DSPS

SleepingUgly wrote:is there a solution to this problem where the person ultimately feels as good getting up early as getting up late?

One person with DSPS said that they never quite feel as rested after sliding back their schedule via light boxes and avoiding light at night. I don't understand how this could be true. In DSPS, one's system may be off kilter, but it is still entrained by light to be off kilter.

Dave, thanks for that graph. My sleep doc had talked about sleeping earlier so that one is going with the flow of body rhythms, and that graph illustrates that topic well.

There was a time in life when my body slept - and slept well - at expected times. Once the sleep disorders ruled my nights, even though I could nod out any time day or night, I could not go to sleep, get into a deep sleep, and wake up feeling rested - understandable. I avoided the misery of actually getting into bed until I was so exhausted I had to yield. Once my OSA was effectively treated and the PLMD marginally treated, I was able to go to bed earlier again, even had a brief period of time when I was on a regular schedule that resembled my old normal, till the meds became ineffective and even destructive to my sleep. The last sleep study I had showed my limb movements (and the AI) to be greatly improved but not totally resolved. If I remember right the spontaneous arousals were of more concern than the LM arousals. I have a theory on my spontaneous arousals. One thing that going through augmentation on meds gave me was a better insight into what was happening to me. One of the effects was it blurred the lines between what normally would be experienced while asleep and caused those things to happen while I was aware of them. During this time I felt like I was dozing then becoming aware but not feeling fully awake. During that time I became aware that sensations precede the onset of limb movements. Not so much between each movement while they were patterned, but when a new cluster was beginning. Kinda reminded me of how people describe an aura before onset of a migraine. It would begin as an almost achy sensation in the legs that progressed to a pulling or tightening that culminated in sudden movement. I can't help but wonder if some of my spontaneous arousals were due to these sensations and could not be associated with PLMs because the arousal prevented the PLM from manifesting. But I digress.

Moving to the west coast made what feels like the best hours for quality sleep for me fit better within society's mainstream flow. But even now, even if I am sleepy and feel ready for bed early, like at 10 or 11, I spend the first few hours tossing and turning in and out of light sleep. A bedtime of 2am is the best predictor of avoiding that toss and turn period, though I'm usually so sleepy I go on to bed now between 1130-1230. That 2am bedtime is right in line with my preferred 5am bedtime back in Ohio. Not sure if my body clock is "off" and I should just accept it or if working toward an earlier bedtime is a worthwhile cause. Can't really say how much limb movements still interfere with my sleep without some sort of testing. I can say that my last few hours of sleep before waking feel awesome and I usually wake naturally after about 8 hours in bed.

SleepingUgly wrote:

zoocrewphoto wrote:

What do you call it if the person CAN fall asleep but, for example, 8 hours of sleep that ends at 9am is more refreshing (albeit, not refreshing) than 8 hours of sleep that ends at 7am?

I would call it mild dsps

Many people who try to treat their dsps do this. They do manage to sleep at the "right" time, and they function. But they don't feel as good as they do when they sleep at their own natural time.

Dave, do you agree this is DSPS if someone has more difficulty falling asleep early, but can usually do it (perhaps not quite as early as they would like), but that 8 hours of sleep that ends later feels more sufficient than 8 hours that ends earlier? If so, is there a solution to this problem where the person ultimately feels as good getting up early as getting up late? Or am I destined to feel crappier getting up early, even if I had the same amount of sleep?

I would put together a sleep log for a month to provide some objective data to subjectively assess this.

If this someone who sleeps during the period that is suggested is effective (~0100 - ~0900) does it affect their lifestyle?

If they tried to adjust their sleep period to an earlier time, how long did they try, how did they do it and how sincere (strict) was their attempt?

Are we going to impale some guys, or should I change my avatar again (right now, I feel a little overdressed)?

