Sleep apnea + sleep maintenance insomnia

speppers wrote:
I exercise (both cardio and strength training) from about 4-7 days per week and eat a healthy diet.

If you exercise vigorously, 7 days per week is too much for anyone. 3 to 4 would be appropriate.

With our society's emphasis on exercise and sports, far too many people are involved in overtraining.

speppers wrote: I can't remember the last time that I got a good night's sleep.

Schwarzenegger is famous for saying, "Exercise does not build strength and endurance. Nutrition and sleep build strength and endurance. Exercise tears it down."

If you can't sleep well, I would cut the exercise program waaay back. Like maybe a 30-minute walk daily at no more than 3 mph pace.

Get your sleep straightened out and you can start building your exercise program back up.

"Exercise helps some people be healthier, does nothing for other people and makes some people unhealthier."

If you are not sleeping, you may be in that latter category.

(BTW, I am an exercise fanatic and always have to watch out for overtraining.)

VVV wrote:

speppers wrote:
I exercise (both cardio and strength training) from about 4-7 days per week and eat a healthy diet.

If you exercise vigorously, 7 days per week is too much for anyone. 3 to 4 would be appropriate.

With our society's emphasis on exercise and sports, far too many people are involved in overtraining.

speppers wrote: I can't remember the last time that I got a good night's sleep.

Schwarzenegger is famous for saying, "Exercise does not build strength and endurance. Nutrition and sleep build strength and endurance. Exercise tears it down."

If you can't sleep well, I would cut the exercise program waaay back. Like maybe a 30-minute walk daily at no more than 3 mph pace.

Get your sleep straightened out and you can start building your exercise program back up.

"Exercise helps some people be healthier, does nothing for other people and makes some people unhealthier."

If you are not sleeping, you may be in that latter category.

(BTW, I am an exercise fanatic and always have to watch out for over-training.)

I'd have to agree with a lot of what VVV mentioned above (BTW, lookin' fit dude). I'm also a self-confessed exercise nut, however I know that after I've had a bad patch of sleep that I need to dial things back a bit, mostly because it can exacerbate my sleep problems. It's a fine line to tread but you can do it once you understand how your body works.

Thanks guys! The intensity of my exercise depends on how many days a week I work out. If I'm doing light cardio, I'll often exercise 6-7 days per week. If I'm doing something more, like running long distance or doing sprints, I'll exercise for fewer days per week. Usually I do a mix of both and end up at around 4-5 days per week. I'm fairly certain I'm not overtraining, as I do keep an eye out on all of this, but I will definitely take your advice into consideration. My sleep is my biggest issue right now. The main reason I am a bit careful about keeping up with exercise is because I have quite a bad problem with anxiety, and cardio keeps it nice and under control.

Regarding the alpha wave intrusion, I have alpha wave intrusion disorder. In my case, I was told it is directly related to fibromyalgia. I have fibro, but its the least of my health problems so I've not done a lot of research on the disorder. From my understanding some think, in principle that alpha wave intrusion can cause fibro or the reverse. My sleep doc said this & I read it in a couple of places at that time. I was diagnosed with my sleep disorders 14 years ago & focused mostly on OSA & RLS/PLMD. If you don't have fibro, you may not have any effects of the alpha wave intrusion, but might want to do a little research if you want to understand it better. Hopefully someone with more knowledge than me will come along with more answers.

My hubby has insomnia, so I have sympathy for your insomnia problems. RobySue gave some advice for my hubby & its made a world of difference. She recommended a book 'Sound Sleep Sound Mind' by Barry Krakow M.D. & its been tremendously helpful.

Good luck,
Jen

speppers wrote: I have quite a bad problem with anxiety

Do you and your doctors know that SDB (sleep-disordered breathing) is a major cause of anxiety?

High cortisol levels + sleep deprivation = anxiety

Wow, what a thread! I am speppers' twin, except I am 67 and my insomnia problems correlate with menopause, not young adulthood. I had heard about the lower melatonin dosage and will try that regimen (thanks!) as I have tried every dose before going to sleep (which is not a problem) to no avail. I will also be more religious about my CPAP usage for my PLMD, based upon those links' conclusions. (BTW, I went to Stanford Sleep Center for PLMD and they kind of quoted these reports; they basically pooh-poohed my PLMD complaints because my CPAP should have been resolving them along with my mild OSA. Since my numbers were all perfect, I became even more cynical and pissed and stopped worrying about using my CPAP 100% of the time, although I do use it 80% or more.) I have just unsuccessfully tried Sleep Thru, which is advertised to modulate nocturnal cortisol levels, and I am moving on to 5-HTP tonight. My sleep doc thought maybe a nasal pillow mask might help, so when mine arrives I will be trying that too.

FYI, I go to sleep fine, awaken after 2, 3 or 4 hours, stay awake for 1, 2 or 3 hours, then sleep lightly for a couple more (sometimes deeper sleep). I tried adenosine monophosphate, very small dosages, and it made me nervous and unable to fall asleep, since symptomatically I feel like I lack what I call "sleepy juice". I had a 10 day period of real sleep after I flew back from the east coast 2 months ago, and the jetlag worked to make me think foolishly this had normalized my sleep. I did get off all benzos a little over a year ago. And do agree that my body has now habituated itself to this pattern which, at the moment, seems to be worse. (I used to sleep better every other night.)

Anyway, many thanks for the helpful info!!!

