Sleep deprivation

[joeb]

How many of you have ever suffered from sleep deprivation? Not just going short on sleep for a few days, but going short of sleep for extended periods of time.

I have obstructive sleep apnea. I was diagnosed in the mid 90's and the side effects I had back then from lack of sleep were something else. I would drive down the road and forget where I was going. Get into my vehicle and forget how to start it. Make huge mistakes at work. There was a whole gamut of serious side effects. At that time they said I "woke up" 30 times an hour from low oxygen content in my blood. Well, my cpap machine died 3 years ago. I was finally able to get another sleep study done so I could get another cpap machine. Now I was "waking up" 55 times an hour. I was so sleep deprived I was losing the power to communicate. Words would just escape me. I would forget my wife's name. To post here it would take me a half hour to write a paragraph and I'd just struggle to find the words. I'd have to edit several times to make anything begin to even make sense. And driving skills? It's a wonder I didn't kill myself and other people on many occasions.

The doctor said I had a "sleep efficiency" of 40%. With my back problems I was sleeping 4-5 hours a night so at a 40% efficiency rate I was getting 1.6-2 hours of sleep a night for close to 3 years.

[phkrause]

Man that's awful. Are things getting worse or better? Maybe you should post this in the "As the Doc" section and see if Gerry or Sid have any other answers for you.

[Gregory Matthews]

So, you have OSA. That is the common form of sleep apnea. With proper diagnosis, there are a number of treatments for it. Some are surgical. Some include the use of the CPAP Machine, with or without an oxygen concentrator. With the right medical care substantial relief can be obtained.

You will also need behavorial care. The bottom line is that you can learn to recognize when you are about to fall asleep while driving. And you can learn that the appropriate response is to immediately get off of the road and either sleep for 30 minutes or so, or to turn the driving over to another person.

There are other behavioral issues that have probably been brought to your attention. Take them seriously.

In a sense, you are lucky that you have OSA. It is well studied and treatments are known. 90% of the people with sleep apnea have OSA.

10% of the people with sleep apnea have Central Sleep Apnea (CSA). It is rare, not well studied and with very few documented effective treatments.

I have CSA and understand well what you are going through.

You may at this point in time need evaluation by a nationally recognized institution that specializes in such in order to prescribe the best treatment for you. I was evaluated at National Jewish, in Denver, Colorado, by internationally recognized experts in sleep apnea.

Give it some thought.

What is your insurance coverage? Generally it has coverage.

[joeb]

Gregory,

I don't think I need more studies. I just need sleep. Since I've gotten a new cpap machine the number of hours of sleep I've been getting has been going up. This machine is a "smart" cpap machine. It adapts to the user's needs. It's really different to get used to compared to my old machine. That one would step up to the max pressure needed in a few minutes and then stay there. This machine doesn't do that. It only steps up the pressure after I fall asleep and then have problems. I didn't think it was working at first. It has a small memory card in it and I took it down to Lincaire for them to download the info off it to check it out. It's working as it should, it's just so different I didn't think it was.

It has a small screen and an "info" button that allows me to see the average usage times by week, month, and 3 month time periods. I haven't had it a month yet, but for the 19 days I've had it my average sleep time is around 5 hours. For the last week it's almost 6.5. Part of that is the lessening of the major sciatica attack I've been going through, but part of it is just the ability to actually sleep again. It's going to take me a while to catch on my rest, but I can already tell the difference in my mental functions. My ability to concentrate and my memory are improving already. It's a big relief as I was starting to suspect the beginning alzhiemer's even though I knew I was undergoing major sleep deprivation.

The side effects of sleep deprivation are pretty scary. For those of you who have never experienced them, hope that you never have to undergo them.

[Gregory Matthews]

I have one of those new machines that you mention and probably coming from the same national company. The difference between it and that old machine is like midnight and noon.

[nuff sed]

Sounds like Narcolepsy to me. I don't have it but I do have Sleep Apnea and am on my third machine. This one is BiPap because I did not like the resistance the C-Pap was giving on exhalation. Had my 4th Sleep-study a couple of weeks ago and they are coming tomorrow to adjust the pressure. Unfortunately if I use the machine or don't I feel the same upon awakening...Headache and tired. Nuff Sed

[Gregory Matthews]

Quote:

Sounds like Narcolepsy

There are major differences between narcolepsy and sleep apnea. A specialist in sleep disorders can clearly distinguish between them.

As for me, I do not have narcolepsy. Joeb does not sound like narcolepsy to me.

It should be noted that so-called "sleep studies" are extensive. The brain wave pattern for sleep apnea differs from that of narcolepsy, as well as other differences that exist.

