Waking up and not being able to fall back asleep at night

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
npolite
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Waking up and not being able to fall back asleep at night

Post by npolite » Fri Aug 14, 2015 12:03 pm

I apologize for the long details below.

For the past 2+ years, I always feel tired even after a night's rest. I'm 37 years old, 165lbs. I have a deviated septum where only half of my nose breathes at one time. I believe I injured this years ago while playing basketball, The odd part is that in the daytime if it moves to the side that has the narrow passage I breathe ok.

About 2 months ago I started waking up at around 2:30 in the morning for no reason. I usually go to bed around 10:45 - 11:30 at night. Only July 3rd I started getting an issue where my heart and the top of my stomach feels like it is pounding even though my BP and heartrate are (115-125/67-75 pulse 55-65) ok. It seems like it gets worse with eating food. This new issue also started causing me anxiety and I was unable to actually get to bed until 2am on some days. I figured that the issue happens worse when I eat ice cream at around 9 at night. I have been doing this for years without any problems. Since I have stopped eating ice cream at night I have been able to get to bed without any problem. I still do get up and it ranges from 2:30am until 4am. I am also wondering if I have an issue with my stomach. I get a bit nauseousfor a few seconds every once in a while...nothing too serious. I also had my cardiologist check on my heart and he said it was healthy and that this issue would go away on it's own (not too comforting). S

I have noticed when I take an afternoon nap that if I lie on my back, my mouth does open and I sometimes have a choking sensation on my saliva and wake up from it. I haven't noticed this problem while sleeping. I had a sleep study done and after visiting my ENT, he mentioned that my Oxygen level was at 78%. He wants me to go in for surgery to have the deviated septum trimmed to allow more airflow through the narrow passageway. My concern is that while this probably will help, if the issue is with my mouth opening, won't the issue still be there? Is there something I can take before going in for surgery to determine one or the other? Also should I get a second opinion? I don't know if this sleeping issue is related to heart problem or not. I do have stress at my job but it isn't anywhere near as much as it used to be.

I just don't know what to do and would appreciate any advice. I've tried keeping my room cool with an A/C unit since our central air is set to 76/77 but it hasn't helped, tried a foam mattress topper, didn't help either. This is really hampering my ability to function. I have to work from home because I am afraid of getting into an accident and hurting someone.

Thanks for your time.

sleepinow
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Re: Waking up and not being able to fall back asleep at night

Post by sleepinow » Fri Aug 14, 2015 12:20 pm

npolite wrote:I apologize for the long details below.

For the past 2+ years, I always feel tired even after a night's rest. I'm 37 years old. I have a deviated septum where only half of my nose breathes at one time. I believe I injured this years ago while playing basketball, The odd part is that in the daytime if it moves to the side that has the narrow passage I breathe ok.

About 2 months ago I started waking up at around 2:30 in the morning for no reason. I usually go to bed around 10:45 - 11:30 at night. Only July 3rd I started getting an issue where my heart and the top of my stomach feels like it is pounding even though my BP and heartrate are (115-125/67-75 pulse 55-65) ok. It seems like it gets worse with eating food. This new issue also started causing me anxiety and I was unable to actually get to bed until 2am on some days. I figured that the issue happens worse when I eat ice cream at around 9 at night. I have been doing this for years without any problems. Since I have stopped eating ice cream at night I have been able to get to bed without any problem. I still do get up and it ranges from 2:30am until 4am. I am also wondering if I have an issue with my stomach. I get a bit nauseousfor a few seconds every once in a while...nothing too serious. I also had my cardiologist check on my heart and he said it was healthy and that this issue would go away on it's own (not too comforting). S

I have noticed when I take an afternoon nap that if I lie on my back, my mouth does open and I sometimes have a choking sensation on my saliva and wake up from it. I haven't noticed this problem while sleeping. I had a sleep study done and after visiting my ENT, he mentioned that my Oxygen level was at 78%. He wants me to go in for surgery to have the deviated septum trimmed to allow more airflow through the narrow passageway. My concern is that while this probably will help, if the issue is with my mouth opening, won't the issue still be there? Is there something I can take before going in for surgery to determine one or the other? Also should I get a second opinion? I don't know if this sleeping issue is related to heart problem or not. I do have stress at my job but it isn't anywhere near as much as it used to be.

