Sleeping part of night without CPAP?

[stevos2000]

This is a question that's been bothering me since I've started CPAP (32 days ago). I've fallen into a pattern where I regularly wake up after 5 or so hours of sleep with CPAP. I attempt to get back to sleep with CPAP but typically give up after another hour. So here's the question: Should I disengage from CPAP and return to sleep for 2 more hours (of deep but probably apnea event filled sleep) or should I just get up and face the day with 5 or 6 hours of healthy sleep? I asked one doctor about this, and he said that 4 to 6 hours of CPAP is all that was required. After that he said I should take off the mask and go back to sleep. This seems medically wrong to me and contrary to my own subjective experience. (I've tried both ways). What do you all think? Is this one of those "do whatever works for you" type things that I hear so much from the doctors or is there some real answer based on sound sleep science?

[Pugsy]

While I suppose 5 or 6 hours of cpap use is certainly better than zero use, if you allow yourself to sleep without the machine for 2 hours.....you have 2 hours of stress on your body from the events and possible oxygen level drops that occur during that time. Your body will remember the bad 2 hours and not the previous good 5 hours. So not only will you be allowing unneeded stress and damage to your body, you will likely feel like crap anyway.

Bad, bad habit to get into. First it is 30 minutes without machine...then 60....then 90 ... then 120.....then 3 hours and before you know it you have taught your body a really bad habit and then you say "okay, I will skip the machine tonight".. and before long the machine is gathering dust and not being used at all.

Don't even start to go there. Sleep equals mask on. Simple as that. No exceptions. Do your body a favor and don't let it experience any unnecessary stress and damage...no matter how short of a time period.

[apneawho]

I am not sure if this is possible, but I am sometimes waking up in middle of the night feeling refreshed like it is time to get up but it is not. I was wondering if this is because I am finally getting uninterrupted quality sleep and my body thinks it is time to get up. I have been lying awake with my mask on until I finally do go back to sleep, but it sometimes takes a while. Doesn't happen every night thank goodness.

[jamiswolf]

Hi Stevos,
Like you, my Doctor also told me that using it all night wasn't really necessary. I'm curious if there are any studies out there that show a certain minimum number of hours are sufficient to improve health and pay back the "sleep debt" people talk about.

My Doc, a Pulmonologist and certified sleep specialist told me to try and get at least 4 hours of cpap a day. I'm usually able to keep it on all night, but I don't feel guilty if I abort an occasional night of cpap a little early.
Jamis

[BlackSpinner]

Hi Stevos,
Like you, my Doctor also told me that using it all night wasn't really necessary. I'm curious if there are any studies out there that show a certain minimum number of hours are sufficient to improve health and pay back the "sleep debt" people talk about.

My Doc, a Pulmonologist and certified sleep specialist told me to try and get at least 4 hours of cpap a day. I'm usually able to keep it on all night, but I don't feel guilty if I abort an occasional night of cpap a little early.
Jamis

4 hours is what the insurance requires and is better then nothing but it is not great either. If your SPO drops significantly during sleep it means several hours with the equivalent of someones hands around your throat. Basically sleeping without the machine is like inviting strangers into your house while you sleep, nothing might happen but .... not smart.

[ameriken]

So here's the question: Should I disengage from CPAP and return to sleep for 2 more hours (of deep but probably apnea event filled sleep) or should I just get up and face the day with 5 or 6 hours of healthy sleep? I asked one doctor about this, and he said that 4 to 6 hours of CPAP is all that was required.

A doctor told you to take off the mask and go back to sleep? Can I shoot him?

Remember what sleep apnea is. It is *not breathing* when you sleep. You're holding your breath for 20, 30, 60, even 90 or more seconds. You're going through oxygen desats into the 80's, 70's, 60's, even worse. Your heart, starved of oxygen, starts working even harder with less oxygen trying and deliver what little bit is there to the rest of the body. Your oxygen starved brain loses cognitive abilites. This O2 starvation, even if for an hour or two, still increases your risk of high BP, stroke, and heart attack, and someone posted something about the link between sleep apnea and Alzheimers. It's got to be a pretty ignorant or stupid doctor who thinks it's fine to have these desats.

So, the question is, do you want to take the mask off and put your heart and brain through all that?

I won't even take a 15 minute nap without my machine. My machine is my 3rd lung.

[ameriken]

I've got a better idea of what I'd like to do to that doctor.

When he's got 2 hours left to sleep, I'd like to go in his bedroom, and cover his mouth and nose so he cannot breathe for about 45 seconds. Then about a minute or two later, I'll do it again for about 30 seconds. Another minute or two later, I'll go back and do it for about 90 seconds. Then another minute or two later, for 45 seconds.