Don't you just hate it when doctors get lazy and ASSume everyone is the same?
While some cases of PLMD might be helped by CPAP use, others are not;
and often the disorder needs to be treated separately.
Your doctor seems like one for which I might be scouting around for a replacement.

speppers wrote: I'm turning 26 this month

WANTOKPORO wrote: I am speppers' twin, except I am 67

The mother of the two of you deserves a medal of honor.

WANTOKPORO wrote: ...I will also be more religious about my CPAP usage for my PLMD, based upon those links' conclusions. (BTW, I went to Stanford Sleep Center for PLMD and they kind of quoted these reports; they basically pooh-poohed my PLMD complaints because my CPAP should have been resolving them along with my mild OSA...

WANTOKPORO, just want to discuss this a bit. Without knowing your sleep study specifics, I'll speak in general. Take what applies to you and leave the rest for someone else. About your "mild" sleep apnea... If a sleep study did not include the capture of REM sleep while supine, you don't really KNOW how severe your apnea is. Mild just means that's all you had during that time, not that's it's all you ever have in a night. Did your night of sleep give them adequate information for an accurate diagnosis? Also, I am always suspect of under-diagnosed conditions when both sleep apnea and PLMD are present. Unfortunately, that night's data is all they've got to go on. And, if ANY limb movements from PLMD were present in the diagnostic study, they likely precluded and obscured a number of apnea events that would have shown up in the absence of limb movements. This is a soapbox issue for me because of my years of torment with so many of my medical providers not being knowledgeable on the subject.

About the CPAP helping your legs... It will help your legs IF the movements are related to the apneas. If you have PLMD, the likelihood of it helping your legs is less. In my opinion, PLMD is more likely to worsen on CPAP because the apneas are no longer precluding some of the movements. Again in my opinion, for any doctor to assume CPAP will fix PLMD is a gross miscarriage of responsibility. Now, I am not a medical professional, so take this for what it's worth. But I feel anyone with this dual diagnosis would be best served by first achieving consistent use of confirmed effective CPAP therapy, then if symptoms of poor sleep and/or leg movements continue, perform another sleep study while using their CPAP as usual. So many places redo the diagnostic test - that will not give you an answer. Only a test using CPAP (but NOT another titration) will fully diagnosis the severity of PLMD.

Good luck sorting out what any of this might mean to you.

* For anyone else reading this I'll throw out that if you were diagnosed with PLMD and told your sleep apnea wasn't enough to treat, there's a good chance your apnea picture would change if retested after your legs have been quieted.

WANTOKPORO wrote: I have just unsuccessfully tried Sleep Thru, which is advertised to modulate nocturnal cortisol levels, and I am moving on to 5-HTP tonight. My sleep doc thought maybe a nasal pillow mask might help, so when mine arrives I will be trying that too.

FYI, I go to sleep fine, awaken after 2, 3 or 4 hours, stay awake for 1, 2 or 3 hours, then sleep lightly for a couple more (sometimes deeper sleep). I tried adenosine monophosphate, very small dosages, and it made me nervous and unable to fall asleep, since symptomatically I feel like I lack what I call "sleepy juice".

For several months I've been taking one SeriPhos capsule (1000mg) about one hour before bedtime and have found that it helps damp down my adrenal glands enough so I don't suffer from those dreaded cortisol/anxiety surges which make one's mind and nervous system race, often culminating in night sweats. It has a 5-6 hour latency period, so for middle of the night jitters It works for me if I take it one hour before bedtime. However, like most supplements, go slow cuz it may not be for everyone:

http://www.amazon.com/SERIPHOS-InterPle ... B000N23AE8

5-HTP did absolutely nothing for me for the month I tried it. That was disappointing to say the least.

ChicagoGranny wrote:

speppers wrote: I have quite a bad problem with anxiety

Do you and your doctors know that SDB (sleep-disordered breathing) is a major cause of anxiety?

High cortisol levels + sleep deprivation = anxiety

Yes, we are aware of the link. It's hard to say how long I've had sleep apnea - perhaps forever - and in general, I am unable to ascertain whether it is the SDB that causes my anxiety, or my odd childhood, or my family history, etc. As mentioned, my anxiety problem was quite severe a few years ago (I was agoraphobic), but thankfully, I was officially in remission almost three years prior to my sleep apnea diagnosis. I guess it doesn't really matter what caused my anxiety issues, as long as I am continuing to get treatment both for anxiety and for sleep apnea. Anxiety may be caused by SDB, but it is sustained by negative appraisals and other distorted cognitions, all of which require treatment outside of the CPAP. I am a therapist myself (although just a baby in the field!) and benefited enormously from anxiety treatment.

WANTOKPORO wrote:Wow, what a thread! I am speppers' twin, except I am 67 and my insomnia problems correlate with menopause, not young adulthood. [...] My sleep doc thought maybe a nasal pillow mask might help, so when mine arrives I will be trying that too.

Hello twin! Unfortunately I'm of absolutely no help with the insomnia issues (although, if you haven't tried sleep restriction, that MIGHT be something to consider). However, I can tell you that the nasal pillow mask is the only mask that I am able to use without having utter panic attacks, and (knock on wood) I sleep through the night without taking it off or having any issues. And I sleep on my side/tummy. As your twin, I'm very excited to see how you like the nasal pillows!

Yes, did sleep restriction. "Increased my arousal" was the doc's comment; two weeks+ of terrible sleep deprivation. And then I was anxious, anxious because I was exhausted and had failed the last trick in their bag of tricks.

Ugh, I feel you. Sleep restriction was horrible for me, and unfortunately my sleep efficiency did not increase. Perhaps I didn't give it a very long try (about six weeks). I may try it again, though. Sleep aids are terrible presently.