How to determine Good Sleep?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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robysue1
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Re: How to determine Good Sleep?

Post by robysue1 » Thu Oct 13, 2022 8:51 am

Billymadison420 wrote:
Thu Oct 13, 2022 3:31 am
I agree with your assessment! I am going to do one more meeting with a separate sleep specialist to be the tiebreaker in reading all the data. That way I can put the particular narcolepsy issued to bed. And start focusing on other causes.
That's a very reasonable plan.
Btw here is a known good night of sleep (in that I felt well the next day):
https://sleephq.com/public/da98d7d9-882 ... c513ab8abf

Vs a known bad night of a sleep (felt bad the next day):
https://sleephq.com/public/765931a6-f86 ... c55e2af034
There are a few things that jump out to my eyes in the data you posted.

First, is there any chance that leaks are causing you to wake up more than you think? Overall, you do NOT have a serious leak problem in terms of the size of the leaks or the duration of the largest leaks, but on both nights, there does seem to be some evidence of restlessness after some of the leaks. And if leaks are possibly waking you up, then it may be time to consider whether you need to try to fix them even though they are neither large enough nor long enough to affect the efficacy of your therapy.

Second, you seem to get both flow limitations and snoring detected when the pressure is near the min, which then drives rather steep pressure increases and sometimes there is evidence that you get restless right around the time of a steep pressure increase. Your bad night (Aug 4) has a minimum pressure of 7cm, and your good night has a min pressure of 9cm. Have the number of better (not bad) days increased since you bumped your min pressure up to 9cm? Also your titration study (https://www.dropbox.com/s/mnzns34ikliyzws/PSG.jpeg?dl=0) seems to indicate that they needed to increase the pressure to somewhere between 12 and 14 to eliminate the snoring as well as the apneas and hypopneas. It's just possible that pressure increases might also be triggering some arousals/micro-wakes. Or it could be that the snoring and flow limitations that happen when your pressure is near the minimum are just enough to cause you to arouse or awake and that starts the restlessness. In either case, you might sleep better with an APAP range where the min is higher than 9cm, particularly if you are not dealing with any kind of aerophagia problems.

Third, on the bad night (Aug. 4), it appears that you tried to take a couple of naps earlier in the day. And there appears to be more restlessness throughout the night---as in the breathing pattern does indicate you could be having some problems with sleep maintenance. Though it is counterintuitive, sometimes naps can mess up your night time sleep. And one thing that people with sleep maintenance insomnia are often told to do is to eliminate all naps in an effort to help consolidate the sleep cycles at night and minimize the number and length of the spontaneous wakes during the night.

Fourth, do you need the ramp? On the good night (Sept 9), you ramp up from 7cm to 9cm over what looks like a 5 minute period, but you don't fall soundly asleep until about 5 minutes after the pressure reaches 9cm. (And all five of the CAs scored right after the ramp goes off are SWJ---i.e. they're not "real" CAs that would be scored on an in-lab sleep test.) Starting the night out at your full minimum pressure may make it easier to fit the mask so pesky leaks don't wake you up when the machine ramps the pressure up towards your max pressure setting.

Fifth, once the SWJ CAs are discounted, you really are not having that many events on either the good or bad nights. And that's evidence that your PAP therapy is treating the sleep disordered breathing just fine. Which means one of the following:things:
  • some other sleep problem is causing your on-going daytime fatigue symptoms, with the most likely culprit being some kind of sleep maintenance problem
  • something else is causing your on-going daytime fatigue problems---i.e. the depression and/or anxiety and/or the medications and/or some other health problem is causing the daytime fatigue
  • or both
It's also worth noting that depression and anxiety can lead to sleep problems that result in less than restorative sleep.