I just don't know what to do and would appreciate any advice. I've tried keeping my room cool with an A/C unit since our central air is set to 76/77 but it hasn't helped, tried a foam mattress topper, didn't help either. This is really hampering my ability to function. I have to work from home because I am afraid of getting into an accident and hurting someone.

Thanks for your time.
Most likely a lot of your stress is because of your tiredness. It causes your brain to not function well and overall your quality of health gets worse.

I had the same exact problem you had with waking up "for no reason". That is until I was diagnosed with sleep apnea and started getting treated. Basically I would wake up not knowing why and took naps during the day because I was too tired.Anxiety was also my problem just like you have mentioned

You should get your sleep study results to another doctor or mention getting a Cpap rather than surgery. I heard surgery for deviated septum isn't usually significant in helping with sleeping. Someone should fill in on this because I don't know too much about the surgery. BUT, if your sleep study results indicate sleep apnea, you should definitely consider the Cpap machine approach or any other breathing machine based on your results. And don't prolong the process of getting these things done because you would want to feel much better as soon as you can

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49er
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Re: Waking up and not being able to fall back asleep at night

Post by 49er » Fri Aug 14, 2015 12:43 pm

Hi npolite,

I had a septoplasty and turbinate reduction in March and I definitely still have sleep apnea. I will be getting a follow up sleep study for various reasons to see exactly where things stand but there is no doubt in my mind, I have it.

Anyway, the most optimistic statistic I have seen regarding this operation curing sleep apnea is 10%. A local ENT has specifically said it doesn't. My own surgeon made no promises but hoped by having the operation, it would reduce my severity level which is currently moderate when you factor in the RDI.

Many people, including me, got the surgery with the goal of better tolerating pap therapy. It didn't happen for me but for many people, this does occur so if that is your goal, yeah, then the surgery would be worthwhile. However, personally, in your case, I would start pap therapy first and see how you do with it. You might find it is so helpful that the deviated septum isn't an issue and that surgery isn't necessary.

But if you still feel you need better nasal breathing, then of course, go ahead with it since most people usually greatly benefit
npolite wrote:I apologize for the long details below.

For the past 2+ years, I always feel tired even after a night's rest. I'm 37 years old, 165lbs. I have a deviated septum where only half of my nose breathes at one time. I believe I injured this years ago while playing basketball, The odd part is that in the daytime if it moves to the side that has the narrow passage I breathe ok.

About 2 months ago I started waking up at around 2:30 in the morning for no reason. I usually go to bed around 10:45 - 11:30 at night. Only July 3rd I started getting an issue where my heart and the top of my stomach feels like it is pounding even though my BP and heartrate are (115-125/67-75 pulse 55-65) ok. It seems like it gets worse with eating food. This new issue also started causing me anxiety and I was unable to actually get to bed until 2am on some days. I figured that the issue happens worse when I eat ice cream at around 9 at night. I have been doing this for years without any problems. Since I have stopped eating ice cream at night I have been able to get to bed without any problem. I still do get up and it ranges from 2:30am until 4am. I am also wondering if I have an issue with my stomach. I get a bit nauseousfor a few seconds every once in a while...nothing too serious. I also had my cardiologist check on my heart and he said it was healthy and that this issue would go away on it's own (not too comforting). S

I have noticed when I take an afternoon nap that if I lie on my back, my mouth does open and I sometimes have a choking sensation on my saliva and wake up from it. I haven't noticed this problem while sleeping. I had a sleep study done and after visiting my ENT, he mentioned that my Oxygen level was at 78%. He wants me to go in for surgery to have the deviated septum trimmed to allow more airflow through the narrow passageway. My concern is that while this probably will help, if the issue is with my mouth opening, won't the issue still be there? Is there something I can take before going in for surgery to determine one or the other? Also should I get a second opinion? I don't know if this sleeping issue is related to heart problem or not. I do have stress at my job but it isn't anywhere near as much as it used to be.

