Dream Sleep Arousal Question

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Macpage
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Dream Sleep Arousal Question

Post by Macpage » Wed Apr 29, 2015 8:49 am

All,

I woke up out of a dream last night after about 1 hour of sleeping. The dream was very vivid and quite disturbing. I've had a few of these lately. My heart was pounding, and it took about an hour to get back to sleep.

I thought for sure it was an event so I marked it on the machine by reset. This morning when looking there was nothing. No event, pressure change, flow limitaion. I guess it was the dream and related mental activity. After I awoke, I let things settle and then went for a restroom break. Funny thing, I did show an OA while I was awake before going to the restroom.

Before xPap, like a some of us, I can't remember ever having many dreams. Now, I know it's said here that we only remember if waking up during or shortly after. I have to figure that before there would have been some random wake-ups that would have resulted in remembering a dream. Thus, I assume my SDB was keeping me from having many.

The question is what does this say about therapy, the dreams in general that is. Is it a move in the right direction or a sign of problems due to awakenings?

Thanks,

Mike

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Re: Dream Sleep Arousal Question

Post by Pugsy » Wed Apr 29, 2015 8:56 am

I don't know that it says anything about therapy itself.
I think it just means we have a bad dream and the body responds to a bad dream like it would if we didn't have OSA or use cpap therapy.

Now if the dream was maybe about some sort of suffocation thing or drowning thing and there's a truckload of apnea events flagged immediately prior to the wake up and turning off the machine to document the time it happened...then maybe secondary to the apnea events stressing the body.

Sometimes a bad dream is just a bad dream that just happens with no known "logical" explanation.

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Re: Dream Sleep Arousal Question

Post by robysue » Wed Apr 29, 2015 9:06 am

Macpage wrote: The question is what does this say about therapy, the dreams in general that is. Is it a move in the right direction or a sign of problems due to awakenings?
More dreaming in general probably means your therapy is now allowing you to get into and stay in REM for longer periods of time. Some new PAPers do go through a period of REM-rebound: Once the body discovers that it can safely enter REM sleep, it goes overboard for awhile trying to make up for the years of sleep without much REM. Things settle down to a normal pattern of REM sleep in a few weeks to a few months.

As pugsy says: Sometimes a bad dream is just a bad dream. If there are no events during the time when the dream occurred, it's safe to assume that it was just a bad dream. And waking up from a bad dream is a pretty normal thing, even for people without any OSA. And if the dream is really disturbing, having trouble getting back to sleep is a pretty normal thing, even for people without any OSA.

It's also pretty normal for people to have post-REM wakes: In other words, even people without any sleep disorders will briefly wake up after many of their REM cycles. But if nothing is obviously wrong, they'll quickly fall back asleep, and if the wake is less than 5 minutes long, they probably won't even remember the wake when they get up in the morning.

In other words, for now I'd assume that this was just a random bad dream that was disturbing enough to make it hard to fall back asleep. But I wouldn't waste any time worrying about its significance---unless I started waking up every night for a week or two from really weird, disturbing dreams and was having real problems getting back to sleep every night.

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Re: Dream Sleep Arousal Question

Post by chunkyfrog » Wed Apr 29, 2015 9:16 am

Many dreams are not remembered because we forget them before we awaken.
Before cpap, I remembered them all; and they were horrible.
Suffocation nightmares can be bizarre and dreadful.
I know I still dream, but I sleep so well, they are almost all forgotten.
Pity, because I imagine they are, finally, pleasant.

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Re: Dream Sleep Arousal Question

Post by TheUglyTruth » Wed Apr 29, 2015 9:22 am

Pugsy wrote:Sometimes a bad dream is just a bad dream
Yes!

