Not able to go into deep sleep stage, feedback appreciated!

[cubism_dream]

Hello, Fellow Hoseheads,

For the past few nights, I've been able to keep my nasal pillows on throughout the night (getting 6-8 hours of sleep), yet I wake up unrefreshed and foggy, and wake up a few times in the middle of the night. I'm just not getting into a deep sleep stage. What is the issue? Everything seems to be okay. My pressure is 8-12 APAP, EPR 1. My 95% is at about a 9. My leak level seems insignificant. I feel like I'm experiencing mouth leaks, but I wear a chinstrap. I go to bed around 11pm and get up at 7am. The humidity level on my ResMed S9 Autoset is set at 5.5/6, climate control at 85 degrees (F). I'm taking Mirtazapine to treat depression. My mood has improved because of it and the medicine actually helps me fall asleep.

Despite my few successful nights, over the past few weeks, I've been struggling to sleep with my mask on throughout the night. Sometimes I would doze off in bed without my mask on and wake up in the middle of the night to put it on. I've made a rule for myself that if I'm going to climb into bed, I must put on my mask. So would this inconsistency affect my ability to achieve restful, deep sleep? One thing I want to add is that I've been feeling stressed and anxious for the past few days, so that may possibly be the cause of my grogginess and fatigue.

I'd rather not post a new thread, but my last post (viewtopic.php?f=1&t=84551&p=767169#p767169) received zero responses, yet over 100 views.

Thanks for taking the time to read this, I'll respond to replies ASAP.

[cosmo]

How do you know you are not getting into deep sleep stage?

[lazer]

I have not read up on Mirtazapine, however note, many anti-depressant medications while may seem to help with getting to sleep, turn out to be very disruptive to the sleep stages and most notably REM and DEEP.

[Beckah54]

I don't know if you've already done this, but it might help to post the last few nights graphs. Maybe one of the more knowledgeable forum members could look them over for you and make some suggestions.

[xenablue]

There are some results posted on the OPs original post - he has a link in this thread.

[Beckah54]

Thanks Xena, I saw the link but didn't follow it to his original post.

[kaiasgram]

Hi cubism, I took a look at your graphs. The first thing I noticed was that period of time when you had both lots of leaks and lots of centrals. I wonder if the leak-arousal-central cycle is causing some of how you feel. Your total leak index is within an acceptable range but that doesn't mean your sleep isn't suffering due to leaks. You mentioned that you think you're having mouth leaks so that might be an area to work on. Not always easy when using nasal or nasal pillow masks.

Antidepressants are known to influence sleep architecture, but it's hard to apply research to an individual case especially when other variables may also be involved.

Sorry your first inquiry got overlooked, that doesn't usually happen.

[cubism_dream]

Wow, thanks for all the responses. To answer the question asked by cosmo, I know I'm not in the deep sleep stage because I can easily wake up in the middle of the night when I'm usually deep asleep. This is unusual and has been happening for only the past week or two. I've even tried mouth taping while wearing a chinstrap, and I still feel tired with a slightly dry mouth. I forgot to mention in my original post that sometimes, I wake up in the middle of the night and I find myself not breathing or even choking, even with my nasal pillows on. The pillows sit comfortably and aren't too tight. I feel that I'm getting more Centrals for some reason and this may be causing my symptoms.

I might try to use my original MirageFX nasal mask tonight, to see if that makes a difference.

-CD

[Julie]

Chin straps definitely don't work for everyone (a surprising amount of air can leak out through your lips).

[Pap365]

In addition to taping, try placing your tongue so that it touches the roof of your mouth and the tip rests behind your top teeth. This helps to keep air out of your mouth which can prevent mouth leaks and excess air in the stomach. Some members have "trained" themselves to hold their tongue in place so they could eliminate taping. Even though I wear a full face mask, I use this technique to prevent dry mouth and air in my stomach.

[stillo]

Hi

As Far as i know all antidepressants affect rem sleep in some way or another. MAOIS completely abolish it all together.

Stillo

[jencat824]

Perhaps you could ask your dr if you could try another antidepressant so you could see if that is the problem. I agree some antidepressants can cause sleep disruption, but if you hit on the right med, you can still get properly treated for depression and sleep disorders.

I take a couple of antidepressants, amitriptyline & cymbalta, neither directly for depression, but I don't think they bother my sleep. If the amitriptyline does, I don't kinow it since I've been on it longer than on the CPAP (amtriptyline 20+ yrs, CPAP 12 yrs). The cymbalta however was the result of trying several meds before hitting on cymbalta as a workable alternative. My PM dr INSISTS all his pts take something in along this line of an antidepressant, although I'm not depressed (at least I didn't think I was...).

Tried several that he prescribed before finding that cymbalta, taken in the early afternoon was tolerable. Exapmple: lyrica kept me up day & night, jittery & generally could not stand it. Dr then tried Prozac - crazy drug with halucinations - told him he was nuts if he thought I'd live this was...several tries of several different drugs later, cymbalta didn't look so bad IF taken at the right time of day.

Maybe your use of Mirtazapine is partly the cause, and dr might have an alternative that would still help you get the drugs benefit in another way that would not disrupt your sleep. Maybe the time of day you are taking the Miratzazpine in relation to the time you go to bed could have a cause/effect problem. Everyone is different and our bodies react differently to the same drug.

As for your leaks, I'm struggling to get mine under control. Once I learned I had leaks, I started making progress controling them with a chin strap & changing my masks around. Sounds funny, but if I wear a mask a couple of nights, then another one a couple, etc. my leaks are getting under better control. I started this changing them around just to see what leaked worse, then noticed that when I kept switching, I was getting lower leaks, so I've kept it up. If something works, I don't question it, I just go with it.

Perhaps your change back to another mask might help you with leaks. Watch your leaks over a few nights to see. As I read your posts I see the two problems with your sleep as having multiple causes with your med & with your leaks. Let us know when you hit on the resolution to your problems.

Happy New Year, and a year of better sleep,
Jen

[cosmo]

.

[Wulfman...]

Hello, Fellow Hoseheads,

For the past few nights, I've been able to keep my nasal pillows on throughout the night (getting 6-8 hours of sleep), yet I wake up unrefreshed and foggy, and wake up a few times in the middle of the night. I'm just not getting into a deep sleep stage. What is the issue? Everything seems to be okay. My pressure is 8-12 APAP, EPR 1. My 95% is at about a 9. My leak level seems insignificant. I feel like I'm experiencing mouth leaks, but I wear a chinstrap. I go to bed around 11pm and get up at 7am. The humidity level on my ResMed S9 Autoset is set at 5.5/6, climate control at 85 degrees (F). I'm taking Mirtazapine to treat depression. My mood has improved because of it and the medicine actually helps me fall asleep.

Despite my few successful nights, over the past few weeks, I've been struggling to sleep with my mask on throughout the night. Sometimes I would doze off in bed without my mask on and wake up in the middle of the night to put it on. I've made a rule for myself that if I'm going to climb into bed, I must put on my mask. So would this inconsistency affect my ability to achieve restful, deep sleep? One thing I want to add is that I've been feeling stressed and anxious for the past few days, so that may possibly be the cause of my grogginess and fatigue.

I'd rather not post a new thread, but my last post........received zero responses, yet over 100 views.

Thanks for taking the time to read this, I'll respond to replies ASAP.

I think your problem is what I have bolded in RED.
THE PRESSURE CHANGES ARE KEEPING YOU FROM GETTING INTO DEEP SLEEP.

Try setting your machine in CPAP mode at a pressure of 9 cm. and see how that works for a week or so.

You might try experimenting with lowering your humidity setting, too.


Den

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