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Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Thu Oct 13, 2022 9:41 am

robysue1 wrote:
Thu Oct 13, 2022 8:51 am
  • some other sleep problem is causing your on-going daytime fatigue symptoms, with the most likely culprit being some kind of sleep maintenance problem
  • something else is causing your on-going daytime fatigue problems---i.e. the depression and/or anxiety and/or the medications and/or some other health problem is causing the daytime fatigue
  • or both
It's also worth noting that depression and anxiety can lead to sleep problems that result in less than restorative sleep.
All noted on pressures! I will set a 10-14CM range tonight with no ramp. Give that a shot. Only other thing I can think of is Tinnitus, but I don't think its that. When I got it 16months ago I could NOT sleep. It was horrible. But I have largely largely habituated to it and sleep with a fair amount of neutral sound (white noise) and don't feel that the Tinnitus is causing sleep problems anymore. So I don't really feel like that is at play.

Beyond that I have already looked at CBC/TSH/Vit D/B12 etc...
Next I am thinking Testosterone, Anemia panel, and that isa bout all I can think of at the moment.

Also what can I do to fix the leaks, go with the smaller n20 nose attachment? (i am using the medium)

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robysue1
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Re: How to determine Good Sleep?

Post by robysue1 » Thu Oct 13, 2022 4:20 pm

[quote=Billymadison420 post_id=1423052 time=1665675715 user_id=101109
Also what can I do to fix the leaks, go with the smaller n20 nose attachment? (i am using the medium)
[/quote]
Going smaller might help.

It's hard to say without knowing more about how you think the mask is fitting on your face.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
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Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Thu Oct 13, 2022 5:41 pm

robysue1 wrote:
Thu Oct 13, 2022 4:20 pm
[quote=Billymadison420 post_id=1423052 time=1665675715 user_id=101109
Also what can I do to fix the leaks, go with the smaller n20 nose attachment? (i am using the medium)
Going smaller might help.

It's hard to say without knowing more about how you think the mask is fitting on your face.
[/quote]

It's a bit big.

Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Fri Oct 14, 2022 6:45 am

This happened last night, although the reading and posting is from the 23rd with a similar one. This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up. But I have all of these central apneas that last quite a long time. I was told by the sleep specialist that my central apnea is or is not a concern for the most part. Why does this happen. And it does seem to completely coincide with when my body wants to wake up but I keep trying to go back to sleep.

https://sleephq.com/public/db6c5e3e-d37 ... bf95f5067d

I would say, this kind of night happens very infrequently.

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Julie
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Re: How to determine Good Sleep?

Post by Julie » Fri Oct 14, 2022 6:50 am

I don't think you should be deciding on what (testosterone, anemia) should be looked at for sleep problems - a doctor should, and if yours has so little imagination/knowledge of what those would be, get another doctor.

Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Fri Oct 14, 2022 7:05 am

Julie wrote:
Fri Oct 14, 2022 6:50 am
I don't think you should be deciding on what (testosterone, anemia) should be looked at for sleep problems - a doctor should, and if yours has so little imagination/knowledge of what those would be, get another doctor.
Good point. You are 100% right about that. But as some of us discussed on this topic, it's not looking like sleep problems are necessarily my issue. Fatigue is, and obviously that can be so nebulous

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Re: How to determine Good Sleep?

Post by robysue1 » Fri Oct 14, 2022 8:26 am

Billymadison420 wrote:
Fri Oct 14, 2022 6:45 am
This happened last night, although the reading and posting is from the 23rd with a similar one. This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up. But I have all of these central apneas that last quite a long time.
Specifically because you say, "This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up," I think the last string of CAs (that starts around 6:00 AM EDT) is most likely SWJ and probably would not be scored on an in-lab sleep test as sleep disordered breathing events. It would be nice to get some other people's opinions on this, however. In particular, it would be nice to see what Rubicon and Pugsy think about this data.

I was told by the sleep specialist that my central apnea is or is not a concern for the most part. Why does this happen. And it does seem to completely coincide with when my body wants to wake up but I keep trying to go back to sleep.
It coincides with when your "body wants to wake up" but you "keep trying to go back to sleep" because you are not really asleep even if you don't feel like you are really awake. In other words, you are bouncing back and forth between wake and a transitional, very light form of sleep, but you're not getting all the way to real, established sleep. And so most (or all) of those CAs are a combination of wake breathing patterns mistaken for apnea and/or sleep transitional centrals caused by the normal process of handing off the control of your breathing from the voluntary nervous system to the automatic one.

