[Treatment] "successful" treatment! - but still tired, oversleeping, brain fog

[squeakybeans]

I was diagnosed with mild/moderate OSA in 2017.  I had an RDI of 10.4 and desaturations to 85% in my sleep study (I don't have more info than that)

I have suffered from poor sleep my whole life, so I always come crawling back to my CPAP in desperation for a good night's rest.  I've been using it again for about 3 months now with "good" numbers but not much in the way of feeling better, which has been the case every time.

I tend to oversleep and still wake up exhausted - it takes me 2-3 hours to 'get going' in the mornings.  Headaches, brain fog, yawning at 6pm, the whole thing.  My sleep schedule is all over the place from the oversleeping which makes this a life ruining ordeal.

I've done lots of reading and looking over my data on SleepyHead but I don't know what to make of it.  I do wonder if I have flow limitation sensitivity and that's waking me up?  I have my EPR on 2 and am going to bump it up to 3 and bump up my min pressure to 7 as well.

I'll attach some data for inspection.  Let me know if you need more details.

   

   

[Dormeo]

I think you're on the right track. We don't know whether your flow limitations are messing with your sleep, but they might be. So it makes sense to try raising your EPR to 3. As you probably realize, that means raising your minimum to 7, since your machine can't go lower than 4. See how that goes for at least 3 or 4 nights, and then we can reassess. Possibly you'll want to raise your minimum above 7.

But one big issue you need to face head-on concerns your sleep patterns. You need to have a regular bedtime and a regular time to get up, and at this point, it would be reasonable to aim for no more than 9 hours in bed. Making this change will be tough at first, I'm certain. But you're having a tough time with your current pattern, so you might as well make the difficulties part of a solution rather than part of the problem.

Also, I recommend an honest look at how well you follow this standard advice for better sleep:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

Keep us posted, would you?

[WakeUpTime]

Just wondering about your caffeine content during the day, and into the evening. Sometimes it's a trap, as it is for me. On an occasional really bad sleep night, it's caffeine (and chocolate) to get me through the next day. I also don't feel like much physical activity the next day, which means my body won't be physically tired that evening. That daytime behavior then affects my next night's sleep. It can be a crazy cycle to break.

I'm assuming that you don't have any other medical (and related prescription) issues that are affecting your nightly sleep.

On another note, I know what my settings should be to get my lowest possible AHI. However, I opt for settings that make a more comfortable and longer-lasting sleep, which is a slight deviation from the "ideal settings" for the lowest possible AHI. That's just me though and may not apply to anyone else.

[squeakybeans]

But one big issue you need to face head-on concerns your sleep patterns.  You need to have a regular bedtime and a regular time to get up, and at this point, it would be reasonable to aim for no more than 9 hours in bed.  Making this change will be tough at first, I'm certain.  But you're having a tough time with your current pattern, so you might as well make the difficulties part of a solution rather than part of the problem.  

I know.  Sleep hygiene was a big part of my therapy.  I've been struggling with this for most of my adult life. At some point I was prescribed a FitBit to diagnose a circadian rhythm dysfunction, but I lost my health insurance before that could be concluded.  I want to, but the times I've pushed through I've felt like a narcoleptic, I was falling asleep upright in my chair at work and while driving on the way home.  I can't remember the last time I've woken up and felt decent, let alone good.  This can't just be a lack of willpower or self discipline, right?  

Just wondering about your caffeine content during the day, and into the evening.  Sometimes it's a trap, as it is for me.  On an occasional really bad sleep night, it's caffeine (and chocolate) to get me through the next day.  I also don't feel like much physical activity the next day, which means my body won't be physically tired that evening.  That daytime behavior then affects my next night's sleep.  It can be a crazy cycle to break.

I'm assuming that you don't have any other medical (and related prescription) issues that are affecting your nightly sleep.  

On another note, I know what my settings should be to get my lowest possible AHI.  However, I opt for settings that make a more comfortable and longer-lasting sleep, which is a slight deviation from the "ideal settings" for the lowest possible AHI.  That's just me though and may not apply to anyone else.

Yeah, I should try only having caffeine during normal morning hours.  I like to tell myself "I only have a cup in the morning" but my morning varies.

What other settings help comfort for you?

[Dormeo]

I wonder whether you can adjust your sleep patterns gradually, rather than in one big push. For example, could you start by getting up every day at a time that will usually give you, say, 10 or 10.5 hours in bed? That might help you regularize both your going-to-bed time and your getting-up time, with a modest reduction in total time in bed. Then after a month or two, you could start further reducing the time in bed slowly -- really slowly. Like maybe even just 15 minutes per month.

The idea is that you're aiming to make a long-term change, and if gradual steps work better for you, then that's the way to go about it.

I'll be interested to learn how you do with your adjusted settings.

[squeakybeans]

Nothing I've tried has really stuck, so clearly I need to do something different. I've replaced my blackout curtains with something more sheer. Hopefully more light will help keep my sleep more regular. I'm going to get some bloodwork done soon, too.

I forgot to put the SD card back in the machine so no data for last night. Oops.

[squeakybeans]

Some data with EPR 3.  I'll give it a few more days and see how I feel.

[Dormeo]

Yes, how you feel will be a key piece of information. Next time you post, you might also be sure to mention whether the time on the machine was also your total time in bed. Fingers crossed things will be moving in a better direction for you.

[squeakybeans]

Oh, yeah, will do. Yes that 7:24 was total time in bed - I woke up 30 minutes before my alarm and just got up before I could consider going back to sleep. I'm tired, but hey, I'm awake.

I used to be really bad about pulling my mask off after 3-4 hours, but I got the DreamWear strap with the hard silicone piece that holds it lower on the back of your head and it fixed all of my fit/discomfort/leak issues.

[squeakybeans]

Hmm.. I was able to contact the sleep clinic and get a copy of my study.  


It was one night 6 years ago, but I can't help but wonder if sleeping with a mask strapped to my face is disturbing my sleep just as much as my 'mild' apnea was.