Insomnia Plus OSA

jrfoster · Post by **jrfoster** » Thu Sep 14, 2006 10:38 am

For some reason I have developed insomnia and cannot get to sleep for hours unless I take an ambien cr. It just started this spring and I hope it would go away because I feel like I'm walking in a fog. If I take a sleeping pill, along with my APAP, then I get 6-7 hours of sleep and feel good the next day. Otherwise, I can't tolerate the mask, because I am not sleeping and the next day is awful.

Anyone else suffered with insomnia and overcame it? I need help!

Jeff

Sleepless in St. Louis · Post by **Sleepless in St. Louis** » Thu Sep 14, 2006 12:44 pm

I'd be willing to bet that many members of this board have struggled with insomnia, including me, at some time or other. There are many things that can contribute to this problem. Search around on the web for tips on good sleep hygene. For me, a good diet, plenty of exercise, a good attitute, and once in a while sleep meds have helped me get over rough spots. Depression can also make this problem worse, although I think not sleeping leads to depression more than the reverse. Insomnia is a curse, but there are ways to fight back. Just remember that many cases of insomnia are not permanent, even though it may feel like it is when you're the one suffering.

And continuing your cpap treatment should help in the long run more than it hurts. I can attest to that.

Hang in there.

Tim

caty · Post by **caty** » Thu Sep 14, 2006 1:04 pm

Suffering from insomnia caused to go to the doctor. I'm in my 50's and going through "the change" (sorry all you men out there). Insomnia is a menopausal symptom. Dr. prescribed Lunesta. Didn't work. Went back to the doctor. Sent me for a sleep study. Got xpap. Still suffering from insomnia but not as badly. Usually takes me 1.5 hours to fall asleep and sometimes wake up and have a hard time falling asleep again. I don't want to rely on sleeping aids. Didn't like the taste I got from Lunesta; Ambien doesn't sound like a good idea. I don't use caffeine after 2 pm. I avoid chocolate in the evenings - but none of that seemed to help. Last night had a glass of warm milk before going to bed. I was still up for 45 minutes but I slept pretty good the rest of the night. Have to try it again tonight to see how it works. If the insomnia continues, I'll go back to the doc to see what she suggests. Maybe that new sleep aid, saw it on a commercial, starts with an R, I think. Sorry, memory not what it used to be!

One of the things my sleep doctor did discuss was "sleep hygiene". No caffeine after a certain time, dark cool room, comfortable sleeping clothes, white noise, not going to bed stressed (he suggested writing down things that were bothering me before going to bed and then forgetting about it), getting up and doing something boring for half an hour if not falling asleep within 20 minutes and then trying again.

I do most of these things except for writing down my stresses and getting up after 20 minutes. I should probably try the getting up part, but once I'm in bed I don't want to get out. I guess I'm afraid I'll go back to bed a half and hour later and still not fall asleep.

I wish you well in your quest for sleep!

krousseau · Post by **krousseau** » Thu Sep 14, 2006 1:08 pm

Insomnia predated OSA by many years. Not sure I can say I have overcome it-I just got more relaxed about it and that helps. I no longer worry about using a sleep medication (Ambien CR). I keep a pill and glass of water at my bedside and take it if I'm not asleep by midnight. If I'm going to be driving a lot the next day I always take it by 10 PM and go to bed. I used to get 60 pills and dole them out to myself over a year-now I use it about 1/3 of the time. I use a lot of sleep hygiene/insomnia practices-limit caffeine & alcohol, get exercise, have bright natural light exposure, listen to relaxation CD's, meditate, have a bedtime routine, don't balance checkbook or watch news before bed-you can find it all online. Fortunately I'm retired so if I don't sleep-I just have a lazy day go for walks-read-and sleep the next night. If I still worked I would probably feel more pressure to sleep and use Ambien a lot more.
If I use Ambien nightly for >2 weeks I have rebound insomnia-so taper off of it in that case. I've done that several times in the past three years since starting Ambien.