As you saw in your experiment, certain wake breathing patterns can be technically meet the machine's programmed definition for scoring a CA even though those events are not real because they happen when you are awake.

And part of the transition to sleep involves a resetting of the body's CO2 trigger for breathing and that that can cause some sleep transition centrals that are considered normal on in in lab sleep test.

When you have a long period of "trying to get back to sleep", the wake breathing and the transition to sleep breathing and some actual short periods of sleep breathing all get mixed together into a big mess of what's called sleep-wake-junk breathing around here, or SWJ for short.

As for the other clusters of CAs on this night, here's my best guess. (Note all times are EDT since I'm in Buffalo, NY and SleepHQ always reports the times based on the computer's time zone setting of the person viewing the data.)

The first 3 CAs scored very early in the night (time stamp of approximately 12:26--12:28 Eastern daylight time) look to be sleep transition centrals.

The CA at 12:48 (EDT) appears to be a post-arousal or post-mini wake event. So that's probably a normal sleep transition central.

You obviously wake up around 1:50 EDT and turn the machine off around 1:57. But none of the ragged wake breathing here is mistaken for sleep disordered breathing.

You turn the machine back on around 1:58 EDT and the string of apneas scored between 2:03 and 2:25 appear to be SWJ. Steady sleep breathing really isn't established for more than just a few breaths at a time until a bit after 2:25. Do you remember the 1:50 wake up? If so, do you remember if it took you a while to get back to sleep?

The CAs at 2:32 EDT, 2:38 EDT, and 2:39 EDT also seem to be post arousal or post mini-wake events.

The CA at 2:55 EDT might (or might not) be a post arousal/mini wake event. The ones at 3:00 and 3:03 might or might not be post arousal events.

The CAs between 4:23 and 4:36 EDT appear to be scored during a pretty restless period. In other words, it appears there may have been an arousal around 4:23 EDT and it appears that you may have had some trouble transitioning back to a sound sleep. But this is much less clear than the cluster at the end of the night.

It's not clear what's going on to me when the CA at around 5:08 EDT is scored. But cluster of events between 5:12 and 5:38 EDT appear to be scored during another restless period. They might be SWJ. I'd like to have others opinions on that, however, since it's not clear to me what's going on here.

I would say, this kind of night happens very infrequently.
If this kind of thing happens very infrequently, it may be best to not get too worked up about it when it does happen. We all have the occasional very bad night of sleep, and for some of us, a rare bad night of sleep winds up with a bunch of events being scored during SWJ periods when we're not sleeping very well. It's ok to write off a very infrequent horrible night to a visit from Pugsy's aliens.

People with real central apnea problems that are related to their PAP use would be seeing clusters of CAs during periods of actual sleep on most nights rather than on the occasional, very infrequent night.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

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Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Fri Oct 14, 2022 10:42 am

robysue1 wrote:
Fri Oct 14, 2022 8:26 am
Billymadison420 wrote:
Fri Oct 14, 2022 6:45 am
This happened last night, although the reading and posting is from the 23rd with a similar one. This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up. But I have all of these central apneas that last quite a long time.
Specifically because you say, "This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up," I think the last string of CAs (that starts around 6:00 AM EDT) is most likely SWJ and probably would not be scored on an in-lab sleep test as sleep disordered breathing events. It would be nice to get some other people's opinions on this, however. In particular, it would be nice to see what Rubicon and Pugsy think about this data.

I was told by the sleep specialist that my central apnea is or is not a concern for the most part. Why does this happen. And it does seem to completely coincide with when my body wants to wake up but I keep trying to go back to sleep.
It coincides with when your "body wants to wake up" but you "keep trying to go back to sleep" because you are not really asleep even if you don't feel like you are really awake. In other words, you are bouncing back and forth between wake and a transitional, very light form of sleep, but you're not getting all the way to real, established sleep. And so most (or all) of those CAs are a combination of wake breathing patterns mistaken for apnea and/or sleep transitional centrals caused by the normal process of handing off the control of your breathing from the voluntary nervous system to the automatic one.

As you saw in your experiment, certain wake breathing patterns can be technically meet the machine's programmed definition for scoring a CA even though those events are not real because they happen when you are awake.

