Spoke with my Doctor

[SaltLakeJan]

Hi Beauty, [
Thanks for your interesting reply. You are an independent woman. That's what makes you what you are. When I wrote my "sort of plan" to you, I obviously didn't think it thru.

I'm considering making an outline of the things I want to change, and giving them to a good friend of mine. And, ask her to call me each morning, and go thru the check list. I'll think about it a liittle more.
She has very good health habits, and it would be embarassing for me to admit to her, that on a whim, I stayed up til 4:30 am just to see what was happening on CPAPtalk.com. She would suggest to me, there is something very wrong with my thinking.

Then you commented:

having someone hold you to your goals and keep you on-track will work for you, I think that's a great idea. Good luck, if you decide to try it. I fear I'm too independent for a plan like that, and I might end up resenting the friend

None of us need a baby tender; but Muffy's edicts struck home with me. My comment wasn't fomulated with thought, but spur of the monent. While I have the desire, I need to do something - to start. DH drove me (I can't see well enough to drive today, maybe tomorrow) to the Spa, I did 25 min. on the treadmill. Tried the Eliptical, (made me dizzy)

There are so many things in life we cannot control.; however, I'd like to think that I could improve some aspects. I've rarely gone to bed at 10:30, but I'm setting that as my goal tonight, hope the cortisone will cooperate.

You may be the one to make the most changes - who knows?

Jan

[BleepingBeauty]

Hi Beauty, [
Thanks for your interesting reply. You are an independent woman. That's what makes you what you are. When I wrote my "sort of plan" to you, I obviously didn't think it thru.

First, thanks. Yes, I definitely am independent; sometimes, perhaps, a little too much so. Second, don't be so hard on yourself, Jan. Different things work for different people, and if you think a friend keeping you on-track is helpful, then by all means, go for it. Whatever works is what's right for you.

I'm considering making an outline of the things I want to change, and giving them to a good friend of mine. And, ask her to call me each morning, and go thru the check list. I'll think about it a liittle more.
She has very good health habits, and it would be embarassing for me to admit to her, that on a whim, I stayed up til 4:30 am just to see what was happening on CPAPtalk.com. She would suggest to me, there is something very wrong with my thinking.
Then you commented:

having someone hold you to your goals and keep you on-track will work for you, I think that's a great idea. Good luck, if you decide to try it. I fear I'm too independent for a plan like that, and I might end up resenting the friend

None of us need a baby tender; but Muffy's edicts struck home with me. My comment wasn't fomulated with thought, but spur of the monent. While I have the desire, I need to do something - to start. DH drove me (I can't see well enough to drive today, maybe tomorrow) to the Spa, I did 25 min. on the treadmill. Tried the Eliptical, (made me dizzy)

Yes, Muffy's suggestions struck a chord with me, too. I never thought of myself as having any form of insomnia, but apparently, I do. There are one or two things on her list that I just can't (or won't) do - not right away, at least. One is giving up my two measly cups of coffee in the morning. I really like my coffee, and I don't ingest any other caffeine during the day, so I'm going to keep drinking my two cups in the morning. (There's the independence in me coming out, which sometimes manifests itself as defiance. ) The other is the smoking. Rome wasn't built in a day, and I'll continue to cut down until I can quit again. But for now, I'm content with my current regimen of staying aware of what I'm doing and working towards that goal.

I'm glad you had a good day at the spa. There's nothing near me in the way of a gym, so I'll stick to walking for now and will use my Health Rider when I can muster up the energy needed for that kind of workout.

There are so many things in life we cannot control.; however, I'd like to think that I could improve some aspects. I've rarely gone to bed at 10:30, but I'm setting that as my goal tonight, hope the cortisone will cooperate.

Isn't that the truth? And yes, you definitely CAN make a few small positive changes. You and I are both self-admitted night-owls. If I can get my butt into bed at 10:30, you most likely can too! (To be honest, I didn't think it would really make much difference, but it does seem to be doing just that. Even one more hour of sleep for me is a real bonus, so I'm going to keep at it and see how much better things can get. I'm still tired during the day, but I didn't have to take a nap today. A small improvement, but one I can hold onto and hope for even better results as time goes on.) Old habits die hard, and it's not always easy to make adjustments at this point in life; but it CAN be done, and I have confidence in you.