[rudywoofs (Pam)]

Has anyone tried the "FitBit"? You wear it (as a bracelet or as a pedometer-type of clip-on) and it measures your wake/sleep times (as well as a number of other physiologic data, such as steps taken and calories burned) (It's not supposed to be a substitute for a "sleep study"!!)

https://www.fitbit.com/product

[joeb]

I have one of those new machines that you mention and probably coming from the same national company. The difference between it and that old machine is like midnight and noon.

I took the memory card in for the 2 week download--insurance wants to make sure that you use the machine at least 4 hours a night 72% of the time. The data it gives is amazing. You find out if you're getting leakage around your facemask, whether or not you're snoring and how loudly, if you're having any hypoapnea events, if so how many, and when on the timeline, a minute-by-minute track of how much pressure the machine is putting out, etc.... Putting the timeline together you can see how much leakage causes events and snoring.

The data convinced me I need a chin strap to keep my mouth shut at night.

It's funny though that doctors don't want to see the extended data the machine puts out. They just want to see how much you use it, rather than how much good it's really doing you. All that is left up to the patient to determine and correct. At least that is what the technician at Lincaire told me as all the data the docs ever ask her for is overall usage. So, if the patient isn't smart enough, and curious enough, to do the research for themselves, it just doesn't get done and the treatment can be pretty much useless as far as the doctor is concerned.

If I hadn't been curious enough to ask for a printout of data off the card I'd have never known just inefficient my cpap machine treatment was and what I had to do to improve my results.

[joeb]

Has anyone tried the "FitBit"? You wear it (as a bracelet or as a pedometer-type of clip-on) and it measures your wake/sleep times (as well as a number of other physiologic data, such as steps taken and calories burned) (It's not supposed to be a substitute for a "sleep study"!!)

https://www.fitbit.com/product

I'd never heard of that before. My cpap machine gives me all sleep-related data. It gives me not only the total number of hours I sleep, but also how those hours are broken up over a 24 hour period. It tells me if I sleep from 10pm to midnight, 2am to 6am, 2pm to 4pm(a nap) and the total for that day. It is one very handy tool for anyone with osa.

[joeb]

Sounds like Narcolepsy to me. I don't have it but I do have Sleep Apnea and am on my third machine. This one is BiPap because I did not like the resistance the C-Pap was giving on exhalation. Had my 4th Sleep-study a couple of weeks ago and they are coming tomorrow to adjust the pressure. Unfortunately if I use the machine or don't I feel the same upon awakening...Headache and tired. Nuff Sed

It sounds to me like your machine is not doing the job for you. The headache and tiredness are very common side effects of hypoapneic events. I'm like that when I'm without my cpap machine as then I stop breathing 55 times an hour.

I'd say an autoadjust machine might do you some good, along with whatever it takes to make sure your mask doesn't leak and that you're keeping your mouth shut at night.

I'm using a "large" full face mask and I still open my mouth far enough at night that my lower jaw drops below the bottom edge of the mask--thus the need for a chin strap.

[Gregory Matthews]

Quote:

It's funny though that doctors don't want to see the extended data the machine puts out.

My doc was quite interested in the pages of printed out data and spent a fair amount of time explaining the data to me. However, in his mind, some of the data was not clinically important and he told me that on those items only a competent sleep study would be definitive.

[Gail]

Fascinating!

[joeb]

Quote:

It's funny though that doctors don't want to see the extended data the machine puts out.

My doc was quite interested in the pages of printed out data and spent a fair amount of time explaining the data to me. However, in his mind, some of the data was not clinically important and he told me that on those items only a competent sleep study would be definitive.

I imagine there are some doctors who care enough about their patients to take an interest in the data. Unfortunately, they are not in the majority.

Of course some of the data will only point out things that will need further study, but there is a lot that can be learned from the data. My for-instance showed the definitive need for a chin strap because of the amount of leakage and my ability to correlate that to the times I would wake up with a dry mouth--the air blowing out through my mouth would dry it out so badly that I'd have to drink water to get rid of the "cotton" in my mouth.

I've been using the chin strap for a week now and I can already tell the difference in the quality of sleep I'm getting in my energy levels and the lessening of the need for extended naps during the day. Don't get me wrong, I'm no where close to being caught up on my lack of sleep, but I can definitely tell the difference.

I wondered why, even though I was using a sleep machine, I was always fatigued for all those years after the initial diagnosis and treatment. Now I know why. Even though I was being "treated" my sleep "efficiency" was low for all those years. So, basically I've been sleep deprived since the very early '90s. That's a long time to go without sufficient rest. No wonder my body broke down and I have so many health issues now.