question about apnea and mood

[bayourest]

I often wonder about this: sometimes I will have a less than great night on cpap. I then feel cranky and yawn a lot during the day (note this is still better than sans cpap!!). I might say to a friend "Oh I did not have a good night" (evidenced by how I feel by a higher than normal AHI). Almost invariably the friend will say: "oh you must be worrying about this or that" or "you were kind of stressed" or something to that effect. To my mind, I think OSA is a mechanical, physiological problem that is being addressed by xpap therapy. I think it is different than insomnia (right, Robysue?) and if I am actually asleep the pap should be at work. If I am stressed or worrying and NOT sleeping that is a separate issue IMO. I have this debate with myself from time to time and I wonder what the members of the forum think....I've only been on this for 3 mos. I guess that underlying this question is the inference (that I make) that if everything in my life was "together" I would not have sleep problems...whereas it's actually a relief to me to find out there is an underlying physiological issue. any thoughts about this?

[Pugsy]

I was relieved when I finally got my diagnosis because I finally had a name and a reason that explained some of my symptoms. While effectively treating the OSA and getting at least relief to some of my symptoms which I could directly blame on OSA, that general overall high energy feeling has been more elusive. Even people without OSA will have good nights and bad nights. My husband who doesn't have OSA still comments on having hip and shoulder pain that disturbs his sleep. He is sure cranky when he has a bad night.

Sometimes we all just have some less than ideal nights despite the numbers. Sometimes a small change in the numbers can be associated with how we feel. Sometimes it makes sense and sometimes it doesn't. I remember back towards maybe 4th or 5th months of treatment when I had one of those "hallalujah" days. Felt amazing. Checked my data and my AHI was 10.. Go figure that one. In nearly 2 years I can count on one hand those days despite having extremely good numbers.

I have accepted the fact that treating OSA doesn't treat those other things that maybe might be related to other things. Morning headaches can be from my bad neck and not just OSA. Stuff like that. I think that when I finally accepted this fact my overall frustration with how things were progressing became much less and that in itself helped me "in my mind" to be less moody and again feel somewhat better. The "bad" days came less often. The mind is a powerful drug in itself.

Does all this mean that I gave up and didn't try to improve things? Heck no but I did quit beating myself up over a bad night for whatever reason might have happened.

Just my 2 cents worth for what that might be worth.

[JohnBFisher]

I often wonder about this: sometimes I will have a less than great night on cpap. I then feel cranky and yawn a lot during the day (note this is still better than sans cpap!!). I might say to a friend "Oh I did not have a good night" (evidenced by how I feel by a higher than normal AHI). Almost invariably the friend will say: "oh you must be worrying about this or that" or "you were kind of stressed" or something to that effect. To my mind, I think OSA is a mechanical, physiological problem that is being addressed by xpap therapy. I think it is different than insomnia (right, Robysue?) and if I am actually asleep the pap should be at work. If I am stressed or worrying and NOT sleeping that is a separate issue IMO. I have this debate with myself from time to time and I wonder what the members of the forum think....I've only been on this for 3 mos. I guess that underlying this question is the inference (that I make) that if everything in my life was "together" I would not have sleep problems...whereas it's actually a relief to me to find out there is an underlying physiological issue. any thoughts about this?

A couple points.

First, remember that sleep deprivation is used as a torture! Do not underestimate how much we need it. If you are getting poor sleep is WILL impact you in many, many ways. Besides presenting a severe load on your cardiovascular system, it will adversely impact your mood. Many people are diagnosed with depression who should be getting medical attention to address sleep apnea. Improve sleep and you will improve your mood. It's not just a physiological issue. It has a huge impact on our psyche.

Second, real world is that we will always have some concerns that disrupt our sleep. Some worse than others. We need to deal with such stresses as best as we can to help improve our ability to sleep. Going for a late afternoon / early evening walk. Spending time with a friend away from our stresses (and away from drinking) can be a huge help. Take time to listen to relaxing music. Take time to watch an engaging movie. In other words, take time to PLAY! How do you know if you are playing? If you loose track of time, you are playing. And that is one of the easiest ways to counter such stress.

Lastly, disrupted sleep - either from sleep apnea or day-to-day stress - is disrupted sleep. Your body can not tell the difference. And it WILL impact you both physically and psychologically.

