Overcoming long-term sleep debt

ems wrote:

mgaggie wrote:

ems wrote: I don't believe in sleep debt or that you can make up for lack of sleep, and think it's a bunch of nonsense. I don't think you can make up for lost sleep or the lack of oxygen from years past. Once you start successfully using your machine it's likely you'll start reaping the benefits, thus having more energy and feeling better.

If you believe in the bolded part, can you explain to me how after using a machine with a minimum of 7hours per night for 6 months and a AHI average of 1 I still feel tired and no energy upon waking?

I don't really "believe" in the bolded part. I just didn't want to upset the OP, along with the fact that some people are fortunate enough to actually reap the benefits. Unfortunately, I'm not one of those people and I guess neither are you. That's a big reason why I have such a difficult time using the machine. When something highly annoying isn't making you feel any better, it's hard to continue to use it.

Well, that was revealing.

I LOVE using my machine(s) and really hate taking it off to get up in the morning. When I was working, I averaged about 6.5 - 7.5 hrs per night, but since I retired in 2009 my average has increased to about 8.5 hrs per night. Some nights are more than 10 or 11 hours.......most of those in the Wintertime.


Den

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ems wrote:We are arguing over words... nuff.

I'm done, too.


Den

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Revealing... how about honest?

Has nothing to do with how I feel about the term, "sleep debt".

It might get down to definitions.

I suspect that what is commonly known as "sleep debt" is mostly inflammation (local and systemic) caused by nightly OSA-related attacks on cellular tissues by stress hormones (among other things); and as this inflammation subsides due to xpap therapy, so do many of the symptoms, including the ones of which Wulfman Den describes.

I also saw improvements in a long list of sequelae, some fairly quickly after beginning xpap, and others over time. My guess is that as local and systemic inflammation subsided due to optimized xpap therapy, and that led to dramatic easing of several symptoms.

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Starpilot wrote:How much sleep debt have I accumulated? How will I ever pay it all back?

If you're not sleeping more than your base sleep requirement, the answer as to when you pay off your sleep debt is "never", and of course, repayment depends on how big your debt is.

As noted in the Dement work, "The Promise of Sleep", there are number of ways to determine your basic sleep needs, and then you can do a running total of your sleep debt. There are several methods to estimate your sleep debt at the moment of your transition to CPAP and now. The easiest of these is to use the Epworth Sleepiness Scale. This method gives you a number that quantifies your level of sleepiness and estimates your sleep debt. You probably did this prior to your sleep studies, if you don't remember the number, call the Manager of the Sleep Laboratory and I'm sure he can find it for you. It looks like this:

Use the following scale to choose the most appropriate number for each situation:

0 = would never doze or sleep.
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping

Situation Chance of Dozing or Sleeping

Sitting and reading ____
Watching TV ____
Sitting inactive in a public place ____
Being a passenger in a motor vehicle for an hour or more ____
Lying down in the afternoon ____
Sitting and talking to someone ____
Sitting quietly after lunch (no alcohol) ____
Stopped for a few minutes in traffic while driving ____

Total score (add the scores up) ____

Dr. Dement equates the Epworth Score thus:

0-5 Slight or no sleep debt
6-10 Moderate sleep debt
11-20 Heavy sleep debt
21-25 Extreme sleep debt

It is implied that sleep debt can accumulate infinitely, but that is not the case. The maximum is probably about 50 hours.

That said, Dement says that you need to run a sleep debt of about 10 to 20 hours in order to fall asleep effectively.

IMO you can repay some of the short term debt, but you simply have to write the long term debt off, as xPAP isn't a time machine. For those of us who are Obese, losing weight is more important than machines or pills for our overall health.

Sludge wrote:Epworth Sleepiness Scale.

Use the following scale to choose the most appropriate number for each situation:

0 = would never doze or sleep.
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping

Situation Chance of Dozing or Sleeping

Sitting and reading ____
Watching TV ____
Sitting inactive in a public place ____
Being a passenger in a motor vehicle for an hour or more ____
Lying down in the afternoon ____
Sitting and talking to someone ____
Sitting quietly after lunch (no alcohol) ____
Stopped for a few minutes in traffic while driving ____

Total score (add the scores up) ____

Dr. Dement equates the Epworth Score thus:

0-5 Slight or no sleep debt
6-10 Moderate sleep debt
11-20 Heavy sleep debt
21-25 Extreme sleep debt

It is implied that sleep debt can accumulate infinitely, but that is not the case. The maximum is probably about 50 hours.

That said, Dement says that you need to run a sleep debt of about 10 to 20 hours in order to fall asleep effectively.

I clearly remember answering those questions when I had my sleep study in 2011... bc the score I got was "1". I even remember debating whether to put a 0 or a 1 next to, "watching TV". I put a 1 bc I remembered "once" falling asleep watching a TV program late at night. I was still diagnosed with OSA.

Sleep debt... I think Dement is about right.