Yes. Okay, I go to bed nearly the same time every night. I never drink any caffeine, alcohol, or take drugs. I am gluten free, wheat free, dairy free, egg free, soy free, nut free and do not eat processed foods. I only use my phone for setting up an alarm clock before bed. This means no computer use, phone use, television use, at least by more than two hours. In fact, I rarely ever use these unless it is for something important like responding to this thread.robysue wrote: Most adult Americans have lousy sleep hygiene. Can you describe your sleep hygiene?
On the split study test the tech increased the pressure from 4cm to 5cm well before you managed to fall asleep with the mask. You can see this by looking at the graphs on page 6 of the split study. It looks to me like the tech increased the pressure from 4 to 5cm about 30 minutes after the titration started. You feel asleep for a short bit when the pressure was at 5cm. At 6cm you actually slept for almost an hour before waking up. The wake and restlessness lasted about 30 minutes or so before you fell back asleep for the last few minutes of the sleep test.
Is it plausible then if my pressure was at 6.5 or 7.0 that I might have slept even longer?
Yes, the home sleep study REM was I believe mostly disrupted by the position of my body (my back), exercise use (I might have exercised during this time, I'm not sure), no machine, and no elevation of my upper back/headYou did get into REM on the ASV titration---but the percent time in REM was not much better than the estimated percent REM on the home sleep test.Also the ASV Titration little sleep because of the high pressure and the warm temperature. When I am at home, I do dream. How do I know? Because I remember having them, and on some rare occasions, on days where I have not had exercised I feel more well rested.
Funny thing is, when I heard the nurse practitioner explain the exercise situation both, either one or both of them laughed. I felt bad, and thought that it was hopeless at finding out if I am ever going to be treated well. I thought that there was no help available to help me.And again you mention the connection between exercise and bad sleep. This is something that you need to be open and honest about with the sleep doc (the old one or a new one if you decide to start over.)
I'm not saying you don't need the ASV. I'm saying that there may be MORE to your wakefulness than sleep disordered breathing.Yes, but as someone suggested before, that my ASV data shows a pressure support throughout the data and that it may cause my wakefulness.I also think you need to be considering the sleep continuity problems as being caused by other things in addition to the SDB that you happen to have. It's important to understand that the CPAP and ASV treat only the SDB issues: they don't fix bad sleep that is bad for other reasons. And since the data you've posted from your ASV machine seems to indicate that whatever SDB you do have is well controlled by the ASV, it's time to start considering other things that you need to address.
Can the spontaneous arousals be caused by a too low pressure along with the pressure spikes of the ASV?If the only underlying cause of your sleep problems was SDB, then the number of spontaneous arousals on the home sleep test and the number of wakes during the diagnostic part of the split study would not be so high.
Oh okay so if my arousals have nothing to do with my breathing, then please disregard the above question that I proposed.(And yes, I know you want to blame the wakes on the conditions in the lab test, but the very fact that you are such a light sleeper is indicative of a large number of arousals, and the data indicate that many of your arousals are NOT respiratory related.)
Okay. I feel like I am much better adjusted to the machine.But in the meantime, the pressure changes (with the ASV in particular), the potential for leaks, the noise of your own breathing, the sensation of air being blown down your throat, and the simple sensation of the mask on your face can all cause short term disruption to your sleep. But dial wingin' doesn't usually fix these problems; time does. And in fact, once the data shows that the AHI is low enough and the leaks are under control, dial wingin' can perpetuate adjustment problems because it takes time to get used to each and every change in settings.
I guess its time to take my sleep journal log back outMemory is not as reliable as we want to think it is. You want the log to be easy to keep. All you need to do is design a spreadsheet or even a paper form to fill in. Ideally it should take you less than 10 minutes to fill in the log.
[/quote]I'd suggest designing a spreadsheet or paper form to fill in that lets you quickly write down the following information at the end of each day just before you go to bed:The next morning you need to add this information to the log:
- What kind of exercise did you do?
- When did you exercise?
- How long did you exercise?
- Relatively speaking, how intensely did you exercise for you?
After a few weeks of data you may see some patterns that are not apparent now. It could be that the time of day you exercise has more to do with how the exercise affects your sleep than you think it does. It could be that some forms of physical activity are more disruptive than other forms are. Or it could be that exercising too long or too hard adversely affects the sleep. In other words, keeping the log may help you discover a way of getting the exercise you crave while minimizing the adverse affects on your sleep patterns.
- What time did you go to bed?
- How long did it take you to fall asleep? (Estimate this----do NOT look at a clock)
- Do you remember any wakes or restlessness? If so, how many wakes or restless periods?
- When did you wake up for the morning? When did you get out of bed?
- Estimate how much sleep you go during the whole night.
- How rested do you feel on waking?
- Do you remember dreaming? (This is optional)
This is a great idea. I will print this information out so I can use most of it or all in my sleep journal. The problem with exercise is that, even a small amount will make my therapy worse which is why I try to not raise my heart rate, so in the rare occasion that I do do exercise, it would be logged in a journal which would help. Thanks