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Sleep Debt
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Sleepster Offline
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Post: #11
RE: Sleep Debt
(03-08-2013 07:10 PM)wilorg Wrote:  Sleep debt is utter rubbish. There is no medical evidence whatsoever, and tons of evidence that one good night's sleep should restore one's exhaustion.

If one good night's sleep should restore one's exhaustion, then doesn't that constitute repayment of a sleep debt? And what if for some reason you can't get that good night's sleep tonight, but have to wait until tomorrow night? Aren't you waiting an extra day to repay the sleep debt?

Quote:What you think is sleep debt is actually something more prosaic - you have become accustomed to a certain sleeping pattern and it takes you brain a while to sort out how to return you to "normal" sleep routines. Once that is achieved you should feel much better.

Yes, I agree.

Quote:There is no such thing as "catching up on xx year's sleep deprivation" - simply not a real thing, no matter how nice and reassuring it sounds.

What you just said in the paragraph before that sure sounds to me like payment of a sleep debt.

I guess I'm not understanding your definition of sleep debt. I felt like crap every morning for several years. Had headaches for decades. All of that was caused by a lack of quality sleep.

Along comes CPAP therapy. After days and weeks and months of using it and getting better sleep I'm gradually feeling more well-rested in the mornings. I don't feel like crap. The headaches are disappearing for days and weeks at a time.

I conclude that my problems were caused by a lack of sleep.
I conclude that the solutions to those problems is adequate sleep.

Why can't I refer to that as a payment of a sleep debt?

Sleepster
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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.
03-08-2013 09:11 PM
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archangle Offline
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Post: #12
RE: Sleep Debt
(03-08-2013 07:10 PM)wilorg Wrote:  Sleep debt is utter rubbish. There is no medical evidence whatsoever, and tons of evidence that one good night's sleep should restore one's exhaustion. What you think is sleep debt is actually something more prosaic - you have become accustomed to a certain sleeping pattern and it takes you brain a while to sort out how to return you to "normal" sleep routines. Once that is achieved you should feel much better. There is no such thing as "catching up on xx year's sleep deprivation" - simply not a real thing, no matter how nice and reassuring it sounds.

While technically, it may not be "sleep debt," but it often seems to act like sleep debt. After some time "paying back," you get better.

I suspect there is also a degree of physiological changes like healing up some of the damage or atrophy of various organs, and readjusting hormones and chemical balance.

The important thing is that you may need more sleep for a while and you may get some slow improvement.

Get the free SleepyHead software here.
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If it's midnight and a DME tells you it's dark outside, go and check it yourself.
03-09-2013 03:50 AM
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DocWils Offline

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Post: #13
RE: Sleep Debt
It is not a debt because you don't build up an account of debts for each bad night of sleep - so if you have 20 hours of bad sleep, you don't need 20 hours of good sleep to repay it. No debt. You can have 20 years of crappy sleep and one night's sleep is all you need to restore your balance, in theory - you don't need 20 years of good sleep to repay it. It takes a long time to get over feeling crappy because there is a lot of damage to the body and psyche that has to be healed, but that starts with the first night you sleep straight through.
03-09-2013 05:41 AM
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archangle Offline
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Post: #14
RE: Sleep Debt
It may not be "debt," but a lot of people do seem to need extra sleep after they start CPAP. Many people feel more tired after starting CPAP. This usually goes away after a while.

I do think that rather than simply dismissing the idea of "sleep debt," we should admit that many new CPAPers experience something that feels like what we think of as sleep debt, and they should not get discouraged and quite.

On this board and others we often have to reassure new CPAPers who are about to give up due to the "pseudo" sleep debt, and many of them do hang on and get over it.

Get the free SleepyHead software here.
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Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
03-09-2013 07:06 AM
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zimlich Offline

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Post: #15
RE: Sleep Debt
Perhaps the difference is in the quality of sleep we get. You see many posters that write they feel worse on cpap than before. I would posit that indeed their sleep is not of the same quality. If someone does not have bad symptoms from sleep apnea (though it's difficult to imagine that person would go for a sleep test), perhaps their sleep with the mask & machine is not as deep. If leaks keep waking them up the arousals might keep them from REM and deep sleep. I learned that successful therapy means using the machine 100% of sleep time and quality sleep in all stages. I know after I started therapy I felt better, but then had a period of time back to my old symptom of excessive daytime sleepiness. I took Provigil and Nuvigil for the first three years of therapy. I didn't experience real, significant changes until I started with ASV.
03-09-2013 08:34 AM
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Sleepster Offline
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Post: #16
RE: Sleep Debt
I guess I can understand the objection to sleep debt not being quantitative in the same way that, say, money debt is.

If I'm supposed to pay someone $8 a day every day for five days, but instead pay only $7 on each of those days I'll incur a debt of $5. To pay back that debt on the next day I must pay $13.

If I need 8 hours of sleep a night and instead get only 7 for five consecutive nights, I can't pay it all back by sleeping for 13 hours on the sixth night.

Nevertheless, damage both physical and mental does occur because of lost sleep. And at least some of that damage can be repaired by getting better quality sleep and more of it.

So instead of calling it sleep debt and sleep repayment perhaps we should call it sleep damage and sleep repair.

A rose by any other name ...

Sleepster
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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.
03-09-2013 11:06 AM
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robgb Offline

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Post: #17
RE: Sleep Debt
Well, not being a scientist, I can't really say whether or not sleep debt is real. I do know that there is dispute over the concept in the scientific community. But then there are those who say man made global warming is a crock despite the majority of the scientific community saying it isn't.

As a layman, I can see the validity in the concept of sleep debt, but I'd be the last to proclaim with any certainty whether or not it's true.
03-09-2013 11:49 AM
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aehjr Offline

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Post: #18
RE: Sleep Debt
Even for the same person, the need for extended quality sleep to correct the damage can differ. When I was first diagnosed with sleep apnea, I slept great and felt wonderful during the titration sleep study and once I received my CPAP machine. No "sleep debt" effects to deal with and I was like a new person.
This time around, I felt like crap for about a year before learning how to turn on the reporting function on my Respironics machine. Never thought about the apnea being an issue because I used the CPAP religiously. Upon changing the settings, I learned my AHI kept repeating a pattern, cycling through a range of 7-24. New sleep study revealed need for higher pressure (10 vice 6) and SleepyHead shows better results (fewer clear airway events, lower leaks and slightly lower AHI) using Autoset. With about 2 months of using an autoset, my AHI averages in the 1.2 range but I don't feel great every day. Some days I still feel a bit tired and not high energy.
What is the difference? I'm five years older, eating healthier and exercising out more frequently. Job and life is less stressful. Except for the age, all the indicators should point to better sleep.
Bottom line - Be patient. It keeps getting better, even if the improvement isn't profound every day.
03-09-2013 02:14 PM
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GaryG Offline

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Post: #19
RE: Sleep Debt
All I know is my first night on CPAP (after a long hiatus) I felt fantastic when I woke up. The day after the first night. Immediate and instant improvement. Also, I'd tend to believe in Dr. Wilborg on a medical issue like this.
03-09-2013 07:21 PM
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Shastzi Offline

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Post: #20
RE: Sleep Debt
It's not the debt so much as paying it back with interest that gets me.

Big Grin

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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03-09-2013 07:59 PM
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