Can sleep apnea contribute to an early onset of REM sleep?

I know that things such as Narcolepsy can cause REM sleep to happen quicker than normal. Though, I was wondering if the sleep deprivation effects of sleep apnea could also cause the same thing? I've read posts where some people have said that they didn't dream much with their sleep apnea, until they got treatment. Though, I usually remember dreaming multiple times a night, and I tend to dream during naps too.

beyondtired wrote:I was wondering if the sleep deprivation effects of sleep apnea could also cause the same thing?

Yes. It's called REM rebound...dramatically increased amounts of time spent in REM (Rapid Eye Movement) for several nights when finally getting effective CPAP treatment, and perhaps going into REM more quickly. In normal sleep, the first period of REM usually happens about 90 minutes after a person goes to sleep and lasts just a few minutes. Each REM cycle thereafter happens about every 90 minutes and each REM cycle is usually longer than the preceding one. The longest time spent in REM (in normal sleep) is the final REM cycle before a person wakes up in the morning.

Apneas are most apt to hit most people who have Obstructive Sleep Apnea when that person is in REM. If a person's untreated obstructive sleep apnea keeps arousing them out of REM or prevents them from reaching REM, or allows them to get just a smattering of REM here and there, that person probably will have REM rebound when they start using effective CPAP treatment. Of course, the sleep disruptions and arousals that the CPAP mask can cause for many people takes some getting used to. Equipment related annoyances (particularly from the mask) can interrupt a person's sleep and keep them from getting healthy amounts of stages 2, 3, and REM. Until the person gets all the CPAP machine/mask pieces of the puzzle in place and can sleep comfortably so that CPAP can do its job effectively all night long, they still might not spend sufficient time in each stage, and might still have disrupted REM.

A CPAP user might, or might not, wake up long enough during a period of REM to be aware of having a dream. If the person doesn't happen to wake up long enough (long enough to commit the fact of noticing "I was dreaming" to memory) during REM, the person could very well get up in the morning thinking, "Gee, I didn't have any dreams last night... wonder if something's wrong?!!" They could have been dreaming up a storm, and just not be aware of the dreams because their sleep was undisturbed during the dream. They slept straight though them. They never woke up long enough (I think it has to be at least a 15 second wakeup to be "awake" enough to be able to "remember" something) during a dream to be aware of "dreaming."

When you read people saying they didn't dream before CPAP and now have tons of dreams.... and others saying they used to have dreams before CPAP and now don't ever have dreams anymore .... bear in mind there's a big difference between truly "not dreaming" and simply "not being aware of having dreamed."

LINKS to dreaming - dreams - REM rebound
viewtopic.php?t=3524

Also, if you mean sleep onset REM, yes, OSA seems to be associated with that in some people, especially males:

http://ajrccm.atsjournals.org/cgi/conte ... /161/2/426

On a personal note, I had that pretty badly myself, before treatment. I would often even start dreaming very vivid dreams before fully asleep. Now that my OSA is treated with PAP, that never happens to me.

rested gal wrote: Apneas are most apt to hit most people who have Obstructive Sleep Apnea when that person is in REM. If a person's untreated obstructive sleep apnea keeps arousing them out of REM or prevents them from reaching REM, or allows them to get just a smattering of REM here and there, that person probably will have REM rebound when they start using effective CPAP treatment.

Wonder if this might explain some of those horrible event clusters I had for the first few months of my therapy? I have mild OSA in non REM sleep and severe in REM (over 50 events per hour). At about 4 or 5 months of therapy I started to see less and less clusters. No change in pressures. I just let the APAP deal with them. Now as I look back on my stuff for the past year I rarely see anything that resembles one of those clusters. I can sometimes spot what is likely REM cycle because of timing and maybe a wee bit of a leak probably from toss and turn or occasional tiny pressure increase or and event. I do know that those clusters when I had them, sure corresponded to REM cycles. I used to think they were because I was on my back but I sleep on my back a lot now and still don't have the clusters any more. Just wondering out loud.

Thanks for the replies. Yeah, I must wake up after a lot of my dreams, like rested gal mentioned, since I remember so many of them afterwards. They usually tend to be real vivid dreams. I have similar experiences to jnk, in that it feels like I'm starting to dream, even before I'm asleep. I'll start to get dream like images that pop into my head shortly before I'm ready to dose off. I know that these things can also happen with Narcolepsy, so that concerns me, and I'm worried that I might have that.

During a recent overnight sleep test, I was diagnosed with mild sleep apnea. I'm going to discuss more about that in another thread. I have to go back in a couple weeks to have a PSG with CPAP titration. I thought I barely slept at all during the PSG, but somehow I was able to get 228 minutes of sleep(I found this out later at my sleep doctor's appt). I also had an MSLT the next day. I was surprised that they still had me do the MSLT.. cause they had told me the night before that I needed six hours of sleep during the PSG, for the MSLT to be considered valid. I was really anxious during the MSLT, cause I didn't think they were going to have enough info from the PSG, and I only fell asleep during one of the naps, and I didn't go into REM sleep.

