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Re: Optimum pressure caveats, indeed!!

Posted by SGS on February 12, 2003 at 19:42:03:

In Reply to: Re: Optimum pressure caveats, indeed!! posted by SGS on February 12, 2003 at 19:26:35:

sorry forgot to address you dreaming question.

Sleep and memory are a strange pair. Going to sleep immediately impairs your memory of things immediately past (probably some sort of memory consolidation is switched off at sleep onset).

REM is normally terminated by a brief arousal and then you go back to sleep again. Some people remember their dreams, some not, because of this memory switch and sleep onset. (think about midnight phonecalls or switching the alarm clock off going back to sleep and having no memory of it when you wake up.) Dreams are probably the same.

What does that have to do with CPAP pressures- particularly in the mild-moderate AHI levels? My theory is that in people with mild AHI the obstructive events are predominantly in REM and supine sleep -pressure delivered by CPAP is in excess of their needs at almost other times. So once REM finishes instead of having the right pressure to stop events you suddenly have more than you need (the hurricane down the throat?) and you wake up (really wake up)- and then have to go back to sleep- thus remembering and having time to mull over dreams more readily and remember them the next morning.

It's easier to wake someone from stage 1 or 2 than from stage 3 & 4 and REM is a fairly impressive disassociation from reality. The over application of pressure during REM might not wake you but it would during stages 1 or 2- perhaps. perhaps.

If AutoCPAPs worked perfectly they would sense the lower pressure requirements as soon as REM finishes and reduce to a more comfortable level reducing your arousal time- then next morning you don't remember dreams as well because they have been "wiped" by the sleep onset memory switch.

That's my theory anyway. Of course if you've only been on CPAP for a week or so you'll probably still be in REM rebound and having lots of dreams anyway. But the theory seems OK when applied to somebody who's been on CPAP for a while and isn't in SWS or REM rebound anymore.

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