If I take a sleeping pill, along with my APAP, then I get 6-7 hours of sleep and feel good the next day.

To that my sleep doc would say-you got the help-Ambien & CPAP. So relax, learn more about Ambien if you need to in order to feel comfortable with it. If you feel like you are "addicted" or don't like the idea of having to take the Ambien every night-learn how to stop it-and actually stop-that will let you know you are in control of the medication and can choose how/when to use it.

jrfoster · Post by **jrfoster** » Thu Sep 14, 2006 6:18 pm

Thank you all for your kindness. I am going to try taking 1 Rozerim tablet 30 minutes prior to bed, and then if I am still awake 90 minutes later I will take a 12.5mg Ambien CR. If I don't get some sleep tonight, tomorrow will be worse than today.

Sleepless in St. Louis · Post by **Sleepless in St. Louis** » Thu Sep 14, 2006 7:41 pm

Good luck. I think sleep meds are a good way to get you out of a bad spot. I don't like using them long term, but man they come in handy once in a while. We're all pulling for you.

Tim

Jere · Post by **Jere** » Thu Sep 14, 2006 7:43 pm

my favorite topic!

Seriously, insomnia is the pits. I have suffered with it since college and it has been a struggle.

There are lots of posts here. If you are having trouble sleeping while you are getting used to xpap, then you are pretty lucky. As you get used to the mask and all that you will probably find the insomnia going away.

All the sleep hygiene tips are helpful (caffeine control is key for me). Something that was very effective for me was, after years of guilt, to give myself permission to take sleep medication if I needed it. It took one excellent sleep doc to teach me that. Putting the pill on your bedstand is a great way to implement this. Hopefully, as the days and weeks pass you will wake up in the morning and find that pill still there much more often than not.

Good luck!

krousseau · Post by **krousseau** » Thu Sep 14, 2006 7:44 pm

I can't believe what I (like me of all people) am going to say next. Just know that I am repeating what the insomnia specialist I saw told me. "One of the things to learn about sleep and insomnia is not to focus on HAVING to sleep." When you are trying too hard it doesn't work. Relaxation techniques can help-I was so tired I ordered one online and paid for guaranteed next day delivery. There are things to think about before you get one: male or female voice, structured progressive relaxation approach, imagery, vizualization, or just soft music. There are also CD's designed to promote delta brain waves-I find the "music" on them irritating-others swear by them. I lean toward the structured relaxation with someone telling me to relax because it distracts me from thinking about going to sleep. I am incurably fussy about the voice too so would never buy without listening.

Jere · Post by **Jere** » Thu Sep 14, 2006 7:56 pm

Sort of like not talking about the elephant in the room.

It has taken YEARS for me to even get half-way to the point of not thinking about sleep when I can't sleep. It's hard. Not impossible, but very hard.

One thing that helps (for me) to stop thinking about not sleeping is to listen to my iPod when I turn off the light. I usually listen NPR shows I have taped - talking works better for me than music.

Just a thought.

krousseau · Post by **krousseau** » Thu Sep 14, 2006 10:13 pm

Reading is also good-textbooks if they aren't too heavy-no to mysteries-history is good. Ironically...William Dement's book "The Promise of Sleep" has been a great book for....er....on sleep. I've been reading it at bedtime for a month and I'm only on page 29. And if you don't fall asleep you will learn more about the subject. Reading is the reason I do want the Hybrid to work for me. If I read and get sleepy-then have to fiddle getting glasses off, mask on, light off-I'm awake again. Now there is a timer on my light-and sometimes the glasses don't get taken off until the next AM.

wabmorgan · Post by **wabmorgan** » Fri Sep 15, 2006 1:44 am

I also have insomnia... have tried Ambein... didn't seem to do anything for me.

jrfoster · Post by **jrfoster** » Fri Sep 15, 2006 7:56 am

Report from last night. I took the Rozerim 8mg tablet with a glass of warm milk 30 minutes before bed. Got into bed, turn on my sound machine with gentle waves rolling in and out, and 90 minutes later was still awake, tired and yawning but awake. Rozerim is not working for me. So I took my Ambien CR and 20 minutes later I was asleep. The next thing I knew daylight was coming through the windows. I guess it would be about 7 hours of sleep. My APAP only went up to 7.5 unlike the 10 that my old CPAP constantly blew in my face. As the day goes on I should feel better than yesterday!

