Brain recovery: how to speed it up ?

There are some interesting studies on brain changes in OSA and recovery associated with CPAP. A number of papers show brain volume loss (as depicted with MRI) associated with OSA, but some studies also show recovery after cpap therapy. Brain volume with MRI is a physically precise but physiologically crude measure in which it's assumed that loss of volume means loss of neurons. At few articles I managed to browse also seemed to show improvement in cognitive function after CPAP, as measured in specific neuropsych tests.

I don't think anyone would disagree that sleep deprivation will cause cognitive impairment in anybody in the short term. This acute impairment (e.g. after one all-nighter) is not likely to be due to lasting brain damage, but from stress responses and all the mysterious things that science is still trying to understand about the role of sleep. Based on my personal and work experience I believe that years of sleep deprivation, with the associated stress and neural disruption, can lead to a more profound cognitive impairment that is not necessarily due to lasting brain damage (usually taken to mean neuronal loss). It is quite possible that, due to the respiratory disruption (hypoxia, hypercapnia, nightly bath of stress hormones), there will be some neuronal loss associated with the condition as well. It's hard to say how much cognitive impairment might be due, in a given person, to the reversible effects of chronic sleep deprivation vs. the more permanent neuronal loss (although I'm not convinced that brain volume loss always means neuronal cell death, and there is evidence that renewal of neurons is occurs more than was previously thought).

In my case, I suspect I was undiagnosed for around three years and was definitely experiencing cognitive impairment (memory, concentration, multitasking, mood) when I finally sought treatment. My philosophy is that it's pointless to worry about long-term neuronal loss etc. when it might very reasonably take many months to recover from years of extreme sleep deprivation. My AHI is still too high (15+ on some nights) but I've only been using CPAP for a couple of weeks. If I still feel fuzzy after six months of AHI<1 then I will start to worry.

As an aside, I also think that the stress of sleep deprivation is conducive to other unhealthy habits that can also affect cognition. High-carb meals provide a very intense jolt of gratification, but also lead to insulin spikes that are definitely not good for mental function. I also found I was drinking more alcohol (not falling down drunk but was having two glasses of wine with dinner more often than I needed to), which in retrospect was kind of a companion drug to heavy high-carb diets and has its own bad effects on both sleep and cognition. After a long day of struggling to stay awake and focused, some 'good' food and a couple of drinks seemed like a nice way to dull the unpleasantness of it all. In fact I think this was making things a lot worse.

I've followed DreamStalkers advice and have dramatically reduced my carb intake. I have started feeling better and my cravings for sugar and carbs really did seem to go down after a few days.

@DreamStalker: I don't know if you read my followup post, but I wanted to stress that I posted the dieticiansofcanada link as a followup to previous discussions about the blather that was being propagated by the mainstream diet counselling field. I don't subscribe to their position - my comment about 'heeding their warnings' was meant to come off as 'follow DreamStalker's advice about supplements etc.' When I re-read the post I can see how it might have looked like an attack. I may well be a timid, indecisive mama's boy but I actually agree with you!

Hi Leptic.

I still feel foggy after 2.5 months of AHI = 0.5

I don't think I would wait that long before becoming a total PEST to my doctor.
Be a squeaky wheel. If you don't keep bugging the doctor, he will think the problem is resolved.
Communicate! We may have suggestions; but this is his JOB. Make him do it!

chunkyfrog wrote:I don't think I would wait that long before becoming a total PEST to my doctor.
Be a squeaky wheel. If you don't keep bugging the doctor, he will think the problem is resolved.
Communicate! We may have suggestions; but this is his JOB. Make him do it!

I started using CPAP since 30 March.
End April 2016, I have reached the optimal point of AHI (< 0.7), with good pressure (8cm H2O). At that point, the doctors were happy and asked me to come back next year, so it will be 6 months from now. They believe that I still have the residual fatigue that I need to wait to recover.

Have you looked at your raw data? I find the ML/algorithms the machine uses make it look good. It's report may not be very accurate however. A 9.5 second OA event still wakes you up and makes you feel terrible, but the machine happily ignores it. Grab sleepy head and peruse a few days worth of data and make sure you are really sleeping well.

gl

m2man wrote:Have you looked at your raw data? I find the ML/algorithms the machine uses make it look good. It's report may not be very accurate however. A 9.5 second OA event still wakes you up and makes you feel terrible, but the machine happily ignores it. Grab sleepy head and peruse a few days worth of data and make sure you are really sleeping well.

gl

I also look at sleepyhead, but does SleepyHead ignore also 9.5 second OSA ?

jaw wrote:I also look at sleepyhead, but does SleepyHead ignore also 9.5 second OSA ?

Set your own event parameters using "Custom CPAP User Event Flagging" --> SleepyHead/File/Preferences/CPAP

jaw wrote: I also look at sleepyhead, but does SleepyHead ignore also 9.5 second OSA ?

In general SleepyHead only reports what the machine reports or has flagged...it's the same for brand manufacturer software...they report what the machine reports and don't do the actual "analyzing" of the data shown.

Now there is a way to alter SH default reporting from what the machine is actually flagging to include user created flagging which Jay has already mentioned.

But yes...if the machine doesn't flag a 9.5 second event (and it won't)....SleepyHead won't flag it either unless you tell it that you want to know if you have some sort of reduction in airflow that doesn't meet the standard criteria.
Standard criteria being at least 10 seconds and something like at least 40 to 50% reduction in airflow. Without both...no flag.
30 seconds at 30 % air flow reduction...no flag
7 seconds at 100 % blockage...no flag
This is what the machine does...the lines in the sand that they are programmed to need.

Last night I had 6 Hypopnea events. Sounds pretty good.

If I lower the CPAP settings to 6s (for 50% reduction in flow), I had another 78! Lame. Can't be helping me any.