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I don't get Level 3 or SlowWave sleep at all.
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Realtor 1 Offline

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Post: #1
I don't get Level 3 or SlowWave sleep at all.
I believe that I have found the reason why I feel so bad all the time & not refresh even after getting any sleep(Which is rare to begin with).

After close to 100 days of hounding at last my Sleep Clinic sent me the complete report of my 2 Sleep studies & on both occasions i only got level 1 & 2 of sleep (mostly Level 2) & some REM sleep which was 27 minutes once & 35 minutes (Amounting to 10% or 11% of the whole sleep).

Strangely the Doctors did not share it with me at all & also did not show any concern at all. Maybe the first time they might have thought that because of severe Apnea I could not go to that level but the 2nd studay was the Titration one & I did not have many episodes of Apnea at all.

I would like to get opinions from the Veterans here. Should I be concerned about this.
I am a Terrible Insomniac for over 4.5 months & encounter problems even with Prescription Sleep Aid.
10-25-2013 06:35 PM
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robysue Offline
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Post: #2
RE: I don't get Level 3 or SlowWave sleep at all.
(10-25-2013 06:35 PM)Realtor 1 Wrote:  Strangely the Doctors did not share it with me at all & also did not show any concern at all. Maybe the first time they might have thought that because of severe Apnea I could not go to that level but the 2nd studay was the Titration one & I did not have many episodes of Apnea at all.
Actually, sleep docs know that sleeping in the lab is a highly artificial environment and hence they expect to see some real problems with sleep efficiency and possible skewing of the sleep staging even on the titration study.

I'm not saying you don't have a problem, I'm just saying that docs tend to take seeing very little REM or Stage III with a very large grain of salt on the first titration study since the novelty of the mask throws a lot of people off.

But you also write:

Quote:I am a Terrible Insomniac for over 4.5 months & encounter problems even with Prescription Sleep Aid.
What prescription sleep aid are you taking and how are you taking it? Some sleeping pills tend to mess up the sleep cycles in certain people pretty bad.

Also, what's your sleep hygiene look like? That can make a big difference in how well a sleeping pill helps you sleep.

For what it's worth, it took me well over 6 months of serious CPAP-induced insomnia before I really learned how to sleep with the machine.
10-25-2013 07:04 PM
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Realtor 1 Offline

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Post: #3
RE: I don't get Level 3 or SlowWave sleep at all.
(10-25-2013 07:04 PM)robysue Wrote:  
(10-25-2013 06:35 PM)Realtor 1 Wrote:  Strangely the Doctors did not share it with me at all & also did not show any concern at all. Maybe the first time they might have thought that because of severe Apnea I could not go to that level but the 2nd studay was the Titration one & I did not have many episodes of Apnea at all.
Actually, sleep docs know that sleeping in the lab is a highly artificial environment and hence they expect to see some real problems with sleep efficiency and possible skewing of the sleep staging even on the titration study.

I'm not saying you don't have a problem, I'm just saying that docs tend to take seeing very little REM or Stage III with a very large grain of salt on the first titration study since the novelty of the mask throws a lot of people off.

But you also write:

Quote:I am a Terrible Insomniac for over 4.5 months & encounter problems even with Prescription Sleep Aid.
What prescription sleep aid are you taking and how are you taking it? Some sleeping pills tend to mess up the sleep cycles in certain people pretty bad.

Also, what's your sleep hygiene look like? That can make a big difference in how well a sleeping pill helps you sleep.

For what it's worth, it took me well over 6 months of serious CPAP-induced insomnia before I really learned how to sleep with the machine.
I have taken a fair amount of sleeping pills including Clonazapem, Trazodone, Amtriptyline, 5 Htp & Zopiclone. Only Zopiclone works for me to a certain extent.
Insomnia was the main reason why I went to the Sleep Lab as I never suspected any Apnea issues, I don't snore . Just stopped sleeping completely after 4 days of no sleep went to Emergency where they gave me the first sleeping Pill(Zopiclone) since then I have been taken one every night. Tried a few times to sleep without one but could not sleep again. Was very surprised when they told me that I had Severe Sleep Apnea. From the 2nd day of putting the mask I became reasonably comfortable with the mask. So Machine & the mask is not much of an issue.
10-25-2013 07:56 PM
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robysue Offline
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Post: #4
RE: I don't get Level 3 or SlowWave sleep at all.
(10-25-2013 07:56 PM)Realtor 1 Wrote:  I have taken a fair amount of sleeping pills including Clonazapem, Trazodone, Amtriptyline, 5 Htp & Zopiclone. Only Zopiclone works for me to a certain extent.
What are you taking NOW? At what dose? And how often do you take it? Every night?

