Needing some help please. Sleepyhead snapshot included.

[jimmye4golf]

Ok here we go. I was diagnosed with OSA back in 2009. I had some issues adjusting to the mask but all is good now. I will say I fall asleep from time to time without my mask on and my wife wants to kill me when I do this because my snoring is like a freight train. I also do not have the best sleep patterns as 3-5 nights a week I will get anywhere from 2-4 hours of sleep (with or without my mask on. Once I wake up it is impossible for me to go back to sleep.I have been to the Dr for this several times and all they ever want to do is prescribe me some sleeping pills. I tried the sleeping pills a few times and felt horrible the next day and would rather get less sleep. This has been going on for about 4 years now. I have days where I wear my mask while sleeping for 2 hours and some days for 8-10 hours. For the most part during the day I am not sleepy as long as I am moving and working but once I sit for 20-30 minutes I get really tired and want to sleep. I work outside as a repairman for AT&T and I climb telephone poles, walk a lot and get into attics etc. Some jobs will require 30 minutes to an hour of drive time and during those times I get extremely sleepy. I also have ADHD and take 60 mg of Vyvanse everyday in the morning (basically speed) but it goes help tremendously with my focus. I was wondering if some of you can see something in my screenshot that could be possibly waking me up. I went to bed tonight at 10 pm (with mask on) and woke up at 12:30, I am 6 ft tall and fluctuate between 225 and 230 lbs and about to be 50 years old in a few weeks. I work 10-14 hour days and have 6 children (31,26,21,10,8 and 4) so I am busy non stop. I am sure if I could get 6-8 hours of sleep per night with my mask on I would prob feel tons better but that just doesn't happen. The first image is with 7 hours of sleep and the 2nd and 3rd are my more typical nights of sleep (last pic is tonight's sleep). Let me know if you need any more info. Thank you.

[LSAT]

First thing I notice is the leak problem....are you a mouth breather? The leaks could be keeping you up. Any reason for using a fixed pressure with the Autoset?

[katestyles]

OP is NOT using a fixed pressure. The auto is just sticking at a pressure that works.

It looks like you are suffering from bad sleep. Your apnea is pretty much under control - (wish I had your AHI!)

You are going to need to look at all the other things that affect sleep, which are lumped under the heading "sleep hygeine"

Obviously you are aware of the need for this, or you would not have looked into sleeping pills.

Leaks could be waking you, but seeing as we can see a night with some serious leakage, which didn't wake you it cannot be as simple as that.

What else have you tried to help you get back to sleep?

[ChicagoGranny]

60 mg of Vyvanse

---------------> Common side effect: sleep problems (insomnia).

[ChicagoGranny]

OP is NOT using a fixed pressure. The auto is just sticking at a pressure that works.

Night of April 12 (7 hours sleep) - CPAP mode Fixed 13 cm

Night of April 14 (2 hours 45 sleep) - APAP mode 5 - 15 cm

Night of April 15 (1 hour 45 sleep) - APAP mode 5 - 15 cm

OP does not mention the changes or the reasons for the changes.

[palerider]

OP is NOT using a fixed pressure. The auto is just sticking at a pressure that works.

Well, you SAY that, but that's not how it works.

Auto machines want to be at the min pressure, so they sit at min until there's an event, and then they raise pressure, when the events stop, they lower the pressure, trying to get back to min.

they don't sit at a middle of the road pressure all night long without any events or flow limitations or snores.

Something's not right with those pics

[jimmye4golf]

I have been on the same dosage of Vyvanse well before the sleepless nights kicked in. When I wake up I usually have something on my mind that I want or need to get done. I tried the sleeping pills that one time. I have became kinda used to the sleepless nights. We have an acre and a half and some mornings around 2, 3 or 4 am I will be putting fertilizer down, putting stuff on ant beds, working on things in my shop and even once I took down our garage door opener after it broke and put the new one up and still had plenty of time to make it to work by 8am.

As far as the AUTO setting I just changed that one time to see if it would make a difference. Dates must be off becauae I made that change last night. Other than that I have never changed the settings. The only time I am a mouth breather that I know of is when my nose is stopped up. Today I was up from about 12:30 last night until now. I worked from 8am til almost 7pm. Came home and ate dinner with my wife and kids then changed the oil in her Expidition and my truck. About to head to bed now because I am exhausted. Im not sure what else to try for the sleepless nights. Ive googled it from time to time and most people take sleeping pills but that's just not for me. I wonder if it's my mind that wakes me? When it firat started happening I would wake up and would be instantly wide awake. I used to lay in bed for hours and could not go to sleep. So I just started making the bestbof it and would get stuff done. I used to joke about there not being enough time in the day but that's not the case anymore. Lol

[jimmye4golf]

If I wake up early enough in the morning I will upload tonights sleep. The pics I uploaded were just one day when I got a decent amount of sleep and 2 when I woke up really early just to see if anyone might have seen a possible cause of me waking early. Well off to bed I go. Thanks for taking the time to read and respond. It's much appreciated. Good night.

