Feeling Tired With Cpap/Bipap. Why?

So you use the cpap/bipap and have success at maintaining an open airway and have good airflow through the nose. Why don't you feel rested? Well here is a theory and I would like to hear what others think as well as any studies or literature that shows how little annoyances can kick a person out of REM sleep or prevent it from occurring. How does one deal with this so that restful sleep can be achieved?

I think the annoyance of the mask on the face can kick a person out of REM sleep. Stuff like cold air leak, air noise, air pressure pulses, hose movement, ect. The face is very sensitive and the slightest touch, tickle, irritation is enough to kick you out of REM? Early in the sleep when a person is extremely tired you might not notice such irritations as much, but later in the nights sleep when the sleep is lighter facial irritations are much more noticeable. Even though your airway is open and your breathing your still not getting the full amount REM sleep that is needed. So you get tired early in the day as you have not been able to complete the full number of cycles of sleep for the nights sleep. The brain keeps trying to start a new cycle that will get to that needed REM sleep. Within an hour or two being awake the brain tries to start a new sleep cycle by putting you to sleep again. When you woke you may have felt OK, but after an hour or two you will feel extremely tired and that may carry on for the rest of the day. How does one deal with this side effect? Are there any drugs, herb, vitamins, minerals or techniques that will help maximize REM sleep so that little annoyances from the mask don't keep you from getting that needed REM sleep?

What other health problems might be a problem that would kick a person out of REM sleep? Centrals, heart weakness, drugs, pain, or what? What is the heart weakness where the heart does not tolerate lower blood oxygen levels?

How does a sleep doctor check to see that a person is getting the REM sleep that they need? Most of the sleep studies only last for 4 to 5 hours and they don't like to alter that. Most of the REM sleep occurs during the last couple of hours. Also being hooked up to all the wires is way more annoying than just the mask. So if a mask keeps you out REM then all the wires are really a pain in the but.

First, it's no longer believed that REM only occurs in the last few hours of sleep, but within 90 mins of lying down and in cycles thereafter (everything else being equal). And the EEG you're hooked up to at sleep studies detects if you're in REM or not. But if you're good at interpreting your software stats (as e.g. Pugsy is), you can get a good idea that way as well, another perk of following your own sleep rather than just depending on the doctors. Pugsy can probably explain it to you if you ask nicely . There are many things that can keep waking you up, however, not all of which are about REM, but one of which may be that if you're on Apap vs Cpap the machine's changing your pressures all night can be disturbing to some people and going onto straight Cpap may be in order.

Are there any devices that can determine when your in REM sleep with out doing the full eeg hook up on the head?

Going to ask you a question - what will knowing you're in REM or not at some time really help? You can't block REM sleep, and Cpap won't change it. What's important is fixing your sleep, whether it's related to REM or not. So it's important to have your overnight stats to read and to look at your sleep 'hygiene' otherwise, what else might be waking you up at those times, whether undiagnosed physical stuff, or meds, or diet, exercise, respiratory or neurological problems, anything. I don't know of other devices short of e.g. monitored MRI's that cost a fortune, or other serious neuro. things that look at REM in the way you'd like, but I think you can fix your problems without them.

borgready wrote:So you use the cpap/bipap and have success at maintaining an open airway and have good airflow through the nose. Why don't you feel rested? Well here is a theory and I would like to hear what others think as well as any studies or literature that shows how little annoyances can kick a person out of REM sleep or prevent it from occurring. How does one deal with this so that restful sleep can be achieved?

I think the annoyance of the mask on the face can kick a person out of REM sleep. Stuff like cold air leak, air noise, air pressure pulses, hose movement, ect. The face is very sensitive and the slightest touch, tickle, irritation is enough to kick you out of REM? Early in the sleep when a person is extremely tired you might not notice such irritations as much, but later in the nights sleep when the sleep is lighter facial irritations are much more noticeable. Even though your airway is open and your breathing your still not getting the full amount REM sleep that is needed. So you get tired early in the day as you have not been able to complete the full number of cycles of sleep for the nights sleep. The brain keeps trying to start a new cycle that will get to that needed REM sleep. Within an hour or two being awake the brain tries to start a new sleep cycle by putting you to sleep again. When you woke you may have felt OK, but after an hour or two you will feel extremely tired and that may carry on for the rest of the day. How does one deal with this side effect? Are there any drugs, herb, vitamins, minerals or techniques that will help maximize REM sleep so that little annoyances from the mask don't keep you from getting that needed REM sleep?

What other health problems might be a problem that would kick a person out of REM sleep? Centrals, heart weakness, drugs, pain, or what? What is the heart weakness where the heart does not tolerate lower blood oxygen levels?

How does a sleep doctor check to see that a person is getting the REM sleep that they need? Most of the sleep studies only last for 4 to 5 hours and they don't like to alter that. Most of the REM sleep occurs during the last couple of hours. Also being hooked up to all the wires is way more annoying than just the mask. So if a mask keeps you out REM then all the wires are really a pain in the but.

