Thought I had back sleeping problem but turns out it's rem sleep disorder

Rob K · Post by **Rob K** » Mon Aug 24, 2020 7:08 pm

I'll change the title of this thread so it's more relevant. It's getting quite lengthy and covered many subjects and moved in a completely different direction.

Rob K · Post by **Rob K** » Mon Aug 24, 2020 7:38 pm

So with Rem sleep disorder they often talk about acting out dreams, talking during sleep and sometimes violent movements. I don't have that going on but I do move a lot during rem stage. Maybe what I have is a mild form of the disorder or maybe it's classified as something else.

AmSleepnBetta · Post by **AmSleepnBetta** » Tue Aug 25, 2020 12:04 am

Hello Rob K,

I see your earlier attempts to stop supine sleep. For me it took the drastic device in the attachment--after all else and so much had failed--to stop supine sleep and OA's that always accompanied it. It took evidence from an accelerometer's position data to quash my denial about the supine sleep I favored life long until then. I recently posted the pic below in a reply to pineh who asked about my supine block. There are more details here, viewtopic.php?f=1&t=180013&p=1362773#p1362773 , and elsewhere (much earlier).

Although you shifted focus a bit toward motions during REM, it might be that if you could stay off your back your sleep would be better as you deal with matters from REM.

Good luck,

ASB

: Vest-2SB-in-vest_4_30_20.png (338.35 KiB) Viewed 2943 times

Breakdown · Post by **Breakdown** » Tue Aug 25, 2020 10:56 am

Just two tips on side sleeping:

1.) Anchor with your feet. Don't stack your legs. If you are sleeping on your right shoulder, your left leg should extend over your right leg, that roll in the hip will make navigating to your back harder.

2.) Consider a teddy bear or pillow to hug. Bonus points if you wedge the thing under your jaw (not throat), in my case it keeps my passageways clear, and decreases the amount my jaw drops.

Just my two cents everyone is different, and different things are going to work for everyone.

zonker · Post by **zonker** » Tue Aug 25, 2020 1:43 pm

Breakdown wrote: ↑
Tue Aug 25, 2020 10:56 am

1.) Anchor with your feet.

what does this mean?

Okie bipap · Post by **Okie bipap** » Tue Aug 25, 2020 3:04 pm

zonker wrote: ↑
Tue Aug 25, 2020 1:43 pm

Breakdown wrote: ↑
Tue Aug 25, 2020 10:56 am

1.) Anchor with your feet.
what does this mean?

Maybe it means grab the bottom sheet with your toes so you don't roll over.

zonker · Post by **zonker** » Tue Aug 25, 2020 4:07 pm

Okie bipap wrote: ↑
Tue Aug 25, 2020 3:04 pm

zonker wrote: ↑
Tue Aug 25, 2020 1:43 pm

Breakdown wrote: ↑
Tue Aug 25, 2020 10:56 am

1.) Anchor with your feet.
what does this mean?
Maybe it means grab the bottom sheet with your toes so you don't roll over.

: shockedkoala.jpg (91.35 KiB) Viewed 2914 times

Rob K · Post by **Rob K** » Tue Aug 25, 2020 6:36 pm

Thanks for all the tips on sleeping position. Nice backpack.

I had to switch focus to rem stage sleep because it turns out it is a major problem. Much greater than sleeping position. I go into what is likely rem stage in all sleeping positions. I moving around so much and adjusting positions and that's how I end up on my back without knowing it. That originally led me to believe I had back sleeping problem. I'm sure that's a small part of it but I can't worry about supine sleeping at this point since I have a much bigger fish to fry. I could start an entirely new thread if that makes sense.

It appears that when I hit rem stage that I'm waking every minute or two minutes up to five minutes. I'm going in and out of sleep an extreme amount. Watched my video from last night and it looked like I woke a lot and moved close to 50 times last night over seven hour period. I only remember waking several times. Felt terrible this morning like I usually do.

Rob K · Post by **Rob K** » Tue Aug 25, 2020 6:47 pm

So the Somnopose chart gives a real good indication of wake ups and movements. The large shifts are just that, shifting from back to side or vise versa. The medium shifts are turning body position a small to medium amount. The smallest spikes are limb adjustments without a body position change. This is the chart from last night, a ton of movements through the night. I really only remember waking several times, but the video and Somnopose chart shows many arousal's. I did see some limb and head jerking last night and a fair amount of feet twitching. It also shows my eyes moving around a lot under the lids, that it what they must call rapid eye movement.

kteague · Post by **kteague** » Wed Aug 26, 2020 6:16 pm

Rob K wrote: ↑
Mon Aug 24, 2020 7:02 pm
Unbelievable how many times I wake and change position. Most of the spikes and large shifts on my Somnopose body position chart are wake ups or arousal's. How many more arousal's are not showing up on the body position monitor and camera. From what I can see on camera and looking at the chart I woke at least 30 times last night and changed position. In the morning I only remember waking maybe 6-8 times, occasionally I'll remember more. This has been happening every night for nearly a decade, even through my sleep studies. Not sure why the docs didn't pick up on that. Maybe two nights in a lab is not enough, or didn't show up, or it has gotten worse, or because I was drugged to be able sleep with all the equipment, or bad doctors, or broken system.

