Severe Nightmares Nightly, Frequent Waking, "edgy" Waking

[vintshave]

I have been on CPAP therapy for well over 10 years. In the last year or so, frequency of nightmares has spiked. Also, I wake up at least 10 times a night. I also feel "edgy" when I wake up, with my pulse rate fairly high. I've also had in an increasing problem with memory over the last year, with a good deal of brain fog. Last night, I accidentally fell into a nap without my mask on. No nightmares at all. What could be going on. I really need to resolve this. It's torture.

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[jnk...]

PAP does not always solve all sleep issues. The symptoms you describe may need to be addressed apart from solving sleep-breathing problems.

https://www.mayoclinic.org/diseases-con ... c-20353515

[chunkyfrog]

My sleep turns crappy when my silicone parts or headgear lose their "bounce".
As much as you might want to make these items last forever--it's not worth it.

[Miss Emerita]

JNK, thanks for the link to that very informative article.

Vintshave, the one comment I'd make is that your nap may not have been long enough to allow a period of REM sleep. Any dreams you had may well have occurred in some other sleep stage.

[DreamDiver]

I have been on CPAP therapy for well over 10 years. In the last year or so, frequency of nightmares has spiked. Also, I wake up at least 10 times a night. I also feel "edgy" when I wake up, with my pulse rate fairly high. I've also had in an increasing problem with memory over the last year, with a good deal of brain fog. Last night, I accidentally fell into a nap without my mask on. No nightmares at all. What could be going on. I really need to resolve this. It's torture.

stats 4-19-2020.jpg

Your data are remarkably consistent. You're really using your machine, with little in the way of large leaks, negligible flow limitation, excellent compliance... Well done! I have questions I hope you don't mind answering. It's going to seem like a wall of questions I know, but I can see you've posted about this same or similar concern before about the same time last year. I hope you'll be okay with that.

Are you really getting almost eleven hours of sleep every night? Seventeen-plus hours last night! Whoa! Do you have a medical condition that causes you to sleep half the day? Is there another reason you are sleeping so much? Most people require 7.5 hours per night, or about a third of any give 24-hour period. Your sleep cycle seems to require almost half your 24-hour period. It might be worth talking to a doctor about that if it's something that has crept up on you in the last year.

What kind of exercise are you getting during the day? Real physical exertion can be an important part of ensuring reasonable sleep. For myself, I find exercise reduces edginess and nightmares better than any drug. Is it too difficult to exercise? Even just walking is beneficial. When my grandfather couldn't get out (Canadian winters) he would wear a trail in the floor around the house just walking. I always thought it was weird as a kid, but now I understand why. It's part of that use-it-or-lose-it concept. Could you walk three miles daily (or at least three times a week), even just a slow walk? Is it something you could work up to?

Last time you bought a mask? Last time you bought a machine? How old is your equipment? If the machine is over five years old, it's possible your machine has passed it's useful motor life. Have you checked your tubes for leaks? This may be having a effect on your therapy.

Are you currently taking any medications or supplements that are sleep related? For instance, if I take melatonin, even under 1 mg, I get terrible nightmares, so I take 5-HTP instead. Drugs may or may not be the answer. It really is best to talk to a doctor about that.

Are you or have you been in a profession or have you persistently held a position working somewhere that is likely to cause Post Traumatic Stress Syndrome (PTSD)? Is it possible you are severely depressed? If you suspect this, you should probably go to a doc.

What do you suspect are the root causes of your nightmares and edginess?

Just some forum housekeeping: I know it's been a while, but if you have the time, could you put your machine and mask information into your profile? It's possible you had them there before, but something knocked them out since you last posted. It will help us know your situation better. If you can't find your machine or mask, you can post them in the text area.

Chris

[vintshave]

I have been on CPAP therapy for well over 10 years. In the last year or so, frequency of nightmares has spiked. Also, I wake up at least 10 times a night. I also feel "edgy" when I wake up, with my pulse rate fairly high. I've also had in an increasing problem with memory over the last year, with a good deal of brain fog. Last night, I accidentally fell into a nap without my mask on. No nightmares at all. What could be going on. I really need to resolve this. It's torture.

stats 4-19-2020.jpg

Your data are remarkably consistent. You're really using your machine, with little in the way of large leaks, negligible flow limitation, excellent compliance... Well done! I have questions I hope you don't mind answering. It's going to seem like a wall of questions I know, but I can see you've posted about this same or similar concern before about the same time last year. I hope you'll be okay with that.

