Still waking up a ton at night

[sectheatre]

I've been using my CPAP about a week now and while I do feel more rested, I am annoyed that I am still waking up a lot of times in the night. I thought that was supposed to stop. Have I just not given it long enough yet? Or can I assume something else is waking me up and that is just the way it's going to be? Thank for your input.

-Sarah

[Slartybartfast]

A week isn't long enough for you to really get comfortable with the machine. CPAP isn't a panacea. It will keep you oxygenated, but fragmented sleep, which is what you're describing, isn't necessarily caused by sleep apnea. Keep at it and after another week or two, talk to your sleep doc. You might need medication.

I found that walking for an hour after work does wonders for my sleep.

OTC sleep aids or herbal remedies like melatonin might help.

[49er]

I've been using my CPAP about a week now and while I do feel more rested, I am annoyed that I am still waking up a lot of times in the night. I thought that was supposed to stop. Have I just not given it long enough yet? Or can I assume something else is waking me up and that is just the way it's going to be? Thank for your input.

-Sarah

Hi Sarah,

Do you have nasal congestion as that could also causing you to wakeup?

Also, if you could fill out your equipment profile, that would help members give more helpful responses. Go to https://www.cpaptalk.com/ucp.php?i=prof ... pment_info.

Thanks!

49er

[sectheatre]

Sorry for not having my equipment filled out. My mask is not available to be selected and I keep forgetting to check which "flavor' of a Res Med S9 that I have. I don't think it's nasal congestion waking me up. I assumed it was apneas waking me up but my machine says I am doing great (below .5 everyday) so that isn't it either.

-Sarah

[Pugsy]

If your mask is not available you can just manually type it in the comments line.

Part of the wake ups might just be the brain remembering there is an alien stuck on your face (sort of hyper vigilant) but it might also point to something else so try to isolate the cause if you can. Leaks? Mask comfort? Pain? Do you take any meds (even OTC) that might mess with sleep? Is your bed pillow comfortable? What pressure are you using?

Lots of stuff besides apnea events can mess with our sleep and cause us to wake up often and/or have trouble getting back to sleep.

[avi123]

There are different kinds of wakings. I have been on CPAP for more than two years and I still wake up at nights to go pee. The number of my wakings could change between one time to four times a night. It looks like they occur randomly but there must be reasons behind it. Go guess. The diuretic effect of OSA is only one reason.

So I would not expect that anyone could improve my wakings by a large measure. But giving up CPAP would definitely be much worse.

[Java]

I have been on CPAP since September 2012, and I still wake up every 1-3 hours. I have been 100% compliant since day 1, and the mask never really bothered me. I practice good sleep hygiene and don't take any medications that would affect sleep. I was hoping CPAP would be the cure to my frequent awakenings and allow me to get some restorative sleep, but no such luck here. On a positive note, I no longer wake up with my heart pounding out of my chest in a state of panic, my blood pressure is down, and I no longer fall asleep during the day.

[hamonrye]

I just started using mine Friday night and have noticed that I do wake up 5 to 6 times but it only takes me a few minutes to fall back to sleep. Before the cpap it would take 20 to 30 minutes to fall back to sleep.

[zoocrewphoto]

I have had several reasons why I wake up. Some of it was just getting used to the machine. It is not normal to sleep with a mask and air pressure. Also, our brains have spent years protecting us by waking us up to keep us breathing. Now, all of a sudden, we have a machine that will keep us breathing, but our brain isn't ready to give up its job and trust that machine. It takes time.

I have found that my sleepy brain is actually pretty smart. For example, after my sleep study, I felt great as it was the first great night of sleep in years. The next night, I was home without a machine, and my sleepy brain knew it was not good. I had a dream where I was trying to contact the sleep doctor to make my appointment for the followup, and I was given an appointment 6 months away. I was so angry because I wanted my machine NOW. I was asleep, yet my sleepy brain knew it wanted a machine, and it wanted it right away. After getting my machine, I skipped most of a night, and I had dreams about going through a building looking for an outlet so that I could plug in my machine and go to sleep. Again, it knew my machine was off and wanted it.

There are also many new things to get used to. At first, the pressure is challenging to get used to. Many people also find that if their machine is set to a low starting pressure (prescription range or ramp), and after a few days or more, it seems difficult to get enough air. That can cause people to wake up. Getting used to the pressure, especially if it is high. Pressure changes up and down bother some people. Leaks. At first, any small hiss would wake me up and drive me crazy. I have gotten used to some minor leaks now. I have also found that drooling will wake me up. Flapping cheeks will wake me up (this happens if my mouth opens too far).

And then there are the non-cpap related things that can cause you to wake up. Pain, coughing, insomnia, medication side effects, etc.

Some people have it easy and things click into place. Some people have a lot of hurdles to manage. The good news is it does get better, and the people here can help you overcome these hurdles.

[jweeks]

...I am annoyed that I am still waking up a lot of times in the night.

Sarah,

Can you describe the wake ups a little? How alert are you, how long are you awake, and do you have to use the restroom when you wake up?

