Searching for REM sleep

[Stutz]

Been a CPAP user for 20 years. It changed my life a lot but have a concern. The question I have struggled with for some time and am looking for ideas is how to get better quality of sleep.. Here goes: Have a respironics autosense 10, Settings are at 9 with a high of 14. I came up with that after watching my results from Oscar over the years. I use a swift fx nasal pillow mask with a chin strap since I am a mouth breather and with a goatee full face masks seem to leak more. Also use lamosin to seal the nasal pillows but usually don’t see a lot of undue leaks. I have taped my mouth also. Most nights my results are an AHI of 1 or below with those split evenly between a central and other.

I have always been a very light sleeper in that if a phone rings I am instantly awake after the first ring. Most nights I notice I never get into a deep sleep and assume I really don’t get into REM much. Of course only a study tells you that but I have noticed when I am off and wake up early, and get up, take my mask off, then lay on the couch without a CPAP, I will usually fall asleep, even if its only for a 1/2 hour I am off into very vivid dream land. I assume that is REM sleep. So my question is really two fold. Will a CPAP machine stop a person from getting restful sleep and just be hiding a different issue? Second is there a way to help my sleep architecture? I know sleep aids really don’t help that and I have tried medical marijuana, but both only keep you asleep, not help the type of sleep. I do notice the times I get that extra couch sleep I seem more focused. I simply want to be able to sleep like a teenager again. BTW 68 yo fair shape not overly heavy, non smoker.

[lazarus]

Will a CPAP machine stop a person from getting restful sleep and just be hiding a different issue?

A properly used CPAP set at optimized pressure(s), as verified by OSCAR, should keep your airway sufficiently stable for the best sleep possible in all stages of sleep.

is there a way to help my sleep architecture? I

Follow the rules of sleep hygiene such as always waking up at the same time every day. That allows your brain to know how to time the last session of REM, which is when most REM takes place.

I know sleep aids really don’t help that and I have tried medical marijuana, but both only keep you asleep, not help the type of sleep.

Alcohol late in the day and other sedatives can destroy one's sleep later in the night and disrupt that crucial final REM session in particular.

I do notice the times I get that extra couch sleep I seem more focused.

If the couch sleep is without PAP, you may inadvertently be doing long-term damage despite the seeming short-term advantage. To get the most benefit from PAP, one should use it for all sleep, no exceptions.

[ChicagoGranny]

I have noticed when I am off and wake up early, and get up, take my mask off, then lay on the couch without a CPAP, I will usually fall asleep, even if its only for a 1/2 hour I am off into very vivid dream land.

That is not necessarily REM sleep. Humans dream in all sleep stages. If you sleep soundly, you don't remember dreams. The only dreams that are remembered are the ones in which you awaken. This is true even if the awakenings are very brief. If I had to bet, I would bet you are having awakenings during those naps. Awakenings caused by breathing events.

is there a way to help my sleep architecture?

Yes. Google sleep hygiene and read some articles from actual medical sites such as Mayo Clinic. Good sleep hygiene is difficult to practice in today's culture. It takes some discipline.

I simply want to be able to sleep like a teenager again.

According to medical studies, teenagers do not get sufficient sleep.

[25YearsOnCPAP]

Published Scientific papers have shown that CPAP does decrease REM sleep. Not a lot you can do about that. Just part of therapy. Anything you might take like Melatonin or other herbs likely won't help. They just help you fall asleep. I have had minimal REM and deep sleep for decades. Unlikely I can fix that. Just side effect of CPAP therapy. Other side effects include reduction in Basal Metabolism Rate (BMR), increasing airway stiffness and lower response to CO2 levels.

[lazarus]

Many published papers are wrong, misunderstood, and out of harmony with consensus medical science.

Optimized PAP allows for more-effective, consolidated REM. Even REM rebound at first.

PAP may lessen some release of hormonal panic juice, but that's a good thing, not a bad side-effect.

Be careful what you read. And a statistical correlation is not the same thing as causal relationship.

Let's be careful out there.

[Dog Slobber]

Published Scientific papers have shown that CPAP does decrease REM sleep. Not a lot you can do about that. Just part of therapy. Anything you might take like Melatonin or other herbs likely won't help. They just help you fall asleep. I have had minimal REM and deep sleep for decades. Unlikely I can fix that. Just side effect of CPAP therapy. Other side effects include reduction in Basal Metabolism Rate (BMR), increasing airway stiffness and lower response to CO2 levels.

If you are going to make a claim about what Public Scientific papers are stating then support your claim by posting links.

[25YearsOnCPAP]

People complain about my posting scientific papers here. Go search PUBMED yourself.

