Rem rebound????

I have been using CPAP faithfully for about 3 months now and originally I felt a lot better. About a month ago, by fatigue level got worse - not as bad as pre-CPAP - but enough for me to doubt what is going on. I am tired and unmotivated inthe day - almost as if I never wake up fully or are still "perturbed" fromt he strange REM world I now seem to be experiencing.

Now my AHI's read about 0.5 down to 0.0 - no events. I sleep like I am drugged! I have never REM'd like this ever before! Now I don't remember my dreams, but wake up as if I came from this nightmare torture chamber (no sex dreams yet - or I wouldn't mind so much)! Pre-CPAP I didn't REM or dream much at all. I guess I have been doing this for at least 30 years - so the change may take some time to get used to.

Now if I get REM rebound right - my body (and mind) are not used to this new life. I am hard to wake up and feel out-of-it for a while until I can get my coffee down in the AM. This is awfully strange! Any insights - and will it get better? I seem to have traded one problem for another. BTW - oximeter data confirms my lack of AHI - no desats to speak of. "technically all looks good. Its the "feel good" part that is not quite right. Any ideas??

Anything?????? Thanks.

Did you toss and turn pre cpap? I'm thinking that maybe now you are so still, that perhaps your body is fatigued from lying in the same position all night long, on a bed that may no longer be suitable.

I'm not up on the rem rebound phenomenon. Are you taking other meds which may have an impact?

I was told that REM rebound would occur around week 4 of CPAP treatment, and that is exactly what happened to me. I was also told that it would last a couple of weeks, which it did.

After 4 and a half months, I have had no relapse with tiredness at all. (Fingers crossed).

We see REM rebound in the sleep lab and many patients awaken feeling like they were beat with a stick. You'll catch up and this should go away...any others on how long this takes? You might be sleeping too long. On CPAP if I sleep more than 7.5 hrs I feel drugged all day, just an idea.

I was told a period of sleeping 10 -12 hours and having lots of dreams and feeling tired on waking up was just making up a sleep deficit and when this deficit was accounted for, things would get better. And they did.

I'm probably way off base but I'll throw it out there anyway. My husband had 2-3 days of this fatigue/sleepiness a few months ago after having been well adjusted for almost 2 yrs. Data didn't show anything amiss. So Mama Bear stayed awake to observe(I guess I'm nuts!) and lo and behold after about an hour of his usual side sleeping he turned onto his tummy which used to be his favorite position pre-cpap. He then proceeded to bury his face into the pillow blocking the vents! He won't dare do that again!

If OP were blocking the vents, wouldn't the oximeter data show?

That's a good question, what happens to the 02 levels when you're rebreathing CO2?

DoriC wrote:That's a good question, what happens to the 02 levels when you're rebreathing CO2?

As long as it is not a closed system e.g. a plastic bag, O2 levels actually go up!! But If you rebreathe too much co2 you will get headaches, shortness of breath and generally feel lousy.

DS breathing means Dead Space.
http://chestjournal.chestpubs.org/conte ... .full.html

Respiratory Effects: DS breathing resulted in a consistent reduction in the apnea index from 29 . 7
to 1 . 1 events per hour (p . 0.01). The AHI also was significantly reduced (43 . 7vs9 . 4 events per
hour, respectively; p . 0.01) [Fig 1, 5]. The Petco2 showed only a slight increase of 1.8 mm Hg during
DS breathing compared to non-DS breathing (40.7 . 2.7 vs 38.9 . 2.6 mm Hg, respectively; p . 0.05).
The minimum Sao2 (93.1 . 1.0% vs 89.6 . 1.3%, respectively; p . 0.01) and mean Sao2 (94.4 . 1.0% vs 93.5 . 1.1%, respectively; p . 0. 01)
improved significantly with DS breathing, with no change in the maximum Sao2 (95.0 . 0.9% vs
94.9 . 1.1%, respectively; p . 0.47). The magnitude of oscillation in the Sao2 was reduced with the
DS breathing as well (Sao2 from maximum to minimum, 5.5 . 0.9% vs 1.8 . 0.4%, respectively;
p . 0.01) [Fig 1, 6].
Cardiovascular Effects: DS breathing did not change the heart rate (65 . 6vs66 . 6 beats/min,
respectively) or the number of ectopic beats (1.5 . 0.7 vs 1.9 . 0.8 events per hour) during
sleep.

