Dapal's Therapy Thread.

[Dormeo]

There's some good information about deep sleep here:

https://www.sleepassociation.org/about-s...eep-sleep/

It helps us with memory and brain health. I use a sleep-stage tracker, and I notice that when I've been short on deep sleep for multiple nights in a row, I get more than usual for a night or two. Did you have less deep sleep during the nights before the image you posted from your smart watch?

For that one night, you were short on REM sleep. Is that usual for you, or just occasional? Smart watches aren't very accurate when it comes to sleep stages, because they don't have an EEG capacity. So I would suggest you look for trends rather than for results on a particular night.

I recommend that you stick with the gabapentin and use it every night. Some side-effects can go away with regular use. I noticed, by the way, that gabapentin and zolpidem (Ambien) should not be used together. See

https://www.mayoclinic.org/drugs-supplem...g-20064011

Did your doctor talk with you about the possible drug interactions?

On the "lots of CAs" chart, it looks to me as though you woke up just before 4 -- that's the flow rate that goes higher and lower. And then I would guess you were awake or semi-awake for at least the next 9 minutes. Your breathing pattern isn't the nice and regular pattern that I'd expect to see during sleep.

[sheepless]

when I took gabapentin I had to gradually increase the dose over several days and when I quit it I had to gradually decrease the dose over several days. I expect you know this but it's probably not a good idea to start and stop it without this procedure. also, while I'm not sure about this, it might take some time, like a week or more, to realize its full effect.

[dapal]

@Dormeo since wearing this smartwatch, my REM range wa3-13% compared to normal range 15-25%. Some day it show normal though. I could not sleep well for a week or so before taking that screen shot .
Last night AHI scored was nice, You were right, I used to wake up around 4 am , some day i could go back to sleep ,other day struggled.
   

[dapal]

I will follow your advice of taking gabapentin. I started the 300 mg dose  but now 600 mg gabapentin . Last night wake up again after 3.30 hour.

[Dormeo]

Just to be sure: the doctor said you should go up to 600 mg, right? Your chart for last night looks good! Seems like you must have gotten back to sleep after your 3:30 wake-up.

[dapal]

I tried 600 mg as told by doctor, but for the first week of using this drug I slept like a baby with just 300 mg. I will reduce that dose back if sleep well.

[sheepless]

I haven't re-read this thread. I assume you're taking gabapentin for restless legs / periodic leg movement. if so, my experience has been that even with meds I still wake too often, although I can't say plm is the only thing that wakes me. even so, admittedly based on a sample of only one (me) I'm suggesting 8 uninterrupted hours may not be a realistic expectation for folks with plm. my personal goal is to have a minimum of at least one uninterrupted 3+ hour session a night (which sadly doesn't happen often enough). in addition, while I think different people respond differently to various plm treatments, my subjective suspicion was that gabapentin didn't help me and may have worsened my waking rls (and by proxy, maybe my sleeping plm). hopefully not the case for you but mentioning because it might take some trial and error to find the plm med that works best for you.

you could scroll through your flow rate at a 10 minute view scale, especially the area before your awakening, to see if there are repetitive patterns indicative of plm. if it's there and you can learn to recognize it, you can monitor it to better assess the effectiveness of plm treatments.

[dapal]

@sheepless
 I love to rub my toes on blanket before sleeping. This habit get worse after I injured my foot. I told my doctor last time seeing him, that I always feel like I need to rub my toes on something and was subscribed gabapentin. I am not sure rubbing toes is kind of restless leg or plm as yours. 
I will wait and see if this drug was my need for sleeping well. How would I know patient of plm by flow scale. Could you give me an example.? Thank you.

[sheepless]

if by 'love' you mean you really like to rub your toes on the blanket, I'd guess that's not restless legs because rls is very uncomfortable. and to my knowledge, mostly felt in the legs. if instead you mean you commonly do it - and it kind of drives you nuts - that would sound more like rls. 

one can have rls or plm or both. factors I believe distinguish between them: rls is voluntary and while awake. plm is involuntary and while asleep. plm movements are periodic. rls movements are not. I'm starting to believe rls can occur while sleeping, but it's not the same as plm. 

I've attached two screenshots of plm picked at random from when I was using apap. I may or may not have events associated with them. another possible clue: runaway high pressure and leaks would often awaken me on apap because of how the machine responds to flow limitations.

lots of things can cause awakenings and one or two a night isn't bad (compared to what I'm used to). based on your 'loving' to rub your toes and unless you find a repetitive pattern in your charts, you probably don't need to worry much about it.  

I never checked this so take it with a grain of salt but I vaguely remember that someone once said in a post here that gabapentin eases anxiety. if true, I imagine it might help sleep even in the absence of rls/plm.

[dapal]

thanks for your inputs. I will have to watch from now on see what things actually make me wake up. But as you said, it might be a sleep cycle work old people.