Dreading bedtime on night 4 of CPAP

[robysue]

First two nights went pretty well all things considered.

Night three was a disaster. First, I could not relax at all and since it has been taking me between 1 1/2 to 2 hours to fall asleep with the CPAP on, I decided that I'd not go to bed until I was good and sleepy. At 1 AM I was wide awake and dreading bedtime. I didn't start to feel sleepy until after 3AM. And when I finally went to bed a bit after 3, within five minutes, the mask got caught in my hair, the hose got in my way of getting comfy, and I needed to talk to my husband. The result was that within 5 or 10 minutes of getting into my bed, I was WIDE AWAKE, and quite simply I completely lost it and threw (yes THREW) the mask across the room towards the CPAP machine and screamed at my husband that I hated the machine. I was an emotional basket-case and it took my husband almost a full hour to settle me down. At one point, he even suggested simply not using it for one night so that both he and I could get some sleep since it was pushing 4 am. Sometime around 4 am, I was able to put the mask back on and with the help of my husband curling around me and hugging me tightly, I was finally able to drop off to sleep around 5 am. Slept until about 10AM, but did wake up twice with bad dreams: Once I dreamed I was dying of CO2 poisoning because my exhaust vent was blocked or there had been a power outage, I can't remember. At any rate, once I was awake, it was clear that the power had not gone off and my exhaust vent was not blocked by anything. In the second dream I was a human goose being fattened up for foie gras. Only instead of forced feeding, I was being subjected to forced breathing---in the dream I felt my lungs being forced to take in more and more air that they had no room for. It was really creepy.

At any rate, here it is my normal bedtime for Sunday night and I'm wide awake with dread. I put all the equipment together about 2 hours ago, but I still know that as soon as I put the mask on and turn on the CPAP machine on, I'll once again be tossing and turning for close to two hours before finally drifting off into a not very relaxing sleep. And I'm worried that I'll have more really weird and troubling dreams that wake me up agian. And so right now, I simply can't seem to relax enough to even try going to bed, even though I'm physically tired and have to get up for work by 7 or 7:30 at the latest.

I'm not really looking for tips on what to do differently. I've got bunches from this forum already as well as my husband. I just need to rant a bit and also ask if there's anybody else who is having really weird breathing-related dreams now that they're using CPAP because the goose dream has left me feeling like I'm a freak all day. I've had daytime sleepiness today really, really bad---and I hardly ever felt sleepy during the day before I started using the CPAP machine. And I never, ever had any breathing related dreams before starting CPAP and while my husband reported that I would stop breathing while asleep, I never, ever remember waking up with a sense of not being able to breathe or a sense of drowning.

[DreamDiver]

Many of us have been where you are and can sympathize.

Dreaming weirdness is normal. Your brain is making new connections to accommodate the fact that you might actually be allowed to fall asleep now. You're relearning how to sleep. That's no small feat, but there are a lot of us here as proof it can be done.

If you can't breathe for real, make sure your pressure isn't set too low.

Feel free to vent any time. We're listening.

[Breathe Jimbo]

I know we should shy away from meds with sedative properties because of possible effects on our upper airway, but sometimes we just need to do what it takes to get to sleep, and then trust the machine to deal with any events.

[Slartybartfast]

Wow. Your hubby's a better man than I am. Hang on to him.

Sounds like you really need to discuss this with your sleep doc. CPAP shouldn't be that bad.

I had dreams of drowning, suffocating, etc., before getting on CPAP. Now, nothing but blissful sleep, usually commencing withing 5-10 minutes of lights out. Everyone's different. You may have other things going on that are keeping you from dropping off to sleep. I suspect that your pressure is set wrong, leading to the feeling of being a force-fed goose.

[Breathe Jimbo]

Don't watch Criminal Minds right before retiring to bed. I made that mistake and woke up to a nightmare with myself and my wife in crime scene photos, etc. No need to get too graphic. Best to calm down before going to bed. Have you ever tried deep breathing, progressive relaxation exercises?

[jweeks]

Robysue,

I can assure you that you will not suffocate if the power goes out. There is an anti-suffocation valve in your mask. The pressure from the machine holds it closed. If the power goes out, or the machine breaks, or the hose becomes disconnected, the valve will open allowing you to breathe outside air.

Is there any way that you can take a few days of medical leave? I think you are putting yourself under pressure, and getting used to the CPAP machine is something that is going to take a bit of time to adapt to. For example, if you are not tired at 1 AM, yet have to be up at 7 AM, that doesn't leave a lot of time for sleep. Before I had my machine, I'd catch some many small catnaps during the daytime that I would be wide awake at bedtime. Then I'd sleep so badly that I'd be tired when I woke up. That becomes a vicious circle that reinforces itself. I had to break that circle and basically learn how to sleep all over again. You might be in a similar boat. My thought that it might take the pressure off of your if you had a week or so where you could simply go to bed when you were tired and wake up when you felt like waking up.