[ChicagoGranny]

I have been on the same dosage of Vyvanse well before the sleepless nights kicked in.

I hear what you are saying, but even you in a comment above describe Vyvanse as speed. Note that our bodies and response to drugs change as we get older. Would you be comfortable skipping the Vyvanse for two nights? Maybe you could do this on a weekend or some other time when you don't have to go to work.

Here is a checklist of other things to look at --->

Good Sleep for CPAPers

- Practice good sleep hygiene (Google it and read several sources; ignore extreme advice.)
- 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 (and sex) only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Do not listen to your breathing or the sound of the machine as you are falling asleep. (Some people, including me, actually find listening to their breathing and the sound of the machine to be relaxing.)
- Distract your mind by thinking of a pleasant, relaxing activity that you enjoy.
- If you are awakening at night, do not be too concerned. It is actually a normal part of sleep. (It does become a problem though for people who, when they awaken, become frustrated and have difficulty returning to sleep.)
- 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

This is a checklist. Some of the things you already do. Some are easy and can be done right away. Others you can work at over time.

CG

[ChicagoGranny]

BTW, there are many cases where subjects with undiagnosed/untreated sleep apnea were first diagnosed with ADHD. Sleep deprivation and other effects of sleep apnea can cause classic symptoms of ADHD. It's possible that CPAP, without Vyvanse, would have been the appropriate treatment for your "ADHD".

[gocamels]

Finding an ADHD treatment with a shorter half-life might help. The half-life of Vyvanse is about 13 hours, meaning you could still be having activity late into the night. By contrast, the half-life of Ritalin is about 2 hours, so it should be gone by bedtime. The complicating factor for some patients is the inability of the brain to calm itself enough to allow sleep. I have known patients who needed a bedtime dose of their ADHD med so they could sleep. As with everything else, no two people are going to have the exact same experience, and it's nearly impossible to generalize an answer, especially in a complex situation involving conflicting issues (ADHD and OSA).

[jimmye4golf]

I did not have time to upload last nights sleep but I ended up with 5.9 hours and AHI of 0.5.

I usually take my Vyvanse around 6am every morning. I would assume (keyword assume) that it should be out of my system about 20 hours later.

I see what you are saying about the Vyvanse. Ive never really considered it may be a problem due to the fact that when I take my Vyvanse it actually slows me down. I used to think ADHD was just a BS excuse until I started taking meds for it. Yes it's a methamphetamine which makes normal people bounce off walls but I can take it and an hour, two or whenever later lay down and take a nap. Medicine has always worked backwards for me. Stuff that should make you drowsy keeps me awake and the daytime stuff knocks me out. My ADHD Dr said its because of the ADHD. Chemical imbalance in the brain (something like that). I suppose my ex might have been right. She always told me I was messed up in the head. Lol. Thanks for the info. I will give that a shot. I will say ot scared me at first when I read "Practice total abstinence". lol. Have a great day!

[ChicagoGranny]

I usually take my Vyvanse around 6am every morning. I would assume (keyword assume) that it should be out of my system about 20 hours later.

If in your case, the half-life is indeed 13 hours, 25% of the dose would still be in your system the next morning at 6:00.

[jimmye4golf]

I googled Vyvanse half life and it says 4.3 - 5.5 hours. I still plan on going a weekend without it just to see. The only bad part of that is when I do have a 2 day weekend one day is mostly my younger kids soccer all day and Sunday is work around the house after sleeping in and sometimes a nap if the weather sucks.

[jimmye4golf]

I also found out this morning while talking to my wife that when I sleep I go from side to back to side quite frequently while I am asleep. Sometimes even flipping over to my stomach. I wonder if the larger leaks could be from all the movement? I have been contemplating a new nasal mask. I've been looking at the Resmed Airfit N30i and the N20. The N30i has nasal pillows or cradle. I tried nasal pillows ablong time ago and did not care for them at all. I wonder if the cradle seals well and is comfy?