Keep waking up in middle of night (3-5AM)

[jccameron]

[Update below in a follow-up message...]

Hi everyone,

I'm a newbie. I just started using a SleepStyle200 HC254 and ResMed Quattro mask last week. I have mild to moderate sleep apnea and it's been set at 6 to 11. I used to start sleeping on my stomach every night but then almost always awakened to find myself on my back. My apnea is mild on my side and worse on my back.

I take ambien to help me fall asleep at night and I generally have no problem falling asleep with the mask on. However, every night for the past week I have awakened between 3-5AM and removed the mask. A couple of times I was aware of doing it and so tried to keep it on but could not go back to sleep. However, most of the time I don't recall even taking it off.

Additional info - I am a mouth breather - I have a deviated septum which makes it nearly impossible for me to breath through my nose. I am seeing an ENT next week to discuss options but that's why I have the full-face mask.

I have PM'ed someone who says they have the software for this machine. Hoping to use that to get a better idea of what is going on. Worried that if I am taking it off for 1/2 of each night, that I won't get the results I need from it.

Any suggestions and pointers for this new user would be appreciated.

[SleepyT]

jc,
you're still new to this...and it's possible you have not formed a habit with your machine..or subconsciously you do not want to embrace CPAP. sounds like a lot of hocus pocus, i know, but many newbies experience this...including me! i don't do it anymore though...so it's a phase you need to move through...perhaps!

could be physical causes too...your deviated septum, drinking alcohol too late in the evening...rain out in your hose...

i guess the short and skinny is...it gets better from here. hang in there while you tweak your way along.

t.

[Rustyolddude]

I did this a few times when I was on Ambien as well. I haven't since I quit taking it.

[kyteacher]

I am also a newbie and would wake up in the middle of the night and "consciously" remove my mask (with nasal pillows). The reason I would wake up is because my pressure would be high, and I couldn't handle it. So I removed my mask and turned off my apap machine. Another reason I would wake up is that I would roll over, and not being use to wearing a mask and head gear, I would wake myself up. Maybe you are removing your mask for these reasons, but are not totally awake to realize you've done this.

Does your cpap have an alarm that sounds when your mask leaks? Mine is set to go off if there is a leak, but it never has, so I don't know if it's loud enough to wake someone in a deep sleep. Just thought if you had an alarm you would wake up and could replace your mask.

Hang in there, I know it's frustrating. I am going on my third week, and don't wake up nearly as many times as the first 2 weeks. I only wake up once or twice during the night, which is good for me. I have tried several mask, and am going to use the Mirage Quattro like you're using. I just can't handle nasal pillows.

[Big_cPAPpy]

I'm a newbie here too. After almost a week I have to say, I feel like I am really struggling; I haven’t slept more than four hours and feel even sleepier now than when I started. I feel I could put up with the equipment difficulties if I were starting to feel better.

Here are my two questions for experienced cPAPers:
- Can I ever expect to sleep through the night with cPAP?
- How long before there is any improvement in my sleepiness?

Thanks in advance

[jccameron]

Thanks for the quick replies. I am definitely going to stick with it for at least a month to see how it goes, but am certainly hoping (and expecting) that I'll be able to make it through the night without waking up. I did at the sleep study center but really need want to just lock the mask in place now so that it stays on or make it so it is too hard to take off while I am sleepy (I know...I know, that dangerous, just kidding).

Other than not sleeping all the way through the night, I have noticed a couple of days where it did seem to help. Of course, those were the two days where the bridge of my nose also hurt so you take the good with the bad. My nose is getting conditioned (or I am not being as rough now) as it's not bothering me as much now.

To the other newbies like me - the only thing that has really been made apparent is that something like this takes at least a few weeks to get used to. So, keep it at for at least that long before even considering giving up.

PS. This looks to be a pretty good, active, encouraging community. I am honestly impressed.

[Kiralynx]

PS. This looks to be a pretty good, active, encouraging community. I am honestly impressed.

It's a great community. I legitimately feel that the tips and suggestions I've garnered through participation here have made my current success possible.

[jweeks]

Here are my two questions for experienced cPAPers:
- Can I ever expect to sleep through the night with cPAP?
- How long before there is any improvement in my sleepiness?

Hi,

Think about it this way...for years, your body has been adapting to waking up all the time at night, sometimes every few minutes, and then falling asleep during the day. Now, suddenly you have changed things, and you are expecting your body to instantly start sleeping through the night. It doesn't quite work that way all the time. You basically have to learn how to sleep all over again, and train your body to stay sleeping throughout the night. For me, I would consistently get up after about 2-1/2 hours, and be awake for an hour or so. My body had as much sleep in those 2-1/2 hours as I used to get in a 9 hour night before treatment. It was hard to break that habit, which took me about 8 months or so.

Another item that I ran into is that since I was up every hour to 90 minutes before treatment, I was always pretty limber. Then when I started CPAP, I would get cramps and would wake up stiff. I simply wasn't used to being in one position for more than a few minutes. I again had to learn how to sleep again by finding comfortable positions and getting a comfortable air temperature in my bedroom.

As far as still being sleepy, that might be something that you should take up with your sleep doctor. OSA might just be one layer of issue, and when that is treated, something else might come to the surface. It might also be that your numbers don't look good. That is something that a doctor, an RT, you, or the group here could take a look at. While others can give ideas, only your sleep doc can make a medical diagnosis and prescribe a treatment. But you also get to be part of your treatment, so you want to get up to speed on your data.

