sleep meds to help with sleep quality

[Stilltrying]

I have been using CPAP on and off for 15 years. I have had sleep apnea for at least 20 years. I often wonder what I could have done with my life if I would have had my sleep apnea under control when i was a student.
Anyway, I am concerned that my CPAP machine prevent apneas at the cost of ruining my sleep quality.
I usually get 8 hours of sleep a night, 4-6 hours with the machine, but I am still tired everyday. The dr has given me provigil, which I use sometimes, but I prefer naps.
I have a ZEO sleep monitor which says I am getting 40-60 minutes of deep sleep a night, my wife gets 120-180 minutes.
If I sleep for a total of 9-10 hours in a night with 4+ hours with CPAP I feel great, but that is not sustainable with 2 jobs. Pretty much all I do is work, commute, eat and sleep. I want some free time back, or at the very least to feel rested.

I take GABA just before bed to increase deep sleep.
Also, the dr gave me Gabapentin that leaves me feeling well rested but about as sharp as a hammer. It increases deep sleep at the cost of cognitive impairment, I can only take it on days that I dont need to be smart.
I have read that GHB is an option but due to misuse is very difficult to get.
Occasionally (2-3x year) I will take a percoset before bed and sleep 9 hours with CPAP and feel terrific the next day but I dont think that is a good long term plan.

Last night I started experimenting with Binaural beats as a means of increasing sleep quality, I dont know how well it worked. I did have an easier time falling back to sleep with the CPAP but I was wearing earphones all night and that wont work when my wife gets back to town.

Any advice will be greatly appreciated.

[49er]

I have been using CPAP on and off for 15 years. I have had sleep apnea for at least 20 years. I often wonder what I could have done with my life if I would have had my sleep apnea under control when i was a student.
Anyway, I am concerned that my CPAP machine prevent apneas at the cost of ruining my sleep quality.
I usually get 8 hours of sleep a night, 4-6 hours with the machine, but I am still tired everyday. The dr has given me provigil, which I use sometimes, but I prefer naps.
I have a ZEO sleep monitor which says I am getting 40-60 minutes of deep sleep a night, my wife gets 120-180 minutes.
If I sleep for a total of 9-10 hours in a night with 4+ hours with CPAP I feel great, but that is not sustainable with 2 jobs. Pretty much all I do is work, commute, eat and sleep. I want some free time back, or at the very least to feel rested.

I take GABA just before bed to increase deep sleep.
Also, the dr gave me Gabapentin that leaves me feeling well rested but about as sharp as a hammer. It increases deep sleep at the cost of cognitive impairment, I can only take it on days that I dont need to be smart.
I have read that GHB is an option but due to misuse is very difficult to get.
Occasionally (2-3x year) I will take a percoset before bed and sleep 9 hours with CPAP and feel terrific the next day but I dont think that is a good long term plan.

Last night I started experimenting with Binaural beats as a means of increasing sleep quality, I dont know how well it worked. I did have an easier time falling back to sleep with the CPAP but I was wearing earphones all night and that wont work when my wife gets back to town.

Any advice will be greatly appreciated.

HI Stilltrying,

Welcome to the forum!

If you could please use the link in my signature to fill out your equipment profile, that would help members better target their advice to your particular situation. Hopefully, you have a data capable machine that will enable to access software that could help everyone determine whether your therapy is optimal or not as that can affect sleep quality.

Any reason why you are only using the machine part of the night? Do you wake up and can't back to sleep unless you take the mask off or is there some other reason? Just curious.

Again, welcome.

49er

PS - To answer your question, the only drug I know of that increases sleep quality is GHB which you rightfully pointed out is hard to obtain due to cost. It has also has stigma due to being known as the date rape drug.

[robysue]

Anyway, I am concerned that my CPAP machine prevent apneas at the cost of ruining my sleep quality.
I usually get 8 hours of sleep a night, 4-6 hours with the machine, but I am still tired everyday. The dr has given me provigil, which I use sometimes, but I prefer naps.

