Can CPAP help improve REM?

[Guest123]

My sleep study showed less than 1% REM. I dont have OSA but have some CSA ànd extreme snoring. I have been on SSRIs for 15 years.. but only noticed cognitive problems and severe fatigue in the last 2. Doctors are saying getting off the SSRIs is not that easy and my depression.. which was no joke.. may return. i am getting nowhere. they told me lack of rem is the price i pay for treating my depression. WTF??? I ve seen posts where cpap has improved rem... but is that only because it is solving their OSA? Any suggestions would be appreciated. This issue is causing problems in all areas of my life. especially my job which is highly technical and involves a great deal of daily learning and memory. Help!

[49er]

My sleep study showed less than 1% REM. I dont have OSA but have some CSA ànd extreme snoring. I have been on SSRIs for 15 years.. but only noticed cognitive problems and severe fatigue in the last 2. Doctors are saying getting off the SSRIs is not that easy and my depression.. which was no joke.. may return. i am getting nowhere. they told me lack of rem is the price i pay for treating my depression. WTF??? I ve seen posts where cpap has improved rem... but is that only because it is solving their OSA? Any suggestions would be appreciated. This issue is causing problems in all areas of my life. especially my job which is highly technical and involves a great deal of daily learning and memory. Help!

Hi Guest123,

As an FYI, I was on psych meds (mostly ADs) for 15 years and got off of them by tapering very slowly at 10% of current dose every 4-6 weeks. Sadly, many doctors taper people way too quickly and as a result, people experience what looks like a relapse when actually the symptoms are due to tapering too quickly.

Anyway, when you are ready to taper your meds and I realize you may not want to, go to http://survivingantidepressants.org/index.php?/index for great support.

49er

[caffeinatedcfo]

My REM has improved but I am strictly OSA.

[ChicagoGranny]

have some CSA ànd extreme snoring

What do you plan to do about this?

[Guest123]

I don't know for sure. My CSA was not bad enough for insurance to cover any treatment.. but.my doctor did write a prescription for a cpap saying it might work.. but will have to pay myself. i was trying to make that decision and posted to this site. Everyone that replied said id be wasting my time and money.. also like my dr says my apnea is very minor. So.. that got me thinking and while i definitely have physical fatigue.. what i am more than anything is mentally exhausted.. never feeling mentally rested like i used to. Which points to the lack of REM. I seem to keep running into dead ends.. all the time desperate to wake up..just once.. feeling rested like i used to. I am ready to give up. Its like no one believes me. I had been saving money for over a year to afford the sleep.study. with all.the apnea in my family and family members complaints of my snoring and other strange sleeping behavior.. i was sure this would "fix" me. Instead I am getting the message.. just deal with it.. there is no solution.

[ChicagoGranny]

My sleep study showed less than 1% REM.

1. What was your Respiratory Disturbance Index (RDI)?

2. What was your number of minutes of sleep and number of minutes of the test? (Sleep efficiency: the number of minutes of sleep divided by the number of minutes in bed. Normal is approximately 85 to 90% or higher.)

[ChicagoGranny]

BTW,

Instead I am getting the message.. just deal with it.. there is no solution.

You are being given bullshit.

[mgaggie]

I strongly urge you to see a psychiarist about either changing your medication or getting off the medication (if thats what you want). IMO General doctors don't have enough experience with mental illness medications.

My anti-depressant inhibits REM sleep (which explains why I never had REM sleep in my second study). It can also cause insomnia, which I have too. So with my apnea its a vicious circle. I have trouble getting to sleep and then going back to sleep when I wake up coupled with the fact I don't get enough REM (if any), it can and does exacerbate my depression. My doctors solution is to up my medication, which makes everything worse.

DO NOT just accept the message to deal with it.

[Pugsy]

Typically the CPAP machine is not normally what is used to treat CSA ....CPAP is normally used to treat OSA..obstructive sleep apnea due to the collapse of the airway tissue. Centrals are when you don't breath and the airway is open. A different type of machine is normally needed because the CPAP machine can't provide the proper pressure in the modality needed to treat centrals.

If your lack of REM is due to the meds then as long as you are on the meds even if you used the type of machine to treat centrals and your minor CSA is well treated you still may not experience much REM as long as you are on the meds.

If your CSA happens to be affecting REM...I don't know if cpap machine is the way to go anyway. Normally for centrals only some sort of non invasive ventilation support machine is used. Their response time for pressure increase are more in line for treating centrals than the constant pressures of cpap/apap machines. In some case cpap/apap machine use in people with CSA actually makes the CSA worse.
Those high end machines used to treat CSA....very pricey and not very easy to adjust pressures optimally at home.

[old64mb]

SSRIs are used in sleep medicine to specifically reduce REM sleep, especially in people with narcolepsy and sometimes with REM behavior disorders.

REM issues are often correlated with cognitive problems, and less than 1% REM is at a level that typically requires intervention. The only time something like that would be acceptable is if you were having something comorbid with REM that required its elimination (typically a parasomnia or such - where you're in danger of hurting yourself or someone else while in REM.)

As has been mentioned by Pugsy, a CPAP isn't going to help with CSA, and if it's classified as mild CSA it's unlikely that's the cause of why you're so bad. Did you end up trying a bunch of different meds before they settled on an SSRI? If that's the case, then it's a more difficult decision to try the process of finding something else, but there are a whole slew of other anti-depressants that don't screw around with your sleep structure that much. A psychiatrist with any familiarity with sleep would be able to help you with that.