Saturday, October 30, 2021

Binaural beats and deep sleep

My last blog bemoaned my lack of deep sleep (according to the CPAP machine who I tend to believe more than the 'smart' watch that reported on a far larger quantity) and suggested that a method of improving the amount would be with binaural beats, described thus "an illusion created by the brain when you listen to two tones with slightly different frequencies at the same time. Your brain interprets the two tones as a beat of its own. The two tones align with your brain waves to produce a beat with a different frequency. This frequency is the difference in hertz (Hz) between the frequencies of the two tones. When you listen to binaural beats, your brain activity matches the frequency set by the frequency of the beat. This is called the frequency-following effect. This means you can use binaural beats to entrain your mind to reach a certain mental state." One has to listen via headphones - this is mentioned elsewhere. Also the sounds themselves have to be less than 1 KHz, a frequency that might seem limiting but it's actually a shade less than two octaves above middle C (256 Hz) and so should cover most musical sounds.

I know that alpha waves help one relax, focus and reduce stress. A hot shower causes the brain to start pumping out the alpha waves, which is why I get many good ideas whilst showering (I had another one last night). Theanine also increases the number of alpha waves. These waves have a frequency of 8-14 Hz, so listening to binaural beats with a difference of the above (barely noticeable) should increase the number of alpha waves.

At the moment, I'm more interested in increasing the number of delta waves: these have a frequency of 1-4 Hz, almost nothing. Delta waves are supposed to be connected to deep sleep, meditation and anti-aging, amongst other things.

A quick search on YouTube for binaural beats brought up several candidates (I hesitate to call them music): I downloaded two. The first lasts for 5 hours (!) that is intended to increase serotonin and dopamine levels in the brain, leading to happiness, calming the mind and improving sleep quality. The other is 'only' two hours long and claims to improve concentration and studying. I listened to this one for a few hours (through headphones, of course) whilst working and it certainly seemed to be calming. There weren't any musical aspects for my analytical mind to latch on to, so I could simply let the sound flow and do its job. After writing this, I note that neither description of these two mentions brain waves, especially not delta waves. 

After downloading the pieces, the next step to consider was how am I going to listen to them. One possibility would be using my good mp3 player, but as I want the pieces to repeat should the need arise (after all, together they last over seven hours which is about the amount I sleep each night), I need a dedicated mp3 player holding just these two pieces. After rooting about a bit with all my spare parts, I realised that I could use one of the mp3 players that I bought for swimming. I decided to use the second swimming mp3 player that I bought as this is easier to load and charge; one connects a regular 3.5 mm jack to it so I could use any type of wired headphones. Later on, I realised that I could also use my mobile phone as an mp3 player but the swimming player seemed to be sufficient.

For the first night (Tuesday) I used the earbud headphones that came with my mobile phone, but after a few hours I had to stop the experiment as these earbuds were causing a great deal of pain. I normally sleep turned to the right (this is healthier) and as a result, I was pressing on the earbud in my right ear. I also had to reduce the volume of the mp3 player, something that is easier to say than do (the controls are very limited and confusing). 

The next day I decided to order the simplest pair of headphones that I could find: hopefully these will be ok. These would be held in place by the CPAP mask. It seems that all the headphones on sale here are gaming headphones with a microphone and thus unsuitable. What to do in the mean time? It occurred to me that I could try the headphones that come with the swimming mp3 player. These hook over the ear (I always had difficulty putting them on when going swimming, but now it seems easy) and the ear buds are flexible, as opposed to the hard earbuds of the first set that I tried. I used these on Wednesday night; not only did they cause me no pain, I also woke up in the morning feeling that I had had a good night's sleep (even though I still had to get up a few times during the night).

Thursday night was not good for experimental results as my nose was blocked for most of the night. I had to get up four or five times during the night, which culminated in walking around the flat at 2:30 am, trying to clear my nose. Yesterday I bought some nose drops from a pharmacy that helped immediately, although they don't have much effect on the cause of the blocked nose. Last night was much better in terms of sleep quality; I also awoke an hour earlier than I intended but still feeling refreshed.

Enough with the theory; what do the data show? As I have noted before, for some reason the CPAP machine provides data up to two days ago, so I only have readings for the first two nights of the binaural beats experiment. To set a base line, on Sunday and Monday I had one and two minutes deep sleep respectively. On Tuesday, even with the hard earbuds that were taken out at 11:30 pm, I had 19 minutes deep sleep - this is one of the highest amounts that I've had since I started recording deep sleep (1st September). On Wednesday, what seemed to be a good night, I had ... (drum roll) 33 minutes deep sleep! On 27 September, I had 34 minutes, so I still haven't broken my own record, but the increase over the past two days is dramatic. 

