The best and the worst.

[Dogjudge]

So on 2/3, I had my best night of sleeping in probably 8 months. Actually slept through an entire night with no interruptions.

I felt as if things were finally starting to go the right way.

It all went downhill from there. Last night it was about 3 hours of sleep. While my CPAP makes me feel as if I'm sleeping more comfortably, and that it's better with than without, 6 hours of interrupted sleep is truly doing me in. Constantly groggy. You REALLY don't want to be around me. Blood pressure is up. In the evening, I feel tired and have no problem going to sleep, it's just constant restless and waking up during the night.

ANY ideas what's going on.

By the way. I do have asthma, and am typically congested (although not bad). Last night I was definitely breathing well and had zero congestion.

HELP.

[chunkyfrog]

Are you being treated for the asthma?
If so, it might be possible that the "asthma" --isn't.
That happened to a co-worker, and to me, as well.
Any number of things may be diagnosed as asthma, at first.
I had pneumonia, so the bronchodilator My HMO doctor gave me was totally ineffective.
After a day of this, I called her back, telling her how useless the inhaler was no help.
She finally did a chest X-ray, and I was correctly dx'd with pneumonia.

[Dogjudge]

Thanks for the comment, but I've been treated for asthma for probably 15-20 years.

It seems to under control. That being said, I've got a doctor appointment mid-March and the doctor is also a pulmonologist.

Since I've been at this since September, I would have thought/felt that I would have seen progress beyond one night here and one night there. I'd be ecstatic to get uninterrupted sleep for a few days in a row.

Toward the middle of December, I was extremely frustrated. Ironically, I had an appt. with my GP, psych (Bi-polar), and had made an appt. with my sleep doc. ALL of them said to start a regiment of Klonopin. I've used that very sporadically over the last 10 years. Now taking 2 mcg/night. At first it helped a bit, but nothing seems to be working at all now. And yep, I know the side effects and downside of Klonopin. My intention is to get into a pattern of being able to sleep and then weaning myself off of it.

Paraphrasing the play "Annie". "Sleep Glorious Sleep".

[Julie]

If you take meds... which ones?

[Dogjudge]

Advair 250/50 - two times/day (Just after I get up and just after dinner.)
Levothyroxine 112 mcg in the AM once per day
Lamotrigene (Bipolar) (200 mg in the AM, 100 mg at noon)
Metoprolpl ER Succinate 100 mg. Once in the AM.

[Sleeprider]

The graph shows some pretty remarkable similarity in timing of increased pressure and events, although results have gotten worse. If it was my therapy (and it's not), I'd increase minimum pressure in hopes of heading off the H and OA that seems to onset with REM or sleep position changes. Hypopneas are getting through under low pressure without preceding snores (VS) and flow limitation (FL) to head them off. The leaks look good and you may need just a little more pressure to head off those mid to late night events.

I have also had pretty good success with reducing flex level. It seems higher flex levels contribute to a higher RERA for me. That may not hold true for you, but it may be worth a try. Whatever you decide to change, try doing only one thing at a time, and give it some time to show a trend.

[Dogjudge]

Sleeprider,

Thanks for the tips.

I teach/have taught dog obedience for 30+ years. Two rules. You have to be smarter than the dog. Only change one thing at a time.

I'll try a higher minimum pressure first.

Thanks again.

[Drowsy Dancer]

Were you prone to insomnia before you started CPAP?

[Dogjudge]

From time to time, I would have what I would call anxiety based insomnia issues.

A little less than a year ago, I started waking up multiple times during the night. It progressed to the point that I never slept through the night. Might wake up. Stay awake for 45-60 minutes and then fall back asleep. Best nights 4-5 hours of "sleep".

About that time, I came across an iPhone app, Sleepbot. Figured why not try it. In addition to moving around quite a bit, it showed that I was snoring nearly the entire night.

Don't have, and don't remember, the results from the first sleep study, but the doctor said I definitely was dealing with sleep apnea. Month later, second sleep study, playing with the different masks. Got my machine about mid/late September.

Didn't really start sleeping tremendously, I was waking up less and it was more restful. Still 6, or so hours of sleep.

About early November, I started waking up in the middle of the night again, or it was nights where I simply wasn't totally falling asleep (don't know any other way to describe it).

Got to the point, where I was totally frustrated about the entire thing. I am more than a little anal, so I had set up a spread sheet, with AHI, estimated number of hours I had actually slept, and then a 1-5 rating for the quality of sleep I was getting. There were a couple of nights where I had tried 0.5 mcg of Klonopin (based on previous doctor recommendations (GP). When the clinician looked at the spread sheet, she felt the Klonopin would be the solution. Since my GP and psych doc had both said the same thing, I figured what the heck. That was maybe mid-December.

Since then, I'l get one night of really good sleep maybe every other week. Last time I had a night of good sleep was on 2/3.

I'm figuring that I need to have my body get into a "pattern" of sleeping again. Once that happens, then I wean off the Klonopin.

[kteague]

You've mentioned restless sleep. Any mention in your sleep study reports of limb movements?

[Dogjudge]

Can't remember if anything was mentioned.

But, with the Sleepbot app, there was quite a bit of movement.

[Julie]

Have you researched side effects, or just plain effects (normally accompanying each med) of those... which could impact OSA or Cpap?

[Huh?]

From time to time, I would have what I would call anxiety based insomnia issues.

A little less than a year ago, I started waking up multiple times during the night. It progressed to the point that I never slept through the night. Might wake up. Stay awake for 45-60 minutes and then fall back asleep. Best nights 4-5 hours of "sleep".

Those are symptoms of untreated sleep apnea.

[Dogjudge]

Julie,

A couple of things.

- Checked with all three doctors about the use of it.
- I've sold ingredients to both the food industry (primarily) and to the pharmaceutical industry. Because of that, I know some of the research people at the pharmas. I was able to talk to some of them about its use.
- I also have a degree in chemistry and one in biology, so when I read some of these things, I can sift through the BS from the reality.
- Over the last maybe 15 years, I've used it maybe 2X per month to treat anxiety.

If you have any other things you'd like to mention, or site you'd send me to, I'm all ears.

As a scientist, one thing that I am extremely cautious about is the "experts" who have no substantiated background. I see it ALL the time in the food industry. There's a guy right now selling something called "Soylent". His claim are weight loss and stabilization. A 100% food replacement. Consume this 3X per day and you don't need to consume anything else. His studies? Well, he and some friends of his consumed the stuff for a couple of months. His background? Well, he's been selling the stuff for maybe a year. Prior to that he spent a YEAR studying perfect nutrition. Prior to that? He was a software engineer for 5 years.

He claims that the company that is packaging the stuff for him did all the other work, to make sure it was nutritionally perfect. Funny. I've sold that company ingredients. The company is a co-packer for companies and doesn't have ONE nutritionist, or food scientist working for them.

[Janknitz]

Any chance you could get hold of a pulse oximeter to see if your 02 sats are doing anything interesting during the night?

Totally off topic but Just curious if you eat the processed foods made with the ingredients you sold???