Many "wakeful" periods - bad sleep or is "sensitive setting" wrong for me?

[andreabrie]

I never thought I got bad sleep until I monitored my sleep with fitbit!  I consistently get sleep efficiencies in the 50-60% range and have over two hours and between 10 and 15 wakeful periods a night.  On the other hand, when I use the "normal" setting, fitbit says I slept all night without waking up and I know that's not true either.  Suggestions?  Do I need to talk to my doctor about this?

[Fit_4_Life]

Thank you for sharing. I had seen what you said about the dropcam on another thread. For that reason, I've been opting to use the sensitive setting. I greatly appreciate that you shared this. This has been very enlightening about my poor quality of sleep for sure.

I'm still going to try for a professional sleep study since I have multiple aspects to my sleep architecture that I think are awry.

I heard on an NPR podcast this weekend about some people (who are wanting to help people get better information about prescription drugs) that one sleep med I'd tried previously only helped people get to sleep about 15 minutes quicker and sleep about 37 minutes later compared to placebo. I don't remember the name of it. That was interesting to me because I remember that particular drug only being minimally helpful. I hate to misspeak and guess at the drug they were talking about...if of interest you may look for it.

You mentioned the meds issue. I think that on meds it could be easy to feel times of wakefulness and yet be drugged enough that one wouldn't move. It seems reasonable. So, it could be that you're still not getting the rest you need...and it would be interesting to know the stages of sleep the med supports...like REM or NREM or...

If there was a program that could connect a dot to certain muscle groups and feed info to fitbit or something similar, I'd love to have that to monitor things like restless leg and grinding of my teeth...

Here's to more high quality rest for us all in our near futures.

[Fit_4_Life]

I just talked to my TMJ doc about this. He said it is common for the sleep study folks not to share your report with you. You may ask for a copy to be delivered to a doc who will review it with you...I think we should be able to get a copy ourselves. There is a large focus on what a CPAP can cure, but there are many more challenges to sleep.

Did your doc have any ideas on how to fix your fragmented sleep? My efficiency measure is higher than yours and I'm still at the 5th percentile? I feel for you.

(As I mentioned in another post in response to flguy, he sold me on the sensitive setting b.c. of his dropcam experience.)

[Fit_4_Life]

Thanks Colin99. I hope to get a test and see my results too.

[SiberianWind]

I found that without my CPAP, I barely sleep. My rheumatologist put me on
muscle relaxers, but that didn't help my sleep. She ended up going with
pain meds next, and I have finally started averaging 4 hrs of sleep each
night. Diet and meds can greatly impact sleep.

[Fit_4_Life]

SiberianWind, I hear you. I have gone through several sleep meds (different types for pain and sleep support). It's hard to find the right one...and then once you do, the body sometimes builds up a tolerance to it over time. What kinds of diet things are you finding affect your sleep?

[redd]

Hello there, i work in a pharmacy. Meds will never replace a CPAP. Most of them will just get you to sleep not keep you there. The biggest problem with presciption sleep and pain meds is the risk of addiction. So when you stop or change meds you get a rebound or opposite affect alot of times. You may want to try melatonin and see if you can reset your sleep cycle. Just a thought. 🙂

[Fit_4_Life]

redd,
I hear you.I was using clonapin(sp?) for several years. I didn't think it was doing what I needed and didn't like feeling dependent, so about 7 months half ago I weaned myself off. It wasn't easy. I was glad I could take some time off to do it. Weaning myself off of ambien about 10 years ago was tougher though.

Melatonin has never done it for me. The mixes that use Melatonin as a leader for marketing and also throw in some things like hops work better (for me), though they can leave me feeling hung over. Right now I'm trying something that has among other things l-theanine and gaba...from Whole Foods. That plus a couple of arthritis strength extended release Tylenol. I'm on night 2 of that and not thrilled but trying to give it time. It's targeted towards those of us in the menopausal years so it throws in black cohosh.

I'd be curious what others have found helps.

~feeling nostalgic for my youth when sleep was easy.

[flguy]

Melatonin never worked for me either, or my wife.  We're both light sleepers and have tried multiple things.  The melatonin gave me headaches early in the morning, sometimes they would wake me up.  Maybe we were taking too much (5mg) but that's what our doc said to try.

That said, I have been taking 45mg of Restoril (temazepam) for about 2 months now, and it's working better than any sleep drug or OTC I've tried.  Granted it's a benzo and there are dependency issues, but there are two things you can do about that: 1) take drug holidays, 2) live with the risk and when you're ready to try something else, work with your doc on a come-down plan.

Regarding drug holiday, I recently completed 1 full week of zero meds after being on 45mg temaz for over a month.  I only went through 3 days of mild withdraw, nothing terrible at all.  I was still able to sleep, but was very aware of my middle-of-the-night awakenings.

