Sleeping pills with cpap

[Axxel]

Does anyone do a combo of sleeping pills with cpap. I use cpap and still wake up every 2 hours. Wonder how well the 2 would do together.

Besides continuous sleep, I need more deep sleep also. What kind of sleep will pills induce?

[Pugsy]

I have used and still use Ambien occasionally no problems with it.

BUT try to isolate what is causing the wake ups at 2 hours. It could be events waking you up if you happen to be having more events in REM sleep. REM sleep starts around 90 to 120 minutes after sleep onset.
You may simply need a little more pressure.

There are also some OTC meds one can try. Melatonin, Benadryl are a couple along with some other minerals that might help.

So any idea why you wake up after 2 hours? Do you go right back to sleep? Have trouble going back to sleep? Pain?

Before resorting to sleeping pills I would suggest trying to isolate the problem and fix it if possible. Sleeping pills are geared mostly to help you fall asleep ....not stay asleep. How much they might help depends on the cause of no sleep.
They have their place but they also come with some potential baggage and unwanted side effects. Make sure you are well educated as to pros and cons and have done a risk vs benefit comparison.

[Axxel]

I have used and still use Ambien occasionally no problems with it.

BUT try to isolate what is causing the wake ups at 2 hours. It could be events waking you up if you happen to be having more events in REM sleep. REM sleep starts around 90 to 120 minutes after sleep onset.
You may simply need a little more pressure.

There are also some OTC meds one can try. Melatonin, Benadryl are a couple along with some other minerals that might help.

So any idea why you wake up after 2 hours? Do you go right back to sleep? Have trouble going back to sleep? Pain?

Before resorting to sleeping pills I would suggest trying to isolate the problem and fix it if possible. Sleeping pills are geared mostly to help you fall asleep ....not stay asleep. How much they might help depends on the cause of no sleep.
They have their place but they also come with some potential baggage and unwanted side effects. Make sure you are well educated as to pros and cons and have done a risk vs benefit comparison.

I think it maybe anxiety/stress. When I was heavier, and my osa was tested as severe, I could sleep for 4-5 hours straight. Then, divorce happened and all the drama with that. Thats exactly when the 2 hour wake ups started. However, I lost weight, retested and was downgraded to mild osa, and dont have that stress anymore. That was 2 years ago. Still waking up at 2 hours. It can take anywhere from 5 minutes to an hour to fall back asleep. In the past, before 2 hr wake ups, and I would wake up once or twice a night to urinate, I could fall back asleep almost instantly.

Melatonin works good to put me asleep when I first go to bed. Doesnt keep me asleep. Even tried timed release melatonin. I guess I will try benedryl. Wanted to avoid doing that especially on a frequent or even nightly basis because it is not good for the prostate if you have issues there and I have had flare ups with that when I was heavier.

I do have shoulder pain, but, I dont believe its waking me up. I didnt have the shoulder problems when the 2 hr wake ups started 2 years ago. Shoulder injury was several months later. Not aware of much pain when Im lying down. Its definitely a possibility though. Not much I can do about it though. Rehabbing the shoulders. Slow healing process.

[M.D.Hosehead]

Axxel, everyone is different and you have to do your own research and make your own decisions.

Ambien and other "Z-drugs" help initiate sleep but typically wear off after a few hours. OTC Benedryl, and low-dose trazadone and doxepin are better at maintaining sleep.

You can look these up on Wikipedia or the internet and discuss them with your doctor. A few people have problems with them; the majority don't.

In my case, I haven't yet found a combination of machine and mask that doesn't wake me up at least hourly. If I could find compatible apparatus, I'd prefer to sleep without meds. So far, though, the combination of restful sleep, apnea control and good oxygen levels requires pharmacologic help.

[Pugsy]

With prostate issues..you know..Benadryl not advise in any great numbers. Heck it may not even help.
So watch it. Melatonin didn't help me either and made me extremely dizzy.

Best thing is to talk to doctor and get his input if you can. There is Ambien CR for maintaining longer sleep..but very pricey when compare to the regular ambien.

