Morning #1 and I'm more tired than ever. Can anyone relate?

[SITNSdaisy]

I started last night using my ResMed S9 auto-regulating BiPap, settings are 6-14 (min, max, set by MD, I can't change), EPR set at 3 (by MD, can't be changed). I used the Quattro full face mask. Temp at 71-72, can't find humidity setting.
Before using CPAP I would wake up 2-3 times a night when I ended up on my back (sleep studies, BTW, indicate CPAP is optional for me). I also would wake up at least once to use the restroom, and at other times to change positions because I have aches and pains. In the 6 months prior to getting this machine, however, I started waking up throughout the night with fists clenched, feeling like I'd been holding my breath too long, like when you try to swim the length of a pool underwater. Achy lungs. That's when my MD and I decided to try CPAP.
So -- last night I woke up about every hour. Once it was to use the restroom. The other times it seemed like I woke up during times when the machine automatically increased the pressure. So it was a restless night, but I was able to fall back asleep each time quickly. I just kept waking up. So this morning I feel even MORE tired I did upon waking prior to using the machine. I can't wait to see how I feel around 3 or 4 PM (my usual "hit the wall" time).
Now, also prior to last night, for about the past year,I have been taking 1/4 to 1/3 of a 10mg ambien at lights out. While most folks take ambien when they wake prematurely during the night I would take it at lights out (usually 11 or 11:30) because for me it induced a deeper sleep and I would only awaken once, around 4 AM, to use the restroom, and could fall back asleep easily. I also felt more refreshed in the morning, although I would still hit my wall around 3 PM. Last night I wanted a "clean study" so I did not take any ambien (nor did I have any alcohol, which I may have 4-5 evenings per week).
So now I'm wondering if a combination of CPAP and 1/4 to 1/3 of a 10mg ambien might be a reasonable combination. The idea is of course to sleep without any chemical aids, but I also want to sleep well and feel refreshed. Any thoughts on this? I'm not going to use Ambien at all for at least this first week or two so I can get a good idea of how this all progresses.
Thank you in advance for reading this lengthy post, and for any thoughts/comments you might have!

[LSAT]

Lets start by having you fill in your equipment in the control panel. It sounds like you have an S9 Autoset or an S9 Escape Auto. Why do you feel that you cannot change your pressure or EPR setting? Do you know the pressure you were titrated at during by your sleep study? Your pressure and EPR sound reasonable, but they certainly be changed if necessary.

[RandyJ]

You could take measures to ensure that you do not sleep on your back (propping big pillows behind your back, sewing a tennis ball in a pouch to the back of your pyjama etc)... then you could probably set your machine for cpap (one fixed pressure) since it seems you may be sensitive to the pressure changes and they are waking you up.

Another option is just to give it a week or two to see if you will get used to the pressure changes and not wake up.

[Sheriff Buford]

You can change your settings. Get a clinical manual, but educate yourself first, understand the pros and cons of the adjustments BEFORE changing the settings. I would suggest you keep what you have and certainly give it time. Your body is probably askin' "What the heck do you have on my face?... take it off!". But don't do it!! Once your body accepts this treatment, it will probably start responding in a positive way. There's no telling how long you had apnea and the damaged it caused your body. It won't heal overnight, but I suspect you probably did some healing and I hope the "feeling better-part" will quickly follow. Work all your issues here. It's a journey, and one we have all taken.

Sheriff

[Guest]

just my opinion, but if you have been taking ambien for about a year at lights out (sedative with a short 1/2 life) and are accustomed to alcohol 4-5 times a week (depressant) ---not having that as part of your nightly routine can certainly induce rebound insomnia/restlessness if that combination has helped you sleep for an extended time period. add in the mask, machine, etc, and minus the sleep aids and it can certainly lead to a restless night. be careful trying to get a "clean study" by eliminating the ambien for "at least a week or two" as that alone may make sleep more difficult and it would seem likely to confuse the cpat with a restless night versus sedative elimination.

[SITNSdaisy]

THank you -- all good points. I'm going to try again tonight. When the equipment was delivered the therapist set certain things up and told me they were locked in according to MD specs. I can change some things, like the EPR and temperature, as well as ramp time. Point well taken about ETOH and ambien, but I don't use ETOH as a sleep aid, just usually have some at dinner or after and then have hot tea, etc. But after a few days I'm sure I'll have some wine (for sure tomorrow, Saturday) so we'll see what that is like. The ambien dose is so small and sporadic I don't think I'm necessarily used to it but that point also well taken -- I'm going to keep my eye on things. I'm keeping a sleep diary anyway, as I'm seeing a cognitive behavioral therapist for sleep issues related to general anxiety and a sleep diary along with other data is a requirement for that.

