Discouraged: still waking up!

[dir1944]

i've been using my cpap machine since january 3, 2014. before being diagnosed with sleep apnea, i was waking up once each night after sleeping for around 4 to 5 hours. since using the cpap machine, i still wake up after sleeping 4 hours. i don't get it. my expectation was that once i used the machine, i would sleep most of the night. well, i'm not and i'm frustrated. i did find this site about a month after using the cpap and the people here were very supportive and told me to "hang in there", it will get better. well, it hasn't.

i did switch from a nasal pillow mask to a nasal mask which i like using better than the pillow mask. however, i don't understand why i still wake up. after i wake up, i'm up for around an hour and then i go back to sleep, but i never put that mask back on. i do have to use the mask for at least four hours per night to comply with medicare but after the four hours are completed, off goes the mask.

will this ever change for me? i know i have a bad attitude about this whole thing but all i want is to "not wake up" after four hours of sleep. any suggestions?

cheers and thank you in advance for your replies
david

[robysue]

If you've been waking up after 4 or 5 hours of sleep for several years, it's going to take some time for your body and brain to let go of that well established habit.

Another thing you should realize is that a few wakes during the night are actually normal---as in people without any sleep disorders often wake up 1-4 times during the night (usually right after a REM cycle). They wake up just enough to determine that there is nothing urgent that needs their attention and they fall right back asleep. When morning comes, they don't even remember the wakes because the wakes lasted less than 5 minutes or so.

So you may need to figure out a way of NOT over reacting to finding yourself awake after a few hours of sleep. It may help to move the clock to where you can't see it as soon as you wake up. Checking the time as soon as you wake up often makes you wake up more fully and extends the amount of time you are awake because your brain immediately goes into "calculate" mode: How long have I been asleep? How much longer until the alarm goes off? And why am I awake? These are all questions that if you start thinking about them in the middle of the night tend to make the wake last longer than it needs to and it's the length of the wake that is disruptive to your sleep ....

[kteague]

Hi. I wanted to check your old posts so as not to revisit things that were already addressed, but apparently the site is experiencing high volume and not doing searches at the moment, so I'll wing it. The first thing I'd want to know is if your data reveals anything going on at the time you wake. I mean, if it's leaks or inadequate pressure causing you to wake up, those things can be addressed. The next thing - and I'm sure you're expecting this - is that your current perspective of using your treatment only to meet compliance requirements is self-defeating. If you needed it the first 4 hours of the night, you NEED it the rest of the night too. No wonder you are discouraged. You are still under the oppression of untreated sleep apnea and probably aren't seeing significant improvement that helps with motivation. On the flip side of this, you have continued and made it those 4 hours a night, so that's a start in the right direction. I'm not discounting the efforts you have put forth. I was not successful early on either so I'm really not trying to give you a hard time. Just suggesting you try to identify possible contributors to your problems, and make a concerted effort toward taking this to the next level so you can find out just what this therapy can accomplish for you. Don't know your situation, but if you have early morning responsibilities, those wake periods would be worrisome, which in itself can contribute to even longer wakings. If your lifestyle allows, can you perhaps go to bed an hour earlier so you can still get adequate hours of sleep even with the break? I would not be so concerned with waking up during the night as I would be the length of time of the wake period and total sleep hours. I personally don't expect to sleep straight through a night, but am glad to have progressed to where my wakings are usually brief. Hopefully you'll get there too, and maybe even beyond.

[dir1944]

robysue....thank you so much for your advice. i think you have given me hope that things will get better. i guess i need to stop obsessing about what time it is when i wake up and just continue with the mask on. but sometimes the mask is just too much and i want to take it off for an hour or so. but i think i will try to put the mask back on after waking.

cheers
david

[dir1944]

kteague...thank you also very much for your advice and perspective of my problem. even though i have a bad attitude, i have used the cpap every night except for two nights. on those occasions, i decided i just had to have a good nights sleep and took an ambien and slept like a baby all night, but i've only done that twice.

i am going to see my sleep therapist this coming wednesday. he's going to evaluate the memory stick in my machine and that will give me a chance to ask him questions. he has sleep apnea and uses the same machine i do. he's had it for 5 years and sleeps very well.

apria evaluated my memory stick about a month ago and seemed to indicate everythink was ok but to tell you the truth, i can't stand the apria woman i've been assigned to and she is useless for advice, so there's no help for me with her. but i don't really think that's her role. she's not a doctor nor a therapist so she's right to not offer me any support. she's just concerned with apria getting paid and selling me more items.

thank you for saying it's normal to wake up. once i wake up, i am not tired and i do stay up for at least an hour. i do fall back to sleep effortlessly and i usually wake up around 5am or 5:30am which is normal for me.

cheers
david

[robysue]

after i wake up, i'm up for around an hour and then i go back to sleep, but i never put that mask back on. i do have to use the mask for at least four hours per night to comply with medicare but after the four hours are completed, off goes the mask.