Before I had my machine, I rarely got any REM sleep. Once I started sleeping, it felt like my body was trying to catch up on a 5 year backlog of missed dreams. I had all kinds of weird and interesting dreams. I only had one that disturbed me, but a number where I was doing things that seem out of character for me. I wonder if you are doing something similar and having some really vivid dreams that are much more memorable to you since you might not have dreamed much in the past few years.

-john-

[Mimmie]

Hang in there and stick with it. It does get better. It took me about 2 weeks to adjust and now I can not even think about going to sleep with my snuffle. I had a horrible time with it, couldn't keep the mask on and all sorts of other problems with the hose. I set the alarm to go off if I removed the mask during sleep and I got a hose cover so it's all soft and fuzzy and doesn't wake me if it lays on me. It does work out and now it's just a part of sleep for me.

[Tired Linda]

I'm not really looking for tips on what to do differently.

Vent away... but I feel I would be remiss if I didn't suggest practicing with your mask may help. This treatment really is a lot of "mind over matter." Pick a time when you can relax during the day, or after work or dinner, but before bedtime. Put on your mask and watch tv, read a book, anything to help keep your mind occupied while you're getting used to having the mask on and air blowing in your face. Start out with 15 minutes at a time if you have to, and work your way up.

This worked out well for me, because I knew if I waited until the last minute before bed, I would have been freaked out when it was time to turn out the lights.

Hang in there, it really does get better.

L

[elena88]

HI Robysue,

wow, deja vu..... sounds exactly like what happened to me, but on night three, I think I packed up the machine.. so you are doing better
than I did..

I would put the nose pillows on and sit there in bed for two or three hours staring at the ceiling feeling like I was getting stuffed up too, it
was sheer torture.. and actually the only way I got thru it was to pretend I was being tortured..

I was sidney bristo double agent spy, caught by the bad guys, and they were using this apap machine to torture me to see if I would rat out
information on my spy buddies.. I was tough, and I didnt crack!

My husband had to rub my back, I was a basket case... for days, then weeks, and about six weeks in, I was getting such crappy sleep, I was
a walking bitch zombie from apap hell... I probably should have been put out of my misery then, but these kind folks talked me out of it..
Anyway, thats the only way I got thru it.. and also, I learned not to go to bed, and not to put the mask on until I my eyes were ready close..
I never yawned much before apap, but after a few months, I started yawning.. so now i got to bed, but I dont put the mask on then.. I watch
tv until I feel like sleep maybe coming in the next half hour, then I put the mask on..
You may not be one of those duck to water people, I wasnt.. so get ready for the ring of fire to continue.. but you can get thru it.. It might
take weeks, or months.. but youll come out the other end.. sooner than later I hope.. dont give up!
However, if you need to take a break one night, to regain your sanity do that.. because you can literally almost lose your mind if you are getting
really disturbed apap sleep for weeks on end.. its not going to kill you to miss a night, no matter what anyone else says.. and it could end up
helping you get thru this ring of fire so you can save your life with the treatment.. baby steps.. do what you can, practice a little bit at a time..
its okay to go backwards a little bit and slow down till you feel comfortable.. your brain is going to try to make sense of this intrusion any way it
can, so yes, the nightmares are beginning.. I had them too.... but at least I was dreaming again! And the good news is, so are you..

[jdm2857]

As Jimbo said, if you can't fall asleep in time to get up for work, consider using a sleep aid for a transition period. But don't go the OTC route. Over the counter sleep aids contain diphenhydramine, an antihistamine, and are disruptive to the normal stages of sleep.

A prescription for Ambien is a better choice.

[jdm2857]

And if you do use Ambien, take it only after everything is set and you are about to mask up. That stuff knocks me out very quickly.

[robysue]

If you can't breathe for real, make sure your pressure isn't set too low.

Already figured this one out. During my ramp up period at the start, I felt like I couldn't breath very well. So I've been slowly but surely increasing the starting ramp pressure. But at my full pressure, this isn't a problem. At full pressure, I've got the opposite problem: I feel like a force-fed goose with air being forced down my throat in amounts that my lungs just can't handle.

I know we should shy away from meds with sedative properties because of possible effects on our upper airway, but sometimes we just need to do what it takes to get to sleep, and then trust the machine to deal with any events.

Family history has lots and lots of near relatives reacting very badly to sedatives. So I really don't want to do this.

Wow. Your hubby's a better man than I am. Hang on to him.

Yep, he's a great guy, we've been married 26 years, and I intend to hang onto him.

Sounds like you really need to discuss this with your sleep doc. CPAP shouldn't be that bad.

My hubby told me this last night around 3:30 or 3:45 AM. I poo-poo'd him at the time. Maybe I shouldn't have. So maybe I'll listen to both him and slartybartfest after all and talk to my sleep doc after all.