When I first started on CPAP, that was the first time in years that I had any real sleep. What I ran into is that after about 2 or 3 hours on CPAP, my brain had more sleep than at any night in the past decade, so it was done sleeping and ready to leave the cave to go out and start the day. I essentially had to re-learn how to sleep all over again.

I pretty quickly got to the point where I was only awake between an hour and two hours. I wanted to avoid anything stimulating like using the computer or reading, so I got in the habit of putting concert videos on the TV. That would allow me to pass the time, yet I could drift in and out without having to keep track of a TV show or movie. It took about 6 months before I was consistently sleeping through the night. Now days, I still wake up at night about once every month or so. Since I sleep so well, it really doesn't bother me too much. In contrast, something external waking me up (like a phone call) messes me up for a day or two.

The key is finding out why you wake up. It could be natural, it could be your brain not yet ready to sleep the entire night, it could be something external, it could be adapting to CPAP, it could be untreated events, it could be a second sleep disorder that has surfaced, or it could be another health problem. That really doesn't help narrow it down any, but at least it gives some context on why it is important to describe it a bit more and to try to collect some data. Getting machine downloads would be very helpful.

-john-

[Magnum]

I have to agree with jweeks and ask how you know you are waking up. For instance I have been on CPAP for several years and I am still very sleepy the next day, even failed a daytime sleepiness test. I wake up at least 2-3 times a night and have no idea why, about 100% compliant and very tired during the day. Using Zeo this past week it has shown I have woke up anywhere from 3 times a night to 6-7 at the highest.

For me we do not know the cause, but Zeo shows I am not in Deep sleep for long. I think waking up can be natural. Unless you are tired the next day, it's probably not an issue. I do know I can wake up on the slighest sound (water dripping outside) but I can't sleep with white noise either.

But I should mention I do know I was waking up about 3-4 AM and finally realized I heard a bus go by. Turns out the Church behind me has been renting out their buses and that is when they are brought back to part, about 2-3 times a week. So a little "hint" and the buses stopped. The church is very respectful of their neighbors:).

[KylaManhattan]

... I essentially had to re-learn how to sleep all over again.

John's observation reminded me of a recent radio broadcast I heard recently where the interviewee was an expert on sleep-related problems faced by infants and toddlers (and their parents). A major thrust of her remarks was that virtually every aspect of sleep -- going to sleep (especially going to sleep alone), staying asleep, getting back to sleep after waking up from a nightmare or the need to use the bathroom, sleeping and waking on a consistent schedule, etc. -- is a skill that has to be learned.

I'd never really thought about sleep as a skill, or even something that had to be learned. Isn't it innate behavior, something that all humans -- indeed, all animals -- do automatically? But the more I reflected, the more I realized she was right. And those of us whose sleep has become disordered because of any number of physical and/or emotional conditions, including apnea, sometimes over a period of decades, really do need to learn again how to sleep, just as we did when we were babies.

To respond specifically to the OP's concern, I've been on CPAP therapy for a bit over 10 months. I swear that for the first month, I got markedly less sleep per night than I had in the months and years leading up to the diagnosis and the start of therapy. But it gradually got better, and now an interrupted night's sleep is the exception rather than the rule.

Like the OP, I had expected that I would experience the benefits of CPAP therapy almost immediately. I think that sometimes, our healthcare providers, DMEs, concerned family members and friends, magazine article writers, etc. may "oversell" CPAP -- or at least minimize the challenges it entails -- because they are so anxious for us to comply with the therapy. And maybe we talk ourselves into such great expectations, too, because how else would we make ourselves submit to something so unnatural? That's one of the reasons why a community like this one is so valuable ... it helps us scale our expectations, and encourages us to keep trying until we hit on the combination of factors that will spell success.

[sectheatre]

Normally I am only awake a few minutes when I wake up. Just long enough to see the clock and aknowledge I am awake again. Once a night I end up having to get up for the bathroom. Last night was a good night. I only recall waking up twice. Maybe with time this will become the norm. Thanks everyone.

-Sarah

[jweeks]

Sarah,

That type of waking up...a few times a night, then quickly drifting off again is pretty normal. Most people do that a few times a night, but they don't remember doing it. You are a little special because you do remember doing it. You might be waking up a little more fully that most people. This might get better over time.

It might be that you wake up like most normal folks, then you realize that you have the CPAP stuff going on, and that is causing you to wake up just a little more fully. This will pass with time as you get more used to it. For example, I can adjust my mask in my sleep, and I don't even know that I am doing it.

I read about this kind of waking up a few months ago. To put it to the test (sorry, I am an engineer, and I have to measure everything), I decided that when I wake up like this, I'll look at the clock. The next morning, I often remember the times that I looked at the clock, but I don't remember being awake. So I know that I am having a few of these wake up and drift back off. From what I read, it happens the most often after the end of a REM cycle. That might be good news for you--it means that you probably are having REM cycles, which means that CPAP is helping you.

While I cannot give you medical advice, if this were me, I'd give it a month or two and then see how it is going.

-john-