Quote: Just stopped sleeping completely after 4 days of no sleep went to Emergency where they gave me the first sleeping Pill(Zopiclone) since then I have been taken one every night.
Are you still taking the Zopiclone? How long have you been taking it? Is it effective at helping you get to sleep?

And would you say your main problem is trouble getting to sleep or trouble staying asleep or both?

And what's the sleep schedule look like? Do you have a more or less regular wake up time? What about a more or less regular bedtime?

And what do you do if you find yourself not sleeping at night?
10-25-2013 09:32 PM
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justMongo Offline

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Post: #5
RE: I don't get Level 3 or SlowWave sleep at all.
I don't get to stage 3 nor delta wave sleep either. I believe it gets worse with age.
I'm not going to reveal my age -- but, Harry Truman was President when I was born; and he had not been elected.

I also think most medical folks would say that benzodiazapines such as clonazapam disturb the deep stages of sleep.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-25-2013 10:29 PM
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Realtor 1 Offline

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Post: #6
RE: I don't get Level 3 or SlowWave sleep at all.
I am 43 years old. They say that after hitting 70 people usually stop getting the Slow wave sleep.

Yes, I take Zopiclone 7.5mg which puts me to sleep but I do wake up after 2.5 to 3 hours & then just toss & turn in bed. Sleep deprivation is driving me nuts. I cannot sleep at all without it. Cannot even take a nap during the day.
I usually go to bed at 11pm & stay in bed with my machine on till alarm goes at 7am .
My doctor yesterday doubled my dose to 15mg but I did still take 1 as I was feeling very sleepy but still got up at 2:30am and could not sleep afterwards.

Will try 15mg tonite.
After a long debate & my wife's insistence my Doctor also prescribed me Cipralex & I had my first dose yesterday .(No one can figure out the reason for this sudden but ongoing Insomnia so maybe Depression could be a reason, although I doubt it but am open to pretty much anything at this stage).
Last night I also felt choking sensations & once noticed myself breathing very heavily through my mouth even with the Chin strap tightly on.
10-26-2013 10:02 AM
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robysue Offline
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Post: #7
RE: I don't get Level 3 or SlowWave sleep at all.
Realtor1,

Did the insomnia start with the CPAP therapy? Or did it start before you started CPAP? The reason I ask is that I wound up having one of the toughest battles with insomnia that I have ever dealt with in my life that started right after starting CPAP. On another forum, I referred to it as my War on Insomnia at the time I was fighting the battle.

Questions that will help me tailor some suggestions for you to try based on my previous experiences.

1) You say that you can't sleep at all without the Zopiclone. What was happening before you started the Zopiclone? Was the CPAP waking you up just as you were climbing into bed trying to get comfortable enough to fall asleep? Had you started to dread bedtime? Or was it some other kind of problem?

2) How long does it take you to get to sleep with the Zopiclone? How much do the sensory stimuli coming from the CPAP equipment bother you before you get to sleep? (By sensory stimuli I mean things like the exhaust flow, the pressure, the noise, the touch of the mask on your face, the touch of the hose if it is against your body, etc)

3) You say you go to bed at 11pm and wake up about 2.5 to 3 hours later. And then toss and turn the rest of the night. Do you watch the clock when you're tossing and turning? Does the CPAP equipment make you physically uncomfortable when you are lying in bed awake trying to get back to sleep? Do you ever get out of bed and go into another room to try to relax by doing something soothing like listening to some quiet music in a semi dark room? Or reading a boring book in a different room?

4) Are you sleepy at all when you go to bed at 11pm? Would it be easy or difficult for you to stay up until 11:30 or midnight if you were NOT worried about the alarm going off at 7 am the next morning? Please note that feeling sleepy is not the same as feeling exhausted.

