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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@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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Thanks for your update.

Heading over to apneaboard shortly - I want to see what OSCAR has to say.

I can safely say my therapy isn't working - averaged 6.4 AHIs/hour last week.

I'm pushing for a sleep study ASAP.

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@johnbishop

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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Just some odds/ends here...

In Feb 2018, I came down with a sinus infection which went 8 months before diagnosis, then followed up with 6 months of antibiotic and surgery in May 2019 to open my sinuses. I had a nasal mask which didn't work at all (sleep depravation) and I finally got a full face mask in late August so that helped me breathe until the sinuses and nose got functional again.

Since then I've used OTC Fluticasone nasal spray whenever there's the slightest hint of congestion. I've played with humidification vs. sinus dryness - currently running the humidity at 4 and the tube temp at 75 - I had to raise the tube temp to prevent condensation in the tube.

I also use an AirFit F30i mask (also hard on the bridge of my nose) which has nasal pillows but also covers the mouth. That appears to work fine, but I also have to cinch it down fairly snugly (uncomfortably so) to keep it on at night due to movement.

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@rjjacobsen

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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I did as suggested, but after looking at the card's data using OSCAR, it only has the last 2 days data. The past data is gone - poof!

The DME supplier was obviously incorrect. Will recheck w/ them on Monday.

Meanwhile, I have two days worth of data viewable with OSCAR for my use in understanding it.

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@rjjacobsen

I did as suggested, but after looking at the card's data using OSCAR, it only has the last 2 days data. The past data is gone - poof!

The DME supplier was obviously incorrect. Will recheck w/ them on Monday.

Meanwhile, I have two days worth of data viewable with OSCAR for my use in understanding it.

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Update: my supplier was able to access the full data even though the card only had 2 days, I then passed this info on to sleep medicine for their analysis and am now awaiting results and recommendations.

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@rjjacobsen

Update: my supplier was able to access the full data even though the card only had 2 days, I then passed this info on to sleep medicine for their analysis and am now awaiting results and recommendations.

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Update: it appears the sleep med team bumped my pressure up from 8 to 9, which didn't help at all. AHIs so far for this month are all over 8, except one over 9 and one just over 5. I'll send them a message.

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@rjjacobsen

Update: it appears the sleep med team bumped my pressure up from 8 to 9, which didn't help at all. AHIs so far for this month are all over 8, except one over 9 and one just over 5. I'll send them a message.

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Looking at the CPAP data via OSCAR, it appears that my AHIs are fairly stable and reasonable (< 5) and then suddenly go crazy for a hour or so a couple times a night, and drop back down to "reasonable". OA events spike to mid 20s-30s during this time along with hyponea events. Flow rate oscillates wildly from - 80 to +110 during these times.

So, the averages look not so bad, but the details appear to tell a different story. This is looking at last night's data which was a better night.

REPLY

If there is any grouping of OSA in short intervals, it is almost certainly positional. It most often means supine sleeping with the pillow lifting the back of the head and forcing the chin toward the sternum. This closes up the airway somewhat and leads to either complete obstruction or to hypopnea and/or RERA (respiration effort relate arousals). We recommend using a suitable size of soft foam cervical collar that are widely available most anywhere medical supplies and medicines are sold.

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@gloaming

If there is any grouping of OSA in short intervals, it is almost certainly positional. It most often means supine sleeping with the pillow lifting the back of the head and forcing the chin toward the sternum. This closes up the airway somewhat and leads to either complete obstruction or to hypopnea and/or RERA (respiration effort relate arousals). We recommend using a suitable size of soft foam cervical collar that are widely available most anywhere medical supplies and medicines are sold.

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Thanks for the suggestion.

I have such a collar - I have disk degeneration in the cervical spine and found it unhelpful for that, but will try it at night. Will also try lowering my pillow height.

Thanks again.

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This is interesting and I can imagine that lack of enough of the right sleep could be detrimental to a persons good health. I’m involved with a cancer study thru Vanderbilt University Hsp in Nashville (I had surgery there in 2021 to remove a cancer growth) and I am waiting on a fitness tracker that they said they want me to wear for 12 weeks.

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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 had the same reaction when I couldn't find an SD card in my machine. I made an appointment with my sleep doctor (responding to a message from NORCO that said I should see my dr. & take the SD card.
I made the appt. and he was mystified, as my newer machine automatically sends the info so NO SD card required. CHECK your machine's name, Number, etc. against the website specs to see if one is really necessary and check with your sleep dr. to be sure you need an appt., etc.

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