FYI, found the direct link to the AASM ICSD for DSPS (as well as the rest of the CRDs):

http://nti.projectneuron.org/lesson/les ... oken-clock

deltadave wrote:I would put together a sleep log for a month to provide some objective data to subjectively assess this.

I keep a sleep log. The difficulty with isolating this variable is that I'm still tired on CPAP. I am still working on the assumption that I would be less tired if I didn't have aerophagia at higher pressures that I presumably need (and was prescribed). Lately I've been using bilevel 9/6-12/8 with a ramp of 7/4 and felt a bit less tired, but now I'm getting aerophagia frequently, presumably because of the higher end of that range (i.e., above 10), which also probably was why I was improved over just 9/6... Sigh.

If this someone who sleeps during the period that is suggested is effective (~0100 - ~0900) does it affect their lifestyle?

I think it improves my life, but there is the residual EDS that interferes with seeing a marked difference. That is, either way I will be tired, the question is only how tired. That will also vary as a function of sleep disruptions, the settings on CPAP (both better when allowing higher pressures, but worse because of aerophagia), and not just as a function of sleep time. So it's complicated.

If they tried to adjust their sleep period to an earlier time, how long did they try, how did they do it and how sincere (strict) was their attempt?

Not 100% strict. But all summer I had to get up earlier than usual, and even when it was only 30-45 minutes earlier and I went to bed earlier to recoup that sleep, there seemed to be a marked difference in how tired I was waking at 8:30 as opposed to 7:45am. It's crazy. Lately I was faring slightly better even at somewhat earlier times (albeit not as early as I would like) but now my nights are worse due to aerophagia disruptions.

Are we going to impale some guys, or should I change my avatar again (right now, I feel a little overdressed)?

I'm willing to impale some guys.

SleepingUgly wrote:I think it improves my life, but there is the residual EDS that interferes with seeing a marked difference. That is, either way I will be tired, the question is only how tired. That will also vary as a function of sleep disruptions, the settings on CPAP (both better when allowing higher pressures, but worse because of aerophagia), and not just as a function of sleep time. So it's complicated.

Well then, any attempt to consider DSPS becomes simple:

G. The symptoms do not meet the criteria for any other sleep disorder causing inability to initiate sleep or excessive sleepiness.

I'm willing to impale some guys.

OK, let's keep this organized:

zoocrewphoto wrote:I would suggest that even if it is secondary, you would still have it until it was eliminated (if ever).

I know mine started long before the sleep apnea, but it's possible that it won't be as extreme after awhile since it wasn't always this extreme. And whether my timing ever changes or not, I am sure that my ability to adjust will improve simply because I am sleeping better.

I also think I've been like this forever. Or at least long before I showed any symptoms of apnea. But for what it's worth I did seem to find it a little easier to force myself into normal sleeping hours after I started cpap. I didn't notice the change right away. One day I just realized it wasn't impossible anymore. For awhile I hoped that it had all been caused by the apnea but that doesn't seem to be true either.

deltadave wrote:

SleepingUgly wrote:I think it improves my life, but there is the residual EDS that interferes with seeing a marked difference. That is, either way I will be tired, the question is only how tired. That will also vary as a function of sleep disruptions, the settings on CPAP (both better when allowing higher pressures, but worse because of aerophagia), and not just as a function of sleep time. So it's complicated.

Well then, any attempt to consider DSPS becomes simple:

G. The symptoms do not meet the criteria for any other sleep disorder causing inability to initiate sleep or excessive sleepiness.

I'm willing to impale some guys.

True, and I'm hoping it will improve if/when OSA is properly treated. However, the OSA wouldn't explain why 8 hours of sleep later is better than 8 hours of sleep ending earlier, would it?

SleepingUgly wrote:However, the OSA wouldn't explain why 8 hours of sleep later is better than 8 hours of sleep ending earlier, would it?

At this point, it would seem that OSA does not enter into the equation whatsoever.

deltadave wrote:

SleepingUgly wrote:However, the OSA wouldn't explain why 8 hours of sleep later is better than 8 hours of sleep ending earlier, would it?