[25YearsOnCPAP]

Published Scientific papers have shown that CPAP does decrease REM sleep. Not a lot you can do about that. Just part of therapy. Anything you might take like Melatonin or other herbs likely won't help. They just help you fall asleep. I have had minimal REM and deep sleep for decades. Unlikely I can fix that. Just side effect of CPAP therapy. Other side effects include reduction in Basal Metabolism Rate (BMR), increasing airway stiffness and lower response to CO2 levels.

If you are going to make a claim about what Public Scientific papers are stating then support your claim by posting links.

https://www.atsjournals.org/doi/full/10 ... vGWs1UrKM8

[zonker]

People complain about my posting scientific papers here. Go search PUBMED yourself.

who has complained? if people have, they need to pipe down. it's just common courtesy when making a claim on the internet to provide citations.

eta: we cross posted; i see you've provided said citation.

comment still stands as directed to other folk. if they don't like citations, they don't have to look at them.

[lazarus]

Here's what I found:

Treat Sleep Disorders

If alterations in REM sleep are due to disruptions caused by a sleep disorder, then treating the disorder can prompt a return to normal proportions of REM sleep. For example, studies have found that after treating obstructive sleep apnea with continuous positive airway pressure (CPAP) therapy, people experience REM rebound sleep accompanied by better mood and higher-quality sleep overall.

https://www.sleepfoundation.org/stages- ... -rem-sleep

REM sleep time increased by 69% with CPAP, REM density increased by 73%, and REM activity by 169%. REM density was highest in the second REM period. Improvement in respiratory disturbance index with CPAP correlated significantly with increased minutes of REM sleep with CPAP.--https://pubmed.ncbi.nlm.nih.gov/2678403/

And, yes, struggling desperately to breathe in order to stay alive while nearly choking to death every few seconds naturally expends a lot of calories at night. Of course. That's no reason for any sane person to view that fact as a reason to choose to live life that way, though. That's why misapplying raw data without the practical wisdom of understanding real-life application in context easily leads to turning seemingly meaningful info into a truckload of red herrings.

Numbers-obsessed researchers often fall for that little trap that they set for themselves and then try to hide it by adding the mathematical word "significant" in order to make it sound to laymen as if some small observation is actually meaningful on its own in the real world. Mathematical "significance" is not the same as medical-application significance.

The fact is, saving us THAT energy expenditure is a feature of PAP, not a bug. The entire metabolism can calm down when any life-threatening condition is corrected.

[25YearsOnCPAP]

Rebound REM sleep in new CPAP patients is well-known phenomenon. However, all studies I found claiming improved sleep architecture after initiation of CPAP look at just 3 months duration. That is NOT long term by any means.

There can be many confounders in evaluating changes in sleep after CPAP.
- long-standing pre-treatment sleep issues
- medications that change sleep architecture
- lifestyle changes on CPAP initiation
- food and drink intake (caffeine, alcohol, sugar)
- development/emergence versus pre-existing previously undiagnosed cardiovascular disease

This makes it very difficult to tease out anything other than association. Causal links impossible to prove.

[ChicagoGranny]

https://www.atsjournals.org/doi/full/10 ... vGWs1UrKM8

This study makes no claims about REM sleep. Perhaps you confused BMR (basal metabolic rate) with REM?

I have had minimal REM and deep sleep for decades.

How would you know? Do you live in a sleep lab?

[lazarus]

Causal links impossible to prove.

In my opinion, if you truly believed that, you would likely be more careful than you have been with claims and implications that CPAP causes sleep problems with REM or otherwise and has odd side-effects, regardless of how many obscure papers you may have read.

[ozij]

Rebound REM sleep in new CPAP patients is well-known phenomenon. However, all studies I found claiming improved sleep architecture after initiation of CPAP look at just 3 months duration. That is NOT long term by any means.

There can be many confounders in evaluating changes in sleep after CPAP.
- long-standing pre-treatment sleep issues
- medications that change sleep architecture
- lifestyle changes on CPAP initiation
- food and drink intake (caffeine, alcohol, sugar)
- development/emergence versus pre-existing previously undiagnosed cardiovascular disease

This makes it very difficult to tease out anything other than association. Causal links impossible to prove.

You resounding criticism of the paper you quoted is quite to the point.
Their coclusions are laughable:
Conclusions: Although a reduction in BMR after CPAP predisposes to a positive energy balance, dietary intake and eating behavior had greater impacts on weight change. These findings highlight the importance of lifestyle modifications combined with CPAP.
It certainly looks like one of many paper created specifically to keep the writer from perishing in the publish or perish race...

There is not a word about REM in that paper, nor do they have a control group for people who did not use CPAP.

[ozij]

People complain about my posting scientific papers here. Go search PUBMED yourself.

Instead of searching pubmed, I searched the user's posts.
Suggest others also do it to judge the valildity of the above statements.