Is dreaming a reliable gauge of sleep quality?

chezdan9 wrote: Do you think it's possible that I was dying?

Anyone with untreated severe obstructive sleep apnea is dying a little quicker than the average person, but deaths of severe OSA patients in their sleep are usually directly caused by other disease states that may or may not have been caused by the OSA. People with severe OSA who "die from it" usually do so in an accident during the day from being one of the walking (or driving) dead. That's my wishy-washy but opinionated answer. I'm known for those.

The main thing is that you got treatment.

How is your treatment going now?

(Don't worry about hijacking the thread. It is common here. I often do it on purpose. Or start another thread to answer the question. Or not. Up to you.)

SuddenlyWornOut45 wrote:I would say, yes. When I dream, as long as they are not nightmares or something, I usually experience "deeper feeling" sleep and wake up feeling more restored and more well rested. By contrast when I never dream (which is most of the time), my sleep quality is not so great. I will admit in my case I rarely dream because I am on big doses of klonopin, which suppresses deep stage sleep.

But if you are not on certain kinds of medications that suppress deep stage sleep and not taking OTC anti-histamines or drinking booze, CPAP therapy SHOULD be giving you more dreams and SHOULD be giving you subjectively deeper feeling sleep that is restorative sleep. If it is not, someone is wrong. Either your CPAP therapy needs tweaking somehow or you need a new sleep study or you need to find a way to get off medications that are dumbing down your deep stages of sleep and preventing the CPAP from doing its full work.

Eric

Comment,

Eric, when you're talking about taking medications and REMS (assuming also dreaming), then many sleep Docters are against taking sleep medication such as Zolpidem (generic Ambien) for sleep because it delays REMs. Would you regard it also as "dumbing down your deep stages of sleep and preventing the CPAP from doing its full work" ? If you say yes, then what would be more important to you, to take the Zolpidem and be able to fall asleep or NOT to take the Zolpidem b/c of "dumbing down" your deep stages or delaying your REMs?

An oddity to consider: I read a medical paper last summer that mentioned people with a certain brain abnormality that caused them not to dream at all. Here's a brief Wiki explanation: "While working in the neurosurgery department at hospitals in Johannesburg and London, Dr Solms had access to patients with various brain injuries. He began to question patients about their dreams and confirmed that patients with damage to the parietal lobe stopped dreaming; this finding was in line with Hobson's 1977 theory. However, Dr Solms did not encounter cases of loss of dreaming with patients having brain stem damage. This observation forced him to question Hobson's prevailing theory, which marked the brain stem as the source of the signals interpreted as dreams."

While the above is easy to understand and accept the weird part is the the medical paper I read concluded that this small percent of the population, a fraction of one percent, have no more mental aberrations or problems that the general population. Their lifespans are normal and their day to day function is identical to everyone else. You'd think they would all be basket cases but you'd be wrong. Maybe dreaming is like our vestigial tailbones... really overrated and obsolete. To put in my two cents worth, I could do without dreams, especially those unpleasant ones which can wake one up. I'll see if I can find the original study... it's quite fascinating.

avi123 wrote:

SuddenlyWornOut45 wrote:
Eric

Comment,

Eric, when you're talking about taking medications and REMS (assuming also dreaming), then many sleep Docters are against taking sleep medication such as Zolpidem (generic Ambien) for sleep because it delays REMs. Would you regard it also as "dumbing down your deep stages of sleep and preventing the CPAP from doing its full work" ? If you say yes, then what would be more important to you, to take the Zolpidem and be able to fall asleep or NOT to take the Zolpidem b/c of "dumbing down" your deep stages or delaying your REMs?

First of all, I remember when Ambien first came out in the nineties. I had been diagnosed with major depression not too long in the late nineties when Ambien came out, but was not diagnosed with sleep apnea nor treated for it with CPAP. I enrolled in a study at the Medical University of South Carolina at Charleston in 1999 for rTMS for refractory major depression. A high tech study of the use of high tech magnet therapy for severe depression, it was being investigated back then as a possible replacement for ECT.

