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Sleep Debt
#21
Well, you can sit smug in your ivory tower and say "there's no such thing as sleep debt" or you can try to help the new CPAP user.

Quite a few new CPAP users feel worse after starting CPAP. They often get discouraged. Many of them feel better if they hang on for a few weeks or even a few months. Experience on these boards indicates it's fairly common.

Unfortunately, many of them report that their doctors are clueless about this. The doctor acts as if he's never heard this.

Imagine what a new CPAPer feels like if he just gets told "there's no such thing as sleep debt." He's going to think:

CPAP isn't working, no point in continuing.
The doctor doesn't know what he's doing.
The doctor doesn't care.
The doctor thinks I'm a nutjob.
The sleep test was just BS, my problem isn't sleep apnea. I'd better give up and start taking those homeopathic duck liver pills.

It would be much better to realize that something happens that acts like sleep debt and some new CPAPers will sleep more or be more tired for a while, but they'll feel better after they adjust.

Me, I think it's more like drug withdrawal from the effects of hypoxia, hormones, etc., than some form of "sleep debt," but ignoring the problem isn't going to help.
Get the free SleepyHead software here.
Useful links.
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.
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#22
Or you can be honest instead of selling a fantasy and say that "you have been sleeping out of whack for quite some time, and that has built up a sleeping pattern that takes time to correct. Like any correction, at first it can feel worse as the body rebels against the change, but ultimately it will help you and you will feel better - stick with it, take courage and you will with time have more energy and better sleep".

Saying there is a sleep debt only feeds a "lies to children" attitude that I certainly don't like too much, when the truth, prosaic though it be, will suffice.
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#23
(03-10-2013, 05:13 AM)wilorg Wrote: Or you can be honest instead of selling a fantasy and say that "you have been sleeping out of whack for quite some time, and that has built up a sleeping pattern that takes time to correct. Like any correction, at first it can feel worse as the body rebels against the change, but ultimately it will help you and you will feel better - stick with it, take courage and you will with time have more energy and better sleep".

Saying there is a sleep debt only feeds a "lies to children" attitude that I certainly don't like too much, when the truth, prosaic though it be, will suffice.

Explaining it is good. Unfortunately, far too often, the response is simply "there's no such thing as sleep debt," with no further explanation. Or to deny that it's common to feel run down for a while when you start CPAP.

You'll note I never suggested lying about sleep debt being real. I just pointed out that smugly denying the idea of sleep debt without explaining that something that acts like sleep debt does happen is harmful to new CPAP patients.
Get the free SleepyHead software here.
Useful links.
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.
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#24
It seems that in this world that something does not exist until someone publishes a study or thesis on the subject.
Before 1700's the scientific community did not believe rocks could fall from the sky in spite of all the things farmers saw and even dug out of their fields. (Dude, like, this boulder was totally NOT here yesterday and there are, like, no wagon tracks leading up to it!)

It seems right now it is a perception though that one needs to "catch up" on lost sleep. Witness the guy that needs to stay up 36 hours and then sleeps for 18 after.
To the person experiencing it, the perception is real.

We do know that sleep issues, can booger up circadian rhythms, sleep stage cycles and sends a lot of other things out of whack.

Getting things set right in a major way by compensating for the apneas (etc) is bound to require a period of readjustment.

I'd like to see someone do a formal study on the effect, we might learn a lot from it.

I can testify that I was getting almost zero REM sleep before I started therapy and now I am getting 90 minutes to 2 hours worth. Did I catch on up on REM? Perhaps. But I can say I have normalized a lot more since I was off therapy.

I throw down the gauntlet of challenge here! NSF, NIH, AMA and a bunch of universities need to do some digging here because SOMETHING is going on.

Cheers & Sleep-well





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

Cool
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#25
Shastzi, this has already been studied in considerable depth, and new papers are coming out each year, so I think your challenge has long since been met and raised. In the German speaking world, you can't become a doctor of medicine without publishing a doctoral thesis, just like in the academic world, so the amount of minutae and arcanae is unbelievable, and a favourite area of publishing seems to be on the finer aspects of sleep and the world around it, including answering all points you raised. It is one reason we know that there is no such thing as sleep debt - dozens of studies confirm it. so have dozens of papers on patient perceptions of sleep and reactions to sleep disorders and reordered sleep hygiene. The literature is full to bursting, nearly.

What is missing is actual improvements on CPAP to refine it to the point that it becomes a subtle and responsive tool, rather than the heavy handed approach it currently has, but these are early days in the technology yet, and with time I am sure that pocket sized machines and nearly invisible air delivery systems will come along that will work in micropascals of air adjustment per decisecond. But that will take some time. I already have seen a fully insertable device that sits in the back of the throat comfortably for the night, but it is in extremely early stages yet, and no saying if it actually will work or not (and you can't close your mouth around the hose, either). Neat thing, matching CTscans with 3D printing - you can do sooooo much. I already made a set of nasal pillows that fit my nose exactly, but haven't been able to get them work neatly with the system yet. But they are soooooo comfortable, and stay on without headgear. The blow back and feedback aspects are harder to get to work, alas....
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#26
Sleep debt or no sleep debt, I kind of like the explanation of "sleep damage." That makes a lot of sense to me. I've been sleeping crappy for twenty years, it only follows that this has been rough on my body (and brain) and it will take time to repair.

Whatever the case, I'm very happy to be sleeping better than I can remember. Even the worst nights on CPAP are much much better than a normal night without.

Smile
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#27
humm.... Thanks wilorg! I am always good for updates. Smile

I am not sure if I care to become a member of the Borg collective yet to get rid of the apnea.
I'll keep an eye on what goes on for now then.

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

Cool
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#28
(03-10-2013, 08:37 PM)Shastzi Wrote: humm.... Thanks wilorg! I am always good for updates. Smile

I am not sure if I care to become a member of the Borg collective yet to get rid of the apnea.
I'll keep an eye on what goes on for now then.

=^.^=


The Borg? Are they Swedish? Tennis people or something?
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#29
Oh, sorry. That was a Star Trek: New Generation Reference. Go to google images and search for "Borg"
They are great fun. People with lots of plumbing hanging on to them. They insist that it makes them more advanced.
You'll also get some images of Bjorn Borg as well but no relation I'm sure.
Smile

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

Cool
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#30
(03-10-2013, 08:48 PM)wilorg Wrote:
(03-10-2013, 08:37 PM)Shastzi Wrote: humm.... Thanks wilorg! I am always good for updates. Smile

I am not sure if I care to become a member of the Borg collective yet to get rid of the apnea.
I'll keep an eye on what goes on for now then.

=^.^=


The Borg? Are they Swedish? Tennis people or something?
[Image: 220px-Bj%C3%B6rn_Borg2.jpg]
http://en.wikipedia.org/wiki/Bj%C3%B6rn_Borg
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