Reduced REM - Lower AHI, Good or Bad?

[newpapper]

If most of the sleep disturbances which cause AHI to go up occur during REM - would a medication that reduces REM (such as an antidepressant) be beneficial or detrimental to overall sleep quality? Is losing some REM sleep a good trade off for a lower AHI?

[CapnLoki]

Seems like a bad tradeoff unless you have strong evidence all your events are REM related. Although statistically the are more events during REM, not all events are REM related, especially if well treated by xPAP. My events, now usually under a dozen, seem scattered through the night, and not well correlated with REM. Cutting my REM in half might reduce events 10%, but I doubt it would lead to most restful sleep.

[newpapper]

Yes Capn, it does seem like a bad tradeoff the way you put it. Not to mention what effect the lost REM may have.

[BlackSpinner]

If most of the sleep disturbances which cause AHI to go up occur during REM - would a medication that reduces REM (such as an antidepressant) be beneficial or detrimental to overall sleep quality? Is losing some REM sleep a good trade off for a lower AHI?

Then you need your pressure set to prevent the events during REM. This is one reason people use an auto machine. REM helps with memory and other mental issues.

[Wulfman...]

If most of the sleep disturbances which cause AHI to go up occur during REM - would a medication that reduces REM (such as an antidepressant) be beneficial or detrimental to overall sleep quality? Is losing some REM sleep a good trade off for a lower AHI?

Your post makes me wonder how you're quantifying/determining your REM sleep......or how you're coming to the conclusion that your events are related to it.

I would (and did) try to adjust my pressure to the point of being "comfortable" and to where my AHI and other events are minimal. Strive for good sleep hygiene. Use a comfortable mask. And, everything else should fall into place.


Den

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[newpapper]

Den - I'm not determining when I have REM sleep or quantifying it. I came to the conclusion that REM was severely impacting my AHI by the following assumptions (may be completely wrong). 1. My AHI was much lower last night when I took the antidepressant Mirtazapine. 2. Antidepressants reduce REM sleep. Therefore most of my apneas were occurring during REM sleep. There may be other factors at play which I am not considering.
If I am having reduced REM it affects memory. Certainly a reduced AHI improves sleep quality but what if it is at the expense of REM sleep?

[Wulfman...]

Den - I'm not determining when I have REM sleep or quantifying it. I came to the conclusion that REM was severely impacting my AHI by the following assumptions (may be completely wrong). 1. My AHI was much lower last night when I took the antidepressant Mirtazapine. 2. Antidepressants reduce REM sleep. Therefore most of my apneas were occurring during REM sleep. There may be other factors at play which I am not considering.
If I am having reduced REM it affects memory. Certainly a reduced AHI improves sleep quality but what if it is at the expense of REM sleep?

What kind of AHI "numbers" are we talking about?
And, while we're at it, what pressure settings are you using?


Den

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[newpapper]

Taking what probably junk apneas out I am figuring AHI of 5 for the good nights without Mirtazapine and .5 for the one night with.
Pressure is 8 with an EPR of 3, and with a fast EPR Inhale setting.

[Wulfman...]

Taking what probably junk apneas out I am figuring AHI of 5 for the good nights without Mirtazapine and .5 for the one night with.
Pressure is 8 with an EPR of 3, and with a fast EPR Inhale setting.

Do you realize that with that setup, your "effective" pressure at the point of the end of your exhale and the beginning of inhale is only "5"?
For all intents and purposes, your pressure is almost non-existent at that point.
This could be a root of your problem.
You may want to experiment with reducing your EPR setting......or even turning it off.

I just looked up Mirtazapine on Drugs(dot)Com. It's definitely not something I would want to take.


Den

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[BlackSpinner]

You need to look at your data in detail to see when your events happen and how badly. Just Ahi tells you noting much. Normal sleep cycles are about 90 minutes long.

[newpapper]

Thank you Den and Blackspinner. I'll consider the whole picture and not just focus on AHI.

[DoriC]

Taking what probably junk apneas out I am figuring AHI of 5 for the good nights without Mirtazapine and .5 for the one night with.
Pressure is 8 with an EPR of 3, and with a fast EPR Inhale setting.

Do you realize that with that setup, your "effective" pressure at the point of the end of your exhale and the beginning of inhale is only "5"?
For all intents and purposes, your pressure is almost non-existent at that point.
This could be a root of your problem.
You may want to experiment with reducing your EPR setting......or even turning it off.

I just looked up Mirtazapine on Drugs(dot)Com. It's definitely not something I would want to take.
Den
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Mirtazapine(Remeron) is a very heavy duty drug and usually used for major depression. It would probably impact your REM sleep and all other stages as well. The low AHI on this drug is not a valid number and probably doesn't represent a good night's sleep. Den's suggestion to lower or even turn off EPR is a good one especially since you're using such a low pressure and don't probably need it. Eventuallly you may wind up needing a higher pressure to prevent your events but you need software to monitor that. Good luck and keep us posted.