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Permalink Reply by RockRpsgt on July 23, 2009 at 3:56pm

i agree with jnk. there is not alot you can do if you want to stay in the airforce. He gave some great advice.

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Permalink Reply by RockRpsgt on July 24, 2009 at 1:12am

7. Test for CPAP????? Isn't that what they just did? LOL sorry had to point that out.

I suggest that you work on your sleep hygiene. Try going to sleep 1 hour earlier for a little while and see if it helps. You could also talk to a private dentist. An oral device may help you with your problem.

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Permalink Reply by Andrea McClure on July 24, 2009 at 2:43am

Thanks for all the responses.
jnk, thanks for the plug about UARS. I'd never heard of it, but it sounds like it fits my symptoms pretty well. I guess the sleep doctor's report mentioned upper airway resistance, but I thought it was just part of sleep apnea.

As far as sleep hygiene, I've done everything my original doctor recommended. I'm typically in bed by 9:30 or 10 every night, then up around 6 in the morning each day. Weekends, I'm still in bed by 10, but I usually sleep till about 8, then take 1-2 naps during the day. If I can afford it at work (haven't been able to for the last couple weeks), I take a nap in my office for about 30 minutes during lunch. If I'm going to read or do anything else before going to sleep, 95% of the time, I'll do it in the living room instead of the bed.

As for the CPAP, they didn't do a split study. The tech said the magic number was 20 apeas/hypopneas in a certain time frame before she would come in to do a titration, and I only hit 19 for the whole night. If it would help, I can upload the report tomorrow. If they had done a CPAP and found that it would help, this thread would be irrelevant because I would already be DQ'd from continuing in the military.

The thing that really baffles me is that when this whole thing started, I was actually doing better overall than I had in years. I got back from a deployment in early March, then started feeling really bad at the end of April. By early April, I was over jet lag, mostly decompressed/destressed from Afghanistan, settling into my new job, my husband and I had gotten through the really difficult reunion time and were doing better relationally than ever before. I had a really stressful couple of years before that, but by April, I was the least stressed that I can remember since I started college. I was eating healthier/more balanced meals, and I was working out more than the minimum 3x/week that the Air Force requires. Even now, work has gotten a little busier, but is still at my optimum performance stress level, I'm trying to eat as well as I can, and I'm working out at least 3x/week. My biggest stressor is that I'm so tired I can barely function. Just in case anything that came up during my deployment or afterward is causing stress that would be contributing, I've been going to counseling for a couple months now.

For the last 5 years or so, 7.5 hours of sleep has been my optimum. Now, it doesn't feel like it is anywhere close to enough. The only thing that has gotten worse since returning in March (other than fatigue) is my allergies. I got them back under control in April/May, and will start immunotherapy in the next couple weeks.

I picked up some breathe-right strips and anti-snoring throat spray at the store today. I figure it couldn't hurt to try, and maybe it would help some.

Thoughts? Will it help for me to upload the report since I'm not sure what is significant or not? All I have is the summary. I don't know if I can get a copy of the full test results since they didn't even forward it to my normal doctor, but I can call and see.

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Permalink Reply by Moe-jo on July 24, 2009 at 4:10am

Have you ruled out pregnancy?

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Permalink Reply by Duane McDade on July 24, 2009 at 4:19am

Here's the deal, without using medical terms. The reason that you're exhausted all the time is not because of weight. I have seen many patients so thin that if they turned sideways .......ok you get it. Sometimes sleep Apnea is sleep stage related. It is very common for one to have Apnea only during the REM part of the sleep cycle. REM is the sleep you get to make you not drowsey.....see the logic? Why would someone have Apneas during REM and not the other stages of sleep? I will tell you ! When a sleeper goes into REM a paralisis sets in this changes the breathing . You use a less muscles to inhale and exhale so where the obstruction/s did not come into play during non-REM when in REM they prevent you from breathing. This fractures the REM . This is not good if you dont want to feel drowsey.

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Permalink Reply by Andrea McClure on July 24, 2009 at 1:26pm

Definitely not pregnant, although that's what I initially suspected.

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Permalink Reply by RockRpsgt on July 24, 2009 at 2:08pm

I did not think of that Duane. Good point. REM deprivation would build up REM pressure making her very tired.

Duane McDade said:

Here's the deal, without using medical terms. The reason that you're exhausted all the time is not because of weight. I have seen many patients so thin that if they turned sideways .......ok you get it. Sometimes sleep Apnea is sleep stage related. It is very common for one to have Apnea only during the REM part of the sleep cycle. REM is the sleep you get to make you not drowsey.....see the logic? Why would someone have Apneas during REM and not the other stages of sleep? I will tell you ! When a sleeper goes into REM a paralisis sets in this changes the breathing . You use a less muscles to inhale and exhale so where the obstruction/s did not come into play during non-REM when in REM they prevent you from breathing. This fractures the REM . This is not good if you dont want to feel drowsey.

