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[Diagnosis] 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
#1
Exclaimation 
2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
Hi! I'm 28 and was diagnosed when I turned 25 with mild-moderate sleep apnea. I use a soft cervical collar in order to remove chin tucking induced apneas and I'm looking to find answers whether I should purchase a AirCurve 10 ASV model, judging from my apneas coming from centrals. I track my sleep using an Oura ring and find that my awake times correlate with the apneas and I find that I rarely dream (even with melatonin or magnessium supplement) and get low REM sleep even with close to zero obstructive sleep apneas after 2 years of therapy. I just want to dream more.


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#2
RE: 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
One thing that frequent wake-ups can do is to trash "sleep architecture," which is the progression from one sleep stage to another. This progression generally happens throughout the night in 60 to 90 minute cycles, with more deep sleep in the earlier cycles and more REM in the later cycles. So if you're waking up a lot, you may in fact be getting less REM sleep than would be desirable.

An aside about dreaming: it can happen in all sleep stages, not just REM, and we often dream but don't remember our dreams.

I have some thoughts about things you might try, but first, would you zoom in to a ten-minute interval that includes several CAs and then post the snippets? If there's a series of CAs, please include the first CA in the series. This will help us understand whether the CAs come as the result of arousals.

Also, could you let us know whether these two charts show your total time in bed for those two nights?

Finally, I urge you to review these guidelines for better sleep. They may seem too vanilla to do any good, but they can really help you if you follow them.

• 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.
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#3
RE: 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
Thanks for the advice! I've been consistent with everything on the list except 

"Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations." 

Generally speaking, if I'm in bed for 9 hours, my actual sleep time according to the Oura is usually around 6 hours so I have a relatively low sleep efficiency score from waking up all the time based on body movement tracked.

I've attached the 3 clusters of central apneas in order labeled 1, 2, and 3! Hope this helps  Smile. As for total sleep time, it's at the bottom left, roughly 5 hours

I've been on a mission to improve my sleep quality for so long now and I hope the missing piece of the puzzle is a new device for central apneas. Fingers crossed. 


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#4
RE: 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
Hello,
 
There are two things that caught my attention with your graphs :
 
1 - Your respiratory rate. The normal respiratory rate for an adult at rest is 12 to 20 breaths per minute. Your RR is near 50, so I believe you are hyperventilating. 

2 - Your inspiratory and expiratory ratio. The I:E ratio denotes the proportions of each breath cycle devoted to the inspiratory and expiratory phases. A typical I:E ratio for most situations would be 1:2 or more, and your’s appears to be inverted.
 
I am not qualified enough to understand the implications of such values, but there are very knowledgeable and kind persons around here. You are at the right place. Help should be coming soon.
 
Best of luck!
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#5
RE: 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
(08-31-2023, 06:25 PM)Kobayashim4ru Wrote: Hello,
 
There are two things that caught my attention with your graphs :
 
1 - Your respiratory rate. The normal respiratory rate for an adult at rest is 12 to 20 breaths per minute. Your RR is near 50, so I believe you are hyperventilating. 

2 - The I:E ratio denotes the proportions of each breath cycle devoted to the inspiratory and expiratory phases. A typical I:E ratio for most situations would be 1:2 or more, and your’s appears to be inverted.
 
I am not qualified enough to understand the implications of such values, but there are very knowledgeable and kind persons around here. You are at the right place. Help should be coming soon.
 
Best of luck!

Woah, I've never paid attention to this. Looking back at other days, my median respiratory rate is around 20-30 but the data attached shows a staggering 50 breaths per minute like you said. Really good info to keep in mind. Appreciate it!
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#6
RE: 2 Yrs CPAP & I Still Don't Dream - Eliminated Obstructive But Central Apneas Present
(08-31-2023, 05:36 PM)Dormeo Wrote: One thing that frequent wake-ups can do is to trash "sleep architecture," which is the progression from one sleep stage to another.  This progression generally happens throughout the night in 60 to 90 minute cycles, with more deep sleep in the earlier cycles and more REM in the later cycles.  So if you're waking up a lot, you may in fact be getting less REM sleep than would be desirable.

An aside about dreaming:  it can happen in all sleep stages, not just REM, and we often dream but don't remember our dreams.  

I have some thoughts about things you might try, but first, would you zoom in to a ten-minute interval that includes several CAs and then post the snippets?  If there's a series of CAs, please include the first CA in the series.  This will help us understand whether the CAs come as the result of arousals.

Also, could you let us know whether these two charts show your total time in bed for those two nights?

Finally, I urge you to review these guidelines for better sleep.  They may seem too vanilla to do any good, but they can really help you if you follow them.

• 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.
Sorry, forgot to quote this earlier! Included response above  Smile
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