Thanks. I have no new events - if anything, I am just sleeping better. I still only average about 7 hours a day at most. Perhaps it's just seasonal - or even emotional, though California has had a decent fall as far as sun and warmth goes - at least northern California.

I really dream like I have never dreamed before! I never really remember much of them, but it seems as if I dream all night. My apnea wasn't that bad - AHI 13.6 originally. Last night it was 0.1. But the dreaming was intense. I guess I will just deal with it and see how my body adapts. Perhaps I have had apnea such a long time that it is a real jolt to the system.

The weird part is that I have taken Adderall (Amphetamine) for ADD form many years now - and it seems to have lost much of it's effectiveness. Seems odd but coincidental.

Bumping this instead of starting a new thread.

Today's my seventh day of CPAP therapy, and the results have been less than . . . immediate.

To give you all some background, my OSA is diagnosed as mild (11/hour), but mostly occurring during REM sleep, so the effect is considered moderate. It certainly felt moderate or stronger, and required going home from work once or twice--not something I can afford to continue in my position.

My interim solution (while waiting for a sleep study and ensuing titration) was to sleep on the couch, elevating my sleep angle to 30 degrees--this appearing to alleviate the worst of the symptoms, although of course as an anecdotal trial it wasn't rigorously scientific.

CPAP therapy started on December 31, which seemed as good a time as any. I've stuck pretty rigidly to it. The results, so far, seem to be an outbreak of acne on my nose, and a tendency to wake up every one to two hours; often, though not always, from dreams in which I'm aware of the idea of waking up. (The mask and machine don't seem to be an issue, though the mask can be a little painful on the nose when I do wake up.) What I can confidently say is that I haven't slept for more than two hours straight through since starting the therapy, despite sleeping in total from between seven and nine hours a night.

If anything, I'm more tired than I was while employing the interim solution. Scratch that--I am more tired. And while I haven't returned to the concentration loss of a few months ago (when my daytime symptoms became severe), I do seem to be almost unrelentingly, consciously sleepy in a way I hadn't experienced before.

The good people at the Woolcock Clinic (Sydney, Australia) told me all about REM rebound, and I wonder whether this could explain the present case. Having read elsewhere today that it can last up to a year, I'm wondering if anyone here has experienced anything similar.

You've just started so keep it up. Many find the sleep disruption you are experiencing diminishes over time. Perhaps REM rebound also. Do have any data from your cpap machine? If you do this information can help determine if your OSA is well treated. Consider the possibility of mouth breathing also (data can help here also).

After some weeks if you still sleep/feel this way you should follow up with your doctor.

As for your nose...there are a number of solutions...Remzzzs (cloth liner), mole skin place on your face or mask at the point of contact, Sleep Confort care pad might help (http://www.sleepcomfortcaresystem.com), Good luck.

spurious wrote:(The mask and machine don't seem to be an issue, though the mask can be a little painful on the nose when I do wake up.)

The mask probably really is the problem... possibly causing just enough pain to cause an arousal. Even if a mask is fairly comfortable, there could be times your sleeping brain becomes aware "there's something on the face" and wakes you to do something about it. Nothing about sleeping with a mask on the face is "natural," so it can take quite some time, even with a very comfortable mask, for some people to get used to sleeping this way.

Another possibility is the main air hose might be tugging on the mask when you move your head in your sleep, or turn over. Mask getting tugged and nudging the face when you move could wake a person.
LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

If the mask causes any pain whatsoever, that will prolong the "getting used to it." I'm a big believer in comfort, so you might want to look into Big Daddy's suggestions for ways to ease the pain the mask is causing on your nose. If padding doesn't help, you might want to see about getting a different mask altogether.

I doubt REM rebound is causing wakeups. The mask is the much more likely culprit, imho.