Sleep Issues That Go Beyond Cpap

[mookie]

I'm wondering if this is an appropriate place to potentially discuss alternative sleep issues that may go beyond cpap therapy?

[Pugsy]

By all means....go right ahead.
Bad sleep isn't always caused by sleep apnea and the cpap can't fix bad sleep if the reason for the bad sleep isn't apnea.

[zonker]

I'm wondering if this is an appropriate place to potentially discuss alternative sleep issues that may go beyond cpap therapy?

to add on to what pugsy says; insomnia. it seems to go hand in hand with sleep apnea for some folks. and hooking up to a machine isn't going to cure that.

and also, it's the reason the sleep hygiene list exists. if anyone is unaware of it, do a google search. while i don't follow the list religiously, the ones i do follow have helped my sleep enormously.

[mookie]

Thank you.

I've been on cpap therapy for I would say at least 10 years. I live up in one of the coldest darkest parts of Canada. I recently got a new cpap machine the ResMed Airsense Autoset 10 for her and i finally was able to add a heated tube. The tube was necessary because this time of year I need to run a room humidifier in order to allow my cpap water tank to last the entire night. This solution has worked well to allow for the proper level of humidity throughout the night. Im receiving very good sleep scores on the app. Between 95 and 98.

Im currently on a journey to defeat a problem I've had for 5 years. About 5 years ago after a mental and emotional breakdown as result of a toxic abusive relationship to a young lady who had undiagnosed borderline personality disorder. After it ended I gained a lot of weight and well my sleep was very disrupted from nightmares and constant flashbacks. At that time I pretty much could only be awake for maybe 8 hours out of the day. My physical and mental health has significantly improved. I went from 510 pounds to 320 and dropping. I no longer have flashbacks or nightmares. Instead of having to have 4 hour naps during the day i can now get away with a 45 minute nap on most days. However, it is very disruptive because my energy drops and my brain starts shutting down at unexpected times which makes me feel a bit trapped if im at a friends house or have responsibilities taken care of that require alertness. I have a job where I work from home so I can typically get a nap in when I need to but I don't want to be trapped in this career forever.

Before i forget i also have a major problem with teeth grinding at night and it has affected me with pain and I think poor sleep quality even with a night guard. I recently have seen improved results by getting botox shots in my masseteurs. But i will be needing a higher dose to completely eliminate the teeth grinding symptoms and this will happen next Wednesday.

I have recently started using a blue light for half an hour in the morning and throughout the day as energy lulls hit me and I've successfully gone 3 days without having a nap. However, It's still a real struggl to push through these energy lulls and i only have 3 or 4 peak hours of mental alertness in the morning and the rest of the time im just pushing through. I have been sleeping for between 8 to 8.5 hours per night and consistently wake up at 7:30am. Ive spoken to doctors about this in the past but they just give me blank looks and want to prescribe me modafinil. I was on it and it helped but it certainly didn't solve the underlying problem and it can be cost-prohibitive. Im wondering if anyone else has dealt with something like this before and if so what they did to beat it and how long it took?

Thanks!

[Pugsy]

Do you wake often during the night?

Are you on any medications at the present time? If so, what?

Is your main issue the daytime need to nap and mental clarity stuff?

Are we sure that your cpap therapy is optimized and there's nothing in there that could stand improving....like what is the overall average AHI and leak rate?

[mookie]

Do you wake often during the night?

Are you on any medications at the present time? If so, what?

Is your main issue the daytime need to nap and mental clarity stuff?

Are we sure that your cpap therapy is optimized and there's nothing in there that could stand improving....like what is the overall average AHI and leak rate?

I don't wake up often during the night. Yes the main issue is with mental clarity and the feeling like the only thing that will solve my problems is a nap mid day. I don't currently have a way of reading data from an SD card so i have been somewhat restricted to the data the app provides. Im going to go out right now and buy an SD card reader so i can post my results.