If you're using Auto mode with your BiPAP, I'd put money on the probability being that the pressure changes are bumping you out of your much-needed sleep stages. When you enter those deep or REM sleep stages, your breathing changes and can trigger pressure increases in your machine. When that happens, it can bump you out of those stages and into lighter sleep stages. You may not actually be awakened, but you're being deprived of the sleep stages you NEED. Consequently, you're dead-ass tired all the time.

Try straight bi-level settings (straight EPAP and IPAP).......not auto ranges.

I use straight bipap. Early in the nights sleep I have no problem sleeping with the pressure cycles or the mask. I'm totally out of it. After about 3 to 4 hours which should be should be about 2 to 3 sleep cycles, I wake up and start to notice the pressure changes, noise, mask irrations. If I take it off, I have no problem falling asleep. Sometime when I fall asleep dreaming starts as well. But being off the mask is very risky as there is a good 80% chance of the breathing being stopped for longer than it should and then you feel bad from it. If the REM/dreaming kicks in good, the not breathing is worse. What I have discovered is that it is so easy to fall asleep and enter dreaming with out the mask on and the machine running. So my theory is that since the REM is in lighter sleep all those little annoyances keep a person from getting to REM sleep. From my experience if you don't get that REM sleep in the last part of the night that is needed, the the brain keeps trying to get into another sleep cycle. If your up and doing things then your so tired and dosing off all the time.

I see people complaining all the time on this board that they use the machine and they are so tired from using it. Some of it is just getting used to using the machine for the newbies, but there is only so much to get used to. If anyone has ever messed with someones face while they are sleeping, it will usually wake them up temporarily. The face is really sensitive and little annoyances will kick a person out of sleep. Not enough REM sleep and the person is still tired. When you get that REM sleep and wake up after it, its like an orgasm, it feels oh so good to have a clear mind.

Has anyone found that using a drug or herb helps them get a restful nights sleep? I have heard that marijuana helps people sleep better.

The only time I wake up tired is if I get woken up in the middle of a sleep cycle. My cycles are about 90 mins long and I go from one cycle to another until I wake up normally at the end of a cycle. A urgent call, loud noises, storm outside that wakes me up in the middle of a cycle is like waking up from the dead.

Otherwise, I can wake up at the end of a cycle without feeling tired at all. Even in the middle of the night (like right now). Went to bed around 9pm and woke up at midnight (2 cycles)... no problem. hit the hay again around 2:30-3am and I will be fine in about 4.5 hours later with more than enough sleep and not feel tired when I wake up.

As for REM sleep, I have lots of dreams when I sleep. Those that I can remember typically have we walking all over the place which due to a disability is hard for me to do normally. Most mornings, I quickly forget what the dream(s) were or what they were about. I can have a number of different dreams a night. I rarely if ever have bad dreams... just walking all over the place. Virtual exercise is what I call it.

As for issues that happen at night... hose popping off, big leak etc.. I just adjust and fall right back to sleep. Don't normally bother me. I don't have those problems often though. I sleep pretty soundly and don't move around much when I sleep.

I almost never use an alarm clock for this reason.

Only thing that I use as a sleep aid occasionally is melatonin. Occasionally 1 tablet 15-20 mins before I go to bed rarely 2. Only for a day or two and then I don't use them. Using them everyday for me loses their effectiveness. More often than not, only when I don't work the next day.

borgready wrote:I have heard that marijuana helps people sleep better.

Most studies show that using THC or CBD effects sleep. It typically shortens the time to fall asleep, reduces the amount of REM sleep and increases the amount of slow-wave deep sleep. Many people report not having any dreams when using it.

However when you stop using THC, REM sleep many times comes back stronger for a few days before that wears off.

borgready wrote:I use straight bipap. Early in the nights sleep I have no problem sleeping with the pressure cycles or the mask. I'm totally out of it. After about 3 to 4 hours which should be should be about 2 to 3 sleep cycles, I wake up and start to notice the pressure changes, noise, mask irrations. If I take it off, I have no problem falling asleep. Sometime when I fall asleep dreaming starts as well. But being off the mask is very risky as there is a good 80% chance of the breathing being stopped for longer than it should and then you feel bad from it. If the REM/dreaming kicks in good, the not breathing is worse. What I have discovered is that it is so easy to fall asleep and enter dreaming with out the mask on and the machine running. So my theory is that since the REM is in lighter sleep all those little annoyances keep a person from getting to REM sleep. From my experience if you don't get that REM sleep in the last part of the night that is needed, the the brain keeps trying to get into another sleep cycle. If your up and doing things then your so tired and dosing off all the time.

I see people complaining all the time on this board that they use the machine and they are so tired from using it. Some of it is just getting used to using the machine for the newbies, but there is only so much to get used to. If anyone has ever messed with someones face while they are sleeping, it will usually wake them up temporarily. The face is really sensitive and little annoyances will kick a person out of sleep. Not enough REM sleep and the person is still tired. When you get that REM sleep and wake up after it, its like an orgasm, it feels oh so good to have a clear mind.

If you're using straight pressures, I'm not sure why you would be noticing "pressure changes".
So, my suggestion is to seriously study your nightly reports to see if you can spot things in there.
Maybe you could list ALL of your machine settings for us to review.