Sounds like sleep maintenance insomnia. Get to sleep okay but just can't stay asleep.
Robysue has some ideas on how to sort through some insomnia issues. While your insomnia is not from the cpap machine she has some good general basic ideas that are pertinent to all insomnia causes.
http://adventures-in-hosehead-land.blog ... er_19.html

In my case I have some pain issues and the pain was causing 20 to 30 wake ups a night. I would go right back to sleep though. I used Ambien to help sleep a little deeper and thus not wake so often with the pain. I have also work on other things to do to lessen the pain so I don't have to take the Ambien.

I now take a tiny amount of amitriptyline an hour or so before bedtime. We are sort of treating it like Fibromyalgia even though I don't have the other classic symptoms. My pain is related to old broken back and some arthritis.
It does pretty good. I don't have a hang over the next morning with such a small amount and I sleep through the night with maybe only a couple of wake ups. It also has greatly reduced my morning headaches from my bad neck.

Talk with your doctor about your problem. There are pros and cons to all meds. Not everyone wants to use the meds.
You know your body better than anyone else. Meds have their place but are not always the perfect solution that we long for. I would prefer to do without them also... but I simply have too much pain and my daytime pain pill (Ultram) wires me up something fierce so I can't take it at night despite the "drowsiness" sticker on the bottle.

[robysue]

I think it maybe anxiety/stress. When I was heavier, and my osa was tested as severe, I could sleep for 4-5 hours straight. Then, divorce happened and all the drama with that. Thats exactly when the 2 hour wake ups started. However, I lost weight, retested and was downgraded to mild osa, and dont have that stress anymore. That was 2 years ago. Still waking up at 2 hours. It can take anywhere from 5 minutes to an hour to fall back asleep. In the past, before 2 hr wake ups, and I would wake up once or twice a night to urinate, I could fall back asleep almost instantly.

You might want to read Sound Sleep, Sound Mind by Dr. Barry Krakow. Because as silly as it sounds, you might be waking up every two hours out of habit---a bad habit that unfortunately got established when you were under a lot of stress. Back then, when you woke up at night and couldn't get back to sleep quickly, I bet you spent a lot of time staring at the clock and worrying about things: worrying about how little sleep you were getting, worrying about the divorce, worrying about all the drama, and so on. But the sad thing is those behaviors can ironically encourage you to continue to have problems with waking up in the middle of the night and not being able to get back to sleep. And unfortunately, it appears that with all the stress in your life two years ago that you accidentally taught your body that it's perfectly ok to wake up every two hours and worry about things.

Right now what do you do when you can't fall back asleep? Still toss and turn and lie in bed worrying about the fact that you're not asleep? And are you still staring at the clock? If that's the case, then working on breaking the habit may be enough (with time) to get you sleeping more or less soundly through the night again. So again, read Sound Sleep, Sound Mind. In it, Dr. Barry Krakow talks at length about what kinds of behaviors we insomniacs often do that encourage us to have problems both getting to sleep and staying asleep and offers multiple strategies for teaching ourselves to break the bad habits and reteaching ourselves how to sleep through the night once again. One commonly suggested strategy for this kind of insomnia is getting out of bed if you can't get back to sleep in a timely fashion. So It may be that on those sleepless nights you would be better off if you simply out of bed after about 20 minutes if you're not making any progress towards getting back to sleep. While out of bed, you should try to do something that is sleep inducing: Make a cup of sleepytime tea or warm mild perhaps. Read a boring book (but not in bed). Simply sitting in the semidark for 15 or 20 minutes might be enough to make you get sleepy. But the point of getting out of bed is to force your body and mind to realize it is NOT ok to be in bed, wide awake and (most likely) worrying about not being asleep.

[TheDreamer]

I'm currently on Lunesta (3mg).... wish I had more or something....that would help me get to sleep and not wake up. The Lunesta is just making it so that I get back to sleep sooner when I do wake during the night...

I started with Ambien, and then Remeron....and then 1mg Lunesta and then 2mg...to now 3mg.