Though, normally at home, I know that I dream like everytime that I take a nap, cause I will remember dreaming after awakening. I also noticed that during the PSG, I went into REM sleep about 13 minutes after falling asleep, but I only got a total of 1.3% of REM sleep? I hadn't remembered dreaming at all during the PSG, and the low 1.3% of REM sleep shows that. Though, that doesn't sound like a typical night of sleep for me, since I usually have several dreams each night. Maybe I didn't sleep long enough to get further into the REM stages of sleep that night? I know that some dreams can occur in other stages of sleep, besides the REM stage. So maybe some of the dreams I have at home are outside of REM sleep? Though, those types of dreams aren't usually supposed to be as vivid as the dreams that happen during REM sleep right? Or maybe I'm analyzing this too much?

beyondtired wrote:Or maybe I'm analyzing this too much?

Maybe and maybe your "maybes" have merit. We have all done the maybes and what ifs with this OSA stuff. It is rare that a night in a sleep study comes anywhere near what we do in our own beds night after night. I had to go for a second study for the titration also. I didn't get enough sleep with enough indicators to qualify for split night. I forget exactly how many minutes I even got on the titration study but it was less than 3 hours.

It is okay to do the "maybes" and "what ifs" but don't beat yourself up over it. Spend the time educating yourself on what you know that you have and how best to manage it. That titration study will eventually happen but it does seem like a long time. I had to wait a little over 3 weeks and it was a very long 3 weeks.

beyondtired wrote:I know that things such as Narcolepsy can cause REM sleep to happen quicker than normal. Though, I was wondering if the sleep deprivation effects of sleep apnea could also cause the same thing? I've read posts where some people have said that they didn't dream much with their sleep apnea, until they got treatment. Though, I usually remember dreaming multiple times a night, and I tend to dream during naps too.

Do you take any of these Rx?

"all selective serotonin reuptake inhibitors, mixed serotonin/norepinephrine reuptake inhibitors, and tricyclic antidepressants cause sleep abnormalities to some extent. These antidepressants have marked dose-dependent effects on rapid eye movement (REM) sleep, causing reductions in the overall amount of REM sleep over the night and delays the first entry into REM sleep (increased REM sleep onset latency (ROL)), both in healthy subjects and depressed patients. The antidepressants that increase serotonin function appear to have the greatest effect on REM sleep. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. Following discontinuation of therapy the amount of REM sleep tends to rebound. Some of these drugs (i.e., bupropion, mirtazapine, nefazodone, trazodone, trimipramine) appear to have a modest or minimal effect on REM sleep."

beyondtired wrote: Yeah, I must wake up after a lot of my dreams, like rested gal mentioned, since I remember so many of them afterwards. They usually tend to be real vivid dreams.

I used to say that I felt like I was up all night watching movies. Lately it's happening again. I have a lot of trouble waking up anyway, and I just keep getting sucked down by what I call the "undertow" and I start dreaming all over again. My alarm can go off and 2 minutes later I'm dreaming again. This can go on numerous times. I don't remember my dreams as well as I used to, though.

I have similar experiences to jnk, in that it feels like I'm starting to dream, even before I'm asleep. I'll start to get dream like images that pop into my head shortly before I'm ready to dose off.

This I don't have.

I also had an MSLT the next day. I was surprised that they still had me do the MSLT.. cause they had told me the night before that I needed six hours of sleep during the PSG, for the MSLT to be considered valid.

So they were aware of the recommended guidelines, and did the MSLT anyway?! You were diagnosed with a disorder, which is one reason not to do the MSLT AND you didn't get adequate sleep the night before, which is another reason not to have done it. All this notwithstanding the many other reasons an MSLT might not have been appropriate. So I'd like to know, what was their reason for overriding the guidelines and doing it? (Tell them that SleepingUgly wants to know. )

Though, normally at home, I know that I dream like everytime that I take a nap, cause I will remember dreaming after awakening.

But how long is your nap? It's not abnormal to dream during a nap, only to go into REM too quickly. And with an untreated sleep disorder, all bets are off because it can be due to sleep deprivation or REM rebound.

I know that some dreams can occur in other stages of sleep, besides the REM stage. So maybe some of the dreams I have at home are outside of REM sleep? Though, those types of dreams aren't usually supposed to be as vivid as the dreams that happen during REM sleep right?

I don't know much about that.

Or maybe I'm analyzing this too much?

Well, you're worried about narcolepsy. Why is that?