Stating the obvious: You might feel better if you figured out a way to sleep with the machine for all 8 hours of sleep every single night. CPAP is not supposed to be a part-time therapy.

So some questions:

1) Why do you take the mask off during the sleep and return to sleep without the mask on for 2-4 hours every night? If the answer is comfort issues, we need to help you fix those comfort issues. If the answer is I just wake up and can't get back to sleep until I take the mask off, you've allowed yourself to fall into the bad habit of waking up and staying awake until you consciously make the decision to take the mask off and go back to bed. And you'll need to work on breaking that bad habit.

2) Do you mask up for the naps? If not, you're feeding that bad habit of allowing your unconscious brain to continue to believe (even after 15 years) that you really don't need to sleep with the CPAP mask on your nose.

3) You say that the CPAP is preventing the apneas at "the cost of ruining [your] sleep quality." Other than ZEO data, can you describe how the CPAP ruins your sleep quality? In other words, what makes "sleep with the CPAP" less satisfying (subjectively) than "sleep without the CPAP"? If you can figure out how the CPAP is disrupting your sleep, we can help you figure out how to minimize or eliminate those problems, which in turn may make your "sleep with CPAP" subjectively as good or better than your "sleep without CPAP."

4) What were the instructions on how to take the provigil? Is it possible that provigil needs to be taken every day in order to be effective? In other words, is provigil a maintenance drug or is provigil a drug to be taken on an "as needed" basis?

I have a ZEO sleep monitor which says I am getting 40-60 minutes of deep sleep a night, my wife gets 120-180 minutes.

The "normal" amount of Stage 3 (Deep) sleep is 10-20% (http://emedicine.medscape.com/article/1140322-overview). So if you're sleeping about 8 hours a night (480 minutes), you'd expect to see somewhere between 48 and 96 minutes of Stage 3/Deep sleep. So your 40-60 minutes of ZEO Deep sleep is pretty much about where you'd expect it to be for a normal adult.

It also looks like your wife's ZEO is over estimating her Stage 3 (Deep) sleep: Under normal circumstances, it would take between 15 and 30 hours of sleep to get 180 minutes of Stage 3 (Slow Wave/Deep) sleep.

The upshot of this? Much as I love my ZEO, I don't think it's data is all that accurate. I think it's good for trending, but I don't think it's good for person-to-person comparisons. In other words, I don't tend to compare my ZEO numbers to other people's ZEO numbers. I know (from a lot of work in looking at my numbers) that my ZEO underscore my REM and (vastly) overscores my WAKE since it thinks I'm awake for long, long periods of time that I have no conscious memory of AND these periods often correspond to when a REM cycle ought to occur. I've learned to conclude that my ZEO is likely misscoring most of my later-in-the night REM cycles as WAKE for some reason. I interpret the ZEO data with that in mind.

Occasionally (2-3x year) I will take a percoset before bed and sleep 9 hours with CPAP and feel terrific the next day but I dont think that is a good long term plan. (emphasis added)

Taking the percoset on a nightly basis is NOT a good long term plan.

But---what if the real reason you feel terrific the next day on those rare occasions that you take the percoset before bed is NOT the percoset, but rather it's because you slept the full 9 hours with the CPAP?

Sleeping with the CPAP all night long, every single night IS a viable, good long term plan

So the real question is: What can we do to help you go from using the CPAP 4-6 hours a night to using the CPAP all night long every single night?

[Todzo]

I have been using CPAP on and off for 15 years.

Interesting. My use is ten full use years. But I am suspicious that it runs the full gamut from a few like me who can use the machine all the time to what are probably the majority which do not use the machine or at least less than four hours a night.

I have had sleep apnea for at least 20 years.

I am probably with you on that! Perhaps longer in my case. First indications were seen in '85' when the Dr. Pronounced me “apnea free” from a three day recording heart monitor test requested at the insistence of my wife.

