Adventures in RBD and Complex Sleep Apnea

I have REM sleep behavior disorder (RBD) and central sleep apnea. If I don’t sleep inclined on a wedge pillow, I also have mild obstructive sleep apnea. I told my neurologist about the fact that OG Kush and Blue Dream marijuana (mj) seems to eliminate all of my obvious symptoms, but I still count apnea events every night using a datalogging SpO2 device and I am probably not getting enough REM sleep as is common with daily marijuana users. Under the care of a sleep specialist, I have probably tried all of the various CPAP and BIPAP settings and masks. Unfortunately, I get stomach bloating and I don’t expect that such machines will work for me. The doctor said to discontinue mj a week before the latest sleep study and stay off of it until the sleep study ends. A couple days after the study, an assistant called to say “Congratulations! You no longer have obstructive sleep apnea. Please make an appointment with the doctor in a year and let us know if you have RBD events.” I was shocked that the doctor seemed to be relying on me to smoke mj despite the fact that I am missing REM sleep and still have apnea events. So I asked the assistant to ensure that the doctor is aware that I am smoking mj and will definitely have REM episodes if I don’t. I expected to hear something, but no word from the doctor. So I called back with additional questions on Monday. Still nothing. I was diagnosed a couple years ago and have been reading this and that. I’m a retired mechanical engineer, so this area of study is new to me. My body of knowledge now makes me think that, if the doctor really just wants me to ‘carry on’, I should probably be getting much more of the CBD and some, but not much, THC. Perhaps some additional mj terpenes would be good, but I understand that this area of collective knowledge is still immature. I read that epileptics may use 300mg of CBD daily. Folks apparently get relief from pain with about 25mg/day, but I’m not in pain. I would guess that neurological maladies (central sleep apnea events) probably require more than a couple mgs/day. My greatest hope is that mj would be curative, but simply minimizing apnea and RBD events while avoiding unwanted long-term damage to my cognitive function or other bad stuff is valuable, of course. If I would benefit from a massive dose, I would want to avoid smoking my brains out. Presently, I smoke a piece of mj about the size of a paper match head an hour or so before bedtime. That tiny amount is entirely effective in avoiding RBD and eliminates the chance that obstructive apena events occur if I slip off my wedge pillow, which rarely happens. I’m thinking that I may need to score CBD oil by the gallon or something. But maybe I could just look for a mj strain with much more CBD. One more thing… I just bought the latest FitBit, which includes a sleep report. It indicates that I am getting ~ 11% REM sleep. So maybe the fact that I use so little mj is the reason I may actually be okay with respect to REM. Certainly, there is not much, presently, in the collective body of knowledge about mj to go on, but if anyone has thoughts, they would be appreciated.

Is there some other way than smoking that you could get your dose of cannabis? There are so many negatives associated with smoking anything for whatever length of time per session. Can you, for example, eat the amount that you need? I’m so glad, though, that the cannabis has seemed to help you. I would keep the dose small, as you are now doing, as this appears to be effective for you. Your apnea is mild. If your study now shows that your apnea level is normal, as you reported, then I just wouldn’t worry about the apnea anymore. You have enough “other” on your plate.

Thanks! I’ve been researching the many ways that cannabis is being processed and read about many strains. It’s a little overwhelming, actually. One issue is cost. If I don’t need a massive dose of CBD, smoking is certainly the least costly. But I do think that smoking it is undesirable, otherwise.

Update: A couple of months have gone by and I found that two 15mg CBD gelcaps worked well, but REM sleep was a little low. (~12% REM sleep as reported on my FitBit which I hope is reasonably accurate.) Deep sleep was very good. Now I inhale one puff of a mj strain called ACDC (0.12% THC and 16.61% CBD) and my REM averages, maybe, 20% and my deep sleep is very good, too. One night, I added a tiny bit of a strain called Northern Lights. My REM was okay at 16% and my Deep sleep was 16% (abnormally high). My SpO2 data surprised me: My SpO2-derived apnea index was just 3.4, but I had suffered four extreme events, one after the other rather early in the night. I must have been sleeping deeply, because my SpO2 alarm didn’t wake me. I would, therefore, suggest that people avoid Northern Lights if they have issues similar to my own. On occasion, I inhale <one puff of OG Kush or Blue Dream recreation-ally well before bed time with no adverse effects.

Perhaps my physiology is changing. Assuming my FitBit is accurate, I no longer get good REM using MJ so I only enjoy it one a month or so recreationally rather than try to use it to improve REM. My doctor had me stop the MJ and try Clonazepam, but I very rarely have RBD and the FitBit did not indicate an improvement in REM. At this point, I just get good exercise, avoid alcohol, and try to follow ‘good sleep hygiene’.