Don't watch Criminal Minds right before retiring to bed. I made that mistake and woke up to a nightmare with myself and my wife in crime scene photos, etc. No need to get too graphic. Best to calm down before going to bed. Have you ever tried deep breathing, progressive relaxation exercises?

I know I'm super-sensitive to what I watch on the tv shortly before bed. I kicked my husband's beloved tv out of our bedroom many years ago because the things he watched before falling asleep were contributing to both insomnia and nightmares for me. Fortunately for me, hubby chose to sleep with me instead of the tv in the living room.

As for the deep, focused, breathing: I really miss being able to do this in bed. Before CPAP I would often do this *in bed* whenever insomnia started to raise it's ugly little head. And it worked like a charm; even if I couldn't fall asleep right away, it would clear stress-based thoughts out of my head and I would get some quality downtime and would feel pretty rested the next morning. But now with the CPAP if I try to breath deeply through my nose, I get a mouth full of air and feel like the force-fed goose. So maybe what I need to do is kick everybody out of the living room an hour or so before my bedtime so I can do some yoga and deep breathing there. I'll try it tonight since I'm the only one still awake.

I can assure you that you will not suffocate if the power goes out. There is an anti-suffocation valve in your mask. The pressure from the machine holds it closed. If the power goes out, or the machine breaks, or the hose becomes disconnected, the valve will open allowing you to breathe outside air.

Yes, I mentally know this fact. Just like I know the crack in the ceiling above my bed is a simple surface crack in the plaster that has not changed an inch in the 13 years we've been in the house. But in that sleep deprived state of insomnia, facts go bye-bye out the window and so I just know the house is going to fall down (because that crack's going to open up) and if the power goes off, I'll suffocate. Trying to be rational once I've crossed over into that strange half-asleep, but can't fall all the way asleep stage just doesn't happen.

s there any way that you can take a few days of medical leave?

I'm a college professor and classes are in session. So no, it's not reasonable for me to try to take a week off. Medical leave does exist, but it would still require me to find someone to cover my classes and give them lesson plans. All of which is more stress than simply functioning with less than optimal sleep.

For example, if you are not tired at 1 AM, yet have to be up at 7 AM, that doesn't leave a lot of time for sleep. Before I had my machine, I'd catch some many small catnaps during the daytime that I would be wide awake at bedtime. Then I'd sleep so badly that I'd be tired when I woke up.

It's rather like being back in grad school actually. And I have NOT been taking any naps at all. I'm wide awake because of the stress of bedtime, not because of daytime naps. Prior to my diagnosis, I'd typically be functioning on 6-7 hours of (apnea and insomnia-interrupted) sleep for the better part of the work week (with no daytime naps and no daytime sleepiness) and sleeping late on Saturday/Sunday mornings. But the insomnia was not as intense as it's been the last four nights. If I could get back to falling asleep 40-50 minutes after going to bed at midnight and sleep more-or-less until 7:00, I'd be tickled pink.

Before I had my machine, I rarely got any REM sleep.

I've had vivid dreams my whole life. No drop off in my dreaming during the period when I've likely had undiagnosed apnea. And remembering two dreams from one night, while not that common for me, is not a new thing either. However, truly weird dreams like the goose dream and stress go hand in hand with me. Now I don't always remember my dreams, but I do remember the sensation of dreaming. If the dreams are sufficiently weird, that sensation is not always a pleasant one when I awake. This summer my dreams were typically normal for me both in number and content. The force-fed goose dream crosses into the stress-induced weird category for me.

I got a hose cover so it's all soft and fuzzy and doesn't wake me if it lays on me. It does work out and now it's just a part of sleep for me.

I got a hose cover at the same time I picked up the machine. The plastic hose during the titration sleep study did bother me a whole lot. Last night I finally fell asleep with my husband curled/cuddled around me and me cuddled up with the hose in its snuggly. I am happy that with the snuggly, the hose feels more like a stuffed toy snake than a plastic vaccumn cleaner hose.

This treatment really is a lot of "mind over matter." Pick a time when you can relax during the day, or after work or dinner, but before bedtime. Put on your mask and watch tv, read a book, anything to help keep your mind occupied while you're getting used to having the mask on and air blowing in your face. Start out with 15 minutes at a time if you have to, and work your way up.