Anyway, I had to go off ALL psych meds for that study. I did not take klonopin or any sort of benzos back in those days, just anti-depressants and a lot of vitamins. I did take some anti-histamines OTC for insomnia back in those days. Looking back on it all, it was all VERY primitive, my "depression" treatment despite having access to some good quality psychiatric resources.

The one drug the MUSC Pdocs doing the rTMS would let us have during that study was Ambien. I was told by a top notch psychopharmacologist that "Ambien was a very good drug, it was very clean" I was told, specifically. Ambien is not like klonopin or other benzos nor like OTC benadryl for insomnia, ambien does not screw up slow wave sleep like benzos or benadryl or barbituates. Additionally, Ambien has a VERY short half life. Its in and out fast, which is good for your sleep architecture, supposedly.

I never had to take much of the stuff during that study. I took a little, not much. I found it to be a weak, subtle medication myself.

I later needed something much stronger for insomnia, BEFORE I was treated for OSA. Klonopin filled that need, but klonopin like all benzos is awful for suppressing deep stage sleep...especially slow wave sleep. Klonopin is why I rarely dream.

If it were me and I had to choose between taking ambien and being able to fall asleep and not taking ambien and having really chronic, severe insomnia, I'd choose the first. I'd take the ambien regular, because it is so weak compared to benzos. Its not even in the same class of drugs as benzos. Its classed as a "hypnotic." Its not useful for anxiety. It does not suppress slow wave sleep. It is a controlled substance, but if I remember right its the lowest control, like schedule 5 I think (have to verify that to be sure on that, its either schedule 5 or 4). The addiction potential is lower than benzos like klonopin and nothing even remotely in the same ballpark as something like prescription narcotic painkillers or prescription amphetamines like Ritalin.

Yeah, if I had to choose between having chronic insomnia and taking ambien at bedtime regular to knock me out, I'd choose ambien regularly. It's effect on sleep architecture is very weak. At big doses I suppose it could suppress respiratory drive (sedation of breathing muscles) some, but thats why you get an autopap or auto bipap.

Eric

Sir NoddinOff wrote:An oddity to consider: I read a medical paper last summer that mentioned people with a certain brain abnormality that caused them not to dream at all. Here's a brief Wiki explanation: "While working in the neurosurgery department at hospitals in Johannesburg and London, Dr Solms had access to patients with various brain injuries. He began to question patients about their dreams and confirmed that patients with damage to the parietal lobe stopped dreaming; this finding was in line with Hobson's 1977 theory. However, Dr Solms did not encounter cases of loss of dreaming with patients having brain stem damage. This observation forced him to question Hobson's prevailing theory, which marked the brain stem as the source of the signals interpreted as dreams."

While the above is easy to understand and accept the weird part is the the medical paper I read concluded that this small percent of the population, a fraction of one percent, have no more mental aberrations or problems that the general population. Their lifespans are normal and their day to day function is identical to everyone else. You'd think they would all be basket cases but you'd be wrong. Maybe dreaming is like our vestigial tailbones... really overrated and obsolete. To put in my two cents worth, I could do without dreams, especially those unpleasant ones which can wake one up. I'll see if I can find the original study... it's quite fascinating.

The thing is "Questioning patients about dreams" doesn't really work. You can only remember a dream if you are awakened during the dream. So to test this he would have to have the people in his lab and constantly being wakened to report if they were dreaming.

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BlackSpinner wrote:The thing is "Questioning patients about dreams" doesn't really work. You can only remember a dream if you are awakened during the dream. So to test this he would have to have the people in his lab and constantly being wakened to report if they were dreaming.

The study was based on electromagnetic brainwave analysis of the REM stages, something that every sleep lab routinely does several times a night. The subjects were totally lacking in REM stages... sorry I forgot to mention the lack of REM earlier.