Thanks to all of you for taking the time to respond. I appreciate it.

One other thing -- my lungs feel a little tight today, and my throat is a little sore (I think I need to change the humidity but can't find that setting). I do have the distilled water reservoir filled appropriately.

Best to you all ---

[DEXSUZ]

To SITNSdaisy:

Whatever you do, avoid alcohol at bedtime. Yes, it 'knocks' us out but in the long run it doesn't help sleep problems.

Go slowly as you become acclimated to CPAP. Getting it right is an art, not hard science.

Check my responses to "amybeth" and consider the Four Week program I advised her to take.

God bless and good luck.

[Lazer1234]

I read that in a sleep study done, so they had used alcohol to induce sleep disorder called UARS.

[chunkyfrog]

Only change one thing at a time. You just started the machine. That's one thing.

[triple20]

Absolutely. I've been on this treatment for 6 months and quite honestly still struggling to find a happy place, still trying to get to the point where I awake every morning fully refreshed.

BUT a heap better than when I started. From what I've been told and what I've read, this deal is definitely all about persistence and patience, so the key is definitely not to give up.

Some folks click with this straight away, others like me take a while to sort the best mix of equipment and settings, even with the help of a sleep tech.
I have woken feeling pretty good on occasion so I know its possible

My next step is to try shaving, I think my facial hair is a problem and helping cause mask leakage, but working on it...

Good luck and keep hanging in there

[SITNSdaisy]

Thanks again everyone! All of your posts are helpful. Intuitively, I know this has to be a process and not an instant fix. I'm thankful that I"m under the direction of a good MD who will follow and assess along with me. Last night was not too bad -- all of my awakenings were due to my various aches and pains, and not from changes in pressure (like they were with night 1). I feel great right now, but I sleep very very late this morning since it's Saturday and we had no activities. I won't be doing that very often but felt like I needed it after the first rough night (I did not want to take a nap yesterday because I knew that would screw it all up).

Best to all of you.

[2 B Sleeping Soundly]

You can change your settings. Get a clinical manual, but educate yourself first, understand the pros and cons of the adjustments BEFORE changing the settings. I would suggest you keep what you have and certainly give it time. Your body is probably askin' "What the heck do you have on my face?... take it off!". But don't do it!! Once your body accepts this treatment, it will probably start responding in a positive way. There's no telling how long you had apnea and the damaged it caused your body. It won't heal overnight, but I suspect you probably did some healing and I hope the "feeling better-part" will quickly follow. Work all your issues here. It's a journey, and one we have all taken.

Sheriff

+ 1!! SITNSdaisy, the Sheriffs advice is almost the exact information I was thinking about when I was reading your post. The only difference is I don't have a southern drawl, carry a badge and a gun, and have the ability to travel instantly to where ever trouble arises and keep all of us Hose heads in line .

John

[RogerSC]

Only change one thing at a time. You just started the machine. That's one thing.

I agree, if you change too much at one time, then you don't know what's causing the problems that you're having. For example, it seems like a good idea to stay on the Ambien until you got used to the cpap thing, which shouldn't take very long in itself, especially if the Ambien is helping you to sleep. Then, once you're used to the cpap, stop the Ambien. And at any point you would have a better feeling for whether your problems were due to not being used to cpap, or stopping Ambien.

Also, as was mentioned, after just a week of using Ambien, I had very little sleep the first night that I slept without it, but was fine the next night. If you've been using Ambien for a year or longer, then your doctor might be able to tell you what to expect when you stop it, but it will most likely take more than one night to get back to "normal". By the way, my week of using Ambien was my first week on cpap, and I used Ambien to help me sleep while I was getting used to all the cpap gear and new noises, and that really did help. After a week, I was ready to stop using Ambien, and was able to get good compliance with the cpap machine and sleep reasonably well after that.

Anyways, sounds like you're motivated to make this work. Just stay with it, and you'll get used to it before too long. It can take some work, playing with different masks, maybe, and so on, since what you're prescribed from a sleep study may not be quite right for sleeping at home, but you'll get there if you just stay with it and take it a day at a time. When you start to look at your data, you can very likely see (with help here and/or from your sleep doctor) what might be done to make things work better.

[SITNSdaisy]

Thanks again to everyone! I stopped using the CPAP for 3 nights while my husband was out of town, but he comes back tonight so I'll resume (with 1/3 ambien). For some reason I thought that contraption would interfere with my ability to ward off danger solo (I don't like it when he's out of town. We have two kids -- He's a light sleeper and wakes up with every little noise, so I don't have to worry about any noises that might be something that needs dealing with).

So I'm back on it tonight. thanks so much!