5) Pre-CPAP what was your sleep schedule like? Bedtime at 11pm? Wake at 7am? How long did it take you to get to sleep? How often do you remember waking up at night pre-CPAP?

6) Has the doc talked to you at all about sleep hygiene? If so, what's he said and how much of it do you do on a regular basis?

7) Do you think you have any other symptoms of depression other than the insomnia?

8) How willing are you to try behavioral approaches to attempting to rein in the insomnia along with your use of Zopiclone? There are some pretty decent self-help insomnia books out there if you are interested in that kind of thing.
10-27-2013 04:44 PM
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Realtor 1 Offline

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Post: #8
RE: I don't get Level 3 or SlowWave sleep at all.
Thanks Robysue!!

I have always been a light sleeper & had some minor Insomnia issues in my early 20's.
I had a very crazy busy Realtor's lifestyle which was like going to sleep at around 2 to 3am, getting up at 7(Because Children get up then for School) but used to go back to sleep till around 10am.

On the 28th of May this yr. I blanked out for a few seconds while driving on the freeway & then 15 days later just stopped sleeping for whatever strange reason. After not sleeping for a second four nights in a row I ended up in the Emergency Room where they gave me Zopiclone to sleep. Zopiclone initially worked for 5 days then stopped. Doctor changed my prescription a few times (Trazodone, which did not work, Clonazapem which worked but made me Zombie like & then Zopiclone was prescribed again). Referred me to sleep clinic where they found out the Severe Apnea.

I cannot say that I feel great wearing the mask & the machine but I am fairly comfortable with the Cpap MAchine & Mask. It just does not help me at all.I get terrible sleep, waking up many many times , if I fall asleep.

Zopiclone usually put me to sleep between 30 minutes to 1.5 hrs. but I do wake up after a while.

I feel sleepy all the time but just cannot fall asleep. Cannot take a single minute Nap during the day either.

I am not too sure if I am really depressed as things were going great for me when everything started. 5 months later I am more scared of these issues as I am the sole Bread earner of this family.This Insomnia is just driving me crazy.
Once I wake up at night I usually stay in bed & try to sleep again instead of getting up & listening to music or to read.

At this moment I am willing to try anything to get myself some good sleep I don't really like taking Zopiclone a my head hurts all the time but it is the only thing which works for me although only to a certain extent.
10-27-2013 08:53 PM
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robysue Offline
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Post: #9
RE: I don't get Level 3 or SlowWave sleep at all.
Realtor1, I'm going to rearrange some of thei things in your last post to make it easier for me to respond.

About your pre-CPAP and pre-emergency room visit sleep patterns you write:
(10-27-2013 08:53 PM)Realtor 1 Wrote:  I had a very crazy busy Realtor's lifestyle which was like going to sleep at around 2 to 3am, getting up at 7(Because Children get up then for School) but used to go back to sleep till around 10am.
So you've got a history of being a bit of a night owl. I can identify with this all too well; I'm currently struggling to get my "delayed sleep phase" problem better under control.

Did this former sleep schedule work for you in the sense that you didn't really feel that you were seriously sleep deprived when you were sleeping in this pattern?

And if you could start sleeping like this again would that be better than what you're currently dealing with?

You write this about what happens now:
Quote:I usually go to bed at 11pm & stay in bed with my machine on till alarm goes at 7am .
and
Quote:Zopiclone usually put me to sleep between 30 minutes to 1.5 hrs. but I do wake up after a while.
Combining this information with the information about your old sleep schedule leads to these ideas:

1) I wonder if you're just plain trying too hard to get to sleep "on time" when your chosen bedtime is far earlier than what you were used to doing before all this stuff started. That might explain why it's taking the Zopiclone so long to work. Look at it this way, if you take the Zopiclone at 11:00 and it takes you 1.5 hours to get to sleep, that's about 1:30, which is about 30 minutes before your old "bedtime". It may be worth moving bedtime back to midnight (or even 1:00) and taking the Zopiclone closer to your old bedtime and seeing if that would help it be a bit more effective at getting you to sleep at the start of the night.

