Ekstatische Lyriken Pinnwand

Sleep Update -- Mild Success with CPAP

written by Pj on Friday January 18th, 2013 -- 7:15 p.m.

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While I've pretty much sworn off posting about my sleep disorder until I've found something that works, I do still think some parts of it are interesting enough to post about.  Particularly when there are images to post or new discoveries.  It's just all that "hey, I tried 5-HTP again, it still doesn't work" shit that makes me want to vomit.  (BTW, if you saw the last post about 5-HTP before I decided to delete it, I eventually gave up on the shit because it just doesn't seem to do anything at all.  It's not even useful as a placebo.)

Anyway, about a month ago I dug out the CPAP machine again.

Every time I do, I wonder why I keep bothering.  With the "nights > 4 hours use" metric that the machine tracks being up to 50, it would seem to be pointless to try anymore.  ...but something about lying around wishing you were doing something inspires you to try pointless things.

Anyway, to make a long and boring story shorter, after a few days I'd found that 8.0 cm of water seemed to be the best pressure to use.  Using 9.0 would cause me to wake up out of breath, as would using 7.0.  After a few days of using 8.0 I found it difficult to sleep without the machine.

I also had two interesting things happen.  Somewhere around the third or fourth day, I woke up several times in a short span of time, and eventually thought to myself "well, fuck, I guess this isn't actually doing me any good" only to realize when taking the mask off that the hose had fallen off the mask, and so there was no pressure under it.  The second happened just a few days ago.  I again woke up several times in a short span of time, and so, despite being tired and not wanting to get up, decided I'd have to in order to figure out why it wasn't working.  So I sat up and looked to my Zeo to see what it said about my sleep, but it wasn't turned on.  I looked around more, but couldn't see light anywhere, as the power had gone out.  I just hadn't noticed since I usually sleep with ear plugs and so not hearing anything isn't that unusual.

So I'm rather convinced at this point that I'm getting something out of using the machine.  I just don't know what that is, as I'm still tired during the day, and I would have thought that a month of use would be enough.  In fact, I've only gotten worse over the last two weeks.

After wanting to connect the CPAP machine to my computer again for the whole month, but deciding to put it off until I felt like it, I finally connected it a few days ago, despite still not having the energy to bother.  It's given me a new hatred for Linux's moronic terminal settings on serial ports, as I spent at least 45 minutes trying to figure out why my hardware had stopped working when it was just those motherfucking useless settings that were incorrect and the hardware was just fine. 

Anyway, while the program I view the data with does record it, I have yet to bother to make anything to turn that data into PDFs so I can view it.  So instead I just look at what's on the screen every time I wake up.

The first and most of the second night, every time I woke up enough to think about it, I looked at the screen and saw what looked like undisturbed and completely regular breathing for the entire previous 18 minutes (the amount of time shown on the screen).  This seemingly confirms what I thought, that is is actually helping, though I can't really be sure until I find the energy to use my data-viewing script so I can see the full recording.  (it's complicated -- new data format for one, but also it probably won't work in FreeBSD without a lot of tweaking, and I'm not in the mood to fuck with shit)

...but, after waking up after sleeping about 12 hours the second night, I still felt like shit, and so decided to bump the machine up to 10 in order to see if that might help. 

After some amount of time at that setting, I found myself having a dream wherein I suddenly found myself wearing a CPAP mask, but for some reason I was having to suck the air into it with great effort, because seemingly the machine wasn't working as intended.  So I followed the hose to the machine, only to find someone had unplugged it.  (Those bastards!) So I grabbed it, carried it around and found another outlet and plugged it in, at which point I woke up.

What I saw on the screen was interesting enough that I spent three minutes figuring out how to start the screen capture program without a mouse that has a scroll wheel.  (Thanks, Gnome application menu!) I eventually noticed the search box and typed "screen" into it, solving my problem.

Here's the screen capture:

You can click it to see it full size.  Each line is two minutes long. 

Obviously where I think the problem began in my dream is somewhat of a guess, but I believe that's the right spot since heavily breathing through the CPAP machine feels exactly like I remember in the dream.  If you're breathing deeply and quickly enough, you actually end up sucking air out of the machine since it can't spin up its motor fast enough, and there's this little flap in the full face mask that starts opening to let in outside air when the pressure under the mask becomes less that the pressure outside the mask.  That's exactly what was happening to me in the dream, except that in the dream I was just trying to breathe normally and the machine was turned off, whereas in reality I was trying to make up for having barely been breathing for the previous 30 seconds.  ...or, you know, so I assume.

This looks different from what I'm used to seeing, as shown in this previously-posted image:

As shown in this image, normally the inhalation waveform starts getting clipped off, while the exhalation remains largely unaffected until I'm just not inhaling enough to exhale.

In the recording from this morning, I see a few waveforms that are clipped, but they don't slowly become more clipped until there's nothing left on top, and the exhalation waveform seems to degrade equally with the inhalation, at least when either of them degrades at all.  In many cases it looks like I just spontaneously stopped trying to breathe.

This reminds me of something I read the day before about complex sleep apnea while looking up specs about random CPAP machines on Craigslist.  Apparently what happens is that, after the obstructive sleep apnea is treated, the patient ends up with central apnea, which is where their respiratory drive simply disappears.  According to the Wikipedia page, this tends to happen to people who've had sleep apnea for a long time.  I wonder if it could be some sort of coping mechanism.  Since inhaling while the airway is blocked is a bad idea (negative pressure on the lungs can cause the little air sacs in them to collapse) perhaps the body eventually learns to not even try to breathe during REM sleep in order to avoid having this happen.  Instead, it just learns to avoid too much REM sleep without intermittent periods of non-REM.

It's all just a guess, but I have at least a dozen pills of Acetazolamide left, which is supposed to stimulate breathing, so I think I'll try adding them to CPAP therapy of pressures greater than eight and see if they make this non-breathing problem go away.


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