Fitness tracker sleep data - extremely low deep sleep.

Posted by rjjacobsen @rjjacobsen, Nov 19, 2023

Broke my old fitness tracker several months ago and finally replaced - new one is more specific. It shows deep sleep between 0 and 8%, light sleep between 60 and 90% and REM between 12% and 36% of the sleep time.

Per the Sleep Foundation a person will typically go through four to six sleep cycles per night. In each cycle, stage 1 (light sleep) is 1 to 7 min, stage 2 (also light sleep) is 10-25 min, stage 3 (deep sleep) is 20-40 min, REM stage is 10-60 min.

Two things of note:
1) I don't seem to have a pattern of cycles at all.
2) I rarely get into the deep sleep stage and when I do, it's far short of that 20-40 minutes.

This is consistent with my feeling severely exhausted even when I wake up and not physically or mentally recovered/refreshed.

I have a CPAP (mild apnea) and it's numbers are reasonable, the AHIs are a bit high (6 to 8, rather than 5 or under), but they bounce a lot.

I'm scheduling my annual exam with my sleep med doctor - it's been 8-9(?) years since my last sleep study, so I will ask if a another is advised. I will also ask about the sleep tracking and cycle business.

I know these fitness trackers aren't medical-grade devices and are subject to error, but this appears way off.

Interested if anyone has seen symptoms similar to this, what diagnostics did their doctors do and what was done for treatment.

Thanks in advance.

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@rjjacobsen

An update: Scheduled an appointment with sleep medicine and the soonest I could get was late February. Sent a message to the doctor and suggested I bring in the memory card to be offloaded and analyzed and they were receptive to that.

Deep sleep has improved a bit since I turned off my bedroom's electric space heater thinking the fan noise it makes may disrupt sleep.

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So I go to pull the memory card from the CPAP to take to the clinic for analysis... but there's no SD card... The last time I saw him a year ago I remember he couldn't download the data reported by the CPAP to the manufacturer's site.

So, after the holiday, I'm to call the vendor that sold/services the CPAP machine if there's something they can do to get the data and to get me another SD card.

Sigh...

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@rjjacobsen

So I go to pull the memory card from the CPAP to take to the clinic for analysis... but there's no SD card... The last time I saw him a year ago I remember he couldn't download the data reported by the CPAP to the manufacturer's site.

So, after the holiday, I'm to call the vendor that sold/services the CPAP machine if there's something they can do to get the data and to get me another SD card.

Sigh...

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I think some of the CPAP machines have built in memory and you have to take the machine to the clinic and they download the data from the machine. That’s the way my ResMed AirMini works.

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@johnbishop

I think some of the CPAP machines have built in memory and you have to take the machine to the clinic and they download the data from the machine. That’s the way my ResMed AirMini works.

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I'm on my second ResMed AirSense 10 - first one reached its end of service life and beyond. Both have card slots and use cards. Am surprised that the sleep tech nurse didn't mention the option to read data from the machine if that was an option.

I recall at my last appointment a year ago I brought the machine in, but they used the card... it's possible they didn't replace it when done.

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@rjjacobsen

So I go to pull the memory card from the CPAP to take to the clinic for analysis... but there's no SD card... The last time I saw him a year ago I remember he couldn't download the data reported by the CPAP to the manufacturer's site.

So, after the holiday, I'm to call the vendor that sold/services the CPAP machine if there's something they can do to get the data and to get me another SD card.

Sigh...

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One another thing - I have chronic pain in shoulders, hips and lower back. I can also take NSAIDs for short durations because they mess up to GI tract.

Tylenol does nothing, naproxen works best and while I try to take that with meals, it causes problems.

As a test, 1 started trying 1/2 tablet and the deep sleep % nudged up a bit, so it appears better pain management is necessary.

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I’ve read that the sleep analysis by the fitness trackers is highly inaccurate. That’s a function of their limited range of inputs compared to a sleep lab.

Mayo has a Q&A entitled “Monitoring Sleep with Fitness Trackers” that should be helpful.

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@oldretiredguy

I’ve read that the sleep analysis by the fitness trackers is highly inaccurate. That’s a function of their limited range of inputs compared to a sleep lab.

Mayo has a Q&A entitled “Monitoring Sleep with Fitness Trackers” that should be helpful.

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Thanks @oldretiredguy (from another really old retired guy!), I thought I would share the link to the 2017 article you mentioned for those who haven't seen it.

Mayo Clinic Q and A: Monitoring sleep with fitness trackers
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-monitoring-sleep-with-fitness-trackers/

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@johnbishop

Thanks @oldretiredguy (from another really old retired guy!), I thought I would share the link to the 2017 article you mentioned for those who haven't seen it.

Mayo Clinic Q and A: Monitoring sleep with fitness trackers
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-monitoring-sleep-with-fitness-trackers/

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While not perhaps accurate and not medical grade, mine maps closely to when I have terrible nights and less bad nights. It also does pick up the effects of changes in environment and medications.

So while they are no substitute for a sleep study, they can be helpful. See:
https://www.hopkinsmedicine.org/health/wellness-and-prevention/do-sleep-trackers-really-work
I'm using mine to try med and environmental changes, but also provide some impetus for a sleep study.

But don't use them to replace a sleep study...

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@rjjacobsen

One another thing - I have chronic pain in shoulders, hips and lower back. I can also take NSAIDs for short durations because they mess up to GI tract.

Tylenol does nothing, naproxen works best and while I try to take that with meals, it causes problems.

As a test, 1 started trying 1/2 tablet and the deep sleep % nudged up a bit, so it appears better pain management is necessary.

