End Of Rope...New Sleep Study??

[Pugsy]

Your FL graph shows a little activity but not horrible amount. I doubt that is much of a factor.

Waking up and remembering it isn't necessarily abnormal. It's normal to wake up after REM cycle has completed. Most of the time the wake up is so short lived we don't remember it but on occasion we don't go right back to sleep and of course the longer we are awake the bigger the problem it creates.

For someone to actually turn the lights off and fall asleep and not wake up at all during the night until the alarm goes off...that's actually rare and an unrealistic goal.
But be want to limit the number of wake ups whenever possible.

I suggest that you continue the medication experiment even if you don't think that your are having that much pain.
Low level pain will definitely mess with sleep quality and just because we don't think it hurts all that bad...the discomfort can cause arousals.

Use the meds for at least a week...then don't use them for a week and keep a detailed log as to how you feel so that you can look back and see if there is any correlation that you can spot.

[msr0459]

Your FL graph shows a little activity but not horrible amount. I doubt that is much of a factor.

Waking up and remembering it isn't necessarily abnormal. It's normal to wake up after REM cycle has completed. Most of the time the wake up is so short lived we don't remember it but on occasion we don't go right back to sleep and of course the longer we are awake the bigger the problem it creates.

For someone to actually turn the lights off and fall asleep and not wake up at all during the night until the alarm goes off...that's actually rare and an unrealistic goal.
But be want to limit the number of wake ups whenever possible.

I suggest that you continue the medication experiment even if you don't think that your are having that much pain.
Low level pain will definitely mess with sleep quality and just because we don't think it hurts all that bad...the discomfort can cause arousals.

Use the meds for at least a week...then don't use them for a week and keep a detailed log as to how you feel so that you can look back and see if there is any correlation that you can spot.

Will do. I just hate taking any medication for extended periods of time. I've even read that nsaids such as naproxen can also be addictive, obviously not like benzos, but would make it harder to sleep upon stopping. IF taking meds for pain and/or inflammation helps with sleep, then what are ones alternatives? I do take fish oil, as well as turmeric, both of which helps with inflammation in the body... but don't really notice any difference with sleep.

[Pugsy]

IF taking meds for pain and/or inflammation helps with sleep, then what are ones alternatives?

I don't know. I would have to think on that one.
I can't take NSAIDs at all due to GI issues...so I have to take other stuff that probably comes with more problems than NSAIDs...if what you read is correct..which I don't know that I have ever read that they are widely known for being a problem with sleep like that.

I will say this...
which is worse...maybe having trouble later or for sure having trouble now?

I take a medication for pain that makes me a bit groggy the next day but it helps me sleep sounder.
If I don't take it then I don't sleep so great so I am groggy from poor sleep.
So I take it and I am still a bit groggy for a little while but the meds groggy is short lived and not as bad as the "poor sleep groggy with no meds". I have a choice...a little bit bad or a lot bad. Without the meds I feel much worse than with the minor side effect from the meds.

[Okie bipap]

I have taken high dose NSAIDs off and on for several years with no sign of addiction. I was on Motrin for several years, then they put me on Naproxen for several years, and now I take Celebrex for my arthritis.

[msr0459]

I will continue with the 440 mg naproxen 'maybe' combined with 500 mg Tylenol for the rest of this week. Should be a fairly easy comparison since last week sucked so bad. I've always been a light sleeper, so I suppose it's entirely probable that even the smallest amount of pain, even if it's undetectable to me, could be waking me up constantly.

Thanks everyone for all the input,

Marc

[Pugsy]

It's an easy and cheap experiment to make.

About pain and messing with sleep...you might read this recent thread of mine.
viewtopic/t156398/When-you-dont-always- ... mbers.html
I need to update it but just haven't had time. Will try to do it later.

It's still a work in progress but it's been a week now since the first procedure. I can speak from first hand experience how pain messes with sleep and how we feel. And it doesn't have to cause a full blow awakening that we realize and remember...it can just cause an arousal and the arousal messes with the sleep architecture. You end up with not enough sleep in the various stages that we need.

I can tell you this...I have felt better this past week and got more done than I have got accomplished in the last 12 months.
I wish I had done this years ago.
No its not perfect but it is so much better than the way I was...I don't care.

