Starting a Sleep Journal - Feedback Please

Hi everyone.

Now that I'm starting to review my data via EncoreViewer, I was also thinking of starting a sleep journal to see if there were any outside curcumstances that could be affecting sleep/AHIs. Or do you think this futile because this is really a matter between the mask and leaks, not anything else?

Some of the things I was thinking of monitoring:
* What mask am I'm using? Currently have 3 to choose from.
* Wake up to head fog?
* Headaches?
* Alcohol before going to sleep?
* Humidity setting?
* Nightmares?
* Stressed?

Requesting feedback.

Thanks.
Starlette

Although I am only on my second week, I have been keeping a journal since day one.

I also have included cleaning date, equipment dates, and how the night went. (leaking mask, adjusted tightness, etc).

Could really come in handy to look back and look at trends...

caffine (how much & when)
last time you ate
how much physical excercise that day
actual activity 2 hours before bed (TV, reading, sex )

Not only listing what you did that day, but also make a note of how you felt all day/how you felt waking up in the morning.

I've found that tracking all this stuff has been immensely helpful in dealing with sleep issues other than OSA. It helped me to figure out that even though my OSA was being effectively treated, there were still other issues and my sleep wasn't good enough to feel good. without having all that data to reflect back on, I wouldn't have been able to see trends or other issues.

I also track what type and number of pills I take at bedtime (1 naproxen, 2 tryptophan, whatever), plus the mask I am using.

Weezy

I would be sure to include pressure setting and # hours.
and dont forget "other" in case something unpredictable starts to happen!

I'm just finishing up my first month with CPAP and have been keeping a daily log as well. I note the number of hours of sleep, the humidifier setting, which mask I used that night and my AHI for the night. I then have a section where I just write down any observations, if I woke up during the night, if there were leaks/discomfort with the mask, if there were any unusual results in the EncoreViewer reports. I think it's helpful to track what works and what doesn't work and to be able to look back and see what I tried and what the results were.

Added everyone's comments. Thank you so much for the feedback. Just what I was looking for.
It will be interesting what I find out.

Starlette

The most critical part of keeping a sleep log in my opinion is to make sure that you do it in such a way as to minimize any distruption to your sleep patterns. The critical thing is to do ALL the writing in the morning AFTER you wake up if at all possible.

I technically keep "two" sleep logs---one for the apnea data and one for my current insomnia (and, quite frankly anything else). They are easy enough to put together into one master log if I need or want to. I'd been keeping the Apnea data log since Night one of CPAP. Keryn, the PA I'm working with on the insomnia had me start the insomnia log.

1) [Apnea data log] I check my data with Encore Viewer daily. Make notes of the following things in a notebook each morning:

• * Usage
  * AHI and other respiratory data AND computed NUMBER of apneas, hypopneas, flow limitations, and RERAS
  * 90% Pressure settings (if I'm running in auto)
  * time at each IPAP and EPAP pressure
  * average leak and a note about basic shape of leak graph (flat, fuzzy, obvious leaks and number on the rare days I have leaks)
  * notes (if any) about snoring---all night? only at certain times? [My snoring still seems to be an issue since the machine scores it and uses it to raise my EPAP, but snoring rate seems remarkably unrelated to AHI.]

I print out the detailed data sheets from Encore Viewer about once a month to supplement log since it gives me a more detailed record of when the clusters of events happen and when I change pressure levels if I forget to note that down. This log is mainly just data and very short notes related directly to CPAP therapy. And usually contains little or no information about how I feel.

2) [Insomnia log] A better name for this one ought to be the "big picture log" since anything that tends to affect my sleep either positively or negatively winds up in here in one way or another. My basic format is two fold: There's a simple spreadsheet my sleep doctor's office provides with columns labeled Date; Total time for Naps 1 & 2; Time in Bed; Minutes to Fall asleep; Time out of Bed; Number of Times You Awoke; Total Sleep Time; and Comments[/]. The log can be downloaded at http://www.sleepmedicinecenters.com/fil ... %20LOG.xls . The way I use this log are simple:

• * I write in the log AFTER I get up in the MORNING. I don't even keep my log in the bedroom---it stays in the dining room. That way there is no temptation to even think about writing in the log when I wake up in the middle of the night.
  
  * I usually use the PR System One and Encore Viewer to establish the time I go to bed. Wake up time is usually established by looking at a clock, but I use the data from Encore Viewer to confirm that time a lot of the time. Those are the only "times" that I need to be accurate. The "time to sleep" and "total sleep time" are just mental estimates of how long it takes me to fall asleep at the beginning of the night and how long I think I slept for the whole night. According to my PA, my impression of these times is more important than the actual times. So I don't try to keep a mental clock in my head. More about this in a minute.
  
  * The number of times I awoke in the night can be an estimate since I now am not always sure of the exact number. This represents a *major* POSITIVE change in the treatment of my insomnia: In my own logs now (as opposed to two months ago), I've got a range on about half the nights because there are typically one or two "wakes" that I'm not really sure of---they might be wakes, or they might simply be part of a larger wake that I do remember, but dozed off for a few minutes and then re-awoke. And the fact that I'm no longer remembering each and every wake in painful detail is a real sign of progress.
  
  * For the "time asleep estimate", I typically figure out how much time I spent in bed. Then I subtract off an estimated time for getting to sleep. Then I subtract off any "long" wakes that I remember some sense of how long they were. Then I estimate 5 to 10 minutes for any other wakes that I distinctly remember and subtract those off. Any wake up that I think was less than 5 minutes long I typically ignore.
  
  * Comments: I find this small space very confining. The comments box is for very brief comments. Like if there was something unusual about the night (took a lunesta) or what ever else I want to write. I typically try to write a short phrase that describes how I'm feeling when I wake up. And since I'm not supposed to nap, I've moved the information about drugs I may have taken, alcohol, the rare caffeinated drink after 10am, etc. to those columns labeled "naps".

Because I find that small comments box so limiting, I keep a *qualitative* log as well: In other words, I write down my impressions of the following when I wake up each morning in a notebook:

• Any significant problems with excessive daytime sleepiness or fog brain for the previous day. Or a note that I felt really good if that's appropriate.
  
  Any significant problems with getting to sleep that night. (Or positive notes about how easy it was too.)
  
  Any significant memories of any individual wake up during the night. I will usually include a time estimate of how long I was awake, what woke me up if I can remember, any physical discomfort (congestion, painful joints or muscles, and of course, any CPAP related stuff), any mental anxiety or mental mind racing that I can remember, and so on. My PA tells me that I write too much detail. But that's just me. I have noticed that on really good nights, I tend to write a lot less detail. For me, writing about the bad stuff lets me release it and NOT focus on it for the rest of the day. But if writing about the bad stuff makes you focus on it all day long, then it's important to NOT write it all down. I'm working hard (but not yet very successfully) on trying to cut down my written records.
  
  A synopsis of how I feel both physically and mentally when I wake up each morning.

I typically don't go back and review anything I've written on previous days until the whole log sheet is full. Then I'll go back and try to read my own handwriting. And type up the relevant parts for the PA when I have a meeting with her coming up and I have the time. I really ought to type it up for myself since I have terrible handwriting and often cannot read what I wrote if several weeks or months go by.