I use zopiclone to help me sleep at night and because it help to keep my nightmares in check. I also had A.D.D. and take 20MG of Vyvanze upon waking up. It definitely promotes mental energy but my concern is that perhaps my issues are somewhat related to what happens when the stuff wears off.

I should add that i do yogo 3 days a week and im eating in a calorie deficiency in order to maintain long term weight loss.

[Pugsy]

There is some data on the machine's LCD display under the sleep report. Do you have that available?
If not you just need to change a little setting in the clinical setup menu so that you can see the sleep report on the LCD screen.
See the manual here for how to get into the clinical setup menu area if you don't know how.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

The setting is "Essentials" and you need to change it from "On" to "Plus" and then you have some basic information available on the machine itself. AHI, pressure, 95% leak numbers and even category of events.

I will talk about the meds in a minute.

[zonker]

Thank you.

I've been on cpap therapy for I would say at least 10 years.

on the plus side, you have taken some very positive steps to take care of yourself. i hope that you are proud of yourself.

i have tried to get yoga in at least once per week. however, i'm temporarily in position that makes that difficult. i am doing water aerobics once a week and an hour walk every day. so i know the value of keeping the body going.

as pugsy suggests, a large part MAY be that your therapy is not optimized. that's not to discount the other things. the certainly play a part. but if that data from the machine can be displayed here, with the sd card adapter, it could play a big part too.

in the meantime, what does the data on the little screen show as your ahi?

good luck!

oh and eventually you may want to download oscar and start posting some data.

[Pugsy]

Talk to your doctor about your ADHD med...
https://www.healthline.com/health/adhd/ ... withdrawal
I wonder if you are experiencing the crash.
Also...it's known to mess with sleep architecture and cause the sleep you do get to be less restorative. You don't get the normal progression of each sleep stage and the needed percent in each stage to have the best chance of your sleep being restorative.
Might get too much light sleep and not enough deep sleep kind of thing.

zopiclone... What dose do you take? Every night? How long?
https://en.wikipedia.org/wiki/Zopiclone
It is well known to mess with sleep stage architecture and decrease REM and REM is a big part of restorative sleepy cycling.
https://www.drugs.com/cons/zopiclone.html
The half life is relatively short but long term it can build up and cause excessive sleepiness the next day.

Extra care is needed when taking zopiclone because it can cause sleepiness and affect your concentration the next day. Drowsiness can last for at least 11 hours after taking your dose.

Daytime drowsiness is a well known side effect.

Now I am NOT saying that you shouldn't be taking these medications. That is between you and your doctors BUT either one or the combination could be playing a factor in your unwanted daytime symptoms.
There's always a risk vs rewards with any medication. Meaning the problems the medications seem to help fix might be bigger problems than the unwanted daytime symptoms problem. That's between you and your doctor...
I can't say for sure how much of an impact that they are playing but I am betting that they are playing a part.
One by itself is enough...the two of them together almost certain at least a partial factor.

In the meantime...let's see what your machine says is going on. Maybe there's something in there standing up just screaming "fix me and you will feel better"

[mookie]

Here is my sleep data from last night.

[mookie]

Thank you.

I've been on cpap therapy for I would say at least 10 years.

on the plus side, you have taken some very positive steps to take care of yourself. i hope that you are proud of yourself.

i have tried to get yoga in at least once per week. however, i'm temporarily in position that makes that difficult. i am doing water aerobics once a week and an hour walk every day. so i know the value of keeping the body going.

as pugsy suggests, a large part MAY be that your therapy is not optimized. that's not to discount the other things. the certainly play a part. but if that data from the machine can be displayed here, with the sd card adapter, it could play a big part too.

in the meantime, what does the data on the little screen show as your ahi?

good luck!

oh and eventually you may want to download oscar and start posting some data.

Sorry to hear you're in a temporary position where yoga is not an option. I imagine you're recovering from some sort of injury? I have osteo arthritis in my knees so i know what it's like to be limited.

