Finally- an appointment with Sleep Doctor

naturopathic healing

=

1. Homeopathy
2. Herbalism
3. Acupuncture
4. Diet
5. Lifestyle counseling

1, 2 and 3 = quackery, charlatans, pseudoscience and scams.

4 and 5 = good, if based on scientific research; otherwise, much quackery.

Be careful.

beautifuldreamer wrote: This sleep situation started at least 30 or 40 years ago - I maybe have had less than ten days where I can remember getting a full 8 hours of sleep in a night.

Your body may just not want or need a "full 8 hours of sleep in a night".

Seriously. Not everybody needs 8 hours of sleep. A lot of people do fine on 6 or 7 hours. Some people need 9. And a lot of people don't sleep in one continuous stretch: They wake up in the middle of the night, get up and do some things, and then go back to bed and sleep until morning. Google "two phase" sleep.

One of the most critical things a lot of long term insomniacs have a hard time accepting is that there is NOT one correct, best way to sleep every night.

I am glad to start with the CBTI ideas that the sleep doctor gave me to try for now. And the Great sleep hygiene information- Things have gotten chaotic in my bedroom, and today a friend came and helped me to get things more organized- I think that having the room less cluttered and more organized will help also.

Getting the room less cluttered may help.

Kicking all the "screens" out of the bedroom may also help. In other words, you may need to remove the tv from the bedroom and not bring the computer, tablet, or smart phone to bed with you.

robysue, all those questions above I asked just for reference. Please check my ResScan charts from last night.

Statistics:
http://imgur.com/a/GJbP3

ResScan:
http://imgur.com/a/vvryz

Thanks.

avi123 wrote:robysue, all those questions above I asked just for reference. Please check my ResScan charts from last night.

Statistics:
http://imgur.com/a/GJbP3

ResScan:
http://imgur.com/a/vvryz

Thanks.

Avi,

If you want my help, can you please start a new thread instead of hijacking Beautifuldreamer's thread.

Your previous comments in this thread were useful and on topic since Beautifuldreamer is having some trouble with insomnia issues. But I don't want to side track her thread with your issues. Post the links to your data in a new thread and I'll take a look at them.

avi123 wrote: A 20-minute sleep clinic visit with a sleep psychologist/CBT-I specialist averages about $120 and a two week supply of non-generic sleeping pills or two co-payments at a sleep clinic are about $40.

My friend sees a psychologist who does CBT/sleep related issues. It's covered under medicare, at least in CA. Medicare 80% and his supplemental insurance 20%. You might want to check that out.

""This sleep situation started at least 30 or 40 years ago - I maybe have had less than ten days where I can remember getting a full 8 hours of sleep in a night.
Your body may just not want or need a "full 8 hours of sleep in a night".

Seriously. Not everybody needs 8 hours of sleep. A lot of people do fine on 6 or 7 hours. Some people need 9. And a lot of people don't sleep in one continuous stretch: They wake up in the middle of the night, get up and do some things, and then go back to bed and sleep until morning. Google "two phase" sleep.

One of the most critical things a lot of long term insomniacs have a hard time accepting is that there is NOT one correct, best way to sleep every night."""

In my opinion, sleep doctors contribute to this problem with their questionnaires by just asking how many hours of sleep someone gets. Not once have I filled out one in which I was asked to list my perception of the quality which in my opinion is alot more important than the number of hours.

Also, the way the questions are set up, they assume that everyone sleeps in one continuous stretch and don't leave room for people to provide a different schedule.

I have to disagree with you that long-term insomniacs can't accept that there isn't one correct way of sleeping. On the Antidepressant Withdrawal Groups I belong to in which insomnia is a parting gift from being on these meds, most members would be thrilled to get any type of sleep that would help them function better.

Sorry, I didn't mean to get off topic but wanted to address these issues.

Not everybody needs 8 hours of sleep. A lot of people do fine on 6 or 7 hours.

It would be more convincing if some of you could provide links to studies showing the mortality and general health of people who sleep 6 hours is as good as those who sleep 7 or 8. Unsubstantiated pronouncements that "6 hours is fine" are not in the least convincing.

ChicagoGranny wrote:

Not everybody needs 8 hours of sleep. A lot of people do fine on 6 or 7 hours.

It would be more convincing if some of you could provide links to studies showing the mortality and general health of people who sleep 6 hours is as good as those who sleep 7 or 8. Unsubstantiated pronouncements that "6 hours is fine" are not in the least convincing.

The current National Sleep Foundation guidelines for how much sleep people need at various ages can be found at:

https://sleepfoundation.org/media-cente ... s/page/0/1

According to the National Sleep Foundation's web page, these "recommendations are the result of multiple rounds of consensus voting after a comprehensive review of published scientific studies on sleep and health."

