The inability to use CPAP for the entire night
On many nights, new CPAP users begin their night with a good
effort by using their CPAP. Sometimes, however, compliance is
not continued throughout the night. The inability to use CPAP
for the entire night is a great disservice to your health. The
greater part of REM sleep, the most restful part of sleep, is
toward the end of the night between the hours of 4 to 6 am. REM
sleep is often referred to as "Dream Sleep" and is essential to
getting a restful night's sleep.
There are 5 stages of sleep beginning with stage 1 and ending
with stage 5. Stage 1 lasts approximately 1-7 minutes at the
onset of sleep. It is a transitional stage between wakefulness
and sleep. Stage 2 takes up the largest portion of your Sleep
time. While it is a bit deeper than stage 1, it is still
considered to be a light shallow stage of sleep. Stages 3 and 4
are deeper slow wave sleep. Stage 3 is more of a transitional
stage to 4 some where between 2 and 4. REM sleep (Rapid Eye
Movement) or Dream Sleep is Stage 5 Sleep. During this stage,
muscles are completely relaxed and slack. The most significant
Obstructive Sleep Apnea events occur while on your back and in
REM sleep due to the loss in muscle tone. While muscle tone is
still present in stage 1-4, it has disappeared during stage 5
and so it no longer helps to keep the airway open.
The first REM appears about 90 minutes after you go to sleep.
Then the cycle begins again back to stage 2 as the night
progresses. Stage 3 and 4 get shorter and your REM gets longer.
At 5 am your REM is at its peak lasting up to 1 hour long. By
this time of the night, your stage 3 and 4 are almost
non-existent. A normal sleep pattern has between 4 and 5 REM
cycles. The night's sleep cycle often goes like this, Stage
1-2-3-4 -REM then back to stage 2 -3-4 -REM then back again to 2
repeat 4 to 5 times with the last one have very little to No
stage 3 and 4 in it and the REM time getting longer and longer
while the Deep sleep stage 3 and 4 get shorter. What sleep apnea
does is to disrupt the natural sleep cycle. The deeper the Sleep
cycle, the more OSA your going to have. When you obstructed and
need air, you have to come out of those deeper stages. Once back
to stage 1- 2 you can now take a breath. This fragments your
Deep sleep and REM by not allowing you any deep sleep, or very
little real restful sleep and you will never feel refreshed. An
OSA person will get a lot of stage 2 light sleep and very little
Deep (Slow Wave) or REM sleep. So even though you say "how can I
not be sleeping well, I sleep 9-10 hours a night and nap during
the day!". The answer is you're getting a lot of sleep but not
the quality of sleep that allows you to feel rested.
In conclusion if you're taking your CPAP off at 2 or 3 am your
doing yourself a disservice just before you need it the most.
Your apnea will be at its worst and your reparative sleep at its
best.