OSA and Insomnia

[Josiah]

I'm aware that many untreated individuals with OSA have no trouble falling asleep or staying asleep. I also suspect that other individuals suffer from both OSA and Insomnia and the insomnia may be caused by some factor unrelated to the person's OSA. But is it not also the case that there are individuals with untreated OSA who have trouble staying asleep because of the apnea generated adrenal hormones....that in short their insomnia is caused by their apnea?

[lmrapp]

I seem to have the same problem. I am 77 and have had a stroke. I go to sleep at 9:00 pm after watching tv for about 2 hours. I seem to wake up around midnight and toos and turn for the rest of the night. I don't know what I should do. My AHI is around 6.46 according to Sleepyhead. ResMed S9 VPAP Auto with Quatro Pro full mask and cervical collar.

[Josiah]

I seem to have the same problem. I am 77 and have had a stroke. I go to sleep at 9:00 pm after watching tv for about 2 hours. I seem to wake up around midnight and toos and turn for the rest of the night. I don't know what I should do. My AHI is around 6.46 according to Sleepyhead. ResMed S9 VPAP Auto with Quatro Pro full mask and cervical collar.

Insomnia is much more prevalent in the elderly (BTW I'm older than you). How long have you been on CPAP therapy? Did your sleep problems get better or worse after you began CPAP therapy?

[Julie]

Imrapp - just curious why you go to bed so early? Are you tired, or ?? If you're unintentionally messing up your normal circadian rhythm (bio. clock) it's unlikely that you'll be happy. Have you tried going to bed later? Or maybe napping (with Cpap) earlier in the day even for a short time?

[lmrapp]

Why do I go to bed early? I don't know! Probably because I'm tired. For what its worth, I started going to bed early after I had a stroke. Before the stroke I used to stay up late. I was a Representative. When I was in a hotel, I used to go to sleep at 11:30pm.

I've been on CPAP machines for years. This is my second or third machine, but I really like this one (S9 VPAP Auto). It is really quiet. I take oxygen with it (3 liters), but the concentrator is out in the hall, past a closed door.

[MrsRinPDX]

...But is it not also the case that there are individuals with untreated OSA who have trouble staying asleep because of the apnea generated adrenal hormones....that in short their insomnia is caused by their apnea?

My Sleep Specialist (MD) seems to think my insomnia is OSA caused, at least in my case. I was waking every 2 hours all night long, despite being dog tired. Then my memory went to hell. He tells me both will improve with time, using my BiPAP of course.

Indeed, my memory is getting stronger after my first month on the machine. No real change in the waking patterns yet, but again, I was told it would take months not days. I am waking more rested, however, so it's more of an inconvenience at this point because I am feeling better. I'm 52 years old. My AHI during my sleep study was 71.

[MrsRinPDX]

But is it not also the case that there are individuals with untreated OSA who have trouble staying asleep because of the apnea generated adrenal hormones....that in short their insomnia is caused by their apnea?

By the way, the doctor didn't specifically state it was the adrenal glands.

[Josiah]

By the way, the doctor didn't specifically state it was the adrenal glands.[/quote]

I was probably inaccurate in mentioning adrenal hormones, the idea I was intending is that apnea events do cause hormonal responses which are not conducive to restful sleep and may contribute to having trouble staying asleep.

[kteague]

I seem to have the same problem. I am 77 and have had a stroke. I go to sleep at 9:00 pm after watching tv for about 2 hours. I seem to wake up around midnight and toos and turn for the rest of the night. I don't know what I should do. My AHI is around 6.46 according to Sleepyhead. ResMed S9 VPAP Auto with Quatro Pro full mask and cervical collar.

An AHI of 6.46 is unacceptable unless there are extinuating circumstances that make it the best it can be. In sleep study reports we see that a percentage of events cause arousals, so it's logical to think that holds true with residual events while on CPAP. If your therapy can be improved, maybe your sleep would be too. Not saying it would fix all your sleep issues, but reducing the number of wakings has got to be a better sleep situation.

As to the original topic - Of course untreated sleep apnea can be a cause of poor sleep. Sleep studies report some of this as respiratory related arousals. Add stress hormones to the mix as well as the need to urinate due to hormones, and trouble sleeping is rightly expected.

[lmrapp]

I know it is unacceptable, I just don't know what to do about it! I've been slowly changing some of the parameters. It used to be 14/10 plain CPAP. Now I'm trying to use the auto. Here is what I have:
https://imgur.com/a/Y2vDL
If you can make any suggestions, I'd love to hear them.

[LSAT]

I know it is unacceptable, I just don't know what to do about it! I've been slowly changing some of the parameters. It used to be 14/10 plain CPAP. Now I'm trying to use the auto. Here is what I have:
https://imgur.com/a/Y2vDL
If you can make any suggestions, I'd love to hear them.

Looking at your chart you can see that the pressure hit the max several times...meaning that the machine wanted to go higher, but it was restricted. I would increase the max pressure .to16.

[Pugsy]

I know it is unacceptable, I just don't know what to do about it! I've been slowly changing some of the parameters. It used to be 14/10 plain CPAP. Now I'm trying to use the auto. Here is what I have:
https://imgur.com/a/Y2vDL
If you can make any suggestions, I'd love to hear them.

First try increasing the max to 16 as mentioned.
If that doesn't help reduce the AHI (the obstructive stuff which is the OA and hyponeas) then try increasing the minimum from 8 to 9 cm.

The pattern of your clustering of OAs seems to suggest some REM stage sleep involvement and it's common for some people to need more pressure during REM (same thing for supine sleeping).

[lmrapp]

OK, I'll try it tonight.

[lmrapp]

Ok, lets see what happens when I increase the pressure.

[Pugsy]

I also suspect that other individuals suffer from both OSA and Insomnia and the insomnia may be caused by some factor unrelated to the person's OSA. But is it not also the case that there are individuals with untreated OSA who have trouble staying asleep because of the apnea generated adrenal hormones....that in short their insomnia is caused by their apnea?

Yes, it's quite common for people with untreated OSA to have trouble staying asleep because the OSA events keep causing arousals and bouncing them out of sleep. I had it happen to me. My OSA is worse in REM sleep and every time I would go into REM the apnea events would come fast and furious and wake me up. Then I would have to get to sleep all over again only to have it happen each time I went into REM.

So yeah...just the apnea events alone can cause sleep maintenance insomnia (where we have trouble staying asleep).
Unfortunately sleep apnea events aren't the only thing in life that can cause either sleep onset insomnia or sleep maintenance insomnia and using the cpap machine doesn't always fix all insomnia issues because of all the other stuff unrelated to sleep apnea that can cause insomnia. We would like for it to and hope it does but the cpap machine can only fix problems related to the sleep apnea...it doesn't work so great with fixing insomnia related to the other stuff. Been there and done that myself.