Are you really getting almost eleven hours of sleep every night? Seventeen-plus hours last night! Whoa! Do you have a medical condition that causes you to sleep half the day? Is there another reason you are sleeping so much? Most people require 7.5 hours per night, or about a third of any give 24-hour period. Your sleep cycle seems to require almost half your 24-hour period. It might be worth talking to a doctor about that if it's something that has crept up on you in the last year.

What kind of exercise are you getting during the day? Real physical exertion can be an important part of ensuring reasonable sleep. For myself, I find exercise reduces edginess and nightmares better than any drug. Is it too difficult to exercise? Even just walking is beneficial. When my grandfather couldn't get out (Canadian winters) he would wear a trail in the floor around the house just walking. I always thought it was weird as a kid, but now I understand why. It's part of that use-it-or-lose-it concept. Could you walk three miles daily (or at least three times a week), even just a slow walk? Is it something you could work up to?

Last time you bought a mask? Last time you bought a machine? How old is your equipment? If the machine is over five years old, it's possible your machine has passed it's useful motor life. Have you checked your tubes for leaks? This may be having a effect on your therapy.

Are you currently taking any medications or supplements that are sleep related? For instance, if I take melatonin, even under 1 mg, I get terrible nightmares, so I take 5-HTP instead. Drugs may or may not be the answer. It really is best to talk to a doctor about that.

Are you or have you been in a profession or have you persistently held a position working somewhere that is likely to cause Post Traumatic Stress Syndrome (PTSD)? Is it possible you are severely depressed? If you suspect this, you should probably go to a doc.

What do you suspect are the root causes of your nightmares and edginess?

Just some forum housekeeping: I know it's been a while, but if you have the time, could you put your machine and mask information into your profile? It's possible you had them there before, but something knocked them out since you last posted. It will help us know your situation better. If you can't find your machine or mask, you can post them in the text area.

Chris

<<Are you really getting almost eleven hours of sleep every night? Seventeen-plus hours last night! Whoa! Do you have a medical condition that causes you to sleep half the day? Is there another reason you are sleeping so much? Most people require 7.5 hours per night, or about a third of any give 24-hour period. Your sleep cycle seems to require almost half your 24-hour period. It might be worth talking to a doctor about that if it's something that has crept up on you in the last year.>>

17 hours is quite unusual for me. But 9 or 10 hours is not. Essentially, I sleep until I am well rested. The frequent waking and nightmares interrupts my sleep, so even though I may have a lot of hours on the machine, they don't always reflect restful sleep. I have a number of medical conditions, diabetes being the most serious. I also have GERD. Both conditions are treated. Add in some depression and ADHD. Back when I worked a 9-5 job, my life was torture. I have really bad insomnia and I often operated on very little sleep. Before I started with CPAP, my doctor estimates that I got less than an hour of real sleep per night. I had a sleep study in 1988 that failed to diagnose apnea. Then I read a study 10 years later that said that there were many cases of false-negatives in early sleep studies, so I had another study done. The doctor told me that I had an AHI of well over 50. It can still take me a couple of hours to fall asleep, but since I own the company (and it's a global ecommerce business) it really doesn't matter what time of the day I fall asleep or wake up.

<<What kind of exercise are you getting during the day? Real physical exertion can be an important part of ensuring reasonable sleep. For myself, I find exercise reduces edginess and nightmares better than any drug. Is it too difficult to exercise? Even just walking is beneficial. When my grandfather couldn't get out (Canadian winters) he would wear a trail in the floor around the house just walking. I always thought it was weird as a kid, but now I understand why. It's part of that use-it-or-lose-it concept. Could you walk three miles daily (or at least three times a week), even just a slow walk? Is it something you could work up to?>>

Prior to Covid, I was working out 4 times per week. Doing so did not seem to impact my sleep quality or lessen my nightmares. I was hoping that it would

<<Are you currently taking any medications or supplements that are sleep related? For instance, if I take melatonin, even under 1 mg, I get terrible nightmares, so I take 5-HTP instead. Drugs may or may not be the answer. It really is best to talk to a doctor about that.>>