And while they recommend that 24-64 year olds get 7-9 hours of sleep each night, they also state that an appropriate amount of sleep for some individuals in this age group may be as little as 6 hours or as much as 10 hours of sleep. For the 65 and older group, the recommendations are for 7-8 hours of sleep for most people along with the statement that an appropriate amount of sleep for some individuals in the 65 and older group may be as little as 5-6 hours of sleep or as much as 9 hours of sleep.

In my own case, the stress needed to try to get 7-8 hours of sleep every single night aggravates a number of other health conditions AND it makes the overall quality of my sleep go down. I've been working with multiple health professionals for a number of years, including my current sleep doctor, and they all agree that I am much better off getting 6 or 6.5 hours of high quality sleep as opposed to 7-8 hours of poor quality sleep. In other words, there's more to sleep than just the total sleep time.

Beautifuldreamer, the OP, has a 30-40 year long problem with insomnia and she apparently believes that "good sleep" means that you must get 8 hours of sleep before the sleep can possibly be good. My comments directed to beautifuldreamer were nothing more than an attempt to get her to understand that if she is worry too much about her inability to get 8 hours of sleep, that she ought to reevaluate whether she needs that much sleep. In other words, she ought to start focusing on the quality of the sleep she is getting instead of just on the quantity of the sleep she is getting.

beautifuldreamer wrote:This sleep situation started at least 30 or 40 years ago - I maybe have had less than ten days where I can remember getting a full 8 hours of sleep in a night.

Then your age is probably above 65 and you're retired. I am retired. I watch Charlie Rose TV program from 12 a.m. to 1 a.m. and then I put the mask on. If I don't fall asleep within 30 minutes I then take another 5 mg Zolpidem tablet. This usually makes me fall asleep till 7:30 a.m. But then I get a fogged up brain. So I sit on the lounge chair and watch more TV till 11 a.m. while taking some naps. My APAP treatment is doing its job but so far does not help with eliminating the next day foggy brain. There could be other sleep ailments effecting me. I might be suffering from Idiopathic Narcolepsy or Idiopathic Hypersomnia.

Examples:
http://sleepmedicine.com/disorders.cfm?disorder=5

robysue wrote:Beautifuldreamer, the OP, has a 30-40 year long problem with insomnia

You are jumping to a conclusion that her problem all those years was insomnia. You should know well that many people go that long with undiagnosed sleep-disordered breathing (SDB) before getting appropriate treatment. The root of their "insomnia" was SDB all along.

The OP should get her CPAP therapy working well and establish a good sleep hygiene before assuming she has a serious problem with insomnia.

As for you, projecting your problem (and your personal solution) onto everyone who reports an "insomnia" problem may be counterproductive more often than productive.

ChicagoGranny wrote:

robysue wrote:Beautifuldreamer, the OP, has a 30-40 year long problem with insomnia

You are jumping to a conclusion that her problem all those years was insomnia. You should know well that many people go that long with undiagnosed sleep-disordered breathing (SDB) before getting appropriate treatment. The root of their "insomnia" was SDB all along.

The OP should get her CPAP therapy working well and establish a good sleep hygiene before assuming she has a serious problem with insomnia.

The OP is NOT currently sleeping well with her CPAP in spite of the fact that the CPAP data looks good. She has a long history of self described sleep problems. And her sleep doc has said CBT-I is appropriate. It is reasonable to conclude that whatever the cause of her long history of not sleeping well, the current insomnia may need more help than just a little bit of self-help guidelines can provide.

As for you, projecting your problem (and your personal solution) onto everyone who reports an "insomnia" problem may be counterproductive more often than productive.

Perhaps.

But at the same time you have projected your situation and your own solutions onto the OP. And you've encouraged her to ignore her own sleep doctor when you wrote:

ChicagoGranny wrote:

beautifuldreamer wrote:He also gave me a brief discussion of CBTi, a type of therapy used for insomnia

That's usually not necessary if you follow these basic instructions:

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping (and sex) only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Do not listen to your breathing or the sound of the machine as you are falling asleep.
- Distract your mind by thinking of a pleasant, relaxing activity that you enjoy. Thinking of sitting under an umbrella on a quiet beach with a warm gentle breeze works for me.

For all we know the first part of the CBT-I conversation between beautifuldreamer and her sleep doc consisted of exactly what you told her. Certainly every conversation I've ever had with doctors about insomnia has started off with "Practice good sleep hygiene" and all the rest of what you have on that list. Because that's the START of a good CBT-I program. But a good CBT-I program can and should be tailored to the individual's needs and specific issues that are NOT addressed by tightening up on the sleep hygiene and paying more attention to the things on your list.

Not everything is fixed by good sleep hygiene and the rest of the items on your list---which are really nothing more than the larger set of "good sleep hygiene" that I and my doctors have had many a positive conversation about through the years. If practing good sleep hygiene was all that was required to fix everybody's insomnia, I would not have had to have spent well over a year working on recovering from the insomnia that resulted in starting CPAP.

robysue wrote:The OP is NOT currently sleeping well with her CPAP in spite of the fact that the CPAP data looks good.