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Update about the missing SD (memory) card from the ResMed Airsense 10 CPAP. I called the DME supplier and they told me to get a new card (they said in was fine to use my previous CPAP's card). It will ask to initialize the card, then it will write the machine's stored sleep data and send it to where the sleep tech can retrieve it.

Net, no past sleep data is lost and the sleep tech can now pull it, but it should be on the card as well.

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Your occasional AHI of greater than even 3, let alone 5, is affecting your sleep. Over at apneaboard.com, we routinely get people finding us every day and saying they feel exhausted, depressed, and are about to quit their therapy now six months along. We coach them to learn more about their condition, about the machine they've been given, even to the extent of learning that it's the wrong machine (!!) once we learn of the (redacted) diagnosis and prescription for therapy, and how the machine is not responding to their needs if it's set improperly. All these happen regularly across the medical system. If you ask me, it's a crying shame.
The main problem with affected sleep is interruptions. They cause arousals, which the best machines will duly detect and note. With the freeware software we have developed at apneaboard (it's all strictly voluntary, no paid staff, and we immediately cull ALL commercial links found in any posts by members), members can see much more information at their fingertips by inserting their machine's SD card into a reader an importing the night's data into the freeware, called OSCAR. I use it myself. I can see in digital form, and in analog/graphic form, my various events, what type they were, their duration, my tidal volume, my minute vent, the maximum pressure the machine used, and so on and so on... Once a person understands their prescription, and then their machine's settings and therapy type, it becomes obvious what is incorrect or needs refinement.
One data point is called 'arousal's. We become aroused when we begin to sense an impediment or a threat. When we stop breathing due to central apnea, or are prevented by obstructions, we become aroused. Each arousal, often several times each hour, interrupts the sleep pattern progression. With that fact in mind, it should easily be seen why people feel awful, unrested, and even cheated the next day, and why we begin to doubt the veridical nature of the instruments we are using, including the smart watches (I also have a Galaxy watch which I feel is close to what the OSCAR software tells me next day), and we even suspect the PAP machine itself!!!
You must...you simply MUST.,..get your AHI reliably, and consistently, below 3, or you will continue to suffer unduly. Or, you have the wrong therapy, or the wrong diagnosis. One of those three.

REPLY
@gloaming

Your occasional AHI of greater than even 3, let alone 5, is affecting your sleep. Over at apneaboard.com, we routinely get people finding us every day and saying they feel exhausted, depressed, and are about to quit their therapy now six months along. We coach them to learn more about their condition, about the machine they've been given, even to the extent of learning that it's the wrong machine (!!) once we learn of the (redacted) diagnosis and prescription for therapy, and how the machine is not responding to their needs if it's set improperly. All these happen regularly across the medical system. If you ask me, it's a crying shame.
The main problem with affected sleep is interruptions. They cause arousals, which the best machines will duly detect and note. With the freeware software we have developed at apneaboard (it's all strictly voluntary, no paid staff, and we immediately cull ALL commercial links found in any posts by members), members can see much more information at their fingertips by inserting their machine's SD card into a reader an importing the night's data into the freeware, called OSCAR. I use it myself. I can see in digital form, and in analog/graphic form, my various events, what type they were, their duration, my tidal volume, my minute vent, the maximum pressure the machine used, and so on and so on... Once a person understands their prescription, and then their machine's settings and therapy type, it becomes obvious what is incorrect or needs refinement.
One data point is called 'arousal's. We become aroused when we begin to sense an impediment or a threat. When we stop breathing due to central apnea, or are prevented by obstructions, we become aroused. Each arousal, often several times each hour, interrupts the sleep pattern progression. With that fact in mind, it should easily be seen why people feel awful, unrested, and even cheated the next day, and why we begin to doubt the veridical nature of the instruments we are using, including the smart watches (I also have a Galaxy watch which I feel is close to what the OSCAR software tells me next day), and we even suspect the PAP machine itself!!!
You must...you simply MUST.,..get your AHI reliably, and consistently, below 3, or you will continue to suffer unduly. Or, you have the wrong therapy, or the wrong diagnosis. One of those three.

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Hi @gloaming, Thanks for the great advice and the private message. The Apnea Board (https://www.apneaboard.com/) is where I first learned about the OSCAR software. Before the CPAP recall I was using OSCAR and importing the data from my SD card but my replacement CPAP is a ResMed AirMini which doesn't have an SD card. I know that the sleep medicine techs can access the data by connecting to the machine but it's not as easy as pulling out the SD card. I do like the AirMini CPAP and when I get a good nights sleep my AHI is usually between 0 and under 3. Lately due to other health conditions that affect my sleeping position, I move around a lot and have a lot of interrupted sleep times. That and after 4 years I'm still looking for the perfect full face mask. The ones that have worked the best have been the ResMed AirFit F20, the AirFit F30i and I'm currently using the Fisher Paykel Simplus full face mask. But I'm about to go back to seeing if I can live with the F30i mask again which will let the bridge of my nose heal 🙃

The biggest improvement I've made in my AHI numbers has come from finding relief from nasal congestion from a deviated septum and chronic rhinitis. My Mayo ENT started me on a proprietary nasal spray along with a daily nasal rinse morning and evening which did a good job of clearing up my breathing. Then I did the daily nasal rinse for a few months after which helped but was a pain. I traded the daily nasal rinse for a couple times a day using a SinuSonic device which does a good job at helping with the breathing at night.

If I ever get a settlement or replacement from Philips for my Dreamstation and Dreamstation Go for the recall, I may have to give OCSCAR another try. I got rid of both of the CPAPs after almost a year of waiting so now I have nothing to return to them for a replacement. I did recently receive an email from them requesting my prescription and doctor info for a replacement so I'm still hoping I will receive a new one.

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