KayakKid wrote:
Here's the short of it. Went to the Sleep Doc 1 1/2 weeks ago and she gradually had me adjust APAP pressures from 8cm-15cm to 9cm-15cm to 10cm-15cm. I was getting the longest time on the mask after these adjustments since I started 4 months ago. Then something happened a couple nights ago. I would get maybe an hour of sleep between 10PM and Midnight then I'd be WIDE awake til about 4AM or 4:30AM where I'd pass out from exhaustion for an hour or two. (emphasis added)
Any new stressors in your life? Anything happen in the daytime a couple of days ago?
Sudden onset of insomnia or a sudden serious worsening of insomnia symptoms is often tied to stressful events going on in your life.
Has this kind of insomnia pattern ever happened to you before?
Notably on three of the nights you posted data for, the CPAP data ends between 4:00 and 5:00. Did you finally just give up and take the mask off before you "pass[ed] out from exhaustion for an hour or two"? And what happened on the nights of Sunday, May 1 and Monday, May 2? On May 1 you turned the machine on at 10:13 and turn it off at 2:37. Did it take you another couple of hours before you fell back asleep without the mask on Sunday night? On May 2 you turned the machine on at 10:00pm and turned it off for good at 11:11pm? Were you awake all night Monday night until between 4:00 and 5:00?
Past week or so I've tried Ambien (10mg) a few nights, Melatonin (5mg) a few nights and taking nothing for a few nights.
Earlier you said that you were "getting the longest time on the mask after these adjustments since I started 4 months ago" and that something happened "a couple of nights ago". But now it sounds like you've been having the severe insomnia problems for longer than a couple of days. Can you clarify the time line for me?
What was your sleep like before you started APAP four months ago? Regular bedtime was??? Regular wake up time was??? How rested did you feel when you woke up in the morning? And did you ever have trouble falling asleep or staying asleep before you started APAP?
When you first started APAP, how was you sleep? Your writing makes it sound like you have had some real problems with either getting to sleep or staying asleep during the last four months. Is that so? But it also sounds like things were beginning to get better until earlier this week, and that everything has fallen apart quite quickly. That correct?
When was the Ambien prescribed? And did it ever work for you at all?
When did you start taking melatonin? And did the sleep doc suggest a 5mg dose? Or was that the smallest dose you could find? Finally, when do you take the melatonin relative to bedtime? At one point my sleep doc suggested that I take a 0.5-1.0mg dose of melatonin about 6 hours before my desired bedtime as a way of trying to keep my own delayed sleep phase problem under control. (Unfortunately melatonin seems to cause some unpleasant side effects for me, so I had to stop that trial.)
Nothing seems to work. I lay there wide awake on 10mg of Ambien. I've tried calling the Sleep Doc but can't get her to call me back.
When did you take the Ambien? When you went to bed at 10pm? Or after you woke up around midnight and found that you could not get back to sleep? And did you report that 10mg of Ambien did you no good at all?
Best they could do so far was get me an appt for this Friday morning. I don't know what kind of shape I'll be in by then.
It's now Tuesday night. You may get to Friday morning just fine. But if things get worse, then call the sleep doc's office every day this week if necessary telling them exactly how little sleep you seem to be getting and
how it is severely affecting your ability to function in the daytime. If you are worried about whether you will be able to safely drive yourself to the appointment on Friday, mention that too.
A couple questions. Can the APAP cause insomnia?
Lots of things can cause insomnia. Could it be the APAP? Well usually insomina caused by PAPing starts right away because it's usually related to difficulty adjusting to all the new physical stimuli coming from the machine and mask making it more difficult to both get to sleep and stay asleep.
You say that after the pressure adjustments had been made you were getting more sleep than you have in the four months you've been on APAP. How bad did your sleep get immediately after starting APAP?
Could this be Delayed Sleep Phase?
Maybe. Maybe not. Most of the time delayed sleep phase manifests itself as simply not being able to get to sleep until far later in the night than you want (or need) to go to sleep. But you say that you can get to sleep (for an hour or so ) between 10:00 and midnight. And the problem is that you just cannot get back to sleep.
Is this related to the machine at all
There's nothing unusual in your data in the sense of clusters of events.
But there are long periods of time when you didn't use the machine. Of course those gaps are explained by the insomnia you are inquiring about. Likewise the usage on some nights is very low. But you already know that and you say that the severe insomnia is present even on the nights "whether [you] have the mask on or not." So that means we can assume that your insomnia was as bad on Monday night as it was on Saturday night?
So overall I don't think the machine is causing the problem---unless you are noticing a great deal of discomfort that is preventing you from getting to sleep at the beginning of the night. But if that was all that was going on, you'd expect that you'd be able to get to sleep after you take the mask off. And you say taking the mask off does not make it any easier to fall asleep between midnight and 4:00AM.
or something else going on in my body?
Maybe, maybe not. If you haven't had a physical in a while, it's certainly worth have one. But my guess is that no particular cause will be identified.