I know that CPAP does involve mind over matter, as does managing insomnia. Unfortunately, practicing with the CPAP during the day or evening would be difficult: I'm severely nearsighted and even though I'm using a Swift FX nasal pillows mask, my glasses do NOT fit properly over the silicone sides in the headgear. And I can't see either the tv or a book without my glasses. Can't really do much of anything without my glasses: can't write, can't draw, can't knit, can't crochet, can't even have a conversation since I can't reliably see faces across a room (not that I'd be able to have a conversation with the CPAP on anyway). My glasses go on my nose before I get out of bed and they come off my nose right before the mask goes on. Anyway, tolerating the mask is not the problem for me: Until last night's meltdown, I have had no problem lying in bed for 2 hours and without any serious urge to tear the mask off. The problem is that the mask and the hose make it extremely difficult for me to find a position in bed that I'm comfortable lying in for more than 5 minutes or so. And I simply don't fall asleep within five minutes. So I'm tossing and turning. The closest analogy I can think of is this: Trying to find a comfortable sleeping position with the CPAP mask and hose is like trying to find a comfortable sleeping position when you have a really bad, bad head cold where one nostril gets stopped up, so you have to turn over. But five minutes later the second nostril is stopped up, but the first no longer is, so you turn over again, and again, and again. It doesn't help that the way I used to sleep is basically impossible with the mask. Before CPAP, I'd stick my nose either into my pillow (face down) or I'd stick my nose under my husband's arm (yes, in his armpit). Neither position has a natural position for the hose to be threaded into.

wow, deja vu..... sounds exactly like what happened to me, but on night three, I think I packed up the machine.. so you are doing better
than I did..

I would put the nose pillows on and sit there in bed for two or three hours staring at the ceiling feeling like I was getting stuffed up too, it
was sheer torture.. and actually the only way I got thru it was to pretend I was being tortured..

I was sidney bristo double agent spy, caught by the bad guys, and they were using this apap machine to torture me to see if I would rat out
information on my spy buddies.. I was tough, and I didnt crack!

Ah---someone else with an active imaginary life. Yes, I've been doing a whole lot of imaginary daydreaming while lying awake with the mask on. But spies I have not tried. Sounds better than force-fed geese, however, so if I really can't get the dang goose out of my head tonight when I finally go to bed in a few minutes, I'll drag out my old daydreams of Picard and the Borg.

so now i got to bed, but I dont put the mask on then.. I watch
tv until I feel like sleep maybe coming in the next half hour, then I put the mask on..

Wish I could do this, but I really and truly cannot allow a tv in the bedroom. Bedroom needs to be reserved for only sleep and sex; otherwise I develop severe insomnia. Watching tv in bed triggers severe insomnia and then bad dreams for me; reading merely triggers the insomnia.

However, if you need to take a break one night, to regain your sanity do that.. because you can literally almost lose your mind if you are getting really disturbed apap sleep for weeks on end.. its not going to kill you to miss a night, no matter what anyone else says.. and it could end up helping you get thru this ring of fire so you can save your life with the treatment.. baby steps.. do what you can, practice a little bit at a time.. its okay to go backwards a little bit and slow down till you feel comfortable..

More advice that resonnates with what my hubby was telling me. So again, maybe I need to follow his and elena88's advice when I really and truly feel like I absolutely cannot get to sleep and need to.

Thanks to all those who have listened to my rant and given me sympathy and suggestions.

So now I'll go wash my face (which wakes me up, alas, but needs to be done to get a good seal), and then I'll treat myself to a bit of yoga with some soothing music in the background, and then to bed. And I'll let you know more sometime tomorrow or tomorrow night how tonight went.

[Junebug999]

hang in there robysue....hang in there....i'm thinking IF you can....take some time off work....it would take off some pressure. that's is what i'm doing right now......i don't like burning the time, but i just can't go on until this gets better. rant away also....it just helps.....at least here people KNOW how you feel. hang in there! we're wishing SWEET dreams for you!

[robysue]

Junebug,

As I said before, I'm a college professor and classes are in session. So taking personal time is difficult unless it's something truly trivial like a really bad head cold or you're running a fever and you'll only miss one day of classes or truly serious where you're hospitialized and physically can't get to class for an extended period of several weeks or months. The middle cases, like this, are more difficult: You can't simply call the secretary and have her cancel your classes for a whole week (or two)---somebody's got to cover them. And if you're not in the hospital or seriously ill with an infectious disease---i.e. if you can physically get to campus without exposing others to an infectious disease, you're supposed to find the subs, who are usually other faculty members in your department, and provide them with your lesson plans. And that's as much or more stress for me than just teaching my own classes anyway.

I've got a four day week-end at Columbus Day. If I can make it to then without going crazy, I'll be ok. If I get to Columbus Day by taking time off from CPAP, I'll spend that weekend doing serious work on getting use to CPAP without worrying about what time is bedtime and what time is wake up time.

[jdm2857]

I know that this is more easily said than done, but have you considered increasing your level of physical activity during the day? It both helps with stress and makes you a bit more sleepy at the end of the day.

And if you have a pair of glasses the sides of which are not bulky, you might just be able to slide them in under the silicone straps of the FX. I just tried that with my brand-new pair of $1 reading glasses from Target, and it worked well.