Sleep stuff, heart stuff, blood sugar blues

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After the first few days with the ring I was finding my sleep to be pretty awful, and I was noticing that I was waking up quite frequently. Some of it seems to be due to apnea coming and going, but last night while just lying in bed totally awake I started getting “please move” vibrations even though I was definitely breathing, and the ring said my SpO2 was a perfectly-healthy 98%.

But! My heart rate was dropping under 45, which was the configured notification for that.

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Better sleep through technology

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I’ve always had issues where I’ll stop breathing in the middle of the night, but I don’t snore. Sometimes I wake up gasping for air. I’ve suspected central sleep apnea for a long time.

Several years ago I had an in-home sleep study, where they hooked up an SpO2 meter to me and recorded it overnight. There were a number of drops throughout the night, indicative of apnea in general, and as a result I was provided a CPAP machine (on the assumption that it was obstructive, rather than central, apnea).

The CPAP machine didn’t really help much (if at all) and I kept trying to make it work over the next few years. Then due to a change in insurance I needed to get another study to get authorized for continuing the prescription, and they said that the CPAP machine wasn’t helpful for whatever my sleep issue was. I ended up selling it on the used market.

But I was still having apnea issues, and a lack of restful sleep.

Over the past few weeks it’s gotten especially bad, and after someone was evangelizing the Oura ring, I looked into continuous monitoring solutions. I’ve had a cheap finger monitor for years, which has been helpful for spot-checking but is uncomfortable to wear to bed, and also doesn’t record a log, making it less useful for diagnosing issues.

Oura is pretty expensive (and now requires a $6/month subscription plan) and doesn’t do continuous SpO2 monitoring (it only does momentary checks, similar to the current Apple Watch), but perusing other reviews and half-remembering a few videos I’d seen years ago, I eventually came across the Wellue O2ring, which is a continuous monitor which logs SpO2, heart rate, and movement all night long, and can also send a little vibration to your finger whenever the SpO2 drops below a configurable threshold.

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Melatonin isn’t the answer

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I’m finding that taking melatonin every night isn’t actually helping me sleep better, although it does make me tired at a reasonable time. But I’m still waking up in the middle of the night and generally being pretty restless. And it hasn’t helped me with my focus or my pain at all, but the working theory was that sleeping better would be what would help with that, and melatonin hasn’t done that.

I think having used it to adjust my sleep schedule was fine, though, and I’ll keep using it for that purpose in the future.

On the plus side, the daylight saving change didn’t mess with me any more than my sleep schedule was already hecked up.

Melatonin experiment

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Night 1 I had a lot of weird dreams and I was also awake or at least on the edge of consciousness for much of the night. Throughout the day I felt fatigued and crappy. My smart bed concurred, giving me a sleep score of 62 and a “time asleep” of 5:36 (which is an overestimate). I also had many very intense dreams of varying levels of surreality.

But night 2 went much better; I slept through the whole night, I only had one vivid dream (and it was pretty much grounded in reality, albeit about Kafka-esque Internet installation and support issues… so, grounded in reality) and I got a sleep score of 83 with a sleep time of 8:07.

It’s probably not entirely the melatonin to credit with that; last night I also did my longest DDR workout ever, and of course I had a lot of fatigue to catch up on as well. But today I’m feeling pretty good.

Tomorrow will be a bit of a test thanks to daylight saving kicking in (perhaps permanently, much to my chagrin — IMO it should be abolished, as well as making society not so reliant on time-of-day for “productivity” in the first place) so I’m not expecting tomorrow’s anecdata point to be that useful. Unless I’m feeling really good, in which case it’s extra-useful.

Anyway hopefully this week I’ll actually be able to focus on work more than usual, at least for the next two weeks; March 26 is when my house purchase closes, and then the next couple of weeks after that are going to be ridiculously chaotic, both with moving to my new place and selling my old place! Which is of course all the more reason that focus will be important.

Melatonin experiments

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Last night I came across a pop-science video about the link between ADHD and sleep disruptions, and it raised an interesting point: many of the ADHD symptoms are also symptoms of sleep deprivation, and the sleep disruption aspects of ADHD might actually be the underlying cause of many of them.

I’ve always had great difficulty with sleep, with trouble falling asleep at night but then being incredibly fatigued during the day. And I can’t help but wonder how many of my other issues are just plain due to crappy sleep. Maybe my chronic pain isn’t because of an underlying neurological cause, but is because I’m not properly sleeping and healing at night?

I’ve had three sleep studies at this point. The first in-home study vaguely diagnosed me with obstructive apnea, and is why I got a CPAP machine. The CPAP machine didn’t help at all, so a second study to rule out narcolepsy happened. Then the third one verified that CPAP doesn’t actually make a difference for me.

Anyway, one of the things mentioned in the video is that there’s been some success with treating some forms of childhood ADHD with time-release melatonin. So starting tonight I’m going to try taking time-release melatonin and see if that helps me any.

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Nortriptyline updates

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I’ve been at 30mg of nortriptyline for 6 days now, and I’m trying to figure out if this is how I felt on it before. Going through my nortriptyline tag I see that I actually was up to 40mg on my initial tapering, and after sitting there for a while I decided it wasn’t doing enough for my pain and that’s when I tapered down to 20. In one entry I complained that it wasn’t helping my sleep at all, and how it was making me constantly dizzy and tired and headachey.

This time around it’s definitely helping my sleep, and I’m not dizzy, although I am quite tired (despite actually getting a full 8 hours of sleep every night, for once!) and today I had a headache all day. Also plenty of nausea. But at least I got a nice long walk in.

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Disordered thinking

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I have always been a night owl. Society in general shuns the night owl; waking up early is to be praised, you’re a go-getter, you’re proactive. Waking up late means you’re lazy, you’re irresponsible. Medicine is finally waking up1 to the reality that different people have different natural sleep cycles, and this is okay, but their way of describing this is by calling the late-shift folks “delayed sleep phase disorder.”

People who are trans are told they have gender identity disorder.

People whose brains process stimulus differently and have a tendency to hyperfocus on problem-solving are told they have attention deficit disorder.

These aspects are framed as being outliers, deviations from the norm, problems to be fixed.

Disordered.

All these things that are inherent to me are framed as being problems. Things to be ashamed of. Things to cure.

But they are the things that make me who I am, and which give me strength.

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Treatment progress

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On the nortriptyline front, I’m up to 20mg/day and it’s feeling fine. It hasn’t solved my fibromyalgia forever (and after a day of typing and whatnot I’m still in pain, and my pressure points are still indicative of fibro) but it’s helping me a lot all the same. An unsurprising-but-nice thing is that it’s also vastly reduced my anxiety, which isn’t too surprising since that’s one of the on-label uses of this medication that I’m technically taking off-label. Does that count as a side-effect?

On the CPAP front, I’ve switched back to the nasal mask and it’s actually working pretty okay for me. I think the machine has finally learned to reduce its pressure because I’m a lot more comfortable throughout the night, although I still end up waking up at around 4 AM and taking it off so I can scratch my nose. Still, I’m generally feeling a lot more refreshed in the morning. I just need to get in the habit of putting it back on after I wake up and take care of the itching.

Also my cats have gotten used to it, which is nice.

Smart phones, smart watches, what’s next, a smart bed?

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Lately my sleep has been pretty much garbage, and I probably need a sleep study. But sleep studies are expensive and a lot of hassle to maybe find out nothing’s actually wrong, so in the meantime I got a sleep tracker kit.

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