If the CPAP data looks good, then why does her doctor think two pressure increases are necessary?

beautifuldreamer wrote: He increased the settings slightly on my device, and if I can tolerate the change but it doesn't seem to help, he will increase it more- but if I can't tolerate it, he will reduce the settings. His hope that a more aggressive treatment of the sleep apnea will help me to stay asleep longer during the night.

ChicagoGranny wrote:If the CPAP data looks good, then why does her doctor think two pressure increases are necessary?

who can tell what crazy things run through the heads of some doctors. if they were all good and competent, this forum wouldn't exist.

ChicagoGranny wrote:

robysue wrote:The OP is NOT currently sleeping well with her CPAP in spite of the fact that the CPAP data looks good.

If the CPAP data looks good, then why does her doctor think two pressure increases are necessary?

beautifuldreamer wrote: He increased the settings slightly on my device, and if I can tolerate the change but it doesn't seem to help, he will increase it more- but if I can't tolerate it, he will reduce the settings. His hope that a more aggressive treatment of the sleep apnea will help me to stay asleep longer during the night.

It might help to know that Last year, i was trying to find out why I was still experiencing daytime sleepiness and that my average AHI on the BiPap had increased to 10 or 12 AHI. My main concern was falling asleep when I am inactive and quiet (like in a lecture seminar or similar). Also, a few months ago when I got a jury duty notice, my biggest fear was that I would fall asleep during the trial if I was selected for a jury. In the past year I had 2 sessions scheduled (one in January and one Last month) where I would have an overnight study followed by a day time night study. Both times I was not able to sleep during the night, so that canceled the day study. Also after the January overnight study it was determined that I should switch to an ASV. As a follow up to last month's overnight study that was supposed to be followed by the daytime nap study, the sleep doctor called me and he gave me the option of whether or not to have an appointment with the Respiratory therapist to have her put the new settings or I could meet with him- so I chose an appointment with the Sleep Doctor, mainly because I hadn't had an appointment with a Sleep Doctor before.

My Sleep Doctor wants to help me First of all by trying to get the optimal settings to treat the sleep apnea, (he will increase again only IF the new settings aren't helping and if I can tolerate the higher pressure). He thinks that even though currently my average AHI is 3 (since being shifted to the ASV), that for me, that Might not be optimal, since I continue for fall asleep during the daytime.

Then there also appears to be a problem with me sleeping through the night. Averaging 4 to 5 hours per night of sleep, has been a problem to me for many years. Often it involved waking up in the middle and have difficulty falling back asleep. I have noticed that with the new settings for these past few days, I have not noticed myself waking up and struggling with falling back asleep. I wonder if that is because the settings are more suited for me- One of the things that has wakened me in the night is the pressure would seem to get very high (probably it sensing I was having an event), and then I felt like I was fighting the pressure, trying to get it to lessen so I could get back to sleep. I think some nights when I was trying to push the ramp button, I may have pushed the wrong button since I would just reach over to the ASV without opening my eyes to push the ramp. So, at least since these new pressure settings, I haven't noticed the pressure getting too high for me and waking me up.

Mainly I posted this thread, because I felt encouraged and hopeful for better sleep at night and less daytime sleepiness, after having my appointment

I appreciate all the helpful advice, and the person who posted about checking into the split night sleep - I do want to research that. I remember at one point, about 20 years ago, I decided maybe I am just supposed to get up and get going at 4 AM (even though getting to bed near midnight), that I should just get up and seize the day. Then after a couple of weeks of doing that, I caught a cold or flu bug, maybe from exhaustion from averaging about 4 hours of sleep per night. (note: if I went to bed earlier at night, then I would wake up earlier). Then I went back to the habit of trying to get back to sleep when I would wake up in the middle. Note: I am sharing this info regarding how much sleep I get, because it appears that some of you are wondering whether 4 to 5 hours should be considered normal for me . . .

beautifuldreamer wrote: I have noticed that with the new settings for these past few days, I have not noticed myself waking up and struggling with falling back asleep. I wonder if that is because the settings are more suited for me- ... So, at least since these new pressure settings, I haven't noticed the pressure getting too high for me and waking me up.

Well, that is encouraging. It sounds like you are headed in the right direction.

CPAP often takes some "tweaking" of the settings to get optimal therapy. Until the therapy is optimal, most people will not get enough sleep to avoid excess daytime sleepiness.

Many of the members use the free Sleepyhead software to tweak and monitor their therapy including the machine settings. If you are interested, there are some sample reports that Pugsy posted in this thread ---> viewtopic/t103468/Need-help-with-screen-shots.html

Forum members can help you get started with Sleepyhead and learn to interpret and use the reports.