Right now I am doing some wood work. Long story but I am staining some boards to repair and old door and make it look pretty again.
No way would I have had the energy to tackle this project 2 weeks ago. Some days it was all I could do to muster up enough effort and movement to go pee.

[msr0459]

It's an easy and cheap experiment to make.

About pain and messing with sleep...you might read this recent thread of mine.
viewtopic/t156398/When-you-dont-always- ... mbers.html
I need to update it but just haven't had time. Will try to do it later.

It's still a work in progress but it's been a week now since the first procedure. I can speak from first hand experience how pain messes with sleep and how we feel. And it doesn't have to cause a full blow awakening that we realize and remember...it can just cause an arousal and the arousal messes with the sleep architecture. You end up with not enough sleep in the various stages that we need.

I can tell you this...I have felt better this past week and got more done than I have got accomplished in the last 12 months.
I wish I had done this years ago.
No its not perfect but it is so much better than the way I was...I don't care.

Right now I am doing some wood work. Long story but I am staining some boards to repair and old door and make it look pretty again.
No way would I have had the energy to tackle this project 2 weeks ago. Some days it was all I could do to muster up enough effort and movement to go pee.

Thanks for that. I continued my experiment last night. I wish I could say it was good, but alas I still woke up probably 6 times, and feel like crap today. The big difference is yesterday morning I was able to fall back asleep around 5:30, and slept until 7:30...can't do that during the work week. My wife has to be up at 6, so when I typically wake at between 4:30 - 5 ish, I never really get back to sleep. That combined with the multiple wake ups makes for a horrible nights sleep.

I will continue with 2 Naproxen this week though and see how it goes. I will probably take a temazepam this Wednesday just to ensure at least one decent night sleep.

Marc

[Pugsy]

Take a hard look at the number of hours of sleep you are getting when you feel good and when you feel bad.
6 wake ups in 8 hours isn't going to be as much of a problem as 6 wake ups in 6 hours in terms of how you feel.

[msr0459]

Take a hard look at the number of hours of sleep you are getting when you feel good and when you feel bad.
6 wake ups in 8 hours isn't going to be as much of a problem as 6 wake ups in 6 hours in terms of how you feel.

I see what you mean, although I find it difficult to tell how many actual hours of sleep either way. With insomnia we're not supposed to watch the clock. I do glance at my watch, usually upon first awakening, which is typically anywhere between 1 and 1.5 hours after falling asleep. After that I usually only glance at the time if I think it's getting close to 6 am.

Last night couldn't have been more than 4 or 5 hours total sleep time. On a good night it may be closer to 6.5 or 7, but again, that usually only occurs on a weekend day that I don't HAVE to get up early. Sometimes when I'm "at the end of my rope", I'll take a temazepam and sleep for up to 5 or 6 hours straight, then easily fall back to sleep for another hour or so. Oh, if those weren't so addictive, and if I didn't build up a tolerance so quickly, I'd just keep taking those, but alas, not the case.

Thanks,
Marc

[Pugsy]

Here's something you could maybe do that doesn't involve clock watching and remembering.

When you wake up..if you are alert enough just reach over and turn the machine off and then right back on again. This will show up as a break in the therapy line and give you an idea when and how often. It gives you something to use as a marker for known awake times that doesn't involve watching the clock or trying to remember anything.
If you are having trouble falling back asleep..every so often reach over and turn off/on again just so you will have a way to easily see when you were awake and having trouble getting back to sleep.

If you aren't alert enough to turn it off and back on again...that's okay too. This doesn't have to be perfect. Just want to have an idea when and how often you are at least alert enough to turn off and back on.

[msr0459]

Here's something you could maybe do that doesn't involve clock watching and remembering.

When you wake up..if you are alert enough just reach over and turn the machine off and then right back on again. This will show up as a break in the therapy line and give you an idea when and how often. It gives you something to use as a marker for known awake times that doesn't involve watching the clock or trying to remember anything.
If you are having trouble falling back asleep..every so often reach over and turn off/on again just so you will have a way to easily see when you were awake and having trouble getting back to sleep.

If you aren't alert enough to turn it off and back on again...that's okay too. This doesn't have to be perfect. Just want to have an idea when and how often you are at least alert enough to turn off and back on.