2) In your old sleep pattern, you were getting yourself up after a few hours of (apnea-filled) sleep to get the kids off to school and then sleeping a couple more hours. It could be that your body is just not used to the idea of lying in bed being asleep for a full eight hours. And that may be feeding the additional restlessness during the end of the night. Your body may simply not expect and does not want to "be in bed for 8 hours straight."

3) You need to find a way of teaching your body how to sleep when you are in bed again. And that's going to take some hard work. The usual piece of sleep hygiene that a specialist in cognitive behavior therapy for insomnia (CBT-I) uses for this is having the patient restrict the time in bed if they are making NO actual progress towards getting to sleep. People are often told to simply get out of bed and go into a different room if they've been lying in bed for 30 minutes or more without successfully getting to sleep. And to return to bed once they feel like they're starting to actually fall asleep. But with your past history of the four day stretches with NO sleep, this technique may not be practical for you to try. Nonetheless: It may be worth asking for a referral to someone who does CBT-I and do that along with using the prescription sleeping pills.

4) It also sounds like you need to work with someone who can help you set some realistic intermediate goals in your quest to rein in the insomnia. You may never sleep for eight solid hours from 11:00pm to 7:00am even with the help of CPAP and sleep meds, but that doesn't mean you won't be able to get a decent night's sleep eventually. Things to keep in mind about normal sleep patterns as you are working your way through this nasty insomnia:
  • While most adults need around 7-8 hours of sleep, some only need 6 hours to feel decently rested.
  • A few (short) wakes are actually pretty typical of normal sleep patterns. It's not uncommon to wake up after each REM cycle just long enough to make sure everything is "ok" and then fall back asleep. The thing is a noninsomniac doesn't remember those short awakenings in the morning because they are typically less than 5 minutes long.
  • Sleep efficiency can be just as important (or more important to some folks) than total sleep time when it comes to how they feel the next day. Sleep efficiency is the total sleep time divided by the time in bed. "Normal" is regarded as above about 85%---so a normal person might be awake as much as 70 minutes out of an 8 hour "time in bed" window. So if your sleep efficiency is way, way below that, working on improving the sleep efficiency by reducing the time in bed as a way of reducing the time spent tossing and turning and being restless and worrying about not being asleep sometimes is just as valuable as increasing the total sleep time.

Finally, you write:
Quote:At this moment I am willing to try anything to get myself some good sleep I don't really like taking Zopiclone a my head hurts all the time but it is the only thing which works for me although only to a certain extent.
It may not help you since you've got such a profound case of insomnia with that history of 4-day stretches with no sleep. But it may be worth your time to get a copy of Sound Sleep, Sound Mind by Dr. Barry Krakow. The first part of the book looks at common behavior patterns that many insomnias have that tend to aggravate the insomnia and how to change those behavior patterns to something that encourages sleeping when you are physically in your bed. The second part of the book is actually a look at sleep disordered breathing and how untreated sleep disordered breathing can manifest itself as severe insomnia.

Well, it's now past 1:30AM my time, and that's my bedtime when I'm dealing with fighting insomnia. So here's hoping that you got a decent night's sleep when you see this sometime tomorrow.
10-28-2013 12:46 AM
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Post: #10
RE: I don't get Level 3 or SlowWave sleep at all.
(10-28-2013 12:46 AM)robysue Wrote:  But it may be worth your time to get a copy of Sound Sleep, Sound Mind by Dr. Barry Krakow. T
From Shrink Rap Radio, Dr. David Van Nuys, aka “Dr. Dave” interviews Dr. Barry Krakow
Excerpt:
Most insomniacs actually do get sleepy, but they get sleepy at the wrong time of day: often in the early evening, or in the afternoon and they
will even tell you sometimes they doze off. But in the evening time they have done certain things, or certain things have taken hold in terms of their own habits, where they do not necessarily or naturally bring the wave of sleepiness in close to bedtime. And that is one of the things that we teach them: how can you bring the wave around the evening bedtime hours, so that you can tap into it and go to sleep; and if you wake up at night, tap into it again and go back to sleep. Read more http://www.shrinkrapradio.com/248.pdf
10-28-2013 01:21 AM
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