I just don't know what to do and would appreciate any advice. I've tried keeping my room cool with an A/C unit since our central air is set to 76/77 but it hasn't helped, tried a foam mattress topper, didn't help either. This is really hampering my ability to function. I have to work from home because I am afraid of getting into an accident and hurting someone.

Thanks for your time.

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Wulfman...
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Re: Waking up and not being able to fall back asleep at night

Post by Wulfman... » Fri Aug 14, 2015 1:41 pm

npolite wrote:I apologize for the long details below.

For the past 2+ years, I always feel tired even after a night's rest. I'm 37 years old, 165lbs. I have a deviated septum where only half of my nose breathes at one time. I believe I injured this years ago while playing basketball, The odd part is that in the daytime if it moves to the side that has the narrow passage I breathe ok.

About 2 months ago I started waking up at around 2:30 in the morning for no reason. I usually go to bed around 10:45 - 11:30 at night. Only July 3rd I started getting an issue where my heart and the top of my stomach feels like it is pounding even though my BP and heartrate are (115-125/67-75 pulse 55-65) ok. It seems like it gets worse with eating food. This new issue also started causing me anxiety and I was unable to actually get to bed until 2am on some days. I figured that the issue happens worse when I eat ice cream at around 9 at night. I have been doing this for years without any problems. Since I have stopped eating ice cream at night I have been able to get to bed without any problem. I still do get up and it ranges from 2:30am until 4am. I am also wondering if I have an issue with my stomach. I get a bit nauseousfor a few seconds every once in a while...nothing too serious. I also had my cardiologist check on my heart and he said it was healthy and that this issue would go away on it's own (not too comforting). S

I have noticed when I take an afternoon nap that if I lie on my back, my mouth does open and I sometimes have a choking sensation on my saliva and wake up from it. I haven't noticed this problem while sleeping. I had a sleep study done and after visiting my ENT, he mentioned that my Oxygen level was at 78%. He wants me to go in for surgery to have the deviated septum trimmed to allow more airflow through the narrow passageway. My concern is that while this probably will help, if the issue is with my mouth opening, won't the issue still be there? Is there something I can take before going in for surgery to determine one or the other? Also should I get a second opinion? I don't know if this sleeping issue is related to heart problem or not. I do have stress at my job but it isn't anywhere near as much as it used to be.

I just don't know what to do and would appreciate any advice. I've tried keeping my room cool with an A/C unit since our central air is set to 76/77 but it hasn't helped, tried a foam mattress topper, didn't help either. This is really hampering my ability to function. I have to work from home because I am afraid of getting into an accident and hurting someone.

Thanks for your time.
Sounds like you're a candidate for CPAP therapy.
Did they prescribe one for you?

I was sort of in the same place you are. However, none of the doctors who saw me even asked "Can you breathe through your nose?" I just had the (split-night) sleep study done and they prescribed the machine.......so, I avoided surgery on my nasal passages. As long as I use cool, "passover" humidification and not heated, I'm fine. The cool air shrinks the nasal tissues and allows me to breathe fine while I'm sleeping.

I would urge you to get started with CPAP therapy and you'll be feeling much better......sooner.
And, in the meantime......don't sleep on your back.


Den

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Jay Aitchsee
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Re: Waking up and not being able to fall back asleep at night

Post by Jay Aitchsee » Fri Aug 14, 2015 1:50 pm

It sounds to me, though I'm no doctor, that you most likely have GERD and Sleep Apnea. You need to get your hands on that sleep study and see what it says. As others have said, I would want to look at all the options before choosing surgery. If you have the sleep study results and are unsure of what it means, you can post it here and people would be happy to help you decipher it.