[mookie]

Here is the one from 2 nights ago.

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3.PNG (10.66 KiB) Viewed 14844 times

[mookie]

Talk to your doctor about your ADHD med...
https://www.healthline.com/health/adhd/ ... withdrawal
I wonder if you are experiencing the crash.
Also...it's known to mess with sleep architecture and cause the sleep you do get to be less restorative. You don't get the normal progression of each sleep stage and the needed percent in each stage to have the best chance of your sleep being restorative.
Might get too much light sleep and not enough deep sleep kind of thing.

zopiclone... What dose do you take? Every night? How long?
https://en.wikipedia.org/wiki/Zopiclone
It is well known to mess with sleep stage architecture and decrease REM and REM is a big part of restorative sleepy cycling.
https://www.drugs.com/cons/zopiclone.html
The half life is relatively short but long term it can build up and cause excessive sleepiness the next day.

Extra care is needed when taking zopiclone because it can cause sleepiness and affect your concentration the next day. Drowsiness can last for at least 11 hours after taking your dose.

Daytime drowsiness is a well known side effect.

Now I am NOT saying that you shouldn't be taking these medications. That is between you and your doctors BUT either one or the combination could be playing a factor in your unwanted daytime symptoms.
There's always a risk vs rewards with any medication. Meaning the problems the medications seem to help fix might be bigger problems than the unwanted daytime symptoms problem. That's between you and your doctor...
I can't say for sure how much of an impact that they are playing but I am betting that they are playing a part.
One by itself is enough...the two of them together almost certain at least a partial factor.

In the meantime...let's see what your machine says is going on. Maybe there's something in there standing up just screaming "fix me and you will feel better"

I will talk to my doctor. The Vyvanze is pretty essential especially since it helps with binge eating as well as other impulsive decision making. 2 year ago I tried going off medication completely but I needed even more sleep. The zopiclone is 15mg per night.

[colomom]

Congrats on the weight loss, what an incredible achievement!

My son has had great success with using light therapy to treat a circadian rhythm disorder. When using light therapy to treat sleep disorders timing, consistency, and duration of use are all critical factors. I think using the light at random times throughout the day to wake yourself up may not be advisable because it could reek havoc on your circadian rhythm. If you are able perhaps try a brisk walk to the sun to stave off the daytime fatigue.

Considering you are having to take a pill to fall asleep and then a pill to stay away it would be reasonable to ask your docs to look a little deeper to make sure you don't have any additional sleep issues going on.
Have your docs ever considered doing actigraphy or an MSLT? Actigraphy is a watch like thing you were for a couple of weeks that records when you are awake and asleep both day and night (similar to a fit bit). It can be useful in diagnosing circadian rhythm disorders. A Multiple Sleep Latency Test is a day time sleep study in which you try a series of scheduled naps.
Good Luck!

[mookie]

Congrats on the weight loss, what an incredible achievement!

My son has had great success with using light therapy to treat a circadian rhythm disorder. When using light therapy to treat sleep disorders timing, consistency, and duration of use are all critical factors. I think using the light at random times throughout the day to wake yourself up may not be advisable because it could reek havoc on your circadian rhythm. If you are able perhaps try a brisk walk to the sun to stave off the daytime fatigue.

Considering you are having to take a pill to fall asleep and then a pill to stay away it would be reasonable to ask your docs to look a little deeper to make sure you don't have any additional sleep issues going on.
Have your docs ever considered doing actigraphy or an MSLT? Actigraphy is a watch like thing you were for a couple of weeks that records when you are awake and asleep both day and night (similar to a fit bit). It can be useful in diagnosing circadian rhythm disorders. A Multiple Sleep Latency Test is a day time sleep study in which you try a series of scheduled naps.
Good Luck!

Thank you for the response. Part of my issue is that I receive poor doctors care. Im currently without a family doctor and on a waiting list which could take as long as 2 years. I only have access to walkin doctors. That's Canadian health care for you!