Pugsy, How do you tell when in REM sleep.

Pugsy, I often read in your posts that your AHI goes up in REM sleep. Can I tell in Sleepyhead graphs or is this from the unavailable ZEO I keep reading about? I have noticed that being awake increases all events and wonder if some event clusters are due to awakening for a while and not remembering or if I was in REM. It sounds as if brain waves must be read to tell all but is there a way to make an educated guess? I do remember if I am dreaming when my alarm goes off. I am very happy to dream again as I spent a long noticeable time without before being diagnosed and starting cpap, of course I wasn't sleeping either. It has been eleven months and I am just now been getting consistent results under one for the last few weeks. My graphs are much easier to read now,well worth the wait!

Technically we can't tell about REM with any certainty without EEG brain wave data.
Even the Zeos weren't perfect..
There are some folk on the forum that say that they can isolate probable REM sleep by a combination of tidal volume and respiration rate and something else (I forget exactly what it was or is). There's probably some truth to it if a person studies a whole lot of wave form data with volumes and whatever but there is no way without EEG that is 100% certain.

In my case...my OSA is worse in REM stage sleep. Documented at the diagnostic sleep study...12 in non REM and near 60 in REM...pretty cut and dry.
I don't bother with trying to isolate exact REM time frames because it is what it is and what am I going to be able to do about it any?
Normal sleep cycles have a pattern to all the stages...I can easily compare any clusters of events I might have with a normal hypnogram and see when I would be expected to have REM per the hypnogram and see if that time frame correlates to my reports. Like 99% of the time when I was on APAP I always saw either a little cluster of events or a good size pressure increase about 90 minutes after sleep onset...and at around an hour or so before I woke up...

First REM normally occurs around 90 minutes after sleep onset in most people (of course not all but in general that is what happens) and then as the night goes on REM comes on more frequently and last longer with the greatest REM happening right before we wake up.

With my history...easy to spot. And REM worse OSA isn't uncommon and people can usually spot if REM makes things worse by the diagnostic sleep study if they had much REM.
With those whose OSA isn't particularly worse in REM sleep...not so easy to spot but you if you really want to look at your reports under the microscope you could do that and compare what you see (tidal volume, flow, etc) with the normally expected patterns and get a fairly close estimate.
It's just an estimate and that's a lot work...and other than maybe satisfying a curiosity itch there's not a whole lot to be gained. That's why I say "it is what it is". We really can't do anything about REM nor would be want to if we could.

http://en.wikipedia.org/wiki/Sleep
There's a good hypnogram at this link above but go ahead and google "sleep stage" and when you see the images of althe various hypnograms pop up ...go take a look at all of them to get a feel for what is "normal".

If we know we were awake for a period of time...and during that period of time we see events getting flagged..we have to mentally toss those out the window.

Give me a few minutes and I think I have an old report that really points out my probably REM clusters so you can see what I mean. I think I have an old bipap report somewhere from when I was just figuring out what bipap pressure to use and I didn't use quite enough.

Here's an example of what happens to me at fixed pressures when the machine can't auto adjust. It isn't horrible but wasn't quite enough to do a good job. When on APAP I need a minimum of 10 to keep those clusters away and sometimes the machine wanted to go to 18 ish.
On the BiPap Pro I tried EPAP at 9 and wonder if it would be enough with IPAP mixed in but it wasn't. Once I changed to 10 EPAP on this machine those clusters went away.

If you compare those clusters above to normal REM stage sleep cycles in a normal hypnogram...they are really close...the first on wasn't exactly 90 minutes but it was close.

Now I probably had other REM cycles but just didn't have any events happen to sneak past the defenses....I had another night at these pressure that had nothing to show on it to speak of and I put that image below this first one. That's why I say we don't sleep the same way each night.

So I can't always spot REM because I don't always see many events...I can pretty much point out REM when I do have little clusters of events.



same pressure not much going on.

Thank you Pugsy, I have been discounting events when I knew I was reading or listening to an audio book or music. I set the included timer for my audio books to turn off in 30 min. It gives me a time frame and I know if I don't know where I am at the new start place I must have fallen asleep before it turned off and can back up to see how long I listened then check in sleepyhead for the same time. just too much curiosity I guess. The more I know the more I want to know. I will give my graphs a closer look now that I have seen yours. Thanks for the examples.

So this is my cue to post my thoughts on this.

I believe my periods of REM sleep are quite visible on the Respiration graph in SleepyHead. I don't know if its quite so obvious for other people because these graphs are almost never posted in the forum - I've certainly seen a few where REM is not so obvious. But for me, virtually 100% of the "normal nights" follow the pattern shown in my first post on this.

viewtopic.php?f=1&t=94782

I knew the Capn would chime in.
I am not going to dispute your thoughts because I can't. Don't really want to.
Your way of looking is really not that much different from me eyeballing normal patterns what we would expect as REM stage and correlating that way. We are both guessing at something because of a pattern we see.. we don't have EEG to back us up... but you know what...it's close enough for government work anyway for both of us since it makes both of us happy with what we come up with.

I do want to mention this. Just for those people who want to start eyeballing their respiration for REM...and if you all want to do that then you all need to research what phasic and tonic REM are. Have fun.

Postby Sludge on Sat Feb 15, 2014
Maybe in phasic REM (to the tune of ~75% of the time), but respiration in tonic REM tends to be pretty regular.