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circadian rhythm issues?
#1
I've been on CPAP for about 6 weeks now and have had a couple of weeks of AHI in the 3s for the last 2 weeks (last night 2.5 AHI). I still wake up feeling not rested, and my exhaustion and chest pain get worse all day until I sleep at night and I reset myself a bit, wake up, and do it all again.

I have documented here that I've solved this issue twice (before CPAP) by getting off of sleeping pills, going through a couple of days of withdrawal and not sleeping or eating much, and then I get better. I attributed this to the idea that the pills were making my sleep apnea worse so getting off them allowed me to get rested.

When I went to my sleep doctor last month he wasn't convinced that my problem was sleep apnea, but maybe a circadian rhythm issue. But he said to keep with the cpap and see how it goes. Studies suggest that if you fast for a day and then eat a proper breakfast in the sun, you can get your body back on track. It might take a few days of this. I'm about to try it. Anyone have any experience with this or heard of any success stories?
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#2
Melatonin is what you are looking for. It is what people use to get over jet lag because it helps reset their clock. It isn't exactly a sleeping pill. It is what our brains produce when the sun goes down. The chemical tells the rest of our body it is time for sleep. Taking it externally starts the process. Read up on it and understand it before you start so you know when to take it and how much.

I have insomnia and what I do to reset my clock is this:

- I determine what time I want to get up each day, count back 9hrs, and that's when I go to bed.
- 3-4hrs prior to that time, I stop all caffeine and try to avoid my cell phone and tablet. I cannot avoid the computer, however. I try to avoid doing heavy gaming, or anything that will get my brain hyped.
- At about half an hour prior to when I need to go to bed, I start the process. I get everything ready and shut down the house.
- I make it to bed most of the time on time and I do various things to shut my brain off. I do meditation mostly. Listening to "go to sleep now" guided meditiation is my current method. I have some music I use, too. Robin Bullock, some instrumental Celtic, Yo-Yo Ma.
- If I am not asleep within half an hour, I get up for an hour and then try again. No matter how long it takes me, I get up at the time I think I should and do not go back to bed.
- that night I do it again.

Google "sleep hygiene". Don't do anything in bed but sleep. No reading, no t.v., nothing. When your butt hits the sheets, your body should immediately get the idea it is shut down time. Our bodies have positional memories.

There are sleeping pills that are not bad for you. I use Ambien for when my brain just will NOT shut up. I use it probably once or twice a week. I've even cut it in half. Take it and go to bed. Don't take it and wait to feel sleepy.


PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#3
Thanks for the info. I just got some melatonin and will give it a try. Although I don't have any sleeping problems really anymore. Just 'feeling rested' problems. Will try some of these tips along with the cpap and see what happens.
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#4
The melatonin should help with that.

Did the sleep study reveal any periodic limb movement? Wondering if you are still experiencing that even with the sleep apnea being treated.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#5
I had issues with melatonin. I found that it left me as 'hung over' as sleeping pills. So take this into account. Hopefully this won't be the case with you. Just saying.

It sounds like falling to sleep isn't your problem, but feeling rested. Which would suggest apnea (you're unable to get rem sleep because of constant arousals that you're not aware of.) Since your ahi is good, I wonder if you're in that stage of catching up from previous sleep deprivation--you say that it's been two or a little more weeks of good ahi. Sometimes it takes a while to feel the benefits.

Actually if you're falling asleep o.k. why do you want melatonin? I may not be understanding.
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#6
Paula - My sleep study was an 'at home' study and I don't think it recorded any limb movement data. At least, I don't see anything like that in the results.

hegel - Yeah it's a possibility that I just need more time on the cpap to feel the benefits. But I'm really not feeling any better at all so far. From my understanding, the melatonin can help regulate your body's day/night cycle, and isn't just necessarily used to fall asleep.
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#7
If the melatonin makes you feel hungover, try reducing the dosage. Worked for me.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
robysue's Beginner's Guide to SleepyHead
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#8
Getting the right melatonin level can be difficult. Some people can take it with no problem whatsoever. Others feel hungover or, like me, notice no difference at all. There are people who use it like a sleeping pill and believe that is what it is for. If that works for them, good! It isn't supposed to, but hey, whatever works.

michaelba72, you've only been doing this for 6 weeks. I know this may seem like forever but it isn't in terms of sleep. Your body and brain has some adjusting. Some people take longer to adjust than others.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#9
"I have had a couple of weeks of AHI in the 3s for the last 2 weeks (last night 2.5 AHI)."

does this mean that you've gotten your ahi DOWN to the 3's over the last two weeks? and how high was it before? I'm wondering if your effective therapy has only been for the last several weeks.
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#10
Wow, this seems to be making a difference. The last two days I didn't eat anything after lunch for the rest of the day. I took 5mg melatonin at night around 11pm and used my cpap as usual. I left my curtains open and let the sun come in and get me up in the morning. Cooked a real breakfast which I don't usually do, and ate it out on my patio. I felt about 20% better throughout the day. Didn't eat anything after lunch again. Same process last night and I feel another 20% better today. Even did a little hoops shootaround at lunch.

This sounded like pseudo science to me, and I saw no experiences reflecting how sick I am that could stem from a circadian rhythm disorder. But there are some legitimate studies from Yale and others that show how food timing affects you. Combine this with the melatonin supplement and the cpap therapy and maybe I'm finally on the right track.

hegel: 6 weeks ago my first night with the machine had my AHI at 13. It basically went down a little every night until it stayed around 3 for the last 2 weeks. The last two nights with this experimentation it went up to 5 but I feel overall much better.


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