Even so, there have been pairs of days with a similar increase followed by a decrease: on 15-16 October (only two weeks ago), the readings were 25 and 12, preceded by 2, 4 and 1, and followed by three days of apparently no deep sleep whatsoever. Then on 20-21 October, the readings were 11 and 21, followed by another five days of almost no deep sleep. So I can't conclude yet that listening to the binaural beats has caused a continued improvement in the amount of deep sleep; I'll need another week of readings to make it conclusive.

Tuesday, October 26, 2021

My blood pressure is balanced!

I last reported on my blood pressure twelve days ago. Since then I've had family doctor and nephrologist appointments. In both cases, we went over the blood pressure readings along with the sleep apnea data, and in both cases we reached the conclusion that my current medication regime is both balancing my blood pressure and also reducing the number of apneic events per hour to a minimum. I'm not cured, but I'm definitely balanced!

With regard to the beta blockers that I mentioned last time, the family doctor agreed with my compromise of a half a tablet in the mornings. There exists a 'version' of the medication with half the amount of active ingredient, so I was prescribed this version instead of the original tablets, meaning that I no longer have to cut these pills in half. They are very small anyway, and half a pill is like a sliver that is easy to miss; I'm pleased that I have larger - albeit still small - pills to swallow.

I hinted that the nephrologist wouldn't have prescribed one of the blood pressure medications, but this time the subject didn't come up. It was clear that the current regime works, and if there are no problems caused by the various medications (e.g. changes in the blood tests) then it should stay as it is with no changes.

I am still occupied with potassium levels in foods. These days there are all kinds of vegan versions of food (there was an item about this on the news last night), but no one talks about potassium levels. There is more potassium in soy 'milk' than cow's milk. There is no information on the internet about proprietary prepared foods, only for raw materials. Although I make maybe 80% of my food intake from raw, unprocessed, materials, it would be nice to know about these innovative goods.

Hopefully this will be my last post on blood pressure for the time being.

The only topic that still needs to be addressed is the amount of deep sleep that I get every night. This is still in the range 0-15 minutes, an amount that I imagine is insufficient. I have an appointment with a new sleep doctor at the beginning of December; it will be interesting to hear what she says. According to the website that deciphers the data from my CPAP machine, The deep sleep indicator marks the time you spend in deep sleep – an especially restorative sleep phase. During deep sleep, breathing is more even than in all other sleeping/awake phases. The new prisma RECOVER algorithm on your therapy device continuously evaluates the respiratory pattern and calculates the duration of deep sleep from the evenness and quietness of your nocturnal breathing. 

A quick Google search brought up this site with ten tips on how to increase the amount of deep sleep, and I've been doing nine out of the ten tips for years. The odd man out is 'doze off to binaural beats'; normally listening to music keeps me awake as I'm interested in the music, but I'll see what I can do about this. Of course, it doesn't help that I get up between two and four times a night due to nocturia that is probably due to the diuretic effect of at least one of my medications.

Monday, October 25, 2021

Blind date (new song)

I was sitting in the waiting area of an X-ray facility (not for me!) about a month ago when a new song popped into my mind. It was in 5/4 time with a fairly simple chord sequence although with a slightly tricky tune. A few days later I started sequencing the song: as I had 'written' it away from any instrument, the song was very regular, so I had to introduce irregularities such as slightly changing the tune - the first four bars and the second four bars had the same tune, so I had the second phrase 'go up' whenever the first phrase 'went down'. Later on I changed the chord sequence so that each verse had its own peculiarities.

Normally I maintain one midi file for a song, changing it as necessary. Sometimes I make a backup copy when I'm about to make a significant change so I can revert to the previous version if I don't like the change, but this time I decided to keep a new version of the midi file as it was at the end of each day's work so that I could trace the path of changes from day to day. Of course, I haven't referred to any of those files, but fortunately a midi file doesn't take up much disk space.

After a few weeks' work, the arrangement was as close to complete as I could make it. All that was missing - as usual - were the words. I didn't really have the time or mental space to write words for a while, but one day last week on a long walk with the dog, I came up with some ideas about a blind date. At the end of last week, I wrote the words, getting out of bed at 11 pm on Thursday night to change a couplet (with the immortal line 'a wilted lettuce leaf' replacing whatever was there before). 