And part of the transition to sleep involves a resetting of the body's CO2 trigger for breathing and that that can cause some sleep transition centrals that are considered normal on in in lab sleep test.

When you have a long period of "trying to get back to sleep", the wake breathing and the transition to sleep breathing and some actual short periods of sleep breathing all get mixed together into a big mess of what's called sleep-wake-junk breathing around here, or SWJ for short.

As for the other clusters of CAs on this night, here's my best guess. (Note all times are EDT since I'm in Buffalo, NY and SleepHQ always reports the times based on the computer's time zone setting of the person viewing the data.)

The first 3 CAs scored very early in the night (time stamp of approximately 12:26--12:28 Eastern daylight time) look to be sleep transition centrals.

The CA at 12:48 (EDT) appears to be a post-arousal or post-mini wake event. So that's probably a normal sleep transition central.

You obviously wake up around 1:50 EDT and turn the machine off around 1:57. But none of the ragged wake breathing here is mistaken for sleep disordered breathing.

You turn the machine back on around 1:58 EDT and the string of apneas scored between 2:03 and 2:25 appear to be SWJ. Steady sleep breathing really isn't established for more than just a few breaths at a time until a bit after 2:25. Do you remember the 1:50 wake up? If so, do you remember if it took you a while to get back to sleep?

The CAs at 2:32 EDT, 2:38 EDT, and 2:39 EDT also seem to be post arousal or post mini-wake events.

The CA at 2:55 EDT might (or might not) be a post arousal/mini wake event. The ones at 3:00 and 3:03 might or might not be post arousal events.

The CAs between 4:23 and 4:36 EDT appear to be scored during a pretty restless period. In other words, it appears there may have been an arousal around 4:23 EDT and it appears that you may have had some trouble transitioning back to a sound sleep. But this is much less clear than the cluster at the end of the night.

It's not clear what's going on to me when the CA at around 5:08 EDT is scored. But cluster of events between 5:12 and 5:38 EDT appear to be scored during another restless period. They might be SWJ. I'd like to have others opinions on that, however, since it's not clear to me what's going on here.

I would say, this kind of night happens very infrequently.
If this kind of thing happens very infrequently, it may be best to not get too worked up about it when it does happen. We all have the occasional very bad night of sleep, and for some of us, a rare bad night of sleep winds up with a bunch of events being scored during SWJ periods when we're not sleeping very well. It's ok to write off a very infrequent horrible night to a visit from Pugsy's aliens.

People with real central apnea problems that are related to their PAP use would be seeing clusters of CAs during periods of actual sleep on most nights rather than on the occasional, very infrequent night.

Thank you this was very helpful!! Means a lot. Seems like its just the proverbial Sleep/Wake Junk!

Billymadison420
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Re: How to determine Good Sleep?

Post by Billymadison420 » Sun Oct 16, 2022 7:03 am

Billymadison420 wrote:
Fri Oct 14, 2022 10:42 am
robysue1 wrote:
Fri Oct 14, 2022 8:26 am
Billymadison420 wrote:
Fri Oct 14, 2022 6:45 am
This happened last night, although the reading and posting is from the 23rd with a similar one. This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up. But I have all of these central apneas that last quite a long time.
Specifically because you say, "This always seems to happen at the end of the night around 6:30 in the morning when my body is trying to get up," I think the last string of CAs (that starts around 6:00 AM EDT) is most likely SWJ and probably would not be scored on an in-lab sleep test as sleep disordered breathing events. It would be nice to get some other people's opinions on this, however. In particular, it would be nice to see what Rubicon and Pugsy think about this data.

I was told by the sleep specialist that my central apnea is or is not a concern for the most part. Why does this happen. And it does seem to completely coincide with when my body wants to wake up but I keep trying to go back to sleep.
It coincides with when your "body wants to wake up" but you "keep trying to go back to sleep" because you are not really asleep even if you don't feel like you are really awake. In other words, you are bouncing back and forth between wake and a transitional, very light form of sleep, but you're not getting all the way to real, established sleep. And so most (or all) of those CAs are a combination of wake breathing patterns mistaken for apnea and/or sleep transitional centrals caused by the normal process of handing off the control of your breathing from the voluntary nervous system to the automatic one.