Went back to 45mg temaz and now sleeping like a rock again all night, I have no recollection of any movements or awakenings.  Temazepam is NOT for helping you get to sleep, it's for keeping you asleep.  Nothing worked for me until my doc put me on this.  It's a high dose, but I'm an adult and he gave me the choices.  I still use a sound machine and practice other good sleep hygeine.  I feel much better now, sleep efficiencies are in the 80's.  They used to be 60's.  Sometimes your body just needs to re-train itself.  If meds help, then use them as a tool.  Everything carries risk, including not getting enough sleep!

I'm not sure how long I'll use or need the medication, but as long as I'm working on other areas then I don't feel like it's a dead end.  If I start feeling any side effects like memory issues and what not, then I would stop (or if my doctor says to stop).

[Fit_4_Life]

flguy,

Totally respect your journey. It's a tough balance for sure. We absolutely need our sleep for so many reasons. Glad you've found something that's working for you for now.

[colin99]

Hi Ceece, same problem here. My sleep is very fragmented. What I'm trying now is sleepio.com which has an online sleep program. It's mostly about forcing the body to change habits through sleep restriction, setting up a good bedroom environment,  finding a cool-down routine at night and using CBT to deal with psychological problems related to sleep. It's still early but I've seen a bit of improvement; changing the time I go to bed has definitely reduced the time to fall asleep. The restriction part has been hard - cuts out all daytime napping (I used to throw myself onto bed the minute I got home from work and for large parts of the weekend); a few weeks into it and I'm still having trouble with this part of the program.

My sleep window is 6 hours and I average about 50 percent sleep efficiency. My hope is to take the average night from 3 hours to 4 hours - it's progressing slowly but it's beginning to stabilize at 3 hours.

I've also made a bunch of personal changes to try to reset myself: black-out curtains, moving my phone and electronics away from bed (bad tendency to grab the phone at night and play with it when I can't sleep), diet changes, daily exercise (the fitbit shocked me when I saw how inactive I was), restorative yoga.

[redd]

Not saying meds are not the way to go, absolutely not. As a partner insomniac, i have tried everything and had every test done. My particular issue is due to high Cortisol levels which are produced over night. They have yet to find out why other than high stress. The only diagnosis they have come up with so far is narcolepsy, which i disagree with. But I'm not the doctor. 

[ceeceham]

Hello Fit_For_Life

No my doctor's only response to my sleep study was to tell me to research good sleep habits online.  Maybe I need a new doctor!  When I did research fragmented sleep I saw there are varying levels.  I am guessing that since I am unaware of most of my awakenings and never really struggle to fall asleep or get back to sleep if I do awaken that my issue is not getting deep sleep.  I have always seemed to need more sleep than most...at least 8 hours to feel rested and fully functional.  It is only in the last few years that I can sleep 12-14 hours if I have no where else to be and still wake up tired.  In this time period I began treatment for hypothyroid, had extensive bloodwork, started meds for depression and anxiety, and the sleep study to rule out sleep apnea.  I take daily Iron, Vitamin D and B vitamins.  Nothing has seemed to help.

I do find the (low dose) of Klonopin has helped with falling asleep as I no longer lay in bed worrying about any and everything.  The Melatonin I just started recently and I can't say if I see a difference or not.  I am a shift worker...evening shift...and with nursing there is no guessing what time I will be home so I do struggle to maintain a steady bed time and awake time.  I am sure my circadian rhythms are all off.  I have been off of work for 2 months with a shoulder injury so I have been better able to regulate my sleep lately although I think the pain in my arm makes me change position throughout the night. With my fitbit on sensitive my sleep efficiency is 30-40%. 

My doctor doesn't seem to take the fragmented sleep or constant fatigue very seriously.  To be honest I think she writes off most of my concerns as being weight related.  Like I said I probably need a new doctor.  My symptoms are consistent with chronic fatigue syndrome or fibromyalgia though no doctor has made that diagnosis it is just me guessing and trying to find an answer for how I feel.

I do find it is a struggle to increase my activity when even staying awake all day is challenging.  It is nice to be able to talk about all this with other people who understand how important and elusive good sleep is.

[Fit_4_Life]

I feel for you. I feel tired and yet my average restful sleep is around 5 hours/night (does not include unrestful time) and I have 80% efficiency.

I have used good hygiene for years and am always refining it. I really wish there were more experts/help on the sleep architecture pieces...as well as the many aspects to improving sleep. It seems w/ 30-40% sleep efficiency, someone could help you improve that...Hang in there.

Some things I do (in case any of these help you or others)

lower lights and intensity of activities near bedtime

adjust bed padding, bedding, and pillows periodically (getting creative with pillows and padding to help work around whatever aches are worse @ the time (e.g., a shoulder injury) 

use CPAP (sigh)

lower air temp. at night

Maybe take a bath before bed

Maybe a little drink herbal tea w/ milk...

take supplements and Tylenol PM to try to soothe my nervous system

Maybe take magnesium near bedtime (but not right before taking other pills)

Keep a relatively stable sleep schedule
    (I'm actually very fastidious about this because I tend towards a.m. insomnia)

And of course keep away from screens (TV, phone, iPad) near bedtime)

Sometimes meditate before sleep

Often read right before sleep

At one point, I had restless leg syndrome and my doc had me taking iron to get my ferretin levels up. This helped reduce that problem. I don't know but I don't think that's a big issue now.