So then I go homeless and some bunk mates in shelter clearly tell me “you have sleep apnea – get to the doctor”. This time the doctor says “AHI=52/h (90 supine) minimum blood oxygen 55% - Severe Sleep Apnea with Extreme Hypoxia”. Yup, sleep apnea diagnosis improved a bit in 18 years!!!

For me probably for at least 30 years.

I often wonder what I could have done with my life if I would have had my sleep apnea under control when i was a student.

Indeed!!! Me too!!! Me too!!!

Anyway, I am concerned that my CPAP machine prevent apneas at the cost of ruining my sleep quality.

They seem to ignore sleep quality as they build and develop these things. Honestly!! I really wish they had never even thought of “clear airway sensing pulses”. Honestly!!

I usually get 8 hours of sleep a night, 4-6 hours with the machine, but I am still tired everyday.

What usually brings the end of using CPAP in the night??

The dr has given me provigil, which I use sometimes, but I prefer naps.
I have a ZEO sleep monitor which says I am getting 40-60 minutes of deep sleep a night, my wife gets 120-180 minutes.

I used to have and use a Zeo. It did not make a move to a new city. Oh well.

One thing I did learn while using it was that my deep sleep seemed to track with my “steps per day”. I have been moving toward 10,000 steps a day (part of an active lifestyle). In general the more steps more deep sleep.

REM seemed to track with stress and inflammation. More stress and inflammation Less REM.

If I sleep for a total of 9-10 hours in a night with 4+ hours with CPAP I feel great, but that is not sustainable with 2 jobs. Pretty much all I do is work, commute, eat and sleep. I want some free time back, or at the very least to feel rested.

I take GABA just before bed to increase deep sleep.
Also, the dr gave me Gabapentin that leaves me feeling well rested but about as sharp as a hammer. It increases deep sleep at the cost of cognitive impairment, I can only take it on days that I dont need to be smart.
I have read that GHB is an option but due to misuse is very difficult to get.
Occasionally (2-3x year) I will take a percoset before bed and sleep 9 hours with CPAP and feel terrific the next day but I dont think that is a good long term plan.

My opinion is: Step away from the pharmaceuticals, they are not your friends!!!

I challenge you to look carefully at the research for each of the drugs you take. Please do!

When I did I did not like what I saw at all. From now on I will consider a pill that has an objectively proven effect size greater than 70% at the five year mark – proven compatibility with anything else I take – and reasonable side effects and numbers relating to them. If they cannot show me that – no deal!!

Last night I started experimenting with Binaural beats as a means of increasing sleep quality, I dont know how well it worked. I did have an easier time falling back to sleep with the CPAP but I was wearing earphones all night and that wont work when my wife gets back to town.

Any advice will be greatly appreciated.

Give the medical community all of the trust it has truly earned. Look at the research yourself to determine when to use them.

I think that all who have OSA should be hooked up with a dietitian (I used one for several years every six weeks – wish I still had her here in my new town – my own personal studies continue) and a personal trainer. I think OSA develops as a result of our modern lifestyle. Pollution! A chemically farmed diversity reduced food supply tainted with toxic sugar and preservatives! No sun! Little exercise in our days!! Violent compassion squelching media and personal connections by media only. Yes that should make us sick, and it does.

I think the way back is to move away from pollution, learn to eat well, learn to move well, an work toward a compassionate response to those we do indeed see face to face.

[Julie]

Todzo - leave people alone with your ideas! His MD prescribed meds and it's not your place to tell him not to take them. We may question him about them (as Roby Sue did), but it's not the same thing. And believe it or not, diet is not the answer to everything! You are becoming beyond tiresome and potentially a danger to newbies looking for sound advice.

[Hawthorne]

I agree with Julie.

Advising people to stop taking meds their doctors have prescribed for various medical problems is very very dangerous. We don't know why certain meds were prescribed and what they are for. Without that info we are in no way qualified to tell people to stop using them!!
I make sure I ask questions if a doctor prescribes a med - what will this do for me? what if I don't choose to take it? what are the side effects? etc. I believe it is important for a person to do that.