One day at a time. Hopefully, one of those days will be when I can say "I used to suffer from insomnia!"

steph · Post by **steph** » Mon Sep 25, 2006 3:24 am

some great advice here. I have cut out caffein completely and the more active your mind is at night the harder its going to be to sleep.

relaxation cd's are also very helpful. they tend to be expensive but if you search around you can find good deals. Ive gotten my last few from a site where they offer them for free. http://www.audionoesis.com

krousseau wrote:Insomnia predated OSA by many years. Not sure I can say I have overcome it-I just got more relaxed about it and that helps. I no longer worry about using a sleep medication (Ambien CR). I keep a pill and glass of water at my bedside and take it if I'm not asleep by midnight. If I'm going to be driving a lot the next day I always take it by 10 PM and go to bed. I used to get 60 pills and dole them out to myself over a year-now I use it about 1/3 of the time. I use a lot of sleep hygiene/insomnia practices-limit caffeine & alcohol, get exercise, have bright natural light exposure, listen to relaxation CD's, meditate, have a bedtime routine, don't balance checkbook or watch news before bed-you can find it all online. Fortunately I'm retired so if I don't sleep-I just have a lazy day go for walks-read-and sleep the next night. If I still worked I would probably feel more pressure to sleep and use Ambien a lot more.
If I use Ambien nightly for >2 weeks I have rebound insomnia-so taper off of it in that case. I've done that several times in the past three years since starting Ambien.
If I take a sleeping pill, along with my APAP, then I get 6-7 hours of sleep and feel good the next day.
To that my sleep doc would say-you got the help-Ambien & CPAP. So relax, learn more about Ambien if you need to in order to feel comfortable with it. If you feel like you are "addicted" or don't like the idea of having to take the Ambien every night-learn how to stop it-and actually stop-that will let you know you are in control of the medication and can choose how/when to use it.

CollegeGirl · Post by **CollegeGirl** » Mon Sep 25, 2006 4:27 am

Rozerim is not working for me. So I took my Ambien CR and 20 minutes later I was asleep

Wait a sec, wouldn't taking two sleep aids in one night be potentially dangerous, especially for someone with apnea?

Someone else with more knowledge in sleep aids can chime in here, but, even though they're different drugs, it would seem to me to be a bad idea.

I suffered with insomnia myself - I just didn't *want* to go to bed, and I couldn't figure out why I was so scared to. I think subconsciously my body knew it was dangerous for me, sleeping with untreated apnea, even before I knew I had it. The day I got CPAP was the day I stopped having insomnia problems. I wasn't scared to sleep anymore.

As someone else said, if you're still adjusting to your setup, that's probably why you're having insomnia issues. They'll iron themselves out once you've gotten used to everything, more than likely.

Good luck!

jrfoster · Post by **jrfoster** » Mon Sep 25, 2006 8:03 am

CollegeGirl wrote:
Rozerim is not working for me. So I took my Ambien CR and 20 minutes later I was asleep

Wait a sec, wouldn't taking two sleep aids in one night be potentially dangerous, especially for someone with apnea?

My doctor said that Rozerim works differently than Ambien or Lunesta. It works on helping to fix the sleep cycle so you can fall asleep naturally. The others work on putting you to sleep but not helping the cycle get back to normal. Sure hope he is right!

Jeff