You may be the one to make the most changes - who knows?

Jan

Could be. I can't focus on the big picture, though, if I want to make progress. Small goals with big effort seems to work best for me. So I'll just keep pluggin' along, and we'll see how things go. I feel like I'm on the right road, at least.

Join me, won't you?

[Muffy]

Taking levothyroxin at night can generate insomnia, but that would have been too easy.

Sometimes. But lots of folks on the About.com thyroid board swear that taking it at night helps them sleep better.

Having an NPSG to look at certainly adds a lot of objective data to that decision-making process, not only with the timing of the drug, but dosage as well (as in "too much"). Reduced sleep efficiency, overall poor architecture, increased spontaneous arousals, increased awakenings, increased stage shifts, prolonged sleep latency and elevated baseline heart rate would all be reasons to take a close look at dosage and timing of levothyroxin.

Speaking of sleep latency, BB, at what point(s) in the evening do you feel sleepy? There is a "window of opportunity" to take sleep, and benefit could be had from taking advantage of that as well. Keep in mind that all facets of sleep hygiene should be in place to take maximal advantage of this. As noted in the previous slide:



sleep pressure (load) builds throughout the day. However, an ill-placed nap (like at about 6 PM), especially if it's too long (say > 30 minutes) can greatly disrupt that pressure and make it difficult to take sleep once "bedtime" rolls around. This can be graphically, and dramatically, represented as



where

Simulations of the homeostatic Process S increasing in a saturating exponential fashion during waking and declining exponentially during sleep. Blue: baseline with an 8-h sleep episodes; red: sleep deprivation and recovery sleep after 40 hours of wakefulness; green: 2-h nap at 18:00 h and subsequent nighttime sleep. Bars on top delineate sleep episodes.

So you really have to think where and how long a nap, if needed, should be taken. That orange arrow there is where one should place their 30 minute nap, again, taking advantage of natural processes.

I really like my coffee, and I don't ingest any other caffeine during the day, so I'm going to keep drinking my two cups in the morning.

Admittedly, Muffy certainly enjoys her "cup(s) o' joe" in the AM while perusing the boards (and she's done by 6 AM-- don't forget, she's not only a "lark", she's the one that wakes the larks up) so lets compromise-- just quit smoking.

I asked about lab work re: electrolytes, and he says my numbers are fine. (Muffy, darlin', you have to remember that I'm a layperson and don't know what "electrolytes" corresponds to on my lab report.) The doctor pointed out where they are on the paperwork from March and, sure enough, all of those numbers are within the normal range... Carbon Dioxide, Total - 25

CompSAS is largely an entity of hypocapnia (low pCO2), so if that number was elevated and/or PFT shows obstructive or restrictive disturbance, then the origin of all those centrals could come into question. However, that discussion at this point will be largely academic in that you're posting all sorts of good SDB numbers.

Speaking of which, you seem to posting all kinds of good everything numbers, so "soon", if not "now", there needs to be less "fiddling", and just throw this recipe into the oven and let it bake for a while.

So I'll just keep pluggin' along, and we'll see how things go. I feel like I'm on the right road, at least.

So do I.

Muffy

[howkim]

I've gotten the names of several physicians who might be able to work with me on the thyroid issue (if, indeed, there IS an issue that needs further attention) from thyroid-info.com. Several of them are listed as naturopathic physicians, and there's one listed as an integrative practitioner. We'll see how the results look, and I'll take it from there.

Thyroid-info.com is a good source. Just take the comments there with a grain of salt and remember that one person's great doc is a total loser for another.

Hang in there!!

[SaltLakeJan]

Muffy, Your post to BB, inspired me to change things in my life, that need changing. It is brilliant. I sincerely hope I have the tenacity to follow the basic thoughts I have posted in a Word document. I plan to record my success and problems there.

Perhaps the old saying, "Misery likes company" is appropiate here. BB is encouraging me, and I want us both to be able to make these changes in our lives.

