Can't break the restless sleep

[chirurgeon]

I have been really good with wearing the cpap. According to my machine no big leaks or many AHIs. But I can't get any good sleep periods according to my Fitbit. If they last more than an hour I consider myself lucky. No luck in the past week or so. I think part of the problem is the "exhaust" from the nasal pillow. I'm a side sleeper and I like to pull the covers up over my shoulder. But when I do that, it amplifies the exhaust sound. And the cold breeze one my hand and arms. I have called my DME and I'm waiting to hear back if they carry the Airfit p10. But even then, I'm not sure I am going to be able to break the restlessness.

[Pugsy]

Did you have this "restless sleep" prior to cpap therapy or is it totally new?

How many times a night would you estimate that you wake up? When you do, how long before going back to sleep?

Do you take any meds of any kind even OTC? If so, what, dose and when dosage is taken?

[kteague]

Yes, the mask vent can be a sleep buster if your mask's design forces you to alter your customary sleep position. Dealt with that a few times myself. My latest mask change took a few weeks to adjust to and figure out how to accomodate the vents without totally changing my sleep habits. Fortunately the vent air is diffused. Used one once in a lab that was so forceful I'd hate to ever be forced to adjust to it. Is there anything else going on that you can pinpoint that might be causing restless sleep? A common culprit is side effects of a medication. Are you on any meds that could be suspect? Also, limb movements such as in RLS or PLMD can disrupt sleep. Hopefully you will soon have worked through the challenges and begin to get more restfui sleep.

[chirurgeon]

Did you have this "restless sleep" prior to cpap therapy or is it totally new?

The restless sleep on top of my snoring was why I went for my sleep study. So not new.

How many times a night would you estimate that you wake up? When you do, how long before going back to sleep?

The restlessness is counted over 10 times each night. I would say I'm awake at least 4 or 5 times and maybe takes 10 minutes or so to fall back to sleep.

Do you take any meds of any kind even OTC? If so, what, dose and when dosage is taken?

Asthma meds, Singulair, Flovent, hormone replacement for menopause symptoms.

[Pugsy]

Not all sleep disruptions are caused by OSA and using a cpap machine really only fixes OSA related stuff. We would like to put all our problems in the OSA basket and let the machine fix them but unfortunately the machine can't fix bad sleep related to something other than sleep apnea.
People think that it will fix insomnia (both sleep onset and sleep maintenance) issues...and it will but only if the insomnia is only caused by sleep apnea. There's lots of other insomnia causes totally unrelated to sleep apnea and the best cpap therapy in the world can't eliminate those causes.

Now bear in mind that I am not saying that meds are totally responsible but they may be aggravating things. Please research your meds extensively for anything that might mess with sleep quality.
I didn't bother with hormone replacement since I didn't know the name but the very fact you are taking it gives an indication of hormone imbalance which in itself will mess with sleep architecture.

http://en.wikipedia.org/wiki/Montelukas ... se_effects
Side effects include gastrointestinal disturbances, headaches, hypersensitivity reactions, sleep disorders, and increased bleeding tendency, in addition to other generic adverse reactions. Its use is associated with a higher incidence of Churg–Strauss syndrome (whether or not this drug is 'unmasking' subclinical Churg–Strauss is as yet uncertain). Drowsiness is also a common side effect.

http://en.wikipedia.org/wiki/Sleep_disorder
Dyssomnia refers to a group of sleep disorders with the symptoms of trouble falling asleep or maintaining sleep, which may cause an elevated sense of sleepiness during the day. Insomnia is characterized by an extended period of symptoms including trouble with retaining sleep, fatigue, decreased attentiveness, and dysphoria.

Flovent doesn't seem to be quite so much but since it is a corticosteroid, might be a small factor
http://en.wikipedia.org/wiki/Corticoste ... de-effects
Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep.

Finally, take a cold hard look at your overall sleep hygiene to see if anything needs work. Very few of us are perfect in that regard...myself included. Way too much time on the computer late at night.

[chirurgeon]

I know I shouldn't play on the ipad so close to bed time. My main thing is the waking up after I fall asleep. I will discuss this with my dr. I see her in 2 weeks as my first follow up.

[Pugsy]

My main thing is the waking up after I fall asleep

I totally understand. I would do the same thing if I didn't have some help with meds but my issue is pain.
The least little movement in bed causes pain that wakes me up...if I don't move in bed and stay in one position too long it hurts and that wakes me up. Damned if I do and damned if I don't.

I used to have 20 to 30 remembered wake ups and no telling how many not remembered but with meds and lots of experiments to help with bed comfort...they now are down to a respectable 3 to 6 and some nights I get lucky and don't remember any.

One of my normal daytime pain meds, which comes with the usual "may cause drowsiness" sticker also has a little known side effect of insomnia in a small percentage of people who take it and I got lucky. So we had to come up with something else to help at night. I don't dare take one of those pain pills after 6 PM or I will be wide awake at 1 AM cleaning house.

So do talk to your doctor about it. Meds may not be the sole culprit but there may be a combination of culprits that need to be investigated.

[robysue]

I think part of the problem is the "exhaust" from the nasal pillow. I'm a side sleeper and I like to pull the covers up over my shoulder. But when I do that, it amplifies the exhaust sound. And the cold breeze one my hand and arms.

Boy can I identify with this. That jet plane engine design for the Swift FX exhaust ports is a real winner, isn't it?

Seriously, this has been one of my main problems with the Swift FX, but whenever I've tried another mask, I've had problems that are more serious than this one. I've not had a chance yet to try the Airfit, but if I try it when I'm next due for a mask, I plan to.

I'm also a side sleeper. The two things that I've found that help with the jet stream of air flow include:

1) Sleeping in my husband's big fuzzy robe. I can get a double set of fabric over my chest and still move around comfortably and his sleeves are comfier to sleep in than my own robe. And the sleeves are long enough for me to pull my hands into when the jet stream starts blowing on them. Actually I am now sleeping in both an old long sleeve cotton shirt of his as well as his robe. That gives me two layers on the arms.

2) Rather than pulling the covers up over my shoulder, I pull the covers up over my whole head. Yes, I have to make sure there is a pocket for the Swift FX to blow into. But that's not really that difficult to make. And somehow having the covers over my head keeps the noise level down. I don't understand this, but it really does work for me. It also seems to minimize the tendency of the exhaust flow to bounce off the covers and back into my eyes. It still happens, but not as much as when I have my head out of the covers and the covers pulled up over my top shoulder. Of course, pre-CPAP, I liked to pull the covers over my head when I was cold, but I'd always have to "come up for air." With the BiPAP, I've got my own personal fresh air supply and I'll sleep all night with my head under the covers.

[College3girls]

If the exhaust flow is an issue, do not try the Nuance pro gel either. That blows like a jet engine and also bothers my spouse.

I bought the Airfit P10 and used that for the first time last night. Big difference. I think it will be a keeper. It is so light on your face, I woke up a couple of times thinking my mask was off, but it wasn't. I had no leak issues and could finally sleep on my pillow any way I wanted too, including on my stomach.

I too have trouble falling asleep and staying asleep. At least now I can remove forceful cold air blowing on me as one of the sleep problems.