Disappearance of REM sleep behavior disorder after change from BiPAP back to CPAP

I have been using some sort of therapy for sleep apnea for about 10 years. Started out with APAP, still had high AHIs, was told BiPap would fix things. It didn't. Still had high AHIs, as well as what appeared to be REM Sleep Behavior Disorder. I would let out blood-curdling screams in the middle of a nightmare, and kick my dear husband periodically too. I don't remember the settings for the BiPap but they were much higher than what I have now.

I had another sleep study at the end of May, and was put back on plain old CPAP at a fairly low pressure (7). Voila! My AHIs now average 3.9. I don't have the screaming meemies any more, or the kicking movements. Therapy is much more tolerable with the lower pressure.

I had a visit with my sleep doc today. He is a neurologist with sleep disorder training overlaid. I mentioned the disappearance of those REM Sleep Behavior disorder symptoms with the simplification of my therapy. He said they were not connected to the therapy and was mystified.

Anyone else here have any similar experiences?

Just curious.

Deb

When two things happen around the same time, it is natural to associate the two things and to wonder whether one caused the other.

If it is a positive development, it's probably more important to be grateful for it than it is to figure it out.

There is benefit in getting AHI as low as possible. There is also some cumulative benefit over time from just using any form of PAP that helps. But then sometimes our sleep improves for no medically explainable reason.

May your sleep continue to improve, whatever the reason.

I want to question whether you're getting REM sleep or whether the discontinuation of BiPAP is depriving you of REM sleep. If there's no REM sleep, then there's obviously no disordered REM sleep!

BTW, REM sleep is very important. If you're not getting it, it's a problem!

My own experience sort of corresponds to yours- before I was first fitted with cpap over 32 years ago I experienced frequent nightmares of being choked or drowning and would burst out with screams . Those nightmares went away immediately after I began using my wonderful old dinosaur CPAP. and they have never returned through my many years of PAP use. By now, I have been through several different machines and everyone has afforded me relief from my old symptoms. For several years I did use a BiPAP, but never experienced any recurrence ofthe unpleasant dreams. I have returned to CPAP in recent years and definitely do prefer it to BiPAP.

TheDuke

With regards to the question about whether I am getting REM sleep with my new machine/settings, I still dream...but I don't scream (sorry, couldn't resist the rhyme). Seriously, the dreams seem to be less upsetting, although I do have recurring themes in my dreams.

As someone else said: just be grateful for the improvement. Believe me, I am, and hope it continues for as long as possible!

Deb

needzzzzs wrote: ↑

Tue Sep 17, 2019 10:33 am

With regards to the question about whether I am getting REM sleep with my new machine/settings, I still dream...but I don't scream (sorry, couldn't resist the rhyme). Seriously, the dreams seem to be less upsetting, although I do have recurring themes in my dreams.

You can dream in any and all stages of sleep, not just REM. REM may tend to have the more emotionally, uh, engaging dreams, but even that isn't a hard and fast rule.

Properly optimized PAP can straighten out the breathing-related interruptions to sleep cycles, but drugs (even prescribed good ones) and waking habits and plain old DNA can all have a profound influence on the nature and timing of REM as well.