Question about the "adjustment period"

[Esskay33]

In starting my treatment and reading this board (as well as others,) I get the idea there are really two types of adjustment that can/and need to take place when starting xPAP treatment:

1. Equipment - Meaning mask fit, comfort, pressure, which type of PAP therapy is right,keeping the mask on...and then all the side effects I hear about (dry nose, acne, rashes, stuffy noses etc.

2. Would you all agree there is a second adjustment once you get these equipment issues sorted out that is just a mental and subconscious period of time it takes to get used to sleeping with pressure? And the time it take for "healing" from prior sleep deprivation to take place?

My question stems from the fact that I solved all my equipment related adjustments very quickly (and count my self lucky,) and expected a big reveal in waking up a changed man. It didn't happen and instead I am very gradually starting to sleep better, less fragmented and symptoms from pre-treatment are slowly going away.

I write this because I was not expecting the second type of adjustment period and I get the feeling not everyone goes through it...

Thoughts?

[zoocrewphoto]

It varies with each person, but there really is a time of healing. And it often takes time for your brain to learn to trust the machine and relearn how to sleep deeply again.

I had an initial awesome reaction because my titration in the sleep lab was so awesome. I slept over 5 hours straight for the first time in probably decades. But once home with my machine, I had to get used to it. The change wasn't as obvious as that night and day difference.

Over the next few months, I noticed that I was more cheerful, fewer headaches, fewer gerd issues, fewer bathroom breaks, etc.

[Jay Aitchsee]

In starting my treatment and reading this board (as well as others,) I get the idea there are really two types of adjustment that can/and need to take place when starting xPAP treatment:
...
2. Would you all agree there is a second adjustment once you get these equipment issues sorted out that is just a mental and subconscious period of time it takes to get used to sleeping with pressure? And the time it take for "healing" from prior sleep deprivation to take place?
...
I write this because I was not expecting the second type of adjustment period and I get the feeling not everyone goes through it...
Thoughts?

I think two adjustment periods might be a fair assessment. But realize that not all poor sleep is related to Sleep Disordered Breathing (SDB) and SDB is the only thing a cpap machine can fix. I think people often do not get the results they expect because they haven't fixed the other things that might be causing their sleep to be less than optimal and some of these things could be habits that were adopted originally as a result of the SDB which tend to linger after the SDB has been corrected.

If non restorative sleep remains after correcting SDB, other possible causes need to be investigated. Granny's guidelines are a good starting point.

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Use CPAP software, such as the free SleepyHead, to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems
CG

[D.H.]

I felt better than I had in years, and that was within two days. However, that's me, others may take much longer, and the improvement might be more gradual; thus less obvious.

[Arlene1963]

When I was first diagnosed and started treatment I really thought that CPAP would be the solution to all my sleep problems. Boy was I wrong. Firstly, if one has any sleep issues aside from SDB wearing a hose and mask isn't exactly going to help matters!

YUP, it took me a while to adjust mentally to CPAP, and I'm still adjusting to it ...

CPAP made my insomnia and sleep fragmentation worse initially, not better. I had to make a promise to myself not to abandon CPAP when everything in my body fought it for months. It took a good few months to see better and deeper sleep.

The adjustment phase for some of us can be brutal, for others not so much but it is real and needs to be discussed because this is the reason a lot of people ditch therapy.

Not feeling that much better and so why bother?

The promises made on behalf of CPAP need to be tempered so that patients have more realistic expectations and do not expect "miracles" right from the get go. For me the following helped: Checking Sleepyhead daily to tweak therapy and make sure that the therapy was optimal (not easy when half the night is registering false Centrals due to fragmented sleep!), next make sure that I did everything I could to make sleep optimal (psychological counselling, sleep hygiene, acceptance), talking to my husband and friends endlessly about it (really helped) ... coming here and reading daily.

[Cardsfan]

Hi- I've been doing this for almost 2 years now. I would say your original post pretty much describes my experience. Phase 1 of mine was surprisingly a piece of cake. I adjusted to the equipment with very little problems.
Phase 2- feeling the effects: some effects were immediate, you know the ones. Better sleep, not going to the bathroom 3-4 times a night, the weird dreams, feeling rested for the first time in years, etc.
The next phase, 3, was the slight improvements in my long term health. After all this time, I'm still feeling health improvements. My body is taking slow and steady steps to recover from the years of undiagnosed sleep apnea.
Just keep with it, even if you don't feel the results today. It takes time. My sleep Dr said it takes 6 months for the brain to recover.

