Worst Night Sleep of My Life

[JCWarrior]

I have been going through a period of anxiety. Normally my AHI is <1. Like 0.14 typically for the last 4 years.
Haven't had anxiety like this in about 5 years.

Sometimes I would take a low dose of Clonazepam at bedtime to help me get to sleep but I refuse to use it long term.
My sleep Dr prescribed 50-100mg Trazodone at bedtime to help me sleep. I would only take 25-50mg as I hate the way it makes me feel.

I also broke my ankle in Jan and had been wearing a walking boot 24/7 for 6 weeks. With the anxiety and boot, sleep was very frustrating and almost every night I would wake up and get out of bed 1-2 times with hip discomfort or just being anxious and then go back to bed.

I say that to say my sleep has been majorly disrupted.

My primary issue is the anxiety causes me to have a lot of CA's that arouse me and I can not get to full sleep. It becomes very frustrating.

I've been taking the Trazodone for about 4 1/2 weeks. 5 nights in a row I was taking 50mg. Well, I started experiencing some strange symptoms that I contributed to the Trazodone and I definitely didn't like how it was affecting my mood. I reached out to my sleep doctor and, after 3 days, I've still not heard from him. His nurse responded but not with any clear direction.

Wednesday night I took 25mg and noticed less symptoms the next day.

I then reached out to my PCP, who is excellent, and he advised me to stop taking the Trazodone.

Finally to my point......

Ladt night was my first time without Trazodone (or any other medication) and I had the worst nights sleep of my life. Didn't feel like I even slept.

I had an AHI of 8.59! Some of my CA's and OA's (which I normally NEVER have) were up to 71 seconds.

One of my symptoms, when I get anxious, is the need to take a deep breath a lot. Yawn/sigh. I do this constantly throughout the day.
I wonder if that is a contributor to the CA's?

As you can see in the graph, I did get up a couple of times after falling asleep and waking up so many times.

Oddly, my body temp was also out of whack. Hot and sweaty at the start, then cold, then hot.

Any advice (if there is any) would be welcome.

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[Pugsy]

You have it backwards. The centrals aren't causing the arousals...it's the arousals causing the central flagging.
Awake/semi awake breathing irregularities brought on by the arousal getting flagged by the machine but since you aren't asleep they aren't real.
Centrals aren't the problem...your poor sleep is the problem and the centrals are simply a symptom of the poor sleep/arousals.

[JCWarrior]

So the poor sleep is causing the central’s and I assume this may be slight hyperventilating due to anxiety. This is based on my constant need to take s deep breath.

I wish there was a sleeping med that could help me get over the hump without adverse side effects and risk of dependency and issues with withdrawal.

[Pugsy]

The brain is a powerful tool. Sometimes it works for us and sometimes it works against us with the anxiety thing. It's tough to regulate.
You know you are anxious for whatever reason but not so easy to just turn it off.

All medication comes with some sort of baggage...even the lowly aspirin comes with baggage.
What we have to do is decide if the baggage is worth the reward....the old risk vs reward thing that comes with taking any medications.
Damned if we do and damned if we don't kind of thing.

Me...I gotta get some semblance of decent sleep and if that means taking something then I will do it.
I take a pain medication at bedtime that is potentially habit forming...I know this and I am extremely careful with the dosing to not abuse it. If I don't take it I simply don't sleep well at all from the pain. So I have 2 not so nice choices to make....I choose the one that lets me at least get some sleep and feel halfway decent because if I don't I am miserable all day long.

[ziuaploia]

I also used to take Trazadone for sleep (prior to starting CPAP), and ended up having some negative reactions to it. When my doctor took me off I ended up going through some pretty bad withdrawal and it took about a week before my sleeping resumed to what it was before I started it.

As someone who has suffered from long-term insomnia and now sleep apnea, I personally do use a sleeping pill before bed (zopiclone) but this is all with the supervision of my doctor and my psychiatrist.

I'm new to this forum, so I don't have much to contribute in terms of the CPAP aspect of your question. But in terms of sleeping medications, I have tried many and I have yet to find something that didn't cause some degree of dependency. But, in my case, my sleeping pill isn't much different to me than my antidepressant and is just part of how my doctor and I are treating my medical and health issues. If it is something you need, then discuss with your doctor your concerns and see what they suggest. If you are adamant about not taking something, look at more natural solutions like meditation or a warm bath before bed.

Just know that from someone who has experienced the withdrawal of sleeping pills, every time it happens I feel like I don't sleep the entire night, I'm too hot, I'm sweaty, I'm anxious, and it's awful. So maybe once your body adjusts those symptoms will go away.