Normal Amount of REM?

roysann · Post by **roysann** » Wed Sep 07, 2005 9:51 pm

Can anyone tell me what the "normal" percentage of REM when evaluating sleep study results? My study showed that over the entire night I had 12% REM which was decreased. Just wondering how decreased that is from average. Thanks!

Fatigue Fighter · Post by **Fatigue Fighter** » Wed Sep 07, 2005 10:10 pm

Good question! I'd like to know too. My REM sleep was ziltch; nada; zip; zero....
FF

rested gal · Post by **rested gal** » Thu Sep 08, 2005 1:55 am

roysann, while this doesn't answer your specific question it's pretty interesting reading. You might be able to kind of figure how much REM you should be getting, depending on how many hours you sleep:

sleepdisorderchannel.net

Also, Deltadave posted a neat little chart about REM on page two of this topic:

Aug 01, 2005 subject: Confused...still???

deltadave · Post by **deltadave** » Thu Sep 08, 2005 4:59 am

Hi all!
Normal REM should compose about 20% of your sleep, so 90 minutes if you're getting 7.5 hours. Anti-depressants can delay REM onset as well, knocking out one or more REM periods completely. The OSA will fragment the REM period through arousals, then the body finally gives up and waits till the next sleep cycle to try again.
In the CPAP titration, you may see a substantial increase in REM, a REM Rebound, as the body catches up on quality sleep. This is only temporary, as one normalizes sleep through CPAP, the sleep architecture will normalize too.
So that's where that Stage 5 thing came from! That's not really an "official" term, it's just called plain ol' REM.
deltadave

Fatigue Fighter · Post by **Fatigue Fighter** » Thu Sep 08, 2005 4:03 pm

Thanks DeltaDave for the quick education. I did not have any REM in my first titration in May but I did have almost an hour of REM in my second titration on Sept 2. Perhaps that partially explains why I am still "out of sorts" when it comes to feeling better and I just need to be much more patient.

Rested Gal,
Thanks for the URL to Sleepdisorder channel.net. I'll look it up there as well.

Roysann,
Thanks for asking the question in the first place!

FF

roysann · Post by **roysann** » Thu Sep 08, 2005 8:41 pm

Thanks for the great information! I realize that a lot of this is not black or white in nature, but it's nice to have some kind of guideline to go by when trying to interpret results. FF, you're welcome for the question

roysann · Post by **roysann** » Fri Sep 09, 2005 8:46 pm

Is it normal to feel more tired when you are getting more REM with treatment? Last month when I was using the Breeze nasal pillows, the days after I used CPAP I was more tired than the nights that I didn't when I was giving my nose a rest. Now I am using the Breeze but with the nasal mask. I have used it for the past 4 nights and I love it! Way better than the nasal pillows although my cheeks bones are a little sore - nothing that I can't handle though. Two of those days I have been so tired in the afternoon that I have had to take a nap. Every night that I have been using the mask I have only awoke once or twice that I am aware of compared so I think I am getting more quality sleep. Anyone have any feedback?

deltadave · Post by **deltadave** » Sat Sep 10, 2005 3:44 am

Hi all:

I did not have any REM in my first titration in May but I did have almost an hour of REM in my second titration on Sept 2. Perhaps that partially explains why I am still "out of sorts" when it comes to feeling better

Is it normal to feel more tired when you are getting more REM with treatment?

Excessive daytime sleepiness (EDS) may come from 3 causes as it relates to sleep:

Insufficient sleep. The company line is 7.5 hours per night.

Insufficient quality sleep (Sleep Stage Totals). The breakdown of sleep by stage is Stage 1 5%, Stage 2 55-60%, Stage 3&4 20%, and REM 20%. Stage 3/4 gives you the most rest. Reduction in REM due to anti-depressants should not make you tired.

Insufficient quality sleep (Breaks in Sleep Continuity). This is really why we're all here. Every time you have an arousal, like after a hypopnea, apnea or PLM, there is not only a break in sleep continuity, but you also back up at least one sleep stage (except for REM, where you go to Stage 2 or 1, you can't go SWS-REM or vice versa). So OSA keeps bumping you into lighter stages of sleep, and this contributes to #2.

Your first night on CPAP, the toxin has now been removed. Allowed to sleep continuously, you pay back the sleep debt. This results in rebound phenomena, so your REM and often SWS are increased, sometimes dramatically, as the debt is paid. Night 2 or 3, your sleep architecture is a heckuva lot more normalized.
So when some people say "Wow, I felt so much better after that first night in the sleep lab than I do now", that was the rebound effect, and due more to the removal of the toxic OSA than anything else that happened in the sleep lab.
Getting "used to CPAP" means exactly that. You may have trouble maintaining sleep with CPAP on, that is what is now disturbing your continuity somewhat, and must be addressed before all is right in the sleep world.
Also with normalized sleep architecture, you may be sleeping a little bit lighter, not in a coma because you're exhausted, so things like mask fitting are now a big issue. So don't think "This CPAP mask makes my sleep worse." No, it may be more likely that since you're sleeping normally, a mask or pressure bothers you, and that's what you need to get used to.
So, an hour of REM? Yeah, perhaps somewhat reduced, but you have to take that in context.
More REM = more tired? No, I think that's the other way around, when you're more tired, you may get a rebound.
Hope that helps.
deltadave

ufo13 · Post by **ufo13** » Sat Sep 10, 2005 8:01 am

deltadave:

i wrote a a longer post but i got knocked off line, but the gist of it was to thank you for a most interesting and informative description of the various stages of sleep, etc. the most straight forward and easy to understand piece on the subject i have ever read! YOU are a very intersteing and helpful person with GREAT info. KUDOS to YOU!

best to you,

steve,
ufo13

deltadave · Post by **deltadave** » Sat Sep 10, 2005 8:20 am

Hi Steve!
You're quite welcome, glad to help!
deltadave

Fatigue Fighter · Post by **Fatigue Fighter** » Sat Sep 10, 2005 5:36 pm

Thanks DeltaDave! I agree with Steve....you summed it up so succinctly. Thanks again for your helpfulness.
FF

roysann · Post by **roysann** » Sat Sep 10, 2005 9:43 pm

DD, Thank you for the great explanation. You have a gift for explaining what can be complicated stuff in a very easy to understand way. I can't believe how much I have learned since hanging around here!!

rested gal · Post by **rested gal** » Sun Sep 11, 2005 2:42 am

Love your posts, Dave! Great explanations! You're a good'un.

frostman · Post by **frostman** » Sun Sep 11, 2005 7:49 pm

how can you tell with encore pro when you are in REM?? Is there a way to read your data and know this???

WAFlowers · Post by **WAFlowers** » Mon Sep 12, 2005 8:21 am

You can try and make educated guesses based on the pattern of events (apneas are more likely during REM), but they are only guesses. The only way to really be sure when you are in REM would be to have a PSG in a sleep lab.

Normal Amount of REM?

Normal Amount of REM?

How Much REM?

REM and Tired

thanks,,,,,,deltadave!!!!

You're Welcome!!

REM