Seeking input on Rx Sleep meds, SSRIs, insomnia treatment

Rustyolddude wrote: I know I experienced that as a teenager, multiple full awakenings every night..

Actually, I don't think it's that abnormal to awaken several times during the night. Not everyone does but I think alot of people wake up briefly during the night. We usually don't remember it. As long as you're able to go right back to sleep, it doesn't normally present a problem. Your description at the beginning of this thread, though, didn't sound normal at all.

BlackSpinner has a good point about your brain learning to trust that it doesn't have to sleep so shallow in order to "save itself". It is still pretty early days for both you and I.

Rustyolddude wrote:I go to sleep and the moment that I drift off, I wake, often breathing harder and with a racing pulse. Pulse rate graphs indicated this and coincident with the wakings. I repeat this cycle all night. It has been the norm for me for a long time. If/when I actually get a somewhat decent nights sleep my AHI runs around 5-7 at 10cm. Got the go-ahead to bump it up to 11cm.

I'm confused you said your AHI was around 1 in both sleep studies but now you are on CPAP at 10cm?
What do your Encore Pro printouts look like? Sounds like maybe your pressure is too low?
Any centrals on your studies?

If your having alpha intrusions is it possible that you have fibromyalgia?

jskinner wrote:

Rustyolddude wrote:I go to sleep and the moment that I drift off, I wake, often breathing harder and with a racing pulse. Pulse rate graphs indicated this and coincident with the wakings. I repeat this cycle all night. It has been the norm for me for a long time. If/when I actually get a somewhat decent nights sleep my AHI runs around 5-7 at 10cm. Got the go-ahead to bump it up to 11cm.

I'm confused you said your AHI was around 1 in both sleep studies but now you are on CPAP at 10cm?
What do your Encore Pro printouts look like? Sounds like maybe your pressure is too low?
Any centrals on your studies?

If your having alpha intrusions is it possible that you have fibromyalgia?

No centrals. I don't think I have fibro. I've been having pain issues in my arms & shoulders, primarily muscle cramping which I believe is due to poor ergonomics at my work station. I do a good bit of physical work and I don't have any other joint pain. Cutting out the aspartame seems to made a marked reduction in the arm & shoulder pain. Really haven't been dealing wiht any pain when I'm in bed.

I really need to get my reports scanned and posted here. I had two PSG's. First one with a 6.25mg of Ambien

First PSG:
Stage 1, 2, 3 sleep reached, total absence of REM
Study time 362 Min
Total Sleep time 207 min producing low sleep efficiency of 50.2%
Sleep Latency 47 Min
Total Apneas 4
Total Hypopneas 3
Apnea Index 1.2
Hyponea index 0.9
RDI 2
Baseline Sat 95%
Lowest Desat 88%
Number of Arousals 192
Number of Awakenings 103
Longest Hypopnea 18 sec.
Longest Apnea 15 Sec.
No. of Myoclonic jerks 13
PLM's 106
Position 100% Supine

Notes: mod-severe snoring, UAR, Mod-severe alpha intrusions. Maj. of limb movements did not prod. arousals. 126 resp. elicited-related arousals bringing the RDI to 38.5. Followup with PSG & CPAP.

Second PSG w/ 12.5mg AmbienCR & CPAP

Sleep Stage combined totals: 1-93.5min, 2-92min, 3-58min, REM 31min
Study time 512 Min
Total Sleep time 274 min producing low sleep efficiency of 54%
Sleep Latency 6.5 Min, 31min to persistant sleep
Total Apneas 0
Total Hypopneas 3, w/arousals 3
Apnea/Hyponea index 0.7
RDI 9
Baseline Sat 95%
Lowest Desat 91%
Number of Arousals 315/68.9 per hour. Movment related 29, Resp Related 27
Longest Hypopnea 15 sec.
Longest Apnea 0 Sec.
PLM's 115/25.1 per hour with arousals 29/25.2%
Sleep pos. 97.4% Supine

Notes: Poor night with multiple awakinings & arousals (I actually had a typical night, fair for me except for the tech waking me at 3am for a leak adjustment) Titrated pressure optimal at 10cm range of test 8-12 which maintained greater than 90% sat & SDB events were reduced or eliminated. Prescribed CPAP @ 10cm, FFM.



My sleep stage graph looks like a barcode, awake for a few minutes, asleep for 1-2, awake, asleep for a minute etc. heart rate follows the arousals, a nearly solid AR graph.

Now, what has been interesting to note is when I look at my nights in Encore, the totally misearble sleepless nights my AHI is around 1, very few apneas. On nights that I do get some decent sleep, we're talking maybe a 1 hour block and a few 30-45 min blocks, my AHI goes up, generally around 5 as high as 8. So I am apparently having apneas/hypopneas & snores when I actually sleep. But I'm not sleeping. If I can find what is causing the fragmentation, I could probably fine tune the pressure to keep the apneas from waking me. Mind you, Ambien can't get me to a steady deep sleep, gave it 60 days and quit. The Dr. Thompson CD's work as well as Ambien as far as getting me to sleep. Something else it going on, I hesitate to call it insomnia because I'm not constantly awake other than the sleep latency. I'll look at my weekly report tomm. and see if it has improved any with the bump to 11cm but I've been dragging all week, sleepy during the day, woke before the alarm just about every day.

Pugsy wrote:

Crickette wrote:I have learned that Ambien is one of thos medications that effects apnea. It causes more events.

That's odd.. My sleep doctor says that Ambien won't make OSA worse and is quite comfortable prescribing it for sleep related issues. I take it off and on and my data (I have the software) is pretty consistent with or without the Ambien.

I'm not sure where I read that at, but I did talk with my physician and he says no worries there. I do have to say that more good things have come from being on CPAP where the ambien is concerned. I was having to take it every night just to get a halfway decent nights sleep (if you want to call it that), and I quit sleep walking. I think being "tethered" to a machine has helped that greatly.