Will I still need sleep meds once I get used to BiPAP?

[Char1ieJ]

There probably isn't a categorical yes or no answer to this question, but I started thinking about it this morning. Because I don't sleep at night (haven't had a FULL night's sleep in at least 8 years), I have been taking prescription sleep meds forever. Currently, I am on Restoril -- but I've taken Ambien and a couple others over the years.

*IF* my new Bi-PAP machine helps me sleep better, deeper, longer, will I still need sleep meds once I get used to it

If any of this helps anyone guess or nail down an answer, I would appreciate some wisdom.

Initial study info:
AHI = 11.8
02 levels not noted in my copy, but sleep lab tech said they were dangerously low.

Titration study info:
Bi-PAP/VPAP settings prescribed: IPAP = 17 // EPAP = 14
Final pressure (17/14) AHI was 0.9
Sleep efficiency 79.3%
Sleep latency 24min
Stage 1 = 1.5%
Stage 2 = 61.1%
Stage 3/4 = 14.3%
23.2% REM w/ 69min latency

[ChicagoGranny]

Your machine is only designed to help you breathe better. If you do breathe better you may be able to sleep better.

Time, data and persistence will answer your questions.

Best of luck,

[chunkyfrog]

If you seek to get off/reduce the meds, consult with your doctor on gradual, safe withdrawal and
behavioral changes you may need to make to help your sleep hygiene. Good luck.

[Sir NoddinOff]

I'm not a doctor, but I can give you the benefit of my experience. I was an on-and-off user of various sleep meds for a few years, never really heavy but I hated to rely on them. That being said, in the almost six months I've been on APAP. I currently only take sleep meds a few times a month, some months not at all. This only happens when I'm really ill or totally stressed out. I'm very pleased to report that I now sleep fairly normally while using my machine. I can't make any claims that the CPAP machines solve insomnia (indeed, they sometimes don't, as many will confirm on this forum), however for me it was a life saver. NOTE: If you go off Z-drugs, Benzos or opiate based drugs BE SURE TO TAPER OFF THEM over a period of weeks, preferably a month.

[Pugsy]

It depends....
Mainly on what was causing the inability to sleep in the first place. If the poor sleep was totally related to sleep apnea then there stands a very good chance that sleep meds won't be needed past the adjustment phase (if you have one).
Often though we have other things that impact the quality of our sleep.

When I first started therapy I had no problem falling asleep but I woke often and past the adjustment phase (waking to feel the alien stuck on my face) I still woke often but it was due to pain. I have the old arthritis pretty bad and it hurts to move so each time I would turn over in bed it would hurt and wake me up. I would go back to sleep quickly enough but only to wake up again with next movement. 20 to 30 times a night and it sucked. Horrible sleep in general though the OSA was well treated.
Still felt like crap too...but it was because of the poor quality sleep from the frequent awakenings which were totally unrelated to the sleep apnea.
So over time my doctor and I have tried various things to help reduce my pain and sleep a little "deeper" so that minor pain doesn't cause fragmented sleep. I would have had the same problem without OSA diagnosis.

We tend to want to put all our ailments and problems in the "OSA basket" and hope that the machine will take care of all the problems in the OSA basket. Sometimes it isn't that simple.

[Char1ieJ]

First, THANK YOU for the answers. I didn't really think I would get a categorical YES, you can throw those meds in the trash... nor a NO, xPAP won't help with what ails you. Everyone who has answered confirmed my suspicions. A part of my poor sleep/wake cycle might be totally unrelated to OSA -- especially since my AHI was only 11.8. I saw someone mentioned 53 -- whew! [And yes, I know there are other factors besides AHI.]

Anyway, I promise those who have mentioned it that I wouldn't dare just drop a prescription med cold turkey. My GP is a personal friend and has a vested interest in my care. So, he closely monitors my well being and kicks my tail if I don't do what he tells me to do. Haha! And before we try anything new, he always gives me the low down on gradually coming off a med and gradually starting a new one. Maybe it's because my wife has his home phone number and isn't afraid to use it.

I don't mind taking Restoril. It makes me at least go to sleep. OTOH, I wish we could throw it all in the "OSA basket", as Pugsy said -- and then throw it all out the door when xPAP works for us. As ChicagoGranny said, "Time, data and persistence will answer your questions." I'll be patient and see what happens. THANKS again!

[5thumbs]

There is hope that you will go off meds if your situation is similar to what mine was. I had insomnia for the past decade and was asking my doctor for more ambian, sonata, etc. Finally he sent me to a sleep clinic/doctor and I would say that my insomnia is essentially gone. In the past 4 months I have only had to use a sleep med 2-3 times to get to sleep or stay asleep. AHI has gone from 25 to <1. It took some work for me to adjust to the relatively high pressure (17) but things are much better for me.

Good luck

[Char1ieJ]

There is hope that you will go off meds if your situation is similar to what mine was. I had insomnia for the past decade and was asking my doctor for more ambian, sonata, etc. Finally he sent me to a sleep clinic/doctor and I would say that my insomnia is essentially gone. In the past 4 months I have only had to use a sleep med 2-3 times to get to sleep or stay asleep. AHI has gone from 25 to <1. It took some work for me to adjust to the relatively high pressure (17) but things are much better for me.

Good luck

Awesome! THANKS for the words of encouragement. My IPAP is also 17 (EPAP is 14). I'm hoping to get my machine today. Wouldn't you know it -- BCBS quickly approved the request from the "preferred" DME. But, when I decided to go with the local DME, BCBS has asked more questions and wanted another form filled out. Ugh! Anyway, that's been done and faxed back (yesterday). I guess I'll get the machine today or tomorrow. So, we'll know within a couple months if I can start eliminating Restoril or not. My hope is to be able to eliminate more than just Restoril -- maybe my night time pain med, too. That would be excellent!

[5thumbs]

Before CPAP I would wake up 4-6 times a night and could not get back to sleep. I speculate that the AHI's were inducing this. If I took an Ambian (or other sleep aid), it would help me get back to sleep, but it would not keep me asleep. After starting CPAP, I may wake up 1-2x a night (usually due to a leak from the mask), but after adjusting, I can fall right back asleep. I am on APAP with the upper limit set at 17. I set the exhale pressure to be 2 units. thru the course of the night, my pressure usually stays below 13. The doctor told me to keep set at 17 and I've stuck to that.

Good luck getting your machine. It took some nudging from me both to the doctor's office and the DME to finally get it. once I identified a DME that was motivated to get me a machine, I had an appointment and a machine within 72 hours.

[chunkyfrog]

On the other hand:
My sleep problems were totally due to apnea, even though my diagnostic AHI was only 13.
Anything is possible. Good luck and good sleep, good buddy.

[RandyJ]

I hope for your sake you can get off them, but if you have been taking them for a long time I would make sure that I had the therapy dialed in and going great before weaning off of them. It may be a difficult transition but if you are determined you will succeed. Good luck!