Before the prescriptions...I had found Advil PM helpful...and, taking an Aleve at bedtime is part of my routine now....

I'm also on Ropinirole....and a bunch of other things....

The Dreamer.

[Axxel]

One thing I forgot to mention and this is a major factor and cant believe I forgot it, but I worked graveyard shift for 3 years ending in December 2010. The 2 hr wake up insomnia started about 1.5 years into that time period. Maybe my bodies clock is just permanently messed up?

[Pugsy]

The 2 hr wake up insomnia started about 1.5 years into that time period. Maybe my bodies clock is just permanently messed up?

You know it could be or it could also just be a bad habit from previous stressors.
Bad habits are so darn easy to make and often so difficult to break.

[ThirdOutOfFive]

I have fibromyalgia, and take sedative anti-depressants in order to sleep. I took them for both sleep studies and take them everynight with PAPpy. OSA or no OSA, I couldn't sleep with out the pills. Of course, I have told the doc. If in doubt, you should check with your doc to make sure you aren't taking something that might not mix with any other 'scripts or OTC drugs/supplements you are taking.

[JohnBFisher]

... If in doubt, you should check with your doc to make sure you aren't taking something that might not mix with any other 'scripts or OTC drugs/supplements you are taking. ...

I would like to emphasize that. I have no problem with taking medications to help promote sleep. In fact I periodically use a prescription anti-depressant (Remeron) to help promote better sleep. But it usually helps to talk out some of the issues with your doctor. Your doctor might have some suggestions to help you get better sleep. Also, remember that some wake ups during the night are normal and should not really be a problem ... as long as you can easily get back to sleep. In fact, it's only fairly recently that people started to think they should sleep through the entire night. Pre-industrial revolution, segmented sleep was considered the norm. For example, Shakespeare refers to First and Second Sleep:

http://www.historycooperative.org/journ ... 00343.html

But as another poster noted, if it comes fairly regularly and is not stress related, then it might be a cluster of apneas that awaken you.

And as you note, if it seems to be stress / habit related, you can start to alter the habit.

Best of luck to the original poster, as you strive for better sleep.

[Bright Choice]

Great suggestions here. One other thought: very subtle leg jerks can awaken you. That's true for me. You might check with your md. Did you have leg movements during psg?

[JointPain]

I always wondered if taking sleep meds when you have OSA was dangerous, since supposedly we need to wake up to clear the apnea (which still occur, albeit relatively infrequently, when on XPAP therapy).

Sounds like they're perfectly safe though.

[DrowsyDan]

Someone mentioned "period leg movements during sleep". A similar condition is "restless leg syndrome" (RLS). I've had RLS for years, and antihistamines can definitely make it much worse. Benedryl/diphenhydramine is an antihistamine, it's the same drug contained in things like "Ibuprofen/Tylenol PM", etc. If it's OTC & it says "PM", it likely contains an antihistamine to help you sleep, probably diphenhydramine. OTC sleep drugs like unisom/doxylamine are also antihistamines. They're fine for occasional use if you don't have RLS, they can be very unpleasant if you do.

In my personal experience, muscle relaxants like Flexeril/Cyclobenzaprine have also caused severe RLS. Opioid drugs (codeine, Vicodin, etc., the class of drugs used as narcotic analgesics) will greatly reduce RLS, and are sometimes used in its treatment.

I've taken Ambien/zolpidem for sleep, in fact, I used it during both my sleep studies. The "CR" (constant release) variety works especially well to get you through the night, again, occasionally. I find the drug causes my mood to be depressed the next day, however, and I personally know someone who has had sleep walking/eating while on the drug.

[Bright Choice]

I always wondered if taking sleep meds when you have OSA was dangerous, since supposedly we need to wake up to clear the apnea (which still occur, albeit relatively infrequently, when on XPAP therapy).

Sounds like they're perfectly safe though.

I am not sure what you mean that you need to "wake up to clear the apnea". Apenic events are "cleared" with the use of xpap and the goal is to sleep through the night without arousals. One should be able to sleep through the night even if you have some apenic events that show up during the night.