-john-

[GaryG]

CPAP is just one of those things that doesn't work until it does. I mean, you have to have patience and persistence, and be willing to try multiple masks of different types, and then once you find a mask you can wear, work on reducing the leaks, and then and only then worry about if you feel better.

In fact, until you get it working, it is normal to feel worse. With OSA, you already aren't getting restful sleep, and add to it, wearing something strange on your face that blows air, I mean it takes time. There's lots of help me by folks certainly a lot more knowledgeable than me. It took me over 6 weeks to get that AHA night where I woke up with my nose clear and felt just a tad better.

[Wulfman]

Hi everyone,

I'm a newbie. I just started using a SleepStyle200 HC254 and ResMed Quattro mask last week. I have mild to moderate sleep apnea and it's been set at 6 to 11. I used to start sleeping on my stomach every night but then almost always awakened to find myself on my back. My apnea is mild on my side and worse on my back.

I take ambien to help me fall asleep at night and I generally have no problem falling asleep with the mask on. However, every night for the past week I have awakened between 3-5AM and removed the mask. A couple of times I was aware of doing it and so tried to keep it on but could not go back to sleep. However, most of the time I don't recall even taking it off.

Additional info - I am a mouth breather - I have a deviated septum which makes it nearly impossible for me to breath through my nose. I am seeing an ENT next week to discuss options but that's why I have the full-face mask.

I have PM'ed someone who says they have the software for this machine. Hoping to use that to get a better idea of what is going on. Worried that if I am taking it off for 1/2 of each night, that I won't get the results I need from it.

Any suggestions and pointers for this new user would be appreciated.

Pre-therapy, I was a mouth-breather when I slept, too. Restricted nasal passages (enlarged turbinates?) and possible deviated septum. If you're using heated humidity with your machine, I'd suggest turning it way down or off. I even keep my distilled water in the refrigerator. The cool air keeps my nasal passages open when I sleep and I can get a sufficient amount of air without having to open my mouth. I've contemplated visiting an ENT, too, but as long as things are working out, I'll save my money. I've also read that the people who had turbinate reduction and septoplasty are still using CPAP. Also, if you're not already, I'd suggest doing nasal cleansing/rinses before bedtime.

Taking off the mask during the night is a pretty universal experience for new users.


Den

[jccameron]

Okay, so, after posting here that I could not make it through the night with the mask on, I went to bed a little later than usual (1AM) but and this is a huge but, the mask was still on at 7:30 AM when I woke up for good. Several times during the night I did indeed wake but managed to keep the mask on and go back to bed. When I did wake in the morning, the breathing in the mask almost seemed normal compared to when I went to bed. That felt good.

The only difference last night was that while watching an hour of TV before bed, I put the mask on and tried to get more comfortable with it even while awake. I did, learn, however, that trying to adjust your mask while sitting up and watching tv is a BAD thing because, not surprisingly, gravity does a good job of helping keep the mask on. I had that mask so tight at first while sitting up (to remove the leaks) that I thought my head would slowly explode.

So, to other newbies - you might want to try practicing with it on before bed time in front of the tv. Then, when you go to bed, do something distracting but tiring - I use my iphone to play a boring game of solitare until my eyes and head start to nod off.

Now, all I can hope is that the improvement continues.

[Wulfman]

Congratulations.
Hang in there......it gets better.


Den

[Scarlet834]

Me too, me too! I'm a nearly 2-week user and almost a week into my second mask. I am trying to allow the adaptation period many have mentioned, but at the moment I am severely concerned about how whether I can function (at work) the way I felt yesterday and today and am thankful that I am in the middle of a 2-week vacation. I had flashes of "something good" early on, but unfortunately those were with the mask that destroyed the bridge of my nose. I can easily wear the nasal pillows all night, and any leaks I have adjusted in the middle of the night have been pretty slight. I swallowed an unusual amount of air last night, no pain, but hopefully that doesn't impact the pressure that went down the airways. My therapist told me that getting 5 hours of quality sleep a night should make a difference, as opposed to 8 hours non-quality sleep before CPAP. Thinking back to my sleep study, the bouts of breathing struggle were concentrated between 3-5 am. So I might be getting the same 5 hours sleep I always was and have not completely solved 3-5? Anyway, I am focusing on that early morning time period for solutions and hoping this is just my body getting used to something new.

[Big_cPAPpy]

PS. This looks to be a pretty good, active, encouraging community. I am honestly impressed.

I'll second these sentiments!!! Thank you everyone for such great responses.

I did talk to the tech at my DME, who said that if I am already getting 4 hours, then I am ahead of the curve. Here too, I am hearing that it takes a lot of time to adjust, so I am much less discouraged today than I was yesterday. Maybe I can use the extra time to catch up on my reading!

I have a follow up with the DME after 1 month, and at the sleep center after 2 months, and I am determined to try to sleep as much as I can with my CPAP until then. Hopefully, I will have worked out the kinks (literally and metaphorically) by then. This site is a great resource for encouragement and tips.

[Jason S.]

You have very much the same issues as me, with the moth breathing and the deviated septum. I wonder if your Ambien is wearing off/wearing thin and that's why you are waking. Although I always awaken in the night. Is that really a big deal if you can go right back to sleep? I've never fallen asleep and then stayed asleep all night long until morning.