Waking in the middle of the night

[MarkWill]

For each of the four nights I have had my device I've got to sleep OK but have woken in the middle of the night. Each time I have found it very difficult to get back to sleep with my mask (pillows). It's strange to me that I can get to sleep OK when I go to bed but can't get BACK to sleep when I wake up (without removing the mask).

This morning was a good example. I went to bed late (2am) and took about 15 mins to nod off. Being late to sleep I would have thought I'd sleep through the night but I woke up at 3:30am and couldn't get back to sleep with my mask. I ended up taking it off. I got to sleep quickly without the mask.

So this is all a bit of a drag. I got about an 90 mins on the device this morning and, though that's the shortest so far, it's consistent with the pattern. I haven't had decent sleep with the device yet and so I am very tired during the day.

Any suggestions on why I might be waking? I don't feel particularly uncomfortable when I first go to bed, either with the mast or the tube. I am also curious why I can't get back sleep.

Not working for me yet at all but I'll be patient.

Mark

[Sir NoddinOff]

Search this site for 'sleep maintenance insomnia' for lots of write-ups (the search window under the CPAPtalk logo). It's a common problem and one I used to suffer from. Probably you are just going thru a spell of getting used to CPAP and it will soon go away.

IMO getting to sleep at 2am is too late to maximize your best night's sleep, unless for some reason you can sleep till 10am. Also, try not to take off your mask, you are defeating the basic tenet of CPAP therapy.

[Janknitz]

It took me a long time to be able to "sleep through the night" on CPAP. Something that may be happening is that you are waking because of pressure changes when you go into REM sleep. If you look at your data you may be able to see what's waking you. But it may be best to give it a few weeks to see if it's just a matter of your body adjusting to this foreign thing you have to sleep with now. If it's that it will gradually stop waking you.

[Julie]

And I wonder if your thinking of it as 'the device' rather than 'my machine' or even just 'the hose' has you unconsciously equating it with medieval torture 'devices' rather than a modern life saver...

[robysue]

This morning was a good example. I went to bed late (2am) and took about 15 mins to nod off. Being late to sleep I would have thought I'd sleep through the night but I woke up at 3:30am and couldn't get back to sleep with my mask. I ended up taking it off. I got to sleep quickly without the mask.

I would suggest that you try do the following when this happens:

If you can't get back to sleep within 10-15 minutes after the wake up, take the mask off and get out of bed. Go to the bathroom. Read a book. Do a crossword. Listen to some quiet music. Do NOT start web browsing or watching TV. And do NOT look at the clock when you are out of bed. Once you start to feel sleepy enough to face putting the mask back on, go back to bed and put the mask on and see if you can get back to sleep relatively quickly.

Any suggestions on why I might be waking? I don't feel particularly uncomfortable when I first go to bed, either with the mast or the tube. I am also curious why I can't get back sleep.

My guess is that you are waking up right after a REM cycle. Post-REM wakes are common and normal. It's just that most people quickly establish there's nothing important enough to wake up for, so they turn over and go right back asleep. The wake is less than 5 minutes long, and they don't even remember it in the morning.

But when you wake up at the end of a REM cycle, you happen to notice that there's this thing on your face and air being blown down your airway. Since your brain has not yet learned how to fully trust this thing, it wakes fully up to figure out just what this thing is. And once you are fully awake, your brain has trouble letting go of the idea that this thing is not fully trustworthy, and that's why you find it hard to get back to sleep.

It takes time for your brain to figure out that the thing on your face is a friendly thing rather than a hostile thing. Once the brain figures out that having the thing on your face is strongly correlated with NOT having to constantly arouse to restart the breathing, it will become easier to quickly fall back asleep when you have a perfectly normal post-REM wake.

[LSAT]

I think you are expecting too much too soon. Just use your machine all night, every night and a week or two from now see how you are doing. Your brain needs to adjust to this therapy.

[MarkWill]

And I wonder if your thinking of it as 'the device' rather than 'my machine' or even just 'the hose' has you unconsciously equating it with medieval torture 'devices' rather than a modern life saver...

No, no issue there, Julie. I don't have any emotional difference in my reaction to "the device" vs. "my machine" and in all seriousness I've found myself to not be too bothered about having to use this device - sorry, I mean my machine I actually kinda look forward to going to bed (which is not me AT ALL normally), since it's all rathner fascinating to me.

[MarkWill]

IMO getting to sleep at 2am is too late to maximize your best night's sleep, unless for some reason you can sleep till 10am. Also, try not to take off your mask, you are defeating the basic tenet of CPAP therapy.

No disagreement there. Over the last 6+ months I have found myself often not being able to get to sleep till the wee hours. So, it's not by design.

I have found it difficult to keep the mask on when I wake up. I've really given it a good shot but, at that time of morning, there's only so much patience I have. On a couple of nights I tried for maybe 30 minutes or so. As soon as I have taken the mask off I've drifted off pretty quickly.

[MarkWill]

I would suggest that you try do the following when this happens:

If you can't get back to sleep within 10-15 minutes after the wake up, take the mask off and get out of bed. Go to the bathroom. Read a book. Do a crossword. Listen to some quiet music. Do NOT start web browsing or watching TV. And do NOT look at the clock when you are out of bed. Once you start to feel sleepy enough to face putting the mask back on, go back to bed and put the mask on and see if you can get back to sleep relatively quickly.

Thank you, RobySue. I'll give it a shot.

[MarkWill]

I think you are expecting too much too soon. Just use your machine all night, every night and a week or two from now see how you are doing. Your brain needs to adjust to this therapy.