Good idea. For instance last night with the multiple awakenings, I only turned the machine off twice during the night to go pee. Some nights I'll go to the bathroom once, other nights maybe 3 or more. I'm convinced though that I go to the bathroom 'because' I'm up, I'm not up because I have to go to the bathroom.

Marc

[msr0459]

Here's something you could maybe do that doesn't involve clock watching and remembering.

When you wake up..if you are alert enough just reach over and turn the machine off and then right back on again. This will show up as a break in the therapy line and give you an idea when and how often. It gives you something to use as a marker for known awake times that doesn't involve watching the clock or trying to remember anything.
If you are having trouble falling back asleep..every so often reach over and turn off/on again just so you will have a way to easily see when you were awake and having trouble getting back to sleep.

If you aren't alert enough to turn it off and back on again...that's okay too. This doesn't have to be perfect. Just want to have an idea when and how often you are at least alert enough to turn off and back on.

I used the machine to log my wake ups, as you suggested. As you can see below, I found myself awake a total of 11 times! I really don't know what's going on here, as this past two weeks have been among the worst ever. I will usually get at least 2 or 3 decent nights sleep in 7 days. Today is in fact worse than yesterday. I will be taking a temazepam tonight, so hopefully I'll get at least one decent night.

[Pugsy]

Yep...and I bet that with the known 11 wake ups there are some arousals that you don't remember. We all have a few of those.

Sometimes meds are needed. There is a time and place for them. With my back pain issues I have been taking something ever since I started cpap.

Sleep maintenance insomnia is a bitch...even if we know what is causing it there isn't always an easy fix available.

As you can well see...your AHI is great and leaks are well controlled so on paper things look good in terms of the sleep apnea being treated.
But your sleep quality is in the toilet and we don't know why and that's why you feel like crap.
Unfortunately the cpap machine can't fix bad sleep when the bad sleep isn't caused by sleep apnea stuff.
Like I always say...getting the good numbers is easy...feeling them is a whole different ball game for any number of reasons.

[msr0459]

Yep...and I bet that with the known 11 wake ups there are some arousals that you don't remember. We all have a few of those.

Sometimes meds are needed. There is a time and place for them. With my back pain issues I have been taking something ever since I started cpap.

Sleep maintenance insomnia is a bitch...even if we know what is causing it there isn't always an easy fix available.

As you can well see...your AHI is great and leaks are well controlled so on paper things look good in terms of the sleep apnea being treated.
But your sleep quality is in the toilet and we don't know why and that's why you feel like crap.
Unfortunately the cpap machine can't fix bad sleep when the bad sleep isn't caused by sleep apnea stuff.
Like I always say...getting the good numbers is easy...feeling them is a whole different ball game for any number of reasons.

Took a temazepam last night. It usually works better than it did,... still had multiple awakenings, but feel waaay better than previous week and a half, so I think 'something' has to be going on internally. Maybe hormonally, chemicals?? Who knows. As usual, not sure what to do at this point. Taking temazepam every night would be a major double edge sword. I would sleep better for a while, not sure how long,.. but it would likely stop being effective like everything else. I went down that road with clonazepam a decade or so back. It does have a much shorter half life though.

Here's my data from last night:



Marc

[Pugsy]

Again not a lot on the report to blame the poor sleep quality on unless we want to maybe wonder about the Flow Limitations.
They aren't horrible but they are there. If you were using an apap machine in auto mode the machine would want to try to kill some of those FLs.

What happens if you were to use a little bit higher pressure? Ever tried that?
I don't know that it would help but it is something to try to see what happens.

You need to talk to your doctor about what could maybe be used to help sleep quality and reduce those awakenings.
Not everything out there comes with as much potential baggage as the temazepam. Sometimes we just need a little help and there is a time and place for that sort of help.

In terms of sleep studies. Here's the deal, while they can tell us when we wake up or have an arousal they can't really tell us why it happened unless the arousal happens with a known apnea event of some sort.
If you have ever read sleep studies you will see mentioned so and so number of spontaneous arousals. That means not related to a respiratory whatever but out of the blue and no known cause that they can put a label on.
In other words the information available during a sleep study doesn't always point to a reason for the arousal...just that the arousal happened.
Obviously extremely hard to fix a problem if we don't know the cause of the problem.