'

Isn't that the truth? And yes, you definitely CAN make a few small positive changes. You and I are both self-admitted night-owls. If I can get my butt into bed at 10:30, you most likely can too! (To be honest, I didn't think it would really make much difference, but it does seem to be doing just that. Even one more hour of sleep for me is a real bonus, so I'm going to keep at it and see how much better things can get. I'm still tired during the day, but I didn't have to take a nap today. A small improvement, but one I can hold onto and hope for even better results as time goes on.) Old habits die hard, and it's not always easy to make adjustments at this point in life; but it CAN be done, and I have confidence in you.

Small goals with big effort seems to work best for me. So I'll just keep pluggin' along, and we'll see how things go. I feel like I'm on the right road, at least.

Join me, won't you?

Thanks BB, you are a great motivator

Jan

[BleepingBeauty]

BB, at what point(s) in the evening do you feel sleepy? There is a "window of opportunity" to take sleep, and benefit could be had from taking advantage of that as well. Keep in mind that all facets of sleep hygiene should be in place to take maximal advantage of this. As noted in the previous slide: <snipped>
sleep pressure (load) builds throughout the day. However, an ill-placed nap (like at about 6 PM), especially if it's too long (say > 30 minutes) can greatly disrupt that pressure and make it difficult to take sleep once "bedtime" rolls around.

So you really have to think where and how long a nap, if needed, should be taken. That orange arrow there is where one should place their 30 minute nap, again, taking advantage of natural processes.

Well, it's hard to pinpoint a time when I'm "ready" for bed, since I'm accustomed to being tired for much of the day. But normally, I start to think about going to bed somewhere around 10 or 11 p.m.

When I've allowed myself to nap (always with the machine), it's in the early afternoon for about an hour. I know not to let myself nap later in the day, as that will definitely wreak havoc on my bedtime.

Admittedly, Muffy certainly enjoys her "cup(s) o' joe" in the AM while perusing the boards (and she's done by 6 AM-- don't forget, she's not only a "lark", she's the one that wakes the larks up) so lets compromise-- just quit smoking.

I pretty much follow suit with you, then, as I'm done drinking my coffee at around 6:00 a.m., too. Compromise is good, and you already know I'm working on quitting again. One thing at a time, Muffy dear.

Carbon Dioxide, Total - 25

CompSAS is largely an entity of hypocapnia (low pCO2), so if that number was elevated and/or PFT shows obstructive or restrictive disturbance, then the origin of all those centrals could come into question. However, that discussion at this point will be largely academic in that you're posting all sorts of good SDB numbers.

Well, I'll have the PFT results immediately on Thursday, so I'll let you know what's what then.

Speaking of which, you seem to posting all kinds of good everything numbers, so "soon", if not "now", there needs to be less "fiddling", and just throw this recipe into the oven and let it bake for a while.

Can do. Speaking of baking, I found this in my recent search for avatar options, and it hit my twisted funnybone:

I feel like I'm on the right road, at least.

So do I.

Muffy

It's about time I started to feel like I was making some progress. And it's nice to have you concur, Muff. Yay!

[BleepingBeauty]

BB is encouraging me, and I want us both to be able to make these changes in our lives.

Thanks BB, you are a great motivator

Jan

Awesome, Jan! I'm glad to be one of the people on this forum who's able to help someone else, in whatever way possible.

We're both receiving very good advice and assistance with our sleep-related issues here. We can do this!

[Muffy]

Get an absolutely fixed bedtime and awakening time, use it 7 days a week, do not drift. Sleep is a heap of biorhythms that must be set and/or taken advantage of.

The fixed bedtime I can deal with; but how do I adopt a fixed awakening time? If I wake up too early, just stay in bed and wait for that time to arrive, even if I'm not sleeping?

No, do what you're doing. When you wake up, get up. The goal is to get your sleep consolidated into the night. This amount should theoretically be about 7.5 hours (a sleep cycle is about 90 minutes, ending in a REM period, you should awake naturally after a REM period, so sleep time should be a multiple of 90 minutes, 6.0 hours is too little, 9.0 hours is too much).

