Wake up after 3-4 hours and have trouble falling asleep

[agi]

I have been using a BiPAP since Sept 2011. From the beginning I did not have a problem falling asleep. And up to recent times when I woke up during the night (sometimes 2-3 times) to go to the bathroom, I had no problem falling back to sleep. I have an enlarged prostate which is why I wake up so much. I stop my intake of liquids past dinner to limit the amount of times I wake up.

However in the last 3 weeks, after 3-4 hours on my machine, I have a problem falling back to sleep. Seems like I get nervous wearing the mask (sometimes claustrophobic) and I end up removing my headgear (I wear a`nasal pillow system) and shutting off my machine. It's the only way I can relax and fall asleep. I also wear a chin strap to contain breathing through my mouth.

When I do sleep, the machine works great. It ramps up over 30 minutes when first turned on. Optimal pressure during titration is 13/9 cm of water with backup respiratory rate of 12 breaths per minute. My AHI has been reduced to 0 events per hour. Most days I am not tired but I wish I could get at least 7 hours per night of sleep. Any suggestions?

[LSAT]

You might try a Full Face mask. The combination of nasal pillows in your nose and a chinstrap holding your mouth closed may be a problem for you. I found that a FF mask felt much more comfortable since my nose and mouth were free of everything. I could wiggle my nose and open my mouth if needed without problems.

[robysue]

However in the last 3 weeks, after 3-4 hours on my machine, I have a problem falling back to sleep. Seems like I get nervous wearing the mask (sometimes claustrophobic) and I end up removing my headgear (I wear a`nasal pillow system) and shutting off my machine. It's the only way I can relax and fall asleep. I also wear a chin strap to contain breathing through my mouth.

You've got to break that bad habit of turning the machine off and taking the mask off just so you "can relax and fall asleep."

Every time you do this you are encouraging your unconscious mind (and perhaps your conscious mind too) to get nervous and claustrophobic when you return to bed and turn the machine back on. You are rewarding some stubborn part of your mind for getting nervous and claustrophobic by doing exactly what it wants: Taking the mask off and sleeping without it. You have to quit rewarding this behavior. You have to convince this stubborn part of your mind that sleeping without the mask just ain't going to happen.

The best way I know of breaking this habit is to NOT allow yourself to consciously fall asleep without the mask---EVER. When you are lying in bed after returning from the bathroom, give yourself a reasonable amount of time to fall back asleep. If you get nervous or claustrophobic, take the mask off and get out of bed. Go into a different room and settle yourself back down. Do something quiet and relaxing to take your mind off the mask. Maybe all you'll need is sitting in the semi-dark for about 5 minutes. Maybe you need to work on relaxation a bit more. The point is: Only go back to your bedroom when you are both calm enough and sleepy enough to put the mask back on when you go back to bed.

If the habit of "taking your mask off so that you can go back to sleep" is deeply ingrained, you may need to repeat this cycle several times in the middle of the night. But if you are conscientiousness about never consciously allowing yourself to return to sleep without the mask, in a few nights to a couple of weeks, you should begin to see a decrease in the amount of the nervousness and claustrophobia that sets in after you return from the bathroom.

When I do sleep, the machine works great. It ramps up over 30 minutes when first turned on. Optimal pressure during titration is 13/9 cm of water with backup respiratory rate of 12 breaths per minute. My AHI has been reduced to 0 events per hour. Most days I am not tired but I wish I could get at least 7 hours per night of sleep. Any suggestions?

In my humble opinion, you need to get more mask time by cutting out the tendency to sleep without the mask on after your bathroom break.

For trying to get at least 7 hours of sleep, you may need to fix a standard wake up time that you use seven days a week. That will encourage your body to start getting sleepy at the same time each night. And go to bed only when you are sleepy---not just because the clock says bedtime.

[Otter]

I have been using a BiPAP since Sept 2011. From the beginning I did not have a problem falling asleep. And up to recent times when I woke up during the night (sometimes 2-3 times) to go to the bathroom, I had no problem falling back to sleep. I have an enlarged prostate which is why I wake up so much. I stop my intake of liquids past dinner to limit the amount of times I wake up.

What else are you doing for your BPH?

However in the last 3 weeks, after 3-4 hours on my machine, I have a problem falling back to sleep. Seems like I get nervous wearing the mask (sometimes claustrophobic) and I end up removing my headgear (I wear a`nasal pillow system) and shutting off my machine. It's the only way I can relax and fall asleep. I also wear a chin strap to contain breathing through my mouth.

When I do sleep, the machine works great. It ramps up over 30 minutes when first turned on.

The ramp may be what's making you nervous. The problem with a 30 minute ramp is that if you fall asleep before the ramp time is over and go immediately into REM (which I've read is fairly common among the sleep deprived) there may not be enough pressure to prevent apnea. Hence, you'll wake up with a start before you ever really fall asleep, and it may feel like it's the mask that's suffocating you even though it does give you some pressure during ramp. This is not a comfort feature, it's torture. I suggest you do away with the ramp entirely, or at least cut the time back to 5 or 10 minutes. You want the machine to ramp up when you're still awake so that the pressure is there to catch you when you fall asleep. Time spent waiting for enough pressure to sleep is just time to get claustrophobic and wake up completely.

[ozze_dollar]

Happens to me all the time. I sleep for 4 hours and I wake up. Perhaps something wakes me up,who knows. I now just dont worry about it,I try not to look at the clock,I just lay there and eventually I get some more sleep. Some people say if you cant sleep you should get up and do something.I dont like that idea. I usually stay in bed for at least 8 hours and get 5 to 6 hours sleep. Most times I am not tired through the day.
So its just my age,insomnia and it is what it is.