As kteague points out, you do need to use the mask all night long. And until you do, you're not going to feel any better.

Also--the tendency to take the hated mask off after you've woken up is another way you're training yourself to keep waking up during the night: The part of your brain that hates the whole CPAP thing knows that you'll just give in and take the damn thing off if you wake up. Hence that part of your brain that hates the mask may be triggering you to wake up right after four hours of sleep. The only way to defeat that part of your brain is to NOT give in to it. After you go back to bed after the wake, you need to be masked up.

i am going to see my sleep therapist this coming wednesday. he's going to evaluate the memory stick in my machine and that will give me a chance to ask him questions. he has sleep apnea and uses the same machine i do. he's had it for 5 years and sleeps very well.

Two things:

1) Be sure to request a hard copy of the report the doc generates from the memory stick. You want to be sure the doc is looking at the efficacy data as well as the usage data.

2) If your Icon is not an Icon+, you can be hold of the software and look at your own data and learn to understand what it means. Sometimes being able to see the fact that the machine is doing its job of preventing almost all of the apneas and hypopneas is enough motivation to keep on masking up even when you really don't want to.

apria evaluated my memory stick about a month ago and seemed to indicate everythink was ok but to tell you the truth, i can't stand the apria woman i've been assigned to and she is useless for advice, so there's no help for me with her. but i don't really think that's her role. she's not a doctor nor a therapist so she's right to not offer me any support. she's just concerned with apria getting paid and selling me more items.

Apria may very well have looked at nothing except the usage hours---that's all they need in order to get paid.

[dir1944]

robysue....thank you again for your advice. you seem to be an expert about this and i really appreciate your reply to my plea for help. ok, so last night i put the mask on at 8pm and fell asleep around 8:45pm. when i woke up, i didn't even look at the clock so i have no idea when i woke up and i think i fell back to sleep. then i woke up again and was really up! so i looked at the clock and it was 1:30am. so, that was a longer night's sleep than i'm used to. but i did get out of bed for around an hour or so and then went back to sleep, without the mask on and i woke up at 5:30am. i know, i know, i'm supposed to put the mask back on when i go back to sleep and i will try to do that tonight. but i sincerely want to thank you for your advice about keeping it on all night.

cheers
davd

[DEXSUZ]

To dir1944:

I was a lousy sleeper my entire adult life and began CPAP one year ago. Right off the bat, I had many of the problems you've mentioned but have found nocturnal bliss as I adapted to the gear and the way it works.I've got a simple program that did wonders for my adaptation to assisted sleep. Here it is:

This is the four-step program I devised. I had a tremendous sleep study at the local krankenhaus but ran into a granite roadblock as I attempted to get accustomed to masks on my own. You might want to give this a try:

My main advice is to back away from immediately trying to do all-nighters with your full-face equipment. Use my four-step weekly plan WHICH WORKED WONDERFULLY for me:

1) During the first week sit, watch TV, or read with your equipment whirring away next to you. Get accustomed to the sounds, feelings of the moving air, and all the external trappings of the great chance at quality sleep you are nearing. Do NOT go to bed with the equipment.

2) Take the phone off the hook, draw the shades, evict everyone from the house, don't think about any nearby clock, and loosen your clothing as you lie on your bed in mid-afternoon. Turn on the CPAP gizmo, put the mask on your face, and close your eyes. Think peaceful thoughts, whatever they are to you. At some point in the week you WILL fall asleep. After you have this nap, you'll be amazed at what a refreshing experience it was.

3) During the third week have all your CPAP gear ready for action as you go to bed for the night. As you've done so many times throughout the years, you'll awaken far before morning. When you do, slap the mask on your face and turn on the CPAP gear before your groggy brain has any idea what's going on.

4) After successfully completing the first three steps at your pace, decide on a night (mine was March 3rd) when you have full confidence and will retire for the night WITH your mask on. You'll succeed!

My biggest mistake was expecting everything to go perfectly from the first night. It rarely occurs because the brain must be retrained after all those years of awakening in the middle of the night. One must be patient and keep anxiety as far away as possible. On March 3rd, I had a goofy sort of celebration to mark one year of refreshing sleep I never had - over four decades - before last year.

By the way, I went to bed at 10:30 last night and awakened at - ready for this? - 7:45 this morning. For decades that NEVER happened.

Best of luck and God bless.