No wonder I've felt so bad and had so many health problems all these years.
I feel better since starting xpap like 7-8 years ago but never totally recovered and now I think I know why.

Seen twitching legs on camera occasionally, but it was minimal so it's not periodic limb movement disorder.
'
No twitchy legs while I'm awake so it's not restless legs syndrome.

Back sleeping is not the main problem, but doesn't help.

So the main problem is REM stage sleep disorder. My sleep studies show apnea being probably 5x times worse during REM stage.

During REM stage:
Breathing gets very erratic from looking at Oscar flow rate
I assume the machine is taking care of a lot of apnea events at that time
Still getting a lot of events that last 8-10 seconds
AHI is under 1 nearly all the time and those events are false positives from arousal's
Many arousal's during REM stage

Now to figure out how to deal with REM Sleep Disorder. I'll get studying and would much appreciate any insight.

Replying with time constraints so I'll have to be direct. Nothing you said above rules out PLMD, and much you've said raises suspicion. Can you do a video with the camera focused on your legs without bedding over them? Not saying you don't have a REM issue. Just saying you have not ruled out PLMD. Until you rule out every possibility your symptoms and data suggests, you are chasing rabbits.

Rob K · Post by **Rob K** » Wed Aug 26, 2020 8:30 pm

I'm only using a bed sheet so it reveals quite a bit. My feet are close to the camera and easily viewed. I do get foot and sometimes lower leg twitches, usually about 2 minutes before I wake up. I don't see a lot of it. Happens just randomly and a small fraction of the time before a wake. I don't think PLMD is it, but I'll study it and keep it open as a possibility.

Have been taking notes on the last three nights of video. I go in and out of sleep a lot. Last night was about 35-40 times, night before was about 45-50 and night before that was about 30-35. I usually make some sort of body, limb or mask adjustment upon arousal. There also could be arousals that I'm not seeing on camera if I don't move. Certainly I'm in and out many times during what it likely the rem stage.

Here's last nights chart. Sleep onset was 12:20am and wake up was 8:02am. Normally I get to sleep fast, but had all this data running through my brain for a while.

kteague · Post by **kteague** » Thu Aug 27, 2020 3:59 pm

A video with no sheet over feet or lower legs and no socks on is preferable. PLMD movements can be so small as to be easily missed. Sometimes it's simply a flexing and release of the big toe, but can commonly involve the feet and/or lower legs or other body parts. When I didn't know what my legs were doing when I slept, I thought I just slept restlessly and changed positions a lot. Again, I have no idea if you do have it, but it's one possible explanation for lots of arousals.

Rob K · Post by **Rob K** » Thu Aug 27, 2020 8:01 pm

Will do, I'll check it out. I didn't know it could be that subtle and be a problem. My sleep study about 5 years ago showed a number of limb movements only during deep sleep stage. The doc must have thought it to be insignificant because he didn't mention it. Things change though.

kteague · Post by **kteague** » Fri Aug 28, 2020 4:47 am

The same way that a sleep study can capture only what happens during that one night in regards to sleep apnea, the same with limb movements. Do you happen to have a copy of your old study to see exactly what was said about limb movements? Another consideration if one happens to have both OSA and PLMD, they can mask each other in a sleep study. Whichever one is most strongly active that night wins in the competition for credit for causing arousals. An apnea event may preempt a movement, or a movement may cause one to stir and preempt an apnea event. Hard to get a conclusive study in such cases. Also, treating either of the diagnoses gives potential for the other to more fully manifest, as there is more uninterrupted sleep in which to act up. Once I went on CPAP my limb movements really came out to play. Some people's limb movements resolve with CPAP treatment. From what I've read, true PLMD isn't as likely to resolve. With limb movements there's a difference if they are classified as periodic, not to be confused with random limb movements or movements related to respiratory effort. Periodic refers to a patterned timing, and often a stereotypical appearance. Sorry if this is TMI. If it doesn't turn out to relate to you, sorry about the dump.

Rob K · Post by **Rob K** » Sat Aug 29, 2020 2:39 pm

No, please give as many details as possible. This has been a tough nut to crack for a very long time.

Sleep study from September 2015 says in regard to limb movements: Periodic limb movements were mildly elevated at 17.2 per hour, a finding of uncertain clinical significance.

Numbers show that movements contributed to 1.9% of arousals with or without tiration.

Hopefully I'll get a chance to review the video footage you suggested sometime this weekend.

Thought I had back sleeping problem but turns out it's rem sleep disorder

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Re: Thought I had back sleeping problem but turns out it's rem sleep disorder

Re: Thought I had back sleeping problem but turns out it's rem sleep disorder

Re: Thought I had back sleeping problem but turns out it's rem sleep disorder

Re: Thought I had back sleeping problem but turns out it's rem sleep disorder

Machine	Mask

Additional Comments: Reluctant side sleeper: DIY P10 headgear, Silipos sealed mouth, cervical collar, CMS50I SpO2, accelerometer (for position and motion), supinity block