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Re: Dream Sleep Arousal Question

Post by Macpage » Wed Apr 29, 2015 10:00 am

robysue wrote:More dreaming in general probably means your therapy is now allowing you to get into and stay in REM for longer periods of time.
chunkyfrog wrote:Many dreams are not remembered because we forget them before we awaken.
I guess I am thinking about where I fall in the spectrum. I remember dreaming when younger but not much at all as an adult. Like you guys say, everyone probably has at least some dreams they remember, especially the bad ones. Even though I felt OK until the brief period before my diagnosis, I assume not remembering hardly any in my case was the SDB. At least, I hope so. Otherwise, all this dreaming means lots of arousals and I'm getting less sleep. That would be not fun. With the exception of a few bads ones, most have just been really wierd to the point of being funny.

Best,

Mike

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Re: Dream Sleep Arousal Question

Post by Macpage » Wed Apr 29, 2015 10:26 am

robysue wrote:It's also pretty normal for people to have post-REM wakes: In other words, even people without any sleep disorders will briefly wake up after many of their REM cycles. But if nothing is obviously wrong, they'll quickly fall back asleep, and if the wake is less than 5 minutes long, they probably won't even remember the wake when they get up in the morning.
I've read a lot of your posts regarding insomnia and the other aspects of sleep that cause arousals or the lack of ability to get back to sleep.

I'm going to post about some of this more in general about how to measure where we are in treatment, but I'll ask you, Pugsy, Frog, and anyone else following. How do you know when to start looking at other factors outside of SDB if one isn't progressing as well as they think they should.

My wife thinks it's mostly stress/anxiety/depression causing havoc with me and my sleep since the xPap "seems" to be going well. She says it's all the middle age, male internalization, etc. making it difficult to rest well even after treatment. She says she feels it all as well at this stage of life. I say it's just SDB for her as well. She can't get our 4 year old boy out of her bed.

There's probably logic in all of this. I certainly wish I handled what life hands out as well as many of you. I see much to admire about folks here and others I know facing challenges in everyday life. I know there's always great advice here, and I sincerely appreciate it.

Best,

Mike

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Re: Dream Sleep Arousal Question

Post by krikit » Wed Apr 29, 2015 10:13 pm

~ thank you "Chunkyfrog" for your post!! I'd been having nightmares for quite awhile and was afraid I was "coming down" with dementia! I also woke up several times at night ~ blaming it on needing to use the bathroom ~ clueless as to the fact that my oxygen levels were dropping and my brain was forcing me awake to breath! I was just diagnosed last month and am trying to adjust to the C-pap process. At this point, I am able to tolerate the mask for about 5 hours then have to take it off. Although I don't sleep very well with the mask on, I don't have nightmares but after I take it off and go back to sleep, they start again and are so vivid and weird. Am looking forward to getting to the point where, like you, I'm able to sleep well and peacefully!!

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Re: Dream Sleep Arousal Question

Post by Wulfman... » Wed Apr 29, 2015 10:28 pm

A link to discussions and articles about dreams and dreaming.

viewtopic.php?t=3524


Den

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borgready
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Re: Dream Sleep Arousal Question

Post by borgready » Wed Apr 29, 2015 11:04 pm

You are having some kind of problem with the cpap theapy. Start trying to figure out what it is because something is not working right. If all goes well you won't remember your dreams.

Those vivid dreams that have death themes, chasing or being chased themes, fight themes are triggered from lack of oxygen. You woke up with your heart pounding was just another sign of not breathing right. The heart pounding comes from build up of CO2 in the blood.

I find it odd that you said before cpap you never had any bad dreams. If you get the bad dreams and wake up from them you usually have no problem remembering them. So I assume you was not that bad off before doing cpap.

If your on psych meds, they can do screwy things with the mind as well. I would say they magnify the effects that would already be there.

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Re: Dream Sleep Arousal Question

Post by robysue » Thu Apr 30, 2015 12:10 am

Macpage wrote: I've read a lot of your posts regarding insomnia and the other aspects of sleep that cause arousals or the lack of ability to get back to sleep.