Just about anything can be sleep related. I take over 20 drugs and supplements, so my body is a chemistry set. I've been on the same ones for many years, so I'm not sure that's doing it - unless my body is responding differently to the same drugs. I suppose that's possible. I tried Melatonin. That did me no good. My doctor doesn't seem to have much insight into the sleep part of my health. When I tell him I have insomnia and nightmares, he says something along the lines of "yeah, that's a bitch"

<<Last time you bought a mask? Last time you bought a machine? How old is your equipment? If the machine is over five years old, it's possible your machine has passed it's useful motor life. Have you checked your tubes for leaks? This may be having a effect on your therapy. >>

Mask is new. I use nasal pillows a P10. My machine is 7 years old. I've been trying to get a new machine for months. Sleep center just hasn't gotten around to sending them my last sleep study. It's really frustrating since a machine is MUCH cheaper than a monthly fill of insulin. Since apnea has such an impact on health, I have no idea why insurance companies jerk you around on a machine. Tubes don't leak. Also, is it correct to assume that if there were a machine problem, that it would show in my numbers?

<<What do you suspect are the root causes of your nightmares and edginess?>>
I have a restless mind. But that's always been true. I don't know why the nightmares are so vivid and frequent in the last year. I think my head hates me.

[DreamDiver]

<<Are you really getting almost eleven hours of sleep every night? Seventeen-plus hours last night! Whoa! Do you have a medical condition that causes you to sleep half the day? Is there another reason you are sleeping so much? Most people require 7.5 hours per night, or about a third of any give 24-hour period. Your sleep cycle seems to require almost half your 24-hour period. It might be worth talking to a doctor about that if it's something that has crept up on you in the last year.>>

17 hours is quite unusual for me. But 9 or 10 hours is not. Essentially, I sleep until I am well rested. The frequent waking and nightmares interrupts my sleep, so even though I may have a lot of hours on the machine, they don't always reflect restful sleep. I have a number of medical conditions, diabetes being the most serious. I also have GERD. Both conditions are treated. Add in some depression and ADHD. Back when I worked a 9-5 job, my life was torture. I have really bad insomnia and I often operated on very little sleep. Before I started with CPAP, my doctor estimates that I got less than an hour of real sleep per night. I had a sleep study in 1988 that failed to diagnose apnea. Then I read a study 10 years later that said that there were many cases of false-negatives in early sleep studies, so I had another study done. The doctor told me that I had an AHI of well over 50. It can still take me a couple of hours to fall asleep, but since I own the company (and it's a global ecommerce business) it really doesn't matter what time of the day I fall asleep or wake up.

<<What kind of exercise are you getting during the day? Real physical exertion can be an important part of ensuring reasonable sleep. For myself, I find exercise reduces edginess and nightmares better than any drug. Is it too difficult to exercise? Even just walking is beneficial. When my grandfather couldn't get out (Canadian winters) he would wear a trail in the floor around the house just walking. I always thought it was weird as a kid, but now I understand why. It's part of that use-it-or-lose-it concept. Could you walk three miles daily (or at least three times a week), even just a slow walk? Is it something you could work up to?>>

Prior to Covid, I was working out 4 times per week. Doing so did not seem to impact my sleep quality or lessen my nightmares. I was hoping that it would

<<Are you currently taking any medications or supplements that are sleep related? For instance, if I take melatonin, even under 1 mg, I get terrible nightmares, so I take 5-HTP instead. Drugs may or may not be the answer. It really is best to talk to a doctor about that.>>

Just about anything can be sleep related. I take over 20 drugs and supplements, so my body is a chemistry set. I've been on the same ones for many years, so I'm not sure that's doing it - unless my body is responding differently to the same drugs. I suppose that's possible. I tried Melatonin. That did me no good. My doctor doesn't seem to have much insight into the sleep part of my health. When I tell him I have insomnia and nightmares, he says something along the lines of "yeah, that's a bitch"

<<Last time you bought a mask? Last time you bought a machine? How old is your equipment? If the machine is over five years old, it's possible your machine has passed it's useful motor life. Have you checked your tubes for leaks? This may be having a effect on your therapy. >>

Mask is new. I use nasal pillows a P10. My machine is 7 years old. I've been trying to get a new machine for months. Sleep center just hasn't gotten around to sending them my last sleep study. It's really frustrating since a machine is MUCH cheaper than a monthly fill of insulin. Since apnea has such an impact on health, I have no idea why insurance companies jerk you around on a machine. Tubes don't leak. Also, is it correct to assume that if there were a machine problem, that it would show in my numbers?