As you saw in your experiment, certain wake breathing patterns can be technically meet the machine's programmed definition for scoring a CA even though those events are not real because they happen when you are awake.

And part of the transition to sleep involves a resetting of the body's CO2 trigger for breathing and that that can cause some sleep transition centrals that are considered normal on in in lab sleep test.

When you have a long period of "trying to get back to sleep", the wake breathing and the transition to sleep breathing and some actual short periods of sleep breathing all get mixed together into a big mess of what's called sleep-wake-junk breathing around here, or SWJ for short.

As for the other clusters of CAs on this night, here's my best guess. (Note all times are EDT since I'm in Buffalo, NY and SleepHQ always reports the times based on the computer's time zone setting of the person viewing the data.)

The first 3 CAs scored very early in the night (time stamp of approximately 12:26--12:28 Eastern daylight time) look to be sleep transition centrals.

The CA at 12:48 (EDT) appears to be a post-arousal or post-mini wake event. So that's probably a normal sleep transition central.

You obviously wake up around 1:50 EDT and turn the machine off around 1:57. But none of the ragged wake breathing here is mistaken for sleep disordered breathing.

You turn the machine back on around 1:58 EDT and the string of apneas scored between 2:03 and 2:25 appear to be SWJ. Steady sleep breathing really isn't established for more than just a few breaths at a time until a bit after 2:25. Do you remember the 1:50 wake up? If so, do you remember if it took you a while to get back to sleep?

The CAs at 2:32 EDT, 2:38 EDT, and 2:39 EDT also seem to be post arousal or post mini-wake events.

The CA at 2:55 EDT might (or might not) be a post arousal/mini wake event. The ones at 3:00 and 3:03 might or might not be post arousal events.

The CAs between 4:23 and 4:36 EDT appear to be scored during a pretty restless period. In other words, it appears there may have been an arousal around 4:23 EDT and it appears that you may have had some trouble transitioning back to a sound sleep. But this is much less clear than the cluster at the end of the night.

It's not clear what's going on to me when the CA at around 5:08 EDT is scored. But cluster of events between 5:12 and 5:38 EDT appear to be scored during another restless period. They might be SWJ. I'd like to have others opinions on that, however, since it's not clear to me what's going on here.

I would say, this kind of night happens very infrequently.
If this kind of thing happens very infrequently, it may be best to not get too worked up about it when it does happen. We all have the occasional very bad night of sleep, and for some of us, a rare bad night of sleep winds up with a bunch of events being scored during SWJ periods when we're not sleeping very well. It's ok to write off a very infrequent horrible night to a visit from Pugsy's aliens.

People with real central apnea problems that are related to their PAP use would be seeing clusters of CAs during periods of actual sleep on most nights rather than on the occasional, very infrequent night.

Thank you this was very helpful!! Means a lot. Seems like its just the proverbial Sleep/Wake Junk!
This pattern happened again last night. Happened at the same time. But only happened because I went back to sleep. There is about 30 minutes of that SWJ followed by actual sleep.

1. https://www.dropbox.com/s/b873ncc264hyb ... t.png?dl=0. (whole night)
2. https://www.dropbox.com/s/n3tf0ooy62vlt ... a.png?dl=0 (central apnea in the morning)
3. https://www.dropbox.com/s/3nh8whmkmvtbh ... 2.png?dl=0 (central apnea in the morning closer)
4. https://www.dropbox.com/s/3h6gz2xlaiamp ... p.png?dl=0 (Back to sleep)
5. https://www.dropbox.com/s/wam3agf79nda5 ... a.png?dl=0 (close up of central apnea)


I will add that my Board Certified Sleep Specialist (beyond the session last night) has looked at all my sessions and said my OSA is treated beautifully and that the CA's when they happen are normal and are happening from a sleep-wake/wake-sleep transistion.

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robysue1
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Re: How to determine Good Sleep?