Actually, we are not qualified even if we knew why a person's doctor prescribed certain things.

CPAP and diet are not the answer to every medical problem. We will not somehow be cured of every ailment we might have when we get going with CPAP. As far as I am concerned it is the same with diet. While a good, healthy diet is very good for everyone, it will not cure things.

I speak for almost 12 years successfully on CPAP 100% of my sleeping time. I have other medical issues and would not even think of stopping my meds on advice from an internet forum.

[chunkyfrog]

Hmmm, never heard of a homeless doctor--or dietician, either.
Todzo, you sound like a conglomeration of fantasy and nightmare. The inside of your head must be a snake pit!
It will be such a relief when you finally give up trying to get attention that you clearly do not deserve.

[ems]

In Todzo's last post in this thread which is too long to repost, he is suggesting that the OP do research on sleep meds and the other medications he is currently taking. I don't see where he is telling the OP to STOP his meds. At least I didn't read it that way. He is suggesting possible alternatives to pharmaceuticals which isn't always a bad idea.

Actually, I think this is one of Todzo's more sensible posts.

[robysue]

If I sleep for a total of 9-10 hours in a night with 4+ hours with CPAP I feel great, but that is not sustainable with 2 jobs. Pretty much all I do is work, commute, eat and sleep. I want some free time back, or at the very least to feel rested.

I take GABA just before bed to increase deep sleep.
Also, the dr gave me Gabapentin that leaves me feeling well rested but about as sharp as a hammer. It increases deep sleep at the cost of cognitive impairment, I can only take it on days that I dont need to be smart.
I have read that GHB is an option but due to misuse is very difficult to get.
Occasionally (2-3x year) I will take a percoset before bed and sleep 9 hours with CPAP and feel terrific the next day but I dont think that is a good long term plan.

My opinion is: Step away from the pharmaceuticals, they are not your friends!!!

I challenge you to look carefully at the research for each of the drugs you take. Please do!

Whether Todzo is telling Stillingtrying to stop taking the meds or simply research them and ask questions about them while continuing to take them as prescribed is in the eyes of the beholder.

[ems]

Whether Todzo is telling Stillingtrying to stop taking the meds or simply research them and ask questions about them while continuing to take them as prescribed is in the eyes of the beholder.[/quote]



Since my granddaughter thinks that I am positively the most beautiful grandma in the entire world, I tend to agree with you.

[jaybeem]

I am currently taking Gabapentin as a sleep aid. I agree about the brain fog, but have been cutting back on the dose until I find a happy balance between sleep quality and fog. I am down to 100 mg, which I take a few hours before bedtime if I am not going out. The fog is almost gone, so hopefully I have almost found a good balance. It is the best sleep aid I have found for quality of sleep and for lack of side effects. Maybe talk to your doctor about dose?

[ems]

I am currently taking Gabapentin as a sleep aid. I agree about the brain fog, but have been cutting back on the dose until I find a happy balance between sleep quality and fog. I am down to 100 mg, which I take a few hours before bedtime if I am not going out. The fog is almost gone, so hopefully I have almost found a good balance. It is the best sleep aid I have found for quality of sleep and for lack of side effects. Maybe talk to your doctor about dose?

It's amazing how many meds are prescribed for various ailments (off label). I was taking Gaba for a short period of time for Migraines. Didn't help the Migraines and didn't help me sleep either.

[chunkyfrog]

A really good idea is to take a list of ALL your meds, and OTC meds and supplements, to your doctor.
Sometimes a pharmacist (if he has time) can check for interactions.
Some foods also react with supplements and drugs, (think grapefruit, but the real list is looong)
I'm one of the lucky ones who rarely need help sleeping, but I can feel your pain, as when I do need help, the effect is profound.
--Just curious, have you ever looked into behavioral therapy for insomnia?
It's a long process, not for everyone, but the successes are amazing.