On Friday I tried to record the vocals. The range of the song is from A below middle C to A above middle C - one octave - which normally would give me no problems, but on Friday I had a 'frog in my throat' that prevented me from singing the low notes. After many abortive attempts at singing the song, I had a break and considered my options. In the end, I raised the song up a tone (so easy to do with midi) and found that it was now much easier to sing. 

A 5/4 rhythm usually requires very precise phrasing; the lyrics needed the odd syllable to be pruned in order to make the song singable, but by the time of the key change, I had the phrasing almost completely fixed in my mind. That said, I introduced a little syncopation in the tune that hadn't been there before (this song normally has four syllables in a bar, where the first syllable is on the first beat, the second syllable on the 'and' of the second beat, the third syllable on the fourth beat and the fourth on the fifth beat, or in musical speak, two dotted crotchets followed by two crotchets) - I delayed the third syllable by a quaver.

Then comes the part that is for me the hardest - finding the correct equalisation and volume levels for my vocal track. For the last few songs, I've kept a template file with all the settings, making this part less difficult than it was before. Even so, today I decided that the vocal was too shrill, so I toned it down a little.

The idea for the song came from something that I was reading about mirror neurons and how people signal their feelings, or rather how person #1 can read what person #2 is feeling by looking in person #2's eyes. I think that I'm not very good at reading other people's expressions; I asked my wife whether my face betrays emotions and she says that for most of the time I keep a poker face. The idea of the blind date was supposed to have the protagonist failing to read his date's expressions, but in a sense, I ran out of space to write about this. The third and final verse reads

By the evening’s end, I am unsure of what to do
Share a taxi cab or make my farewells, say adieu?
What were the signals I was sending, tell me what they mean
Will she find me worthy of her time and will she
Want to see me again?

That condensed the entire almost autistic inability to read expressions into one verse, which was not my original intention.

Listening to the song now, there seems to be a mis-match between the music and words (not in musical terms) that is not too surprising as I have been listening to the music for a month whereas I have been listening to the words for only a few days. That said, the words are sounding more integrated with the tune now.

Nearly always it happens that I am very impressed with just an instrumental arrangement but become deflated after I listen to the recording with vocals. This song was no exception......

Thursday, October 14, 2021

Potassium levels in blood

It's been four weeks since I started taking the potassium-sparing drug spironolactone; it's also been four weeks since I stopped drinking milk as well as not eating potassium rich foods. Today I did yet another blood test to see how my body is reacting to the medication and how my diet is faring.

My potassium level is 4.8 mEq/l, which is comfortably below the recommended maximum level of 5.1 mEq/l. Last month the value was 3.9 mEq/l, but before that it was 4.9 mEq/l. I've had my blood tested for potassium nine times so far this year, and the values have varied from 3.8 to 4.9. My conclusion is that I should keep on with my low potassium diet for at least another month.

So what have I been eating? Chicken has less potassium than fish, so I've been cooking the 'chicken and rice in a pot' dish every week. For breakfast I've been eating an omelette (eggs don't have much potassium) with grated cheese (even less potassium). In the evenings, apart from salad (cucumber along with red and yellow bell peppers, no potassium rich tomatoes) and tuna (canned tuna is apparently potassium deficient), I've been eating some peculiar vegan deserts.

The desert pictured on the left would appear to be a typical chocolate flavoured mousse. But it's vegan and in fact it's made from sesame (in Hebrew, sumsum, that explains the name 'soom')! I caught a whiff of sesame (a taste that I generally don't like) when I opened the container, but afterwards it was like eating a regular chocolate desert. The funny thing is that both my wife and my daughter thought that it tasted terrible! Maybe there are advantages in being almost anosmic.

A second desert that I tried but liked less is a bizarre concoction based on oats. I bought two based on blueberries and two based on apples; so far I've only tried the first, and its taste is somewhat peculiar. Most of the taste is fine but there is an intruding note that I can't describe. This is definitely edible but less enjoyable than the chocolate sesame. I'm not going to try the banana based version as this probably has got a higher level of potassium.

As I have discovered very quickly, there is no legislative requirement to print potassium levels on foods so no one does. Thus I don't know whether non-dairy ice cream is better than dairy ice cream, or even how much potassium is in the two above products. 

I used to say that I was a 'milkaholic'; I would drink more than the usual daily amount, and like an alcoholic, I would say that the first drink slides down so easily that another one is immediately called for. I quit the milk without any problems, although occasionally I find myself eyeing the milk cartons in the fridge. To be honest, I had two cups of tea with milk today: I didn't find the taste particularly enticing so it looks like I can stay 'on the wagon' with few problems.