A number of studies are showing 7.0 hours of sleep to be associated with reduced risk of mortality and obesity (I don't know why that is, I always seem to come out right at 7.5).

Interestingly, too much sleep appears to be associated with increased mortality and a number of other issues. The huge Kripke Study showed:



Muffy

[SaltLakeJan]

Hi Beauty

After reading Muffy's "editorial" on the perfect amount of nightly sleep - 7.5 hrs., I hope my almost 10 hour sleepathon last night - could be considered "catch-up" from the sleep deficit . Yesterday, with your encouragement, I took a walk. Later, I worked toward the 10:30 bedtime, got in bed about 10:22 and slept till 10:10 this am.

Awesome, Jan! I'm glad to be one of the people on this forum who's able to help someone else, in whatever way possible.

We're both receiving very good advice and assistance with our sleep-related issues here. We can do this!

BB is encouraging me, and I want us both to be able to make these changes in our lives.

Thanks BB, you are a great motivator

Jan

I guess the next step for me is to establish a time to awaken.

Muffy wrote:
Get an absolutely fixed bedtime and awakening time, use it 7 days a week, do not drift. Sleep is a heap of biorhythms that must be set and/or taken advantage of.

This is not the easiest task we have undertaken.!!!!! It would be easier to fail than succeed, That's why it is important we are supporting each other. I certainly appreciate the "Pep Talks" you give me. I can't say about you, but I was so obviously undiscliplined about sleep, that I was inviting sleep chaos, and that's what I got.


Stick with me B.. and with your help we may accomplish miracles.

Jan

[BleepingBeauty]

Hi Beauty

After reading Muffy's "editorial" on the perfect amount of nightly sleep - 7.5 hrs., I hope my almost 10 hour sleepathon last night - could be considered "catch-up" from the sleep deficit . Yesterday, with your encouragement, I took a walk. Later, I worked toward the 10:30 bedtime, got in bed about 10:22 and slept till 10:10 this am.

If those times are correct, then you actually slept for nearly 12 hours, not 10.

I guess the next step for me is to establish a time to awaken.

Sounds like a plan. It's easy enough to do that.

It would be easier to fail than succeed

Isn't that true of most everything in life?

That's why it is important we are supporting each other. I certainly appreciate the "Pep Talks" you give me. I can't say about you, but I was so obviously undiscliplined about sleep, that I was inviting sleep chaos, and that's what I got.

Ditto, to everything said there.

Stick with me B.. and with your help we may accomplish miracles.

Jan

You got it!

Oh, and P.S.: We're obviously cross-posting in our respective threads, as I responded to a similar post of yours in your own thread, apparently at the same time you were posting in this one. Poor Muffy. She's concerned about keeping our (mine, yours, and mar's) details separate, and we're making it that much more difficult for her to keep track.

[Muffy]

After reading Muffy's "editorial" on the perfect amount of nightly sleep - 7.5 hrs.

Muffy did not say that exactly, she said

This amount should theoretically be about 7.5 hours

There's going to be normals on either side of that, too. The point is, sleep has a pattern ("architecture") which needs to be optimized in terms of both "quality" and "quantity". And about 7.5 hours of "sleep" means "sleep". If one is in "bed" from 10:30 - 6:00 but has a 60 - 90 minute block of "wake" in the middle of the night, then that could be a problem.

And I must say that I am sooooo disappointed. While the U-shaped graph of sleep mortality in Kripke certainly looks impressive, a closer look at short sleepers showed the hazard ratio to only be in the 1.07 range there. Why did not anyone say, "Is that really something to lose sleep over?" Especially if you recall how Yaggi showed a hazard ratio of 1.75 - 3.30 of the occurrence of catastrophic event in treated OSAS? I mean, what's up with that?

Indeed, a search of the literature shows that short sleepers (up to a point, anyway) may not have a great deal to worry about:

A Prospective Study of Sleep Duration and Mortality Risk in Women

Correlates of Short and Long Sleep Duration: A Cross-Cultural Comparison Between the United Kingdom and the United States

Mortality Associated With Sleep Duration and Insomnia (Kripke)

Important Concept #6247: A problem is a problem only if it's a problem.