So, do what you can to improve your sleep. Address the apnea. And address the stress. And here's hoping you will realize your dream of more dreams!

[Pugsy]

Well said John.
Clearly, concisely and to the point.

[Big S]

JohnBFisher wrote:
Lastly, disrupted sleep - either from sleep apnea or day-to-day stress - is disrupted sleep. Your body can not tell the difference. And it WILL impact you both physically and psychologically.

I couldn't agree with this more! For me, when I deal with the biggest stress issues in my life, I sleep better.

Luckily, I haven't had big problems with cpap therapy. My mask doesn't leak too much and I seem to sleep well. For this reason, I don't spend much time with the data. If I feel good, I know I slept well. If I don't, then sometimes I check out the data and sometimes I just go back to bed for an hour or so. Since the previous lifetime of fragmented sleep has tired me, I don't ever feel guilty about doing this.

[robysue]

bayourest,

JohnBFisher has hit it on the nail: Sleep deprivation---regardless of it's cause----plays havoc with our minds and our bodies.

Now OSA is essentially a mechanical problem and CPAP addresses it well, most of the time. But as you note, we all have a bad night sometimes. And an AHI higher than normal could easily leave both your mind and body with a bit of stress from the sleep that was more disturbed than usual because of more apneas or longer apneas or both, and that can easily leave you in a bad mood or a cranky mood the next day.

You also wrote and asked:

To my mind, I think OSA is a mechanical, physiological problem that is being addressed by xpap therapy. I think it is different than insomnia (right, Robysue?) and if I am actually asleep the pap should be at work. If I am stressed or worrying and NOT sleeping that is a separate issue IMO.

As for insomnia---it basically covers not sleeping long enough caused by any of the following: not falling asleep soon enough and not being able to stay asleep once you fall asleep and waking up significantly earlier than you want to and not being able to get back to sleep. Stress can cause insomnia in some folks. But so can lots of other things. My own current insomnia (which is NOW responding to the sleep restriction and good sleep hygiene!) was triggered by all the sensory overload from starting CPAP and the fact that originally I was just enough over titrated to make my stomach and eyes and ears feel really wretched every time I slept with the mask on. And because I understood the consequences of untreated OSA and myself well enough, I was sleeping with the mask on all night, every night right from the start. By the end of November the insomnia monster was growing fat and strong with plenty of food---from the continuing sensory problems with sleeping with CPAP, from my complete crash and burn in terms of daytime functioning, from the stress that the CPAP and CPAP-induced insomnia was creating in my daily life, and from all the things that have fed previous insomnia monsters through the years. The forces that were feeding this insomnia were wide and varied and the insomnia was resistant to all the good sleep hygiene tactics that I'd used to tame other insomnia beasts in the past. I can't imagine how much worse this insomnia could (would) have gotten had I not already internalized about 70--80% of the standard good sleep hygiene rules and was using those tried-and-true rules as soon as I started having problems getting to sleep and staying asleep.

And once a bad bout of insomnia starts, one of the things it feeds on most readily is worry rather than stress itself. Worry about <fill in the blank> can keep a nasty insomnia monster well fed for months (and years). And in a real twist of irony, one of the things that many insomniacs spend time worrying about is the insomnia itself. One of the fastest, quickest ways to turn a little baby insomnia monster into a full-fledged beast with nine heads is to lie awake in bed staring at the clock worrying about the insomnia: worrying about the fact that you are not asleep, worrying about how little you've slept, worrying about how long you've been awake, worrying about how close it is it morning, worrying about ....

That's why it's so important when dealing with insomnia to be willing to get out of bed if you're not sleeping anyway and go do something relaxing in a different room until you are sleepy enough to return to bed and try again. And why it's so important to put the clock somewhere where you can't easily see it when you are lying in bed not sleeping ... It's the most reliable way to keep yourself from worrying about the insomnia while lying in the bed not sleeping.

But like treated OSA, for a person with chronic insomnia tendencies, some nights are simply "worse" (more restless and more sleepless) than normal---even after you've got the insomnia firmly under control. And yeah, a bad night for the insomnia affects my mood and functioning as much (or more) than a bad night for the OSA.

[SleepyT]

Well said John.
Clearly, concisely and to the point.

Dittos. Well done.