increase in sleep problems, but that severe of a restriction on caloric intake does effect things. Are you working with a doctor or nutritionist of some sort in your weight loss plan? If not, then you might want to consider working with one. After all---losing the weight is only part of the battle: Once you are down to what you want to weigh, you will need a strategy for keeping the weight off. And if you just go back to "eating normally" there's a high chance that you will gain the weight back over time.
Once you are better able to articulate what your goal of "feel good" actually entails, then it will be time to figure out some achievable short term, achievable goals that will start moving you towards your long term goal. And once your short term, achievable goals are articulated, you may also be able to figure out a way of tracking your progress so that you can see that you are not just spinning your wheels and never getting anywhere in terms of reaching your long term goal of "feeling good."
Two more hours of sleep today and I would probably feel great. At least its Friday.
You are spinning your wheels here. You think that two more hours of sleep is going to be the magic bullet and fix all your problems. But the goal of getting two more hours of sleep every single night is NOT realistic
right now. As in it ain't going to happen any time soon---particularly if you just keep doing what you are currently doing.
You need some
realistic short term goals. Here are some things I would suggest for short term goals:
- Get your sleep efficiency up to 90% on a consistent basis even if you're only sleeping a bit more than 6 hours a night.
- Once you are sleeping a bit more than six hours every night with a sleep efficiency of 90% (or more), start slowly increasing the amount of sleep in small increments.
- Do something enjoyable for yourself every day. It doesn't need to be physical. And it doesn't need to be the same thing every day. It does need to be something that is NOT sleep related. If you enjoy reading or watching a tv show, make the time to do that. If you have a particular meal that you really like that's on your diet, make it and enjoy eating it.
And here's how I'd track progress towards
achieving those modest, realistic
short term goals:
1)
Track some data on a daily basis for at least two weeks and preferably a month. The data you need to track is pretty simple, but you need to be honest in tracking it. Here's what I'd suggest:
- Sleep data: Bedtime, wake up time (i.e. when you get out of bed), time in bed (total time you spend in bed trying to sleep), estimated total sleep time, and estimated sleep efficiency. Sleep efficiency = (estimated total sleep time)/(time in bed). This data should be recorded in the morning when you first get out of bed.
- Daytime energy level. This data should be recorded in the evening right before you go to bed. You need a simple scale: 0 = No energy for anything to 5 = enough energy to get through your day without feeling like you are exhausted.
- Daytime mood level. This data should be recorded in the evening right before you go to bed. You need a simple scale: 0 = very depressed to 5 = not depressed at all.
- Daytime "activity" notes. Jot down a note or two about anything you do that is enjoyable in any sense of the word. Focus on positive things that make you feel even a tiny bit better. In other words, if you really enjoy supper, make a note that supper was nice. If you enjoy reading a book or watching a tv show, jot that down. If you find the energy to take a walk and enjoy it, jot that down.
Tracking this data is the only way you're going to be able to tease out whether the overall quality of your sleep is the root cause of your problems OR whether some of your problems are related to other issues.
2)
Get your sleep efficiency up to 90% on a consistent basis. You are currently sleeping no more than about 6 hours on a "less bad" night. Pick a 7 hour "time in bed" window that works for you. I suspect it may be 3:30-10:30. And work
hard on getting yourself out of bed every single day at 10:30 AM (or whatever your chosen wake up time actually is) regardless of how little or how much sleep you got during the night. Do NOT go to bed until your chosen bedtime even if you are tired or a bit sleepy. The idea is that you need to consolidate the sleep you are getting into nice solid full sleep cycles. You are more likely to feel rested with six hours of very good, well consolidated sleep than you are getting 7.5 or 8 hours of very fractured sleep. But the only way to teach your body to consolidate the sleep is to NOT allow yourself to lie in bed for an hour or more each morning trying unsuccessfully to get back to sleep.
3)
Slowly try to increase the total amount of sleep. Once you have a week or two of having a sleep efficiency of 90% or so in your designated seven hour time in bed window, add 15-30 minutes to the time in bed window. (It's your choice of whether to got to be earlier, get up later, or do a small amount of both.) And keep using the new "time in bed window" until you are consistently seeing a sleep efficiency of 90% in the new time in bed window. And then increase the time in bed window again. Keep slowly adding time to your time in bed window until you reach your goal of getting 8 hours of well consolidated sleep. (A side note: If you are in bed for 9 hours, and you get 8 hours of sleep during those 9 hours, the sleep efficiency is 8/9 = 89%, which is "close enough" to 90% to not worry about.)
