Sleep Apnea or Depression?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Jasba64
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Sleep Apnea or Depression?

Post by Jasba64 » Sun Jul 16, 2017 10:16 am

I've been religiously using my CPAP since October with nothing but struggles. I sleep no better than before and wake up ever couple of hours. Half of the wake-ups are from my itchy nose contributed by the Full Face Mask. Anyway, what prompted me to have a sleep study in the first place was this constant waking up. I have always dreamed a lot with plenty of nightmares. 10 years ago or more, I quit smoking using Chantix. 4 years ago, I stopped all alcohol intake. It was after the alcohol stop that I found myself waking up. I have read where alcohol can actually help with falling asleep but there aren't any added benefits of usage and actually just the opposite. Trust me, I don't plan on taking that habit up again. I am 52 years of age, single and not much of a social life. I work shit work. I do a lot of reading on the Sleep Apnea topics and wonder if I truly have it. Being all wired up, I slept on my back during the sleep study. That is most likely why I snored and scored what I did. My normal sleeping is between stomach and side. I recently read where sleep apnea could be misdiagnosed with depression. I took an online depression test and scored moderate. This morning I woke up at 3:30, took my mask off and then went back to sleep. Most likely laid there for an hour but today, I don't have a headache which I have most days after therapy. I feel pretty good, too. I think I'll lay off of Cpap for a few days and see how I feel. Oh, when I say depression, I am NOT suicidal by any means. I actually live a very nice life. Good job, good pay, nice house, new vehicle, building up a strong 401(k), etc.... Like I said, not much of a social life is the downfall.

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Julie
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Re: Sleep Apnea or Depression?

Post by Julie » Sun Jul 16, 2017 10:46 am

Hi... first thought is to wonder if you've thought of taking another test, second is to ask if you use Sleepyhead (free) software and if so can you post some graphs, etc? If you need help to do it we'll give that. Third = a little confusion as you said your work is shit, but near the end you list "good job", which I guess maybe the money's ok, but you hate it?

Many people with OSA were first diagnosed with depression, but I wonder if a) you have coincidental depression, or b) whether your pressure settings are high enough to be effective, and c) how do you feel about your mask - if it's not doing a good job or fit properly it will definitely impact your therapy.

Strongly suggest you DON'T self diagnose depression online... please see a doctor if help here isn't helpful.

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Jasba64
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Re: Sleep Apnea or Depression?

Post by Jasba64 » Sun Jul 16, 2017 11:02 am

Haha, it was supposed to have read "shift" work. I work 6-6 both ways. Sorry for the confusion. I tracked SleepyHead for several months and finally stopped. I read where Cpap can cause Central Apneas. I have had 2 sleep studies performed. First said pressure of 6 and second with mask the entire time, on Ambien showed pressure of 9.

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Re: Sleep Apnea or Depression?

Post by Jasba64 » Sun Jul 16, 2017 11:05 am

I've been using my Cpap machine in Apap mode. It's a temporary thing but works for now. I have a DreamMachine Pro. Here are my sleepyhead results for as long as I tracked them. http://jasba64.imgur.com/

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Re: Sleep Apnea or Depression?

Post by Julie » Sun Jul 16, 2017 11:14 am

Just wondering about your upper setting - have you tried it higher?

And, have you ever tried a soft cervical collar to hold your head off your chest (blocking airway), and keep jaws closed, not that your leaks look horrible or anything.

Have you checked out local places/organizations, etc. for social opps (not apps) that might take you 'out of yourself' a bit? Looked into classes, etc?

I do think shift work is bad on OSA, and 6 on/6 off is pretty bad... any chance you can do anything at all about that, at least lengthen spans?

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Jasba64
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Re: Sleep Apnea or Depression?

Post by Jasba64 » Sun Jul 16, 2017 2:54 pm

I work 6 to 6 both ways meaning sometimes days and sometimes nights. I never work more than 4 in a row. I used to sleep up to 12 hours a day when I was off. I have worked shift work for nearly 30 years and still have 9 more years to go. It's not a choice right now. My oxygen level is fine. Always 90 or above according to my last sleep study. I'm going to stay off the Cpap for a week and see how I feel. I always felt better before I started therapy. In 9 months, I feel worse and more tired than ever before therapy. I'll keep you posted on any updates.

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Jay Aitchsee
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Re: Sleep Apnea or Depression?

Post by Jay Aitchsee » Sun Jul 16, 2017 3:43 pm

Jasba, one thing I've noticed since learning about Sleep Apnea is that Apnea and Depression seem to go hand in hand. It's kind of a chicken egg thing. Depression causes poor sleep. Poor sleep causes depression. Round and round.
I suggest you google sleep hygiene and make sure you practice all the steps you possibly can. At the same time, google self help for depression and you will see that the two overlap. Now, it is import to practice all the steps; exercise, diet, caffeine, social interaction, etc., etc., religiously. Oh, and I know of at least one study that found that abstinent alcoholics suffered from disturbed/fragmented sleep for years after quitting drinking. Unfortunately, there was no remedy offered, but my experience indicates good sleep hygiene helps. And no, I'm not suggesting you begin drinking again.
I didn't study your charts, but your AHI is too high, mostly hypopneas it appears, but hypopneas can be disturbing, too. I think you should try to get your AHI consistently under 2. If you post a recent chart, people here will help you do that. Pugsy is great at it.
I think if you work at it, you can start feeling better.