[doxielvr08]

Just for fun I switched my fitbit over to sensitve setting to see what that would look like. I feel like it's way off!

So on normal for 8/3 I slept 7h 28mins, and then 16x restless at 38 mins awake....this seems normal since I know I wake up and have to readjust often.

Last night I had it on sensitive and it says I got 2h and 56 mins of sleep and 301 mins restless 20x

That can't be right, I don't feel exhausted. I think it must of picked up other movement besides me or I just move a lot more then I think I do. I know I have restless legs and I have had complaints from hubby that I move a lot in bed. I also sleep with a fan on so I wonder if I rolled over if my hand was near the fan if it picked up on vibration at all? I think I will keep it on normal going forward. It was interesting to see the difference though.

Since I wake up rested and I don't feel tired during the day I think it's safe to say that I'm getting enough sleep just probably twitch or move a lot. My kids still crawl into bed at night, most of the time I don't even feel them get in bed until I wake up with no room to move so a lot of the movement could also be them shaking the bed.

[Fit_4_Life]

doxielvr08

I  hear you. It makes sense to bounce the data up against your experience. The sensitive setting seems to align with my level of feeling tired vs.or rested. And someone further down in these postings did a video cam and compared it to the sensitive setting and it lined up well...So I'm sticking to sensitive.

It could be interesting to move your fan or see what happens if you're ever sleeping alone...Both the fan and a partner who moves a lot seem that they could cause false positives...especially a restless partner.

[doxielvr08]

I might try sleeping in one of my kids beds this week and see what it shows. Of course withouth the kid lol. I saw that study to with the camera and sensitive setting, that was the reason why I switched it to sensitive but yah there has to be another factor. I will update after I try my kids bed

[flguy]

I doubt the fan would be causing vibration, but if you have restless legs that could definitely trip the fitbit sensor, especially if you hand is down near or on your leg when it's happening.  If you don't normally wake up from restless legs, then it can probably be considered a false positive, but good to know nevertheless.

[doxielvr08]

i only consider my fan because its on my night stand less than a foot away, sometimes i feel the vibration of the fan in my pillow if the night stand is touching the bed....i think i will try moving it farther away to just to be sure.

[colin99]

Hi Ceece, it seems to be very hard to get answers to sleep issues. For a long time my doctor just gave me pills and tried to treat it that way. Finally I had a sleep test - it came back with a mild (if there is such a thing) apnea issue. I'm not perfect with the machine even though it's a very light pressure setting but it hasn't done much for my sleep.

I'm a member of an online sleep program now; looking at it, I think the improvement has been that the lowest amount of sleep per night has increased but the upper level is stuck at 3 hours or so. That's about 50 percent efficiency (part of the program is to do sleep restriction so I'm in bed 6 hours a night). Yuck 😞

Some things that have helped:

1) Very dark curtains; close to completely dark at night. I've never had a dark ,dark room before.

2) For the past four weeks I've been doing a restorative yoga program before bed. It's part of Jon-Kabat Zinn's mindfulness practice. This has helped with falling asleep problems - in the past I'd be lying awake for at least an hour before falling asleep. That's getting better.

3) The fitbit pointed out to me how little exercise I was getting so I'm doing  a lot more walking. I'm iffy about whether this is helping or if I'm doing too much all at once and wearing myself out more.

4) I've banished my electronics to a table away from my bed. I had a bad habit of grabbing the cell phone in the middle of the night and playing on it if I couldn't sleep.

5) I'm taking melatonin but not sure if it's helpful. I've also read that magnesium can help so I've started to take that recently. There's also a sleep/mood supplement I'm taking.

I'm currently reading "Sound sleep, sound mind". The author has some interesting points about the interplay of emotions and thoughts. Still early in the book but he hit home to me with discussing time fears - I'm constantly worrying about how much sleep I'm getting and whether I'll fall asleep. Even with all the alarm clocks removed or taped over, I still have the time fears.

I was on a Klonopin derivative last year; there didn't seem to be much help for my anxieties and such so my specialist weened me off it. I'm beginning if that was premature and it was giving me that extra hour or so of sleep. I'm been thinking about that recently; it's good to hear that it helps you!

My sleep specialist is very much into non-prescription fixes (fixing the underlying anxieties, thoughts, etc that keep me awake). My doctor is the exact opposite. I'm not sure where I fall between these two.

It seems that for sleep problems, we're all test cases.

Colin

[Fit_4_Life]

I hear you Ceece. There are so many components and the medical community isn't always that helpful. I requested a sleep study in late June, remindd my doc re the referral a few weeks later. She apologized and has not followed up to say anything...meanwhile I now have bad hip pain I am trying to figure out. It bands, hips, sigh...