Post by robysue1 » Mon Oct 17, 2022 8:54 am

Billymadison420 wrote:
Sun Oct 16, 2022 7:03 am
This pattern happened again last night. Happened at the same time. But only happened because I went back to sleep. There is about 30 minutes of that SWJ followed by actual sleep.

1. https://www.dropbox.com/s/b873ncc264hyb ... t.png?dl=0. (whole night)
2. https://www.dropbox.com/s/n3tf0ooy62vlt ... a.png?dl=0 (central apnea in the morning)
3. https://www.dropbox.com/s/3nh8whmkmvtbh ... 2.png?dl=0 (central apnea in the morning closer)
4. https://www.dropbox.com/s/3h6gz2xlaiamp ... p.png?dl=0 (Back to sleep)
5. https://www.dropbox.com/s/wam3agf79nda5 ... a.png?dl=0 (close up of central apnea)
Yep. That last nasty looking cluster of CAs after you turn the machine back on a bit aft 6:30 is pretty clearly SWJ and/or wake breathing while attempting to get back to sleep. But I'd say you didn't really get back into a real sleep for about an hour: The second cluster of CAs scored between 7:20 and 7:40 also look like SWJ. And the breathing between the two clusters does not appear as smooth as the normal sleep breathing during the rest of the night even when looking at it on the image that shows the whole night.

I will add that my Board Certified Sleep Specialist (beyond the session last night) has looked at all my sessions and said my OSA is treated beautifully and that the CA's when they happen are normal and are happening from a sleep-wake/wake-sleep transistion.
I'm inclined to trust your sleep doctor on this: I do think your machine is scoring some sleep transition CAs that don't really have much meaning in terms of your therapy. I know it's a bit frustrating to hear, but you may want to simply get out of bed when the body just won't seem to go back to sleep after that early morning wake. Get up and do something that you enjoy so that you won't resent being up for a while. And go back to bed after your body starts to feel sleepy again.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

Correct number of posts is 7250 as robysue + what I have as robysue1

Profile pic: Frozen Niagara Falls

Billymadison420
Posts: 234
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Re: How to determine Good Sleep?

Post by Billymadison420 » Mon Oct 17, 2022 6:13 pm

I'm inclined to trust your sleep doctor on this: I do think your machine is scoring some sleep transition CAs that don't really have much meaning in terms of your therapy. I know it's a bit frustrating to hear, but you may want to simply get out of bed when the body just won't seem to go back to sleep after that early morning wake. Get up and do something that you enjoy so that you won't resent being up for a while. And go back to bed after your body starts to feel sleepy again.
I am going to try that. I just feel exhausted the second I get out of bed. I guess I am just depressed. Ugh. It's tough. My mom was diagnosed with ALS back in March. I think my existing depression, on top of my mom's terminal illness, on top of obsessing over a misdiagnosis has made a huge combination of circumstances.

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Re: How to determine Good Sleep?

Post by robysue1 » Tue Oct 18, 2022 11:53 am

Billymadison420 wrote:
Mon Oct 17, 2022 6:13 pm
I'm inclined to trust your sleep doctor on this: I do think your machine is scoring some sleep transition CAs that don't really have much meaning in terms of your therapy. I know it's a bit frustrating to hear, but you may want to simply get out of bed when the body just won't seem to go back to sleep after that early morning wake. Get up and do something that you enjoy so that you won't resent being up for a while. And go back to bed after your body starts to feel sleepy again.
I am going to try that. I just feel exhausted the second I get out of bed.
When your body doesn't want to be asleep even though it's exhausted, you still may find getting out of bed will (eventually) lead to better quality sleep.

Right now, your body (and brain) do not fully accept that lying in bed = time to be asleep. And the more you toss and turn and fret while trying to get back to sleep, the more you help convince your body (and brain) that lying in bed does not equal time to be asleep.

As I recall you've said that you will be consulting with a neuropsychologist about CBT-I. That person may very well tell you the same thing: That if you are still awake after 15-20 minutes after trying to get back to sleep after a middle night wake or early morning wake, you need to just get out of bed and quit trying to go back to sleep. Do something relaxing to get your mind off your worries and problems and go back to bed when you start feeling sleepy again. (You may find that you only need to be out of bed maybe 10-15 minutes before you're sleepy enough to get back to sleep.)