We can attach an O2 monitor to watch how bad his oxygen desats are and we can repeat this pattern for the next two hours, and then we'll let him wake up and go to work. We'll repeat this every single night.

Then, I'd like to ask him if he would tell any of his patients that 'this is ok'.

[jamiswolf]

Greetings,
I knew this would trigger disagreement and I'm not surprised. One thing to consider is that sleep apnea comes in many flavors. I have mild-to-moderate OSA (AHI 21) and lived without treatment for many years. Perhaps my Doctor took all that into consideration and wouldn't have given that same advice to someone with severe apnea and critical desats.
Jamis

[Pugsy]

one thing to consider is that sleep apnea comes in many flavors. I have mild-to-moderate OSA (AHI 21)

Yeah, I know. I happen to have 2 flavors of OSA. Mild in NonREM sleep.. AHI of 12 I think it was. In REM pretty bad..AHI 53. Sleeping position doesn't seem to matter.

BUT during non REM sleep those apneas might not have been hugely numbered but they were hugely long being 45 seconds to a minute and more and my Oxygen levels dipped to 73%. So in theory based on "mild", I should be able to take an hour long nap and not likely go into REM sleep and not do a whole lot of damage to my body. I have inadvertently fallen asleep on the couch for 30 minutes to an hour. My husband says I snore something awful and I always wake up feeling like crap.

Everyone is an individual and must decide what is acceptable for them based on whatever their situation is.
For me I know if I start allowing a little cheating here and there with wearing the mask....I would eventually be cheating a lot. So I try lot to let myself be tempted to start down that slippery slope.

[NightMonkey]

Typical.

[ameriken]

For me I know if I start allowing a little cheating here and there with wearing the mask....I would eventually be cheating a lot. So I try lot to let myself be tempted to start down that slippery slope.

I'm the same...on my very first night with the machine, I slept through 5 or 6 hours with no problem. I woke up about 5am for a potty break, and then went back to bed. I figured what the heck, I did really good so I'll just sleep for another couple of hours without that darned uncomfortable mask. As I laid back down I thought about it. If I sleep without the mask now then tomorrow night if I wake up I'll be tempted to do it again. I realized I would be starting a bad habit, so, I got up and put the mask back on and fell asleep with it for a couple more hours. The best way to break a bad habit is to never start it in the first place.

[Kody]

I noticed I've started doing this, waking up to take a drink of water because mouth is all dried out, etc. etc. Then next thing I know it's 2 hours later and I just wake up without the mask on. Bad habit to get started. I think it DOES make a difference because I feel very worn out still the next morning. Our bodies has a way of getting used to things good or bad, and getting into the habit of sleeping with the Mask off for any length of time is not a good one to start. Best of luck to you.

[robysue]

This is a question that's been bothering me since I've started CPAP (32 days ago). I've fallen into a pattern where I regularly wake up after 5 or so hours of sleep with CPAP. I attempt to get back to sleep with CPAP but typically give up after another hour. So here's the question: Should I disengage from CPAP and return to sleep for 2 more hours (of deep but probably apnea event filled sleep) or should I just get up and face the day with 5 or 6 hours of healthy sleep? I asked one doctor about this, and he said that 4 to 6 hours of CPAP is all that was required. After that he said I should take off the mask and go back to sleep. This seems medically wrong to me and contrary to my own subjective experience. (I've tried both ways). What do you all think? Is this one of those "do whatever works for you" type things that I hear so much from the doctors or is there some real answer based on sound sleep science? (emphasis added)

I think that boldfaced, italic sentence says it all: You know it's medically wrong AND you know going back to bed for two hours of maskless sleep makes you feel worse. So DON'T DO IT.

It really is that simple: Never sleep without the mask.

As to why your doc is giving such bum advice? May he's just plain tired of dealing with noncompliant patients who were never lucky enough to discover this site. But at the same time, he's just too stupid to figure out that he's got some responsibility to educate his patients about how to make it easier to become fully compliant with therapy---as in sleeping with the mask every night, all night long.

[robysue]

I am not sure if this is possible, but I am sometimes waking up in middle of the night feeling refreshed like it is time to get up but it is not. I was wondering if this is because I am finally getting uninterrupted quality sleep and my body thinks it is time to get up. I have been lying awake with my mask on until I finally do go back to sleep, but it sometimes takes a while. Doesn't happen every night thank goodness.

If this starts to occur more frequently, you might want to consider simply going to bed later. Because once our bodies are indeed getting uninterrupted, restorative sleep, it's perfectly reasonable to assume that we might not need as much "time in bed" as we did when we were arousing ourselves all night long fighting to breath ....

[archangle]

I asked one doctor about this, and he said that 4 to 6 hours of CPAP is all that was required.

Your doctor is an idiot.