O2 Ring and REM

[coldfeet7]

Crimson Nape and Kappa were right. I got my sleep study consult and I had PLMs at the rate of 85/hr resulting in 22 arousals/hour (during the 2 hour window that I did sleep). My O2 Ring was sensitive enough to point me in the direction of PLMD with its motion sensor. It has been a great tool to fill in the Resmed data to get a clearer picture.

The Dr started me on Pramipexole to see if that gives me a good nights rest and possibly eliminates many of the CAs that might be coming from the PLM arousals. So until I have titrated up to an effective dose and held it for a month, we won't know if an ASV machine is needed. I have already started researching the side effects of this dopamine agonist (DA) and how to address things like augmentation, etc. The list of 'possible issues' with this drug are troubling. My hope is that dosages for PLMD are low enough to avoid most of them.

What I can't understand is why I have a tendency to have really poor sleep after I come back to bed from my routine quick bathroom break (typically between 4:30 and 5:30). If I will have a rash of CAs, it is usually in the last two hours of sleep. My inclination is to just pull the mask when I get up for the break and go without it for the remainder of the night.

Attached are the last two nights. Sunday was without the DA and Monday with the first night of it (1/2 a .25mg tablet). You will see I had movement during the CA barrage, but perhaps it can be controlled all night without having to go to more than 2 tablets.

[kappa]

Good that your doctor is looking to address the PLM. Did they discuss use of a Gabapentinoid such as Pregabalin (Lyrica) or Gabapentin (Neurontin) rather than a DA? Are Ferritin levels, etc all checked as well?

[koala1]

[quote pid='406031' dateline='1627413393']

What I can't understand is why I have a tendency to have really poor sleep after I come back to bed from my routine quick bathroom break (typically between 4:30 and 5:30). If I will have a rash of CAs, it is usually in the last two hours of sleep. My inclination is to just pull the mask when I get up for the break and go without it for the remainder of the night.
[/quote]

I won’t help you with finding a cause, because I would like to know myself why it is happening. 
For me, sleeping again after waking up too early (usually 1.5-2h too fast) is NG. I will feel way worse if I sleep again. 
After using CPAP and Vellue ring I could see I have some CA or hypopnea when I fell asleep again, and my SpO2 levels change and drops a lot. 

I can only recommend not sleeping at all if you wake up too early. In my case I am much more rested with less sleep then after going through such junk second sleep

[S. Manz]

.............. maybe look into an Oura ring or a Fitbit tracker or etc.  These things show REM sleep.  Whether they are accurate is another question. 

I had read a lot of good reviews about the Oura Ring, so went ahead and ordered one after using a Wellue ring device for a year.
My ring only samples 1/min and its reporting is limited to O2 saturation and heart rate.

[selfcoacher]

I have a Wellue O2 Ring and have been wonder if the pattern of pulse, SpO2 and micromovements correspond to a phase of sleep, specifically REM. Anyone have some understanding of REM sleep that might help me decide? From my brief research, it appears breathing and pulse change during REM. The patterns and the number of occurrences with more toward the second half of sleep seem to suggest REM.

I've attached a Viatom only import into OSCAR (no CPAP). By zooming in on the scale of the movement readings, I can see twitches (?) that correspond to the time of many SpO2 swings.

The description of sleep myoclonus seems like it describes the tiny twitches I am seeing in the data. (My wife has seen them in the morning before I wake.)

"Myoclonus is a brief twitching of the muscles that can occur separately or in groups, as well as in a sequence or at random."

You do get more erratic heart and breathing rate during REM sleep, so you can infer some stages from the data.  Looking at the ring screenshot data, I would guess that most of the events and clusters are during REM stage.  Dreem 2 is no longer sold to consumers, but you can get Muse S, which still probably has better staging than all non EEG trackers.  The new Oura ring that got just announced has made some bold claims for accuracy, so you might check it out as well.