I guess I am just depressed. Ugh. It's tough. My mom was diagnosed with ALS back in March. I think my existing depression, on top of my mom's terminal illness, on top of obsessing over a misdiagnosis has made a huge combination of circumstances.
My sympathies. It sounds like you are going through a really tough time in your life right now. And all of this could easily explain your ongoing symptoms of daytime fatigue and waking up unrested and exhausted. All of this could also be triggering those middle of the night wakes that you find it hard to get back to sleep from.

If you are willing to get some counseling about how to deal with the combination of feeling depressed along with the fact that your mother is now seriously ill, counseling may help you better accept the things you cannot change right now in your life. And learning to accept those difficulties that you are going through may help you find the energy to plow through the day when you feel awful and fatigued from the time you get up.

_________________
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Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

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Billymadison420
Posts: 234
Joined: Mon Jul 11, 2022 9:02 pm

Re: How to determine Good Sleep?

Post by Billymadison420 » Wed Oct 19, 2022 6:18 pm

robysue1 wrote:
Tue Oct 18, 2022 11:53 am
Billymadison420 wrote:
Mon Oct 17, 2022 6:13 pm
I'm inclined to trust your sleep doctor on this: I do think your machine is scoring some sleep transition CAs that don't really have much meaning in terms of your therapy. I know it's a bit frustrating to hear, but you may want to simply get out of bed when the body just won't seem to go back to sleep after that early morning wake. Get up and do something that you enjoy so that you won't resent being up for a while. And go back to bed after your body starts to feel sleepy again.
I am going to try that. I just feel exhausted the second I get out of bed.
When your body doesn't want to be asleep even though it's exhausted, you still may find getting out of bed will (eventually) lead to better quality sleep.

Right now, your body (and brain) do not fully accept that lying in bed = time to be asleep. And the more you toss and turn and fret while trying to get back to sleep, the more you help convince your body (and brain) that lying in bed does not equal time to be asleep.

As I recall you've said that you will be consulting with a neuropsychologist about CBT-I. That person may very well tell you the same thing: That if you are still awake after 15-20 minutes after trying to get back to sleep after a middle night wake or early morning wake, you need to just get out of bed and quit trying to go back to sleep. Do something relaxing to get your mind off your worries and problems and go back to bed when you start feeling sleepy again. (You may find that you only need to be out of bed maybe 10-15 minutes before you're sleepy enough to get back to sleep.)

I guess I am just depressed. Ugh. It's tough. My mom was diagnosed with ALS back in March. I think my existing depression, on top of my mom's terminal illness, on top of obsessing over a misdiagnosis has made a huge combination of circumstances.
My sympathies. It sounds like you are going through a really tough time in your life right now. And all of this could easily explain your ongoing symptoms of daytime fatigue and waking up unrested and exhausted. All of this could also be triggering those middle of the night wakes that you find it hard to get back to sleep from.

If you are willing to get some counseling about how to deal with the combination of feeling depressed along with the fact that your mother is now seriously ill, counseling may help you better accept the things you cannot change right now in your life. And learning to accept those difficulties that you are going through may help you find the energy to plow through the day when you feel awful and fatigued from the time you get up.

Went to Penn Medicine. Indeed you are correct! Narcolepsy is fully ruled out. The Arousals are the issue. We are looking at me going to an ENT to deal with Nasal Congestion. I have had bad nasal congestion my whole life. So much so that it makes breathing out of my nose very difficult especially at night.

I will absolutely be doing deeper therapy to work on my grief with my mother. I will also be working with the Neuropsychologist on CBT-I and coping strategies, and my obsession on somatic symptoms.

You are all wonderful people. Sorry for pestering you all to death with my Narcolepsy fears.

Billymadison420
Posts: 234
Joined: Mon Jul 11, 2022 9:02 pm

Re: How to determine Good Sleep?

Post by Billymadison420 » Sun Nov 06, 2022 6:23 pm

I have sought psychiatric help, but I don't think anyone can help me at this point.

I cannot continue to function without any energy. I cannot live like this. Thank you all for trying to help me <3