<<What do you suspect are the root causes of your nightmares and edginess?>>
I have a restless mind. But that's always been true. I don't know why the nightmares are so vivid and frequent in the last year. I think my head hates me.

Okay, there are a lot of extenuating medical circumstances over which I'm unqualified to give advice. It would be great if you could get together your medical team: the sleep doc, the docs in charge of your various meds, your primary care provider, so you and they can all go over what's going on with you in an actual face-to-face discussion. Some things could come to light that were not evident from the perspective on the isolated specialists. We live in an age of zoom conferences. There's no reason why it couldn't be made to happen, though our medical system is hardly set up for this. My dad insisted on it a few times when he had cancer about 40 years ago, and it gave them all perspective for his particular case. Is this possible?

As to why get a new machine, well, data and algorithms have gotten better since the RemStar series. The data are probably okay, but the motor could fail at any time. I'm glad to hear you're getting a new machine soon! You would probably go for the DreamStation Auto since you're familiar with the RemStar... But why not try an Airsense 10 Autoset? It uses a much gentler algorithm than the Respironics line. The Respironics line uses a 2cm pulse every couple seconds when it's attempting to test for obstructive apnea. For me, that huge pressure change was a wake trigger and frustrating as hell. I hated it! Also the algorithm caused me to feel like I was running a marathon every night. For the first couple months on the Respironics machine, I was sore in my mid-section from the workout. It would anticipate my breath just a millisecond early on both inhale and exhale -- just enough that my body tried automatically to keep up. But I couldn't. My body would always try to breathe faster, but couldn't. It felt awful! The Resmed line (Airsense 10) uses tiny .5cm pulses milliseconds long that don't disturb my sleep. The algorithm determines just when I'm about to inhale and exhale almost in unison with when my body wants to do either. It's just easier, more restful. I refuse to be sleep-tested in a lab that uses Respironics machines to this day. Resmed is the only way for me. It might make a difference for you.

Before I had my machine, I was having nightmares all the time. For forty years prior, I pretty much had sleep apnea but didn't know it. At some point, my brain started using nightmares and truly bizarre dreams as a way to startle me into breathing again. Perhaps sometimes the brain takes a "whatever works" attitude. Maybe in your case, even though you have the machine to help you breathe, your subconscious has still not accepted that and is rebelling against giving into letting the machine help you. I started with an M-Series pro in the Respironics line. I hated it, but didn't know any better. As soon as I changed over to the S9 Autoset (Resmed line), I started seeing better results.

I wonder... Until you can talk with your doctor team, and if you're tired to the point of being angry about being hounded by your nightmares... Until you get your new machine... How would you feel about trying to confront your nightmares head on? Consider: Your data look reasonable. You know on a conscious level that your machine is making a difference. If you're going to be confronting nightmares anyway, have you considered changing mental tactics? What would happen if you went into your dreams with a warrior attitude and faced those nightmares? Seems cheesy I know... but maybe conquering the nightmares will allow your subconscious to finally agree with your conscious decision to let the machine help you.

Just a thought.

[Julie]

I strongly suggest you get your meds re-evaluated, or at least keep a journal comparing what you take when, how long you've been on what, how much you take of each and what side FX are likely for which. Just because something acted one way years ago, possibly with a different (or lesser) mix of other meds, doesn't mean it's still ok now or not reacting with the older you (and the other meds), never mind what other conditions you might now have. Seriously.... do it. You might be surprised.

[DreamDiver]

I strongly suggest you get your meds re-evaluated, or at least keep a journal comparing what you take when, how long you've been on what, how much you take of each and what side FX are likely for which. Just because something acted one way years ago, possibly with a different (or lesser) mix of other meds, doesn't mean it's still ok now or not reacting with the older you (and the other meds), never mind what other conditions you might now have. Seriously.... do it. You might be surprised.

Julie's right to bring this to the forefront. Excellent suggestion to do this first.