On the other hand, if you're a short sleeper, and are falling sleep at the wheel on I-5 going 80 miles an hour, then chances are you're gonna have a slightly higher hazard ratio than somebody who has no symptoms.

I hope my almost 10 hour sleepathon last night - could be considered "catch-up" from the sleep deficit.

Yeah, I would imagine it's best to just kinda "freewheel" after all the recent events. 10 (or 12 hours) might've set you up for a bad night last night, but just "make do" till the crisis is over. Maybe a well-placed nap at the afternoon dip will be helpful.

Today's Fun Thing To Know

The U-shaped graph of sleep duration and other stuff occurs in a few other things. Like weight for instance, as shown in the Quebec (from the French words "Que" meaning "Why" and "bec" meaning "am I living up here?") Family Study:

Poor Muffy. She's concerned about keeping our (mine, yours, and mar's) details separate, and we're making it that much more difficult for her to keep track.

Not to worry. I've got it now. Hey, Jan, how's the horseback riding? BB, you still Scuba diving? Mar, you gotten over the measles yet?

Muffy

[BleepingBeauty]

Today's Fun Thing To Know

The U-shaped graph of sleep duration and other stuff occurs in a few other things. Like weight for instance, as shown in the Quebec (from the French words "Que" meaning "Why" and "bec" meaning "am I living up here?") Family Study: (to which BB responds with ):

(image snipped)

Well, that could explain why it's been such a struggle for me to lose weight, especially recently. What a cruel joke (and a vicious circle) for those of us with sleep and weight issues...

Poor Muffy. She's concerned about keeping our (mine, yours, and mar's) details separate, and we're making it that much more difficult for her to keep track.

Not to worry. I've got it now. Hey, Jan, how's the horseback riding? BB, you still Scuba diving? Mar, you gotten over the measles yet?

Muffy

It's a good thing you've got a big brain, Muffin.

[SaltLakeJan]

Morning, BB, The Motivator Extraordinary

Awesome, Jan! I'm glad to be one of the people on this forum who's able to help someone else, in whatever way possible.

I am profiting by Muffy's advice to you:

BB, at what point(s) in the evening do you feel sleepy? There is a "window of opportunity" to take sleep, and benefit could be had from taking advantage of that as well. Keep in mind that all facets of sleep hygiene should be in place to take maximal advantage of this. As noted in the previous slide:

Last night around 8 p.m., I noticed signs of sleepiness. By 8:30 there were still there. I cut short the pre-bed routine, was in bed by 8:45, and asleep around 9 p.m. I can hear you say, "Wonderful Jan" What do either of us say, when I awakened at 4:30? You will come up with a good one-liner.
I did get the magic number of sleep hours - 7.5. I'm anxious to know how you did yesterday & nite.

And, Muffy, thanks for placing me in the Horse Race - I'm going to win - place - or show. Jan

[ozij]

BB, this is for you:

"Health at Every Size" Excerpts from Linda Bacon's book.
Please concentrate on you health and not on you weight. Concentrating on weight, and using it as a reinforcement makes us stop our healthy behavior when long term weight loss fails -- as it does for 95% of the population.

O.

[BleepingBeauty]

Morning, BB, The Motivator Extraordinary

I like that title.

I am profiting by Muffy's advice to you:

Yes, I saw that in your own thread this morning (and responded there). We have to stop "meeting" like this, Jan.

I cut short the pre-bed routine, was in bed by 8:45, and asleep around 9 p.m. I can hear you say, "Wonderful Jan" What do either of us say, when I awakened at 4:30? You will come up with a good one-liner.

Well, when I wake that early and can't fall back to sleep, what I say is not something I can repeat here.

I did get the magic number of sleep hours - 7.5. I'm anxious to know how you did yesterday & nite.

I was asleep by 11:00 and woke at nearly 6:00 this morning. Not quite the 7.5 or 8 hours I'm working towards, but getting closer.