I'm going to post about some of this more in general about how to measure where we are in treatment, but I'll ask you, Pugsy, Frog, and anyone else following. How do you know when to start looking at other factors outside of SDB if one isn't progressing as well as they think they should.
My own personal take on when to start looking at other factors outside of SDB if one isn't progressing as well as one thinks s/he should?

Well, let's see.

First: You need to make sure that therapy is indeed effective: If the treated AHI is still too high, that's a problem. If the leaks are large enough and long enough to effect the quality of the therapy, that's a problem. If you are not sleeping with the mask for the entire time you're sleeping, that's a problem. If you're still snoring that's probably still a problem.

Next: You need to examine whether therapy is so uncomfortable that it's interfering with your ability to get a decent night's sleep: If your mask hurts, that's a problem. If rainout is waking you up multiple times a night, that's a problem. If aerophagia is waking you up in the middle of the night, that's a problem. If the CPAP is making it hard to get to sleep and you didn't have that problem before CPAP, that's a problem. If you wake up multiple times a night tangled in the hose, that's a problem.

But if your CPAP therapy is effective AND comfortable, then it's time to start looking for other causes for why you're not feeling as well as you should. But exactly what kinds of things you should be looking at are really dependent on your own medical history and also what's going on in your life.

If you have other known medical problems that can cause problems with sleep or cause daytime fatigue and/or sleepiness, then those are obvious candidates. If you are on any daily medication, it's worth looking at whether sleep problems or fatigue are among the side effects.

If you haven't had a general physical in a while, seeing your PCP and getting all the standard tests to rule out the usual suspects for excessive daytime fatigue or sleepiness. Thyroid, anemia, vitamin levels, and more can all cause problems that include EDS and fatigue. And it's possible to have more than one medical condition, so it's important to rule these out. This is particularly important if you don't have any identifiable problems with obvious bad sleep.

If you have no known medical problems and your therapy is effective and comfortable, but it just seems like your overall sleep is of bad quality, then it's time to start thinking of other causes of bad sleep. If you have a history of other sleep problems beyond the OSA, then it's important to realize you have to fix all your sleep problems before you will have a chance to start getting good sleep every night.

Insomnia has a lot of potential causes. Untreated sleep apnea is one potential cause---if you're not on CPAP or if your CPAP therapy is not yet optimized. But there are a whole host of other things that cause insomnia. Bad sleep habits (of which I've got plenty) are a prime cause of a lot of insomnia in this country. But so is stress. And anxiety. And depression. And simply getting older puts you at higher risk for insomnia. Many people need less sleep as they get older and their sleep becomes more fragmented as they age. For women, the hormonal changes in menopause trigger a lot of insomnia in middle aged women---it can be tough to get to sleep and stay asleep when you're experiencing hot flashes. And worrying about insomnia is itself a huge cause of (more) insomnia in a lot of people.

PLMD can ruin sleep. And it can manifest itself after PAP therapy is optimized. Kteague is the resident expert on that issue. And although it's not the same thing, RLS can also ruin sleep.

Sleep phase problems can ruin sleep for some people. The easiest fix for sleep phase problems is to sleep when your body wants to be asleep and not worry about the fact that you sleep at "funny" times compared to the rest of the world. But many of us can't do that because of jobs. Or kids. Or other constraints. And if your circadian rhythm is badly out of alignment with what you need it to be, it can take a lot of effort both to realign it to your desired sleep time and it can also take a lot of effort to keep it aligned with your desired sleep window.

The spring and fall time changes are enough to mess up some people's sleep for anywhere between a week and a month.

Outside disturbances can cause problems for some people. Pets in the room may disturb your sleep more than you realize. Or living on a very busy road. Or too much light coming in from the street light. Or the neighbor's A/C unit if it's outside your bedroom. Some of these things you can fix. Some you can't.

And of course, there's a whole host of other official sleep disorders. Whether to consider them would depend largely on whether you have any additional symptoms that point towards one of them. And that would really need the help of a qualified sleep doctor.