[dir1944]

dexsuz....thank you very much for your advice. wow! i'm envious of you sleeping that whole night from 10pm to 7:45am
that is really quite an accomplishment.
i just want to make sure i understand. in step three, you go to sleep without the mask and do not turn on the machine? and then when you wake up, immediately put on the mask and turn on the machine? is that right? how long do you do this for? but eventually you do use the mask and the machine when you go to sleep, right?

thanks again for your input. i hope it will help me. i'll try the nap suggestion for sure.

cheers
david

[MitzyG]

I think one of the secrets of success is to find the mask that you really like. Once I switched masks to the Swift LT, I felt so one with the mask. I admit that sometimes I wake up, but I just roll over again. I never feel the "must rip the mask" off feeling. I actually sometimes am so groggy that I don't know the mask is on...it's just there and we're happy together.

I like having the hose attached to the top of my head because then as I roll around, the mask isn't pulling away or slipping. and it feels more like it's a "one" with my face. I breathe quite nicely with it on and it never feels like I'm suffocating or being attacked...it's just conditioned air and I breathe fine. Frankly, if it wasn't for the data coming out of the machine proving that it actually does go up to 13-14, I wouldn't believe it was working properly because it feels so natural (unlike the first machine where I felt it was forcing air into me).

So...I agree with Dexsuz on the recommendations, but make sure you're doing it with a mask you really like.

[Pugsy]

I agree with Robysue's approach..wear the mask when going to bed all the time and try not to strengthen the bad habit of going back to sleep without the mask after a wake up (either short term or long term) ...either at bedtime or in the middle of the night.
It's really easy to make bad habits but really hard to break them. Anytime you allow yourself to sleep without the mask you are strengthening a bad habit.

It's hard enough to start seeing/feeling improvements even with optimal therapy and optimal usage and optimal hours of sleep.
Anytime you reward the bad habit by allowing yourself to not sleep with the mask and machine you are just shooting yourself in the foot.

I know we all cheat sometimes. I cheated yesterday morning myself. Woke up with really bad nausea and after throwing up went back to bed without the mask because I was pretty sure I would have to throw up again...I was wrong and I went back to sleep so I had about 90 minutes without the mask. I paid for it with sore throat from snoring and hubby laughing at me.

[dir1944]

mitzyg and pugsy...you're both wonderful and thank you for your advice. yes, i know i'm not doing myself any good by not wearing the mask after i wake, so because of all of you, i will put the mask back on after waking up. i realize i'm defeating the purpose of the cpap if i don't, but i'm just stubborn!
as i said, i wasn't real comfortable with the nasal pillows and after i switched to the nasal mask, not full facial mask, i was more comfortable. the nasal pillow mask felt claustrophobic and sometimes i would feel like i was suffocating. this doesn't happen to me with the nasal mask i'm using. the tube does not come over my head but from the side but it doesn't impede my turning over at night.

cheers
david

[OboeVet]

David: My 2 cents:

1. If the mid-sleep wake up happens around the same local time, look for another reason: neighbor flushes toilet, neighbor comes home & slams car your, you & your mattress aren't working together and your body needs to change position for a bit, etc.

2. Your biological systems may wake you, like a bathroom break. I also experience wake-ups if I have too much sodium the day before. Also, alcohol can mess up natural sleep cycles, too.

3. DO NOT GIVE UP! Between re-programming your brain and continuing the quest for the mask that works best for you, while you are increasing your vital oxygenation, it takes some people longer than others to settle in.

Wishing you the very best.

Don

[dir1944]

don....thank you for your advice. i live alone in a single family residence on a corner lot. i don't feel that any extraneous noises are waking me up. i feel that my body is so used to waking up, that it's doing it because it has been doing it for so many years. yes, i think my brain needs reprogramming and i will try to do that.
i don't drink and i don't require bathroom breaks during the night.
i guess what had me worried was that if i was waking up because my breathing had stopped, why am i waking up if i'm using the cpap machine which is now supplying more oxygen to my lungs and heart? i'll pose that question to the doctor on wedenday. i guess i'm one of those people that takes longer to settle in. i do like my nasal mask very much as opposed to the nasal pillows type of mask.

cheers and thank you again, don
david

[DEXSUZ]

David:

In step three I'd go to sleep (semi-exhausted, of course) and when I inevitably woke up after only a few hours of sleep, my brain was too groggy to "fight off" the imposition of the mask on my face. I would slap the thing on as quickly as possible, lie back down on my back and think thoughts of almost anything except CPAP. This may sound pretty gauche, but in my days of breaking in the mask, I'd think about the positive aspects of girlfriends I had in the late 1960's/early 1970's. I've been married for almost 42 years so these private reflections relaxed me but I did NOT reveal them to my loving spouse.

So much of getting accustomed to CPAP is winning a mind game with yourself. Mental and psychological patterns developed over for decades must be overcome to save our bodies.

Godspeed and good luck!