Granny's Sleep Hygiene steps (the short version):
ChicagoGranny wrote: - Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Use CPAP software, such as the free SleepyHead, to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems
CG

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Jay Aitchsee
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Re: Sleep Apnea or Depression?

Post by Jay Aitchsee » Sun Jul 16, 2017 5:37 pm

https://www.sciencedaily.com/releases/2 ... 091343.htm
Rotating Shift Workers Have Lower Levels Of Serotonin
People who work rotating shifts have significantly lower levels of serotonin, a hormone and neurotransmitter in the central nervous system believed to play an important role in the regulation of sleep, according to a study published in the August 1st issue of the journal Sleep...

In addition to sleep problems, low levels of serotonin are also associated with other conditions such as anger, depression and anxiety
.

This article doesn't provide much help, but does, as xxyzx points out, suggest that shift work itself could play a major role in your poor quality of sleep. Since quitting shift work does not seem to be an option, In addition to the good Sleep hygiene practices and better CPAP effectiveness mentioned above, perhaps it would be beneficial to seek out the assistance of a doctor familiar with the possible side effects of shift work.

Maybe a referral to such a doctor could be found by talking to other employees at your workplace or possibly from your employer.

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kteague
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Re: Sleep Apnea or Depression?

Post by kteague » Sun Jul 16, 2017 6:39 pm

Shift work is perpetually hard, but sometimes life requires "hard" of us. With shiftwork it can be like the mind doesn't know whether it's supposed to be awake or asleep. What are your depression symptoms? If it is feeling disjointed, lethargic, or unmotivated, in your situation I wouldn't automatically ascribe those to depression. I'll just throw out some things for you to consider Have you had any tests to make sure things like vitamin D, B12, testosterone and thyroid levels etc. are ok? Are you on any meds that could cause sleep fragmentation? Have your studies made any mention of limb movements? On the headaches, is there any chance your mask straps are too tight across the lower skull/upper neck?

If I were you I'd have my machine data looked at in detail by some of the data gurus here. (I'm not one.) They may be able to spot something of interest. Was your entire night in the studies spent on your back? What did your sleep study reports attribute your arousals to? Wondering how high your AHI was and if there's any chance it is positional. But, I'm thinking you must have been symptomatic even with side and stomach sleeping to have ended up taking a sleep study?

My personal opinion is you should do some more investigation before just not using your CPAP. While it's not a sure-fire answer, some people have lowered their pressure then watched to see if their AHI went up. If you did that for a few nights on your back and a few nights off your back it would be interesting to see the outcome. Good luck figuring things out.

As for sleep apnea and depression getting confused, sleep apnea can cause one to have similar syptoms as depression. Depression can cause similar symptoms as sleep apnea. But depression cannot cause a sleep study to be diagnostic for sleep apnea.

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Re: Sleep Apnea or Depression?

Post by TedVPAP » Sun Jul 16, 2017 8:19 pm

Jasba64 wrote:I've been using my Cpap machine in Apap mode. It's a temporary thing but works for now. I have a DreamMachine Pro. Here are my sleepyhead results for as long as I tracked them. http://jasba64.imgur.com/
Your numbers look bad when you run a fixed 9. Some of your numbers are very good when you had pressure between 12 and 15.
I would try a few weeks at that pressure (or 9) but try to sleep on your side. I use pillows to build a barrier to keep me on my side. Also keep a diary; making notes each morning and evening. I would definitely see a doctor.

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Re: Sleep Apnea or Depression?

Post by Jasba64 » Mon Jul 17, 2017 2:27 pm

My theory didn't work. I couldn't sleep without my mask. At midnight, I put it back on. I won't do that again. I did however turn off the pressure relief. The auto exhalation was driving me nuts while I tried to go back to sleep.

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Re: Sleep Apnea or Depression?

Post by guitarman1956 » Mon Jul 17, 2017 7:26 pm

Shift work? Your body has a clock and in your case, it doesn't have a chance to normalize/regulate. Not a mask on the market to fix shift related issues. Don't believe me? Ask yourself this: Is what I'm doing working?

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Re: Sleep Apnea or Depression?

Post by Jasba64 » Wed Jul 19, 2017 8:16 am

I turned the EPR off and my AHI is down to 1.7. The biggest issue I have is that I dream a lot and most of my dreaming is nightmarish and I tend to wake up 3 to 4 times during my sleep. I'll discuss this with my Sleep Doctor next week.

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Re: Sleep Apnea or Depression?

Post by TedVPAP » Wed Jul 19, 2017 7:28 pm

Jasba64 wrote:I turned the EPR off and my AHI is down to 1.7. The biggest issue I have is that I dream a lot and most of my dreaming is nightmarish and I tend to wake up 3 to 4 times during my sleep. I'll discuss this with my Sleep Doctor next week.
At what pressure?

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Use data to optimize your xPAP treatment:
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Re: Sleep Apnea or Depression?

Post by Jasba64 » Thu Jul 20, 2017 6:59 am

I am running it in Auto Trial from 9-15. 95% is anywhere from 9.5 to 10.5. I still have constant dreams and not nice ones which I end up waking up every 2 to 3 hours.

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