And finally there's this: Sometimes the damage from OSA is simply too great for full healing. And there are a small minority of people who simply never feel much better on CPAP than they felt before starting therapy, and they've looked into and eliminated all the usual suspects. But at least PAPing tends to keep the way they feel from deteriorating further as they get older.

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Re: Dream Sleep Arousal Question

Post by Macpage » Thu Apr 30, 2015 8:14 am

borgready wrote:You are having some kind of problem with the cpap theapy. Start trying to figure out what it is because something is not working right. If all goes well you won't remember your dreams.

Those vivid dreams that have death themes, chasing or being chased themes, fight themes are triggered from lack of oxygen. You woke up with your heart pounding was just another sign of not breathing right. The heart pounding comes from build up of CO2 in the blood.

I find it odd that you said before cpap you never had any bad dreams. If you get the bad dreams and wake up from them you usually have no problem remembering them. So I assume you was not that bad off before doing cpap.

If your on psych meds, they can do screwy things with the mind as well. I would say they magnify the effects that would already be there.
Thanks. I can't seem to pinpoint anything with therapy. I'm waking up more than I would like with no obvious causes, especially in the early morning. It very well may be REM rebound as mentioned. I probably have about 3 months in of having my treatment at least looking good by "numbers".

I thought it was something like event related, but nothing at all on my data at the time. I think it's just a bad dream being a bad dream in this case as others have expressed.

Before, xPap I maybe hardly ever remebered any dream of any sort. In reality, I know I had SDB well before being diagnosed but I never had any noticable symptoms other than snoring. I scored nothing else on any of those risk assessments other than snoring. I wish I would have had the knowledge then that I do now. Maybe I was fine as well as sleep architecture then but not so much now. Yet, I have to think that before my architecture was really bad and I really wasn't dreaming much if any. I'm sure we're all unique in that aspect as with most things SDB and xPap.

No meds of that sort. I have tried low dose amitriptyline as an occasional sleep aid but not this night. I'm going to try ambien at some point just to judge the effect.

Best,

Mike

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Re: Dream Sleep Arousal Question

Post by Pugsy » Thu Apr 30, 2015 8:37 am

+1 to what Robysue said...saves me from typing it again

I have other health issues that affect both my sleep quality and how I feel during the day. The best cpap therapy in the world can't fix those issues except maybe allow me to deal with it a little less stressfully.
In terms of remembering dreams...you know it's normal to have a quick arousal that you may or may not remember, at the end of REM stage. So remembering a dream doesn't automatically mean there is something wrong with cpap therapy.

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Re: Dream Sleep Arousal Question

Post by palerider » Thu Apr 30, 2015 8:45 am

Macpage wrote:
borgready wrote:
Thanks.
bear in mind that borgready has some.... unusual theories, to put it kindly, that aren't substantiated by any kind of reliable references...

reading through his/her posts before paying any attention to what he/she posts is advisable.

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Re: Dream Sleep Arousal Question

Post by Macpage » Thu Apr 30, 2015 9:33 am

robysue wrote:My own personal take on when to start looking at other factors outside of SDB if one isn't progressing as well as one thinks s/he should?
Thanks so much for the detailed response. I guess I've thought a lot about all of these aspects, but I must be honest. Even with reading vast amounts of posts and data, I'm just not knowledgeable enough to really judge my situation. I'm also not sure I really trust myself to accurately assess things at the moment. If my mental state is being influenced by anxiety/depression, stress, sleep fragmentation, etc., I might be steering myself into conclusions or assumptions that might not be accurate, logical, or for my best.

I guess it's time that I post a detailed account of my experience. I know I have appreciated how you and others have shared. It's only fair if I'm looking for help that I should take the time to post everything in one place. It's also logical that the best chance for the greatest insight comes from others being able to look at the picture as a whole.

I will post my SDB experience to this point after working on it a little at a time over the coming days. I will try and address all the areas mentioned in detail in the course. I really hope you guys will get a chance to look at it, and I sincerely appreciate all that everyone here does.

Best,

Mike

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