The mental adjustment- That took a while fore me. It is one of those things you just deal with. I don't let it stop me from traveling. And I will not sleep without it. Actually, the first night I got my machine, we left town for an extended trip. I just packed it up and hit the road and hoped for the best.

[Holden4th]

I've been at it for nearly nine months now and while there has definitely been a big improvement I still have a long way to go. I still end up with a feeling of fatigue at some time during the day and initially this worried me. Then a night with no therapy showed me that I had come a long way.

My numbers are well below five and on reflection I no longer wake feeling groggy and like I have been run over by a bus and this is a positive. My mental state is far more positive and I no longer put things off because I feel tired.

Some sleep scientists believe that the sleep you have missed is something that your body needs to catch up on and while this not a universally held opinion I tend to think that this is true for me.

I am currently on vacation and sleeping between nine and ten hours per night. I can feel the good this is doing my body. Going back to work next week will cut this back to eight.

Based on what is happening I expect the gradual improvement I have experienced to continue and maybe, two years down the track, I will feel fully refreshed.

The bottom line is that I now fear a night without therapy.

It will be interesting to look back on this post in twelve months time.

[BlackSpinner]

It does actually take time to learn to sleep in a different way.

And if you think about it your subconscious has work hard for years to be vigilant that you don't die in your sleep for lack of O2 because your breathing stopped. It has had to wake you up enough to get you breathing but not enough to wake you up completely. According to my sleep doctor it can take up to a month for your brain to trust this thing on your face not to kill you.
Plus you have to be aware that even your brain has to heal from sleep deprivation.

[chunkyfrog]

Once your brain accepts therapy, it can be a blessing,
Like soft jammies, a warm bed, and soothing music.

[Goofproof]

I think the Brain adjustment is the hardest part for most people, once you can get your head right, the hardware side is easier to deal with, EXCEPT, when we are started with inferior equiptment and incorrect settings from the get go.

I call it like I see it, I knew if I didn't get treatment right, I die, I was half way there already. I knew I was a mouthbreather, so a full face mask was needed, a no brainer. I lucked out and got a full data XPAP, it turned out to be a "Tank", in my words the best Respironics ever made, like the Energiser Bunny, it just keeps going and going.

Attitude and Mindset are everything, can't has never completed anything, he just makes loosers. I don't allow can't to hang around me. Hopefully, you won't allow him in your care. Jim

[rohdej]

phase 1 - Nocturia went away first night.
phase 2 - Realized I could drive at night somewhere in month 1-3.
phase 3 - month 3-6? Body decided that I had better sleep in 4 hours than previously gotten in 8-12. So I got up and made breakfast, went on walks, enjoyed the sun rise, took a nap with my machine later if needed.
Phase 4 - 6 months to a year. My body settled on 6.5 -8 hrs of sleep depending on activity levels.

Strange ride. Glad I decided to do it.

[palerider]

My question stems from the fact that I solved all my equipment related adjustments very quickly (and count my self lucky,) and expected a big reveal in waking up a changed man. It didn't happen and instead I am very gradually starting to sleep better, less fragmented and symptoms from pre-treatment are slowly going away.

if you break your leg, you don't wake up a changed man the next day, it takes time to heal.

likewise, you're not going to reverse years of inadequate rest and recuperation overnight.

[nobody]

You may go through more than just the 2! I've been using this machine 8 years and some months and earlier this year I went through a period of damn I'm sick of using this thing and started falling asleep a lot of nights without putting the mask on then having to put it on halfway through the night or even going the whole night without it. I think I had finally caught up on all my sleep, got some other issues taken care of which helped me sleep better as well, and I feel so good during the day that I've forgot what it was like walking around like a zombie all the time. Well it didn't take long for that to come back. Takes a long time to catch up but not so long to fall back into feeling like crap if you don't use it. For me it helped to switch masks around. I get sick of wearing the same style mask night after night. Plus over the years it's made dents in my face and I'm really self conscious about it, but in the end I'd rather have dents in my face than bad sleep!