novatom,
First, I would encourage you to start your own thread about your problems. That way your discussion won't get lost here.
But I do have a couple of things to add to what others have said about your situation.
1) I understand your reluctance to simply increase your pressure on your own. When I was still a newbie, I too was very reluctant to change my pressure settings on my own. I'm still not completely comfortable doing it, but will now do it if there is some kind of experiment that I want to run. It's ok to prefer to work with your doctor when talking about changing the pressure settings. It's also ok to be prefer just doing things on your own, the way a lot of folks around here are.
2) You write that your average AHI = 5.05 over the last four months. Yes, that's a tad higher than we'd like to see and than your doc would like to see. But the average AHI over four months does not tell the whole story. Look at the trend of the nightly AHI numbers over that time: Are they going UP? (bad news) Are they going DOWN (good news)? Are they pretty constant for the whole four months? Or are they jumping all over the place---as in one or two nights will be good and then the next night or two will be bad? Because what your doc is going to recommend as far as the pressure setting goes is going to depend on the long term trend in the AHI numbers. It's also important to realize that the kind of events being recorded is important. If most of the recorded events are OAs and Hs, the doc is likely to be willing to increase the pressure. If most of the recorded events are CAs, the doc won't want you to increase the pressure.
But what I really want to talk about are these comments:
novatom wrote:I was diagnosed with moderate SA last fall but I wouldn't have gone for a sleep test if it hadn't been for my chronic insomnia. I didn't have the typical symptoms of SA and CPAP has not had much of an effect on my insomnia. But nevertheless I am thankful for the diagnosis as it revealed a hidden danger that could have had a much more detrimental effect on my health.
and
novatom wrote:I'm in my fourth month now and while I saw some improvement in my sleeping patterns early on (getting back to sleep in a reasonable amount of time), I eventually reverted to my old sleeping patterns, which was very disappointing. I don't even really feel much more well rested in the morning anymore either. I got the best reaction after titration, the best feeling I'd had in years. I have yet to regain that feeling since. I've said this in several other posts here, but I am convinced now that, at least for me, there is zero connection between my sleep apnea and my insomnia. I hope to eventually be proven wrong,
As Morbius has said under many other aliases:
CPAP doesn't fix BAD sleep. CPAP fixes OSA, and if OSA is the
only cause of the bad sleep, then CPAP will fix the bad sleep. But if the bad sleep is being caused by OSA
and other things like insomnia, then CPAP ain't going to fix all of your sleep problems.
In other words, you're probably right: Your
insomnia is/was probably NOT a direct of untreated OSA. And now that the OSA is under control, the
insomnia is continuing to cause your sleep to be worse than you'd like it to be.
So: What kinds of things have you done to try to manage the insomnia in the past? How well did they work?
At your June appointment with the sleep doc, I would strongly urge you to talk about the
insomnia as a separate issue from the
my AHI indicates my pressure needs to be increased discussion.
And before that insomnia discussion with your sleep doc, you need to do some thinking about what kind of help you might want from him in terms of insomnia management. And that depends on what kinds of things you've tried in the past and whether they've not worked at all; worked for a while and then became ineffective; sort of work to make things marginally better; or don't work at all. And in order for the insomnia discussion to be helpful to you, you'll also need to be able to describe the problem accurately. You might want to keep a sleep log for a couple of weeks or a month or so before the June appointment so that you have an accurate record of how bad the insomnia is. A sleep log usually includes the following information for each night:
- bedtime
- estimated sleep latency---i.e. estimated time it took you to get to sleep at the beginning of the night
- estimated number of wakes. You do NOT need to record what time the wakes occurred. You do NOT need to estimate how long it took to get back to sleep after each wake.
- Time out of bed---what time you got out of bed the next morning with no intention of trying to go back to sleep.
- Estimated total sleep time for the whole night. You do NOT need this to be an accurate estimate. You should NOT be looking at the clock all night long. Rather just give this your best shot. If you think you got about 3 1/2 hours of sleep during the whole night, just say 3.5 hours.
- Any notes on waking up: Are you feeling particularly tired? Somewhat rested? Know you had one really long wake because you remember a wake that it seemed like it took forever to get back to sleep? That stuff goes here.
Except for recording the bedtime, all the other information should be recorded in the morning shortly after you wake up. Except for looking at the clock to establish bedtime and "time out of bed", you should NOT be looking at a clock for any of the other data.
Best of luck in taming your Insomnia Monster