At this point, it would seem that OSA does not enter into the equation whatsoever.

So are you saying what I describe here could be explained by DSPS superimposed on sub-therapeutically treated OSA? Or are you saying that until the OSA is completely treated, we can't speak to whether there is a DSPS component?

Do you agree with others who have said that even if one can shift their schedule earlier, they will not feel good during those hours the way they would at their "natural" best awakening time?

I forget if I had asked this question in another related thread but does this DSPS condition constitute someone whom doesn't necessarily feel insomnia - falls asleep and stays asleep presumably lately throughout the night but has another revisited ongoing problem lately on wanting to wake up in the mornings with even 4 alarms going off at various intervals of say 30 minutes apart? I am having a real problem lately of being able to actually awaken in the mornings even though I feel I am getting to bed ok at night and resting throughout the night.

Haven't looked at my data recently though and don't have my card with me at work like I normally do.

lazer wrote:I forget if I had asked this question in another related thread but does this DSPS condition constitute someone whom doesn't necessarily feel insomnia - falls asleep and stays asleep presumably lately throughout the night but has another revisited ongoing problem lately on wanting to wake up in the mornings with even 4 alarms going off at various intervals of say 30 minutes apart? I am having a real problem lately of being able to actually awaken in the mornings even though I feel I am getting to bed ok at night and resting throughout the night.

Two things make me think that it's not DSPS... You said "lately", and I don't see why you'd suddenly develop DSPS just of late, and you aren't having any trouble falling asleep at night. But I'm no expert in DSPS, so take this with a grain of salt.

I first read about DPSD about 2 months ago before that I just thought I had brain damage The same as zoocrewphoto my natural sleep time is between 4am and 6am. I am now 47 and spent a lot of my life struggling and fighting this I have worked a lot of night jobs as they fitted into my strange world and I use a lot of alcohol when I have been working days basically drinking until I feel asleep not a recommend way to get a good nights sleep but was better than when I would not drink and survive on 1-2 hours sleep a day and a few nanny naps.

I went to the doctor (2 so far) and said I believe I may have DSPD both doctors know nothing about it. 1 sent me to a sleep disorder clinic where I have been diagnosed with apnea the thing that really shocked me was the technicians, at 2 clinics, had not heard of it. I will add I live in Australia and from what I have gathered it is not a totally recognised disorder here.

I have been reading what a few people have been writing to get an idea of what it is like think of a time when you have had to do something in the middle of your sleep time say 2am. Your thought reactions are slow you do not totally trust your own answers and you are constantly checking and rechecking to make sure you have made the right decision, when you speak the words do not seem to be connected to your brain even though the words you are saying are correct it just does not 'feel' right. That is what it is like for me when I sleep during the night and work during the day, for me to have a GOOD nights sleep I need to do it during the day

Welcome to the forum, Tony.

Have you gotten a machine yet and started with it? If you have a Resmed machine, you can change the time on the machine so that your data is not split sessions. It resets the data at noon. I have mine set so that it believes that noon is at 3 or 4 pm (depending on the time of year and weather it is daylight saving time). Respironics machines are different, and you have to tell the software what time it is relative to the time zone set for that machine. Somebody here can help with that if you ask.

There will be lots of adjustments to make, but people here are great about helping and solving the various issues that come up.

To help with my metabolic state, keep my knees, and simply to get more healthy I am doing "long term low level exercise" with a bit of resistance training built in.

For example tonight I was three hours at the gym. I did 3 12 rep sets of the "basic 8" plus one resistance training - the rest of that time was spent on a cycle or treadmill at either a very low level (not quite up to even a fat buring heart rate) or at an aerobic heart rate. Probably about 70% low and 30% aerobic.

You end up tired. The up side is that my sleep times have stablized which is strange for this time of year. I usually have the pattern of sleeping a bit later every day.