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npolite
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Re: Waking up and not being able to fall back asleep at night

Post by npolite » Fri Aug 14, 2015 2:41 pm

Thanks everyone for your responses. The sleep study results were sent to the ENT doctor and of course most doctors keep these results without sharing much. I have asked for a copy of the results to be sent to me so they should be here on Tuesday or Wednesday. In terms of sleeping on my back, I really can't fall asleep on my right side for some reason and on my left side the heart pounding bothers me to the point I can't sleep. I also have purchases a chin strap from Amazon and I have used it two afternoons now and feel more refreshed after sleeping with it on.

I will get another appointment with my sister's ENT for a second opinion and see what he says. Also the sleep study I had done was a take at home one if it matters.

I just can't believe how quickly my health and quality of life has dropped in the past 2 months.

npolite
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Re: Waking up and not being able to fall back asleep at night

Post by npolite » Fri Aug 14, 2015 7:40 pm

Wulfman... wrote:
Sounds like you're a candidate for CPAP therapy.
Did they prescribe one for you?

I was sort of in the same place you are. However, none of the doctors who saw me even asked "Can you breathe through your nose?" I just had the (split-night) sleep study done and they prescribed the machine.......so, I avoided surgery on my nasal passages. As long as I use cool, "passover" humidification and not heated, I'm fine. The cool air shrinks the nasal tissues and allows me to breathe fine while I'm sleeping.

I would urge you to get started with CPAP therapy and you'll be feeling much better......sooner.
And, in the meantime......don't sleep on your back.


Den

.
The ENT said to first go in for surgery and fix the nose and see from there. The problem is he won't clear me for the procedure until I get records sent over to him that my heart is ok. He wants me to see another cardiologist but I have already done all of the tests and according to the first cardiologist I visited, they checked out ok. I'm waiting for my primary to review and see where to go but this is taking way too long and I keep getting worse each day too. The ENT didn't even prescribe the PCAP (or something alternatively) as a temporary thing until the surgery which is very frustrating.

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Re: Waking up and not being able to fall back asleep at night

Post by MarylandCPAPer » Fri Aug 14, 2015 7:48 pm

Not all sleep specialists are ENTs. Some are neurologists or pulmonologists, among other specialties. Before you submit to surgery, it would be good to get a second opinion from another sleep specialist, not necessarily and ENT who specializes in sleep therapy. You may need the surgery, but most of us are able to get help by using a CPAP or other PAP-type machine, which is not as disruptive to your life as surgery would be.

Ask for a copy of your sleep study. You are entitled to a copy of your medical records. You will probably have to sign an authorization for the records to be released to you first. If you can post details from your sleep study, experienced people here may be able to help you interpret it.

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Re: Waking up and not being able to fall back asleep at night

Post by borgready » Sat Aug 15, 2015 11:34 pm

Do anything that will improve air flow through your nose. So if you can get surgery and it will improve that air flow then go for it. Cpap therapy works so much better if you can breathe through your nose. Cpap therapy where a person mouth breathes is miserable and hard to deal with. I don't know if there is some type of mouth piece that is available that would allow a cpap user to mouth breathe, but it never hurts to ask. I have not heard of it. I have thought of it but I am not sure if it would be practical. If you are able to improve the air flow through your nose you won't mouth breathe as much. You start mouth breathing when you can't breathe through the nose or the air requirement is more than the nose can provide.

I think the chin strap is a bad idea. Why? Because you are forcing yourself to breathe through your nose which is restricted as it is. This means you have to labor at trying to breathe. My guess is your heart races and pounds(labors) as you do this. Have you ever used a pulse oximeter while you sleep to see how fast your heart beats and how low your O2 gets. Do you get really weird dreams of fighting, being chased, or other weird, scary, dark/evil themes?

npolite
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Re: Waking up and not being able to fall back asleep at night

Post by npolite » Mon Aug 17, 2015 9:58 am

Thanks everyone for your input. I have an appointment to visit my sister's doctor who also specializes in sleep disorders. I am going to have my sleep study results hopefully tomorrow and will post them.

Last night wasn't great. I went to bed at 11:15 and was up at 12 until 3am. Hopefully I can get the dilated septum fixed. My issue may be slightly different. Only one side of my nose works at a time. The issue I feel when I wake up is on the narrow side at night. I don't seem to have any issues through the day but also most of the day the larger nostril is functional.