Not sure I'd totally agree with that just because my questions here are to try to get some sense of what I should be expecting So, I don't really have too many preconceived ideas at this stage.

I will admit to really looking forward to that first full night of sleep, simply because I look forward to seeing how I feel. And, yes, I am curious about the considerable number of folks who have posted on these forums that "it was like putting on a pair of glasses - immediate results". Those folks seem to adjust straight away but I am clearly not in that bucket, which is fine. But hoping each night for that first full night of sleep.

[Pugsy]

yes, I am curious about the considerable number of folks who have posted on these forums that "it was like putting on a pair of glasses - immediate results". Those folks seem to adjust straight away but I am clearly not in that bucket, which is fine. But hoping each night for that first full night of sleep.

Actually the number of folks who had immediate results are in the minority but that doesn't stop us from hoping that we are in that minority.
I just knew I would be in that minority but life gave me a real big surprise in that I didn't go immediately to sleeping 7 or 8 hours..it took weeks and months to work up to 6 hours from my usual 4 and even more to work up to 7.
Now a couple of the symptoms of sleep apnea did go away pretty much immediately once I got my settings tweaked a little (nocturia and morning killer headaches) but the time asleep and energy level improvements were very slow and very gradual.,,,and certainly not what I expected but that's what life gave me. I just knew that with my attitude and knowledge that I would be one of those who had the miracle immediately but it didn't work out that way.

What I didn't do was yield to the little devil on my shoulder telling me to "go ahead and go back to sleep without the mask because you know you want to". That's a slippery slope to get on in terms of bad habits. Bad habits are easy to make and hard to break. Don't go there if you can help it.

I had some sleep issues unrelated to sleep apnea and the machine couldn't fix those. I had to work on those separately but I never let myself go back to sleep without the mask. I knew that habit would be a really tough one to break if I made it.

[chunkyfrog]

For each of the four nights I have had my device I've got to sleep OK but have woken in the middle of the night. Each time I have found it very difficult to get back to sleep with my mask (pillows). It's strange to me that I can get to sleep OK when I go to bed but can't get BACK to sleep when I wake up (without removing the mask).

This morning was a good example. I went to bed late (2am) and took about 15 mins to nod off. Being late to sleep I would have thought I'd sleep through the night but I woke up at 3:30am and couldn't get back to sleep with my mask. I ended up taking it off. I got to sleep quickly without the mask.

So this is all a bit of a drag. I got about an 90 mins on the device this morning and, though that's the shortest so far, it's consistent with the pattern. I haven't had decent sleep with the device yet and so I am very tired during the day.

Any suggestions on why I might be waking? I don't feel particularly uncomfortable when I first go to bed, either with the mast or the tube. I am also curious why I can't get back sleep.

Not working for me yet at all but I'll be patient.

Mark

Just wondering; did you stay up late in order to be really tired, in order to fall asleep easily?
I found that going to bed before I was totally exhausted made sleeping with cpap easier.
Having a clear head helps me relax--exhaustion just makes me konk out, leading to noisy leaks, and poor sleep.
Otherwise, your attitude is good. Just keep working at it, but try to add time every night.

[MarkWill]

Just wondering; did you stay up late in order to be really tired, in order to fall asleep easily?
I found that going to bed before I was totally exhausted made sleeping with cpap easier.
Having a clear head helps me relax--exhaustion just makes me konk out, leading to noisy leaks, and poor sleep.
Otherwise, your attitude is good. Just keep working at it, but try to add time every night.

Not really. I regularly have days where I can't get to sleep and I have just come to know that if I go to bed I'm just tossing and turning. So this is just a case of reading the signs, to be honest.

However, good news overnight. I had my first full night of sleep. I went to bed around midnight and - very unusually for me - slept will after 8. Accordingly, my machine registered over 8 1/2 hours of sleep, which is great. I did wake up once but, for the first time with my mask, managed to get back to sleep pretty quickly. I am super pleased about that. The machine also recorded an average of 2.4 events per hour, which I assume is good.

It will be interesting to see I feel today. I really don't have high hopes that one night is going to make a difference (just seems too good to be true) and I am looking to see how I feel after a few nights like this. That said, I am still mindful of the folks who said they noticed a significant very quickly - this is my first real night of sleep and I secretly hope I will feel at least a small difference I don't right now, but we'll see.

Thanks

[MarkWill]

Actually, I'll go further (in relation to my previous comment). I'm actually feeling really tired this morning, despite the 8 1/2 hours of CPAP-supported sleep. That makes no sense to me but we'll see what happens in the long run.

[Jay Aitchsee]

Hey Mark, I think this 8 1/2 hours is a good thing, maybe too good. I'm betting your tiredness this morning is due to a modified sleep architecture and waking from the wrong stage of sleep. Kind of like hitting the snooze button on the alarm and going back to a deep sleep. Doing so sometimes seems to "reset" the sleep architecture such that when we wake again it seems like we haven't had a enough sleep. So my theory is your sleep deprivation caused you to go back into a deep sleep before waking this morning (maybe after waking in the night), but there wasn't time enough to complete another sleep cycle, so you feel tired after getting up.

Just a theory. I'm guessing, if it's true, you'll feel better this afternoon, and should resolve after a few nights of normal sleep length.

One thing though, regardless of my theory, I think you need to work on your sleep hygiene. You've mentioned bedtimes ranging from before midnight to after 2 AM. If you want to feel rested, you're going to have to work on consistent bed and rise times.