Muffy wrote:BleepingBeauty wrote:Aside from a pharmacological solution (which I will consider, if necessary) and going to bed earlier and on a regular basis, what can I do to improve this situation?
Pick out a "sleep hygiene" handout (Google, they're all over the place) and follow it to the letter. There is no wiggle room, no "bargaining", because your sleep architecture is marginal and you have symptoms (that's a very key point-- like naps are OK, but only if they don't disrupt your sleep).
Get an absolutely fixed bedtime and awakening time, use it 7 days a week, do not drift. Sleep is a heap of biorhythms that must be set and/or taken advantage of.
The fixed bedtime I can deal with; but how do I adopt a fixed awakening time? If I wake up too early, just stay in bed and wait for that time to arrive, even if I'm not sleeping?
At this point, no naps. Naps count towards total sleep time. Napping in the late afternoon might be a good idea for those people who need it and it doesn't affect their sleep, but if you're napping in the morning, that's not napping. That's part of a messed up night of sleep. In your case, I think all of your sleep needs to be consolidated during the night.
I was following that advice until recently. I'm sometimes just so tired that I can't keep my eyes open, no matter how hard I try to wake myself up, and I've allowed myself a nap with the machine (for an hour or so). But I'll get back to no napping at all, somehow.
No alcohol, caffeine, chocolate, smoking.
I can easily live without alcohol and with just an occasional taste of chocolate. But
no caffeine? At all? Muff, you know I love ya, but yer killin' me here... I only drink two cups of coffee in the early morning as it is. Do I really have to give that little bit up?
Re: the smoking, I'm cutting down. I've quit many times in the past, and I'm not done trying to do it again and stay with it. It sure is hard, though. I've tried all kinds of things, including hypnotism, the patch, the pills. I'm working on it, but I can't go cold turkey.
Maybe a light snack before bed, no sugar. Stick to carbohydrates or dairy products.
Most often, if I'm wanting a snack in the evening, I have some fruit. It's usually a banana, an apple, a mango, or a pink grapefruit. Too much natural sugar? Sometimes it's marinated artichoke hearts or some hummus on crackers.
Exercise program.
Cut BMI in half.
Got it.
Evaluate bedding for comfort. Cool room temperature. No noise (especially TV).
I love my bed (Tempur-Pedic); most comfortable mattress I've ever slept on. Bedroom is always cool enough, whether via the breeze from outside, the ceiling fan, or the evaporative cooler in the summer. I like going to sleep with some low-volume background noise; it used to be the radio on a timer set to a mellow station, but I can't get good radio reception where I am now. So I put the tv on, tuned to the soft-rock XM station, with the volume very low, and set the timer for 15-30 minutes. Within a minute or two, the screen goes black, and I just faintly hear the music; but I fall asleep very quickly, and the music never keeps me awake. I just prefer something else in the background besides the white noise from my machine.
Relaxation techniques before bed. Yoga, deep breathing, Herb Benson. Clear mind. No computer before bed (the screen eats up the melatonin). No bright lights during the sleeping period.
I'm looking into learning yoga, and I'll wean myself away from the computer earlier in the evening. No bright lights in my room while I sleep; nightlight in the bathroom, but it's removed from my line of vision and is nowhere near bothersome at any time. Even the blue lights on my machine are no problem for me, although I've read here that they bother others quite a bit. As I live in the middle of nowhere, there are no street lights or other light sources to bother me at night. It's also very quiet around here.
Establish pre-sleep ritual.
Being female has associated sleep maintainance issues. Morph into Roger.
Oh, if only... Men have it so much easier than we do, in so many respects.
Bright light therapy-- as soon as you get up in the morning, go outside and get 15-30 minutes of face-sun.
Hmm. I make it a point to stay OUT of the sun here. My house is really bright, though, as the front faces E and the back faces W, and I have four skylights. Isn't that enough of a "light-jolt"?
A lavender sachet (lavender helps sleep).
Address any pain issues.
I'm not a "sachet" kinda gal, but I like the smell of lavender. No pain issues to speak of. Tendonitis in my shoulders, but it's taken care of with occasional cortisone shots, in lieu of surgery.
Optimize medications-- are you on anything else other than what's listed? (Baseline heart rate looks OK, could take a look at the graph of that, but chances are they don't generate it)(as in the levothyroxine creating issues).
No, I've listed everything I take. I'll speak with the PCP tomorrow about the thyroid med.
If I were to guess, I would say consolidating your sleep would do the most for improving architecture, followed closely by rigid sleep times to set the biorhythms (think of sleep as matching up a pile of undulating chemicals. If you're in the wrong place during a "peak" (or a "trough", depending on the chemical) you're trying to swim upstream.
Ok.
BleepingBeauty wrote:But this is making me scratch my head: Why does my new "CPAP Prescription" say that my AHI is 15.4? Where did that number come from?
Insurance coverage number, the AHI on ambient pressure. She probably made it up.
Ahh. Good to know I'm confused for a good reason.
BleepingBeauty wrote:My fear is that I'll choose the wrong machine and wind up in the same boat a year from now.
IMO, you could use a Shop-Vac with one end stuck in 12 cmH2O of "H2O" (just set it to "blow" instead of "suck") and "Warcraft" for software and be fine (fiddling with lowest effective pressure is your choice, but look what happens in every piece of data that has aggressive "fiddling"). Right now, your problem is not "sleep-disordered breathing", it's "sleep".
Muffy
Okay. Well, a simple data-capable straight CPAP will do me just fine, as long as I can see what's going on and make gradual changes as I see fit. Thanks, Muff.
)