I've also been playing around with the beta blocker medication. After a week of not taking it at all and seeing the number of apneic incidents reduce but the blood pressure slowly rise, I then had a week of taking the medication in the morning. The apnea did not increase (good) and the blood pressure went down again, but there were a few days that I felt completely washed out at 9 am. My compromise was to take half a tablet in the morning: this seems to be the best solution as the blood pressure is good, even in the afternoon, there are few apnea and I don't seem to be tired.

I have yet another doctor's appointment on Sunday. Theoretically I should also make an appointment to see the nephrologist; I like him personally and he has also done a lot for me, but now he seems not to be in agreement with the family doctor.


Friday, October 08, 2021

DBA: Pilot study 2

I see that I last wrote on this topic a month ago. After a flurry of activity, nothing happened during the rest of September due to the many holidays. Things picked up again at the beginning of October, and a few days ago I interviewed the CEO. As I wrote in my thesis, the objectives of the pilot study are:

  • to verify that the methodology used is that of Action Research;
  • to determine the questions to be asked in the interviews or written responses;
  • to determine how much time is needed for an interview;
  • to determine how much time is needed to transcribe an interview and possibly translate it into English;
  • to determine how much time is needed to analyse the interviews;
  • to determine whether there are problems in the collection of collateral material (primarily emails) and to overcome any that arise.

Whilst the pilot study has only just started, I have answers for at least the third and fourth points listed above. The interview with the CEO lasted 17 minutes, the last two minutes of which were not really connected to the topic. It didn't help that several of the answers were "I don't remember", but one must remember that the purpose of the interviews is not so much to glean data about the enhancement being discussed but rather to check the methodology. 

Does anyone want to guess how long it has taken to transcribe an interview of 15 minutes? So far I have got 10 minutes into the interview and it has taken me ... 105 minutes! A factor of about 9-10 minutes transcription per minute of interview! I am seriously considering contracting the transcription out to a service that specialises in this. I wonder how much transcription services cost - of course, Friday night is not the time to reach out to Israeli companies. No one publishes their prices on their sites.

I want to conduct two more interviews in the coming week and maybe two more in the week after. I can't say that I conducted a pilot study consisting of one interview.

Tuesday, October 05, 2021

Continuing the BP saga

About two weeks ago, I noticed that I was often tired during the day. When I looked at the data from the CPAP machine, I could see that the number of apneic events had increased from one to two an hour (an acceptable level) to twenty or more. No wonder I was feeling tired. Then I started researching whether any of my medications could influence sleep apnea, and it turns out that beta blockers might well do this.

As it happens, I had run out of beta blocker pills, so I decided to try a few days (or more) without these pills. The number of apneic events dropped dramatically (good),but my blood pressure and pulse slowly increased. Which is better, preventing apnea or lowering bp? No doubt they are both connected.

I had an appointment on Sunday with my family doctor (booked a few weeks ago) that gave us the chance to go over the detailed sleep and blood pressure logs (like a good student, I prepared all the data beforehand). We decided that the next step in my on-going experiment with medication would be to restore taking the beta blockers, but to take them in the morning and not in the late afternoon. So far, there have only been two days with this new regime; the blood pressure and pulse have dropped to good levels. There's a problem with the CPAP machine such that I can only get data until two days previously, so I still haven't seen how my sleep has been affected. I'll know tomorrow about the first day.

Another development is that my weight has been dropping steadily albeit slowly. On Yom Kippur I probably shed a fair amount of water, but even since then I've lost about half a kilo. This is probably due to my new diet (no milk) although it may also be due to the new medication for aldosterone; I can't see that this medication has had any affect on my blood pressure, but some nights it definitely works as an diuretic. For the last few nights I've been waking four times a night to go to the toilet, meaning that I am definitely losing liquid (and hopefully weight) but this is also ruining my sleep.

Maybe it's just as well that I no longer drink milk or flavoured milk products as there has been a shortage in Israel for the past few weeks. I've nearly run out of rice milk (a poor substitute) so I've been drinking more herbal tea in the past few days. Hopefully 'our' supermarket in Bet Shemesh will have some rice milk as there's none on the kibbutz. Soya or almond milks have more potassium than 'real' milk so these aren't an option.

In another two weeks I'll do yet another blood test to see how the new medication combined with changes in diet have affected my blood potassium level. Will it have gone up? Gone up seriously? Will I have been too strict with myself and now the level has gone down??