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Permalink Reply by RockRpsgt on July 25, 2009 at 2:11am

Oh Cindy, I beg to differ. REM sleep is the sleep that refreshes you. Maybe not in the way that you are thinking though. It is the lack of REM sleep that makes us feel tired. The effects of this are truly seen in apneac pts. Stage REM restores us mentally where as slow wave sleep(SWS), also known as delta or stage 3, restores us physically. It is in stage 3 that we heal or for the young grow. If you were to stay up for 24 hours you would experience a SWS rebound when you slept. Now if you were to sleep in stages 1-3, but were denied stage REM even though your body was rested you would feel like you had not slept. When REM sleep was returned to your sleep cycle you would entere a REM rebound. A person denied NREM sleep over time will eventually go to sleep. A person denied REM over that same period of time will suffer a mental as well as physical breakdown Also your statement does not take into effect the degenerative properties of stage 3 as we get older.

http://www.sleephomepages.org/sleepsyllabus/d.html

Search the topic "REM sleep" at binarysleep.com

Also read about REM in the Essentials of Polysomnography. Very cool stuff. One of my favorite topics

Cindy Brown said:

I have to say that from what I've learned REM sleep is not the sleep that refreshes you, that's deep sleep. REM sleep is more for memory and feeling clear headed. Fatigued would be more a deep sleep deficit.
I would think that any change in stress levels, up or down, can cause a tired feeling. When you're really stressed, living under a deadline perhaps, you release hormones to help you "make it". When the stress is relieved then the fatigue will set in. In other words all that stress takes a lot out of you and now you need to recuperate. Maybe you're just expecting too much from yourself and just need to relax and pamper yourself as much as possible and just give it a little time.

Cindy

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Permalink Reply by Andrea McClure on July 27, 2009 at 11:48pm

Thanks for all the suggestions, everyone!

DDNight - according to the doc, the CPAP would make me non-deployable, like you, to any location where constant power can't be assured. The dr made a point to tell me that I could still be deployed CONUS or to Guam. I laughed, since my career field (Civil Engineer) doesn't have that kind of "deployment", we're overtapped as it is with our AF taskings and ILOs to support the Army. However, the big thing that the doctor told me was that the Air Force will see me as non-deployable with less than 10 years service, and will pursue a medical board. If I had been in >10, it would be more of the situation you're in (if CPAP helps, I could probably stay). But what it sounds like from everything I've read online elsewhere and from the responses here, CPAP quite possibly wouldn't help much anyway.

I'll keep trucking along like I am, using the breathe right strips, anti-snoring throat spray, making sure I stay off my back when I sleep, and I'm about to start allergy shots. Hopefully some combination of those, along with time, will help. If not, I guess I'll cross the next bridge when I come to it.

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Permalink Reply by Mike on July 31, 2009 at 11:52am

This is wonderful advice that I wish I had had after experiencing some fairly intense periods of stress in my life. Even though it is "touchy feely" stuff, one underestimates it at his/her own peril.

j n k said:

If your doctor said to give it some time, that may be worth listening to.

You are really only a few months "back," it sounds like. And you seem to be talking about being 'tired, exhausted, fatigued,' more than sleepy. That can be a sign of a kind of depression. But it can be a sign of needing to give yourself some time to adjust and to get your stride back.

You have the good stress of coming back ON TOP OF the significant stress of having been deployed. Don't demand too much of yourself all at once. Get your rest. Settle in. Talk about it. Keep active. Eat well. But understand that the kind of changes you have been through take some time for anyone of any age, male or female. Stresses, both good and bad, can work on the hormones of any person, of any age, male or female. Maybe some people hide it better. Maybe you are more in tune with yourself than most. But no one can go 120% all the time without paying for it in some way. If you are in a place where your body/brain senses it has some time to deal with some things, it may be trying to slow you down to give it the energy to deal with some things.

If you are a problem-solver and see your present condition as a problem to solve, that may in some ways mean you are working at cross-purposes with yourself. You may be better off to think of your coping as being more a matter of allowing your body to solve its own problems while you continue to do all you can to support it with good sleep, good health-habits, calm relationships, safe environment, etc.

Enough people are putting demands on you that you may need to ease off a bit on the demands you put on yourself while you try to find ways to give yourself that time. It is a way to value yourself and give your 110-pound, 23-yr-young 'machine' that you are living inside just a little more time for some self-'maintenance.' Your aren't 16 anymore, after all. :-)

I know the above isn't so much about sleep. I covered that in my previous post. And if you find the above particularly irritating to hear, feel free to ignore it. I am only trying to throw around some ways of thinking about it, just in case that helps.

jeff

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