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Re: Waking up and not being able to fall back asleep at night

Post by sleepinow » Mon Aug 17, 2015 10:13 am

Yeah sometimes after waking up shortly after sleeping may cause anxiety and may prevent you from falling back asleep. Your going to feel like crap, but just know that after you get your machine or surgery, the healing process will occur and your brain will be more clear and less tired. I wish the testing was much faster than it is. It takes too damn long. Hang in there

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npolite
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Re: Waking up and not being able to fall back asleep at night

Post by npolite » Wed Aug 19, 2015 5:54 pm

Sorry for the late update. I was waiting 3 days now for the hospital to mail me a copy of the report. Since I didn't get it in the mail today I called to follow up. I don't know if the lady who answered was just having a bad day but she said that they didn't have the report. I'm kind of shocked that they lost the report already in under 2 months.

Anyway I called the ENT who prescribed the study and was able to get a copy. Here are the results. I also noticed that even though I mentioned in my paperwork I handed back after the sleep study that I went to bed at 11:30, the time range shows from the time they turned on the machine until I woke up. I had some issues getting the respirator tube to work as it wasn't detecting anything until after I took it off the machine and placed it back on. I don't know if that time was factored into these numbers.

I have an appointment tomorrow with another ENT who also specializes in sleeping issues so we'll see what they say. I'll update everyone tomorrow.

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npolite
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Re: Waking up and not being able to fall back asleep at night

Post by npolite » Thu Aug 20, 2015 9:51 am

I just got back from visiting the other ENT. He mentioned that since I don't have issues during the day that the deviated septum may not be the issue that is causing me to wake up. He suggested that I see a sleep disorder psychiatrist and go from there. The one thing I need to call and follow up with him on is why my pulse goes over 100 at night and why only half of my nostrils work at one time. Whatever that numbing medicine they put into my nose has made both nostrils to work now.

He also mentioned that having the CPAP machine would probably cause more stress at the moment and make it even more difficult to sleep.

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Re: Waking up and not being able to fall back asleep at night

Post by Wulfman... » Thu Aug 20, 2015 12:41 pm

npolite wrote:I just got back from visiting the other ENT. He mentioned that since I don't have issues during the day that the deviated septum may not be the issue that is causing me to wake up. He suggested that I see a sleep disorder psychiatrist and go from there. The one thing I need to call and follow up with him on is why my pulse goes over 100 at night and why only half of my nostrils work at one time. Whatever that numbing medicine they put into my nose has made both nostrils to work now.

He also mentioned that having the CPAP machine would probably cause more stress at the moment and make it even more difficult to sleep.
Just being in REM or having dreams (which can occur in any sleep stage) could cause the pulse rate to rise.
Nostril congestion in one nostril at a time has been discussed at some length. Pugsy posted a Wiki link sometime back about it. Could also be too much or lack of humidity. For some people, too much warm humid air creates more congestion.


Den

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Re: Waking up and not being able to fall back asleep at night

Post by Denial Dave » Thu Aug 20, 2015 12:48 pm

I totally agree... Sleepyhead regularly shows that my pulse rate & respiration rate spike when I go into REM.

Wulfman... wrote:
npolite wrote:I just got back from visiting the other ENT. He mentioned that since I don't have issues during the day that the deviated septum may not be the issue that is causing me to wake up. He suggested that I see a sleep disorder psychiatrist and go from there. The one thing I need to call and follow up with him on is why my pulse goes over 100 at night and why only half of my nostrils work at one time. Whatever that numbing medicine they put into my nose has made both nostrils to work now.

He also mentioned that having the CPAP machine would probably cause more stress at the moment and make it even more difficult to sleep.
Just being in REM or having dreams (which can occur in any sleep stage) could cause the pulse rate to rise.
Nostril congestion in one nostril at a time has been discussed at some length. Pugsy posted a Wiki link sometime back about it. Could also be too much or lack of humidity. For some people, too much warm humid air creates more congestion.


Den

.

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