First appt with sleep Dr. after starting CPAP

I just got home from my first follow-up appointment with my sleep doctor. I started on CPAP 5 nights ago. As expected, the appointment lasted less than 5 minutes and she rushed through everything, she said "things looked great, lose weight, and see you in a year". I hope there are other sleep doctors out there that are more involved!

Anyway - it was still a bit of an eye-opener. I had a terrible first sleep study with 241 arousals in 194 minutes of sleep. I'd asked for and received a copy of that report and wasn't too surprised that I barely had any time in Stage N3 or REM sleep (.5% & 2.8% respectively) since I thought this was pretty typical for me for most of my adult life. After my first few nights of using my CPAP, I was very discouraged thinking that although my apnea is being treated successfully (drastic improvement there) I felt like my overall sleep quality would not improve since I've had this pattern of never getting to lower levels of sleep that predated my apnea by about 30 years! (Here's my recent thread about that: viewtopic.php?f=1&t=74717&st=0&sk=t&sd=a#p685081)

I had also requested the report from the titration study, but hadn't received it until the doc gave me a copy today. I was SHOCKED to see the change in my numbers! My RDI was down from 34.3 to 2.9, arousal index down from 74.5 to 13.3. But most shocking was my sleep stage percents. With the CPAP I spent 29.5% in Stage N3 and 33.3% in REM (was .5% & 2.8%)!! Gigantic difference! I had no idea that it would ever be possible for me to get any decent amount of time in those stages.

Granted, the night of the second study I was ridiculously exhausted from almost no sleep the night before. I could barely stay awake while they wired me up. So that may account for some of the really deep sleep - but the point is I AM capable of really deep sleep and I had totally convinced myself that I wasn't capable of that and probably never would be. I suspect that a "new" typical night will fall somewhere in between. Even still, I feel like I've been given a golden key to a magic world of sleep!!

So, the biggest change I see I need to make is in my attitude and basic belief that decent sleep is possible and even likely now. I also need to increase my time in bed, because even at my improved sleep efficiency, 7 hours in bed still equals less than 6 hours of sleep.

One thing I was't able to get cleared up with the doctor was the question of my snoring. Both reports said, "Loud snoring was present" and my SleepHead data shows an average of 130 snore events per night with most in the 40 range. I think that is a lot. But when I asked her about is, she checked the data my DME sent over and said "it doesn't say anything about snoring". So, she blew off the question. Is this something I should be concerned about? I noted from my SH data that my waking episodes don't seem to correlate with my loudest snoring, so I don't think I am waking myself up (though maybe the neighbors!) Just wondering why she wouldn't have received any information about that from the DME when they are getting phoned in all the info from my machine - supposedly the same info I am reading with the SleepyHead program (right?)

Sounds like you're moving in the right direction! Congrats!

Yes, you CAN learn how to sleep more normally--but it takes time. How long is very individual. Like you, I had spent about 30 years not sleeping much so once I got all the bugs and kinks worked out with my machine, I started working on sleeping better. I've been working on improving my sleep for a little over a year now and there is progress, although it isn't as fast as I'd like, it is still progress.

If you have insomnia in addition to lacking sleep cycles, practice really really really good sleep hygiene (Robysue has great posts on this and I think she has a blog on this now).

Mostly just give yourself time. Eventually your body will learn that it is really SAFE to go into those deep sleep stages and you will begin to have those deeper sleep stages every night. Your body/subconscious learned not to sleep deeply in order to keep you alive and now it has to unlearn that and learn to trust that the machine will prevent your apneas; fortunately, our bodies are very smart and will unlearn those old patterns and develop new patterns.

Weezy

ohwhatanight wrote:Just wondering why she wouldn't have received any information about that from the DME when they are getting phoned in all the info from my machine - supposedly the same info I am reading with the SleepyHead program (right?)

DME has access to Encore Pro..whether they use that access to see the full details available in Encore Pro (and yes snoring is available in Encore Pro daily detailed graphs) is anyone's guess. Did you actually see what the DME sent over?
It is very possible that the DME sent over summary report only. Snoring is in the daily detailed data only.
My summary reports don't even mention snoring in Encore Pro. Here is a typical 1 week summary and most often what a DME will gather and use for reporting.

Thanks for the encouragement, DocWeezy! I am hoping that just knowing now that I CAN sleep better will help me actually relax enough to be able to do it more. I've read her blog about sleep hygiene and actually had a nice long conversation with her about it yesterday so I am planning on making whatever changes I still can.

I'd love it if there was an way to see the sleep stage data at home but I know you need an EEG for that. That info would be very interesting to me and put a lot of my anxiety to rest (all pun intended!)

Pugsy, thanks for posting the summary chart - that looks exactly like what my doctor had. I talked to my DME today and she said she didn't have the detail report either (though someone there does) and that I have probably seen much more detail than she has. She said if I see that my snoring looks like it is still an issue after a while longer to talk to my doctor about it and she can increase the pressure a bit more.

ohwhatanight wrote: I'd love it if there was an way to see the sleep stage data at home but I know you need an EEG for that. That info would be very interesting to me and put a lot of my anxiety to rest (all pun intended!)

If you don't mind spending a bit of $$, get yourself a Zeo. It's got some kind of a EEG in it and it does the sleep stages. It only claims to be 75% accurate, but that's actually pretty good most of the time---particularly when you're starting from almost 0% Stage 3 and 2.8% REM.

You can even export the Zeo data to your PC and then import it into SleepyHead, where you'll get a more detailed sleep stage graph than you see on the Zeo web page.

How cool is that!! I had no idea there was this technology for home. I'll have to check it out. Thanks! I thought it would be years, even decades before something like that would be available.