How Many Hours of Sleep Do You Need?

My nifty sleep study revealed that I have moderate sleep apnea, which means I stop breathing between 15-30 times an hour while sleeping.
Publish date:
October 21, 2014
sleep, sleeping, Apnea, Sleep Apnea, Sleep Hygiene

Remember how way back in the day I did a sleep study? Yeah, me neither. Then I failed to update you all, because, let me tell you, the last few months have been bananas.

The short version of the story is this: My nifty sleep study revealed that I have moderate sleep apnea, which means I stop breathing between 15-30 times an hour while sleeping. Technically, I have an AHI of 29.5 -- which puts me very close to the threshold for severe apnea. If you're wondering, AHI stands for Apnea Hypopnea Index, which is a fancy way of saying "how may times your airway closes when you are trying to sleep."

Technically, people with moderate sleep apnea can approach treatment in several ways, including nasal rinses and trying to keep their nasal passages clear and wearing oral devices, but the gold standard of apnea treatment is continuous positive airway pressure (CPAP). The patient (me) wears a mask that delivers continuous pressure (hence the creative name) to the airway on both inhalation and exhalation -- when you breathe in, it helps you breathe, and when you breathe out, you push against the pressure, which keeps your airway open.

Before you can start CPAP therapy for realsies, they have you do a process called titration, for two reasons:

1) The actual amount of pressure needed is variable from patient to patient. You need to set the pressure on your machine appropriately so you'll be comfortable, which means that you need to sleep with a CPAP that will log data for a respiratory therapist to use. She'll write a prescription that will include the necessary pressure (or range, but more about that in a minute) and to program your machine.

2) Some people really hate CPAP. It just doesn't work for them -- they can't find a mask that fits, they don't like the sensation of being tethered to the equipment with tubing, it makes them feel uncomfortable, they don't like the pressure, they have a tough time with the (negligible -- new equipment is much better) noise, whatever. Titration lets you see if CPAP is for you before you pay for a potentially expensive piece of medical equipment, or beat your insurance company up for it. (FUN FACT: Obamacare does not cover durable medical equipment, including CPAP devices.)

The cool thing about modern CPAP is that you don't have to start out at max pressure, which is actually pretty uncomfortable as you are going to sleep. Instead, you can set a machine to automatically increase pressure as you sleep, doing what's called "ramping," so that you can go to sleep with light pressure and then breathe comfortably through the night. Thus, respiratory therapists send you home with an auto-CPAP that will adjust with you as you sleep, and then they pop out the memory card (this stuff is high tech, people) to read the data from the study.

So and thus, I did my titration study, where I took the device home for about four weeks, slept with it, and discovered that I actually took really well to CPAP (this was confirmed with my data, which showed minimal leakage around my mask, as well as a radical drop in my AHI), and that I didn't have any trouble adjusting to it. Basically, I was a good candidate for CPAP therapy.

So my respiratory therapist wrote me a prescription, and we talked about all those exciting things like maintaining the equipment, using a humidifier (which keeps your nasal passages more comfortable when you're using CPAP in the long term), and so forth. (In case you're wondering, masks and tubing get replaced about every six months, and are washed out with mild soap one to two times a week. Masks and tubing can be quite expensive, depending on your source and the type.)

One of the most interesting things in our conversation was the discussion about how much sleep I needed, now that I was on CPAP and wasn't exhausted all the time. This is actually a subject of recent speculation and debate, because the ideal number of hours, the sleep number, if you will, is seven.

While it can vary from person to person, the range generally falls between six and eight hours. Sleeping too little can expose people to a variety of health risks, but sleeping too much can also cause problems like cardiovascular issues down the line, which is why it's so important to hit a healthy sleep range and stay consistent -- and to get treated for sleep disorders.

Notably, the number of hours of sleep people need also depends on age. You know how newborn babies sleep all the time? That's because they're supposed to sleep around 18 hours a day. Ever been frustrated by a toddler meltdown? Pre-preschool-aged children should sleep around 10 to 12 hours. Kids in school should get ten hours, and those lazy teenagers aren't so lazy after all -- they're healthiest when they get nine to ten hours of sleep every night, unlike adults, who need even less sleep.

My respiratory therapist noted that in addition to shooting for around seven hours, I should also practice good sleep hygiene, which is something I already knew from my insomniac days. While the term always makes me crack up, imagining some sort of prim Victorian pamphlet, the advice actually makes sense: Save the bedroom for sleep and, er, bedroom activities, keep the temperature a little lower in the bedroom than elsewhere, use curtains or blinds to keep light out when you're sleeping, and try to keep a consistent sleep schedule. No computers or other screens in the bedroom, and no phones (I still have trouble with this one).

Being on CPAP, I've noticed an almost immediate difference. I sleep through the night, I sleep a more reasonable number of hours, I don't feel tired during the daytime, and I'm generally a happier person.

Yes, I'll be living with CPAP for life, and some people seem to think it's a high or irritating price to pay, but I think it's totally worth it, because a good night's sleep is pretty core to your general health.

And before you ask, yes, I captured a video of me wearing my Vader Mask, as I affectionately call it:

For those of you who have asked about my Vader mask... #cpap

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