Sleeping aids/pills/etc.

[leshii]

I've had trouble with my CPAP treatment since I began last Monday. I simply cannot fall asleep with the mask on. My pressure is at 18 and the ramp up from 4.0 is too short (I wish it were like 45 or 60 minutes instead of 20). I end up lying there after a long time no longer feeling sleepy and if I couldn't fall asleep when I was actually sleepy, I would never fall asleep feeling the way I do after sitting there for an hour.

So in ten days of use, I've only had the mask on longer than six hours once, and that was the first night when I was so keyed up that I took Simply Sleep an hour before falling asleep. Otherwise, I don't use it (but I always try for an hour or two), or it came off after a couple of hours. It's gotten to the point now that I'm giving up more easily.

I had problems with leaks for the first week and went to the doctor and I got a new mask (smaller size). The new mask fits better and leaks less but, as I told the doctor, I'm not going to fall asleep with this mask on at this pressure. The doctor thought my problems stemmed only from the leaks so he thought, and I hoped, a new mask size would work. (And I took your advice concerning switching to a BiPAP but my doctor wouldn't bite. And trying to get a new mask without paying for it was a struggle, but that's another story for another time).

At this pressure, I have to think about breathing. Otherwise, it's so overpowering that I actually stop. I know it won't happen when I fall asleep but I can't distract myself from concentrating on my breathing and feeling overwhelmed. And since I can't fall asleep with anything that's going to distract me otherwise (TV, radio, etc), I have one thing and one thing only to deal with: this horrible mask.

So finally to my point--the doctor said no sleeping aids, but my results from the night I took Simply Sleep were good (my AHI was under 5.0, down from ~45). I mean, my apnea can't be much worse than it is untreated and I can't imagine this hurricane-force gale being blown down my throat every night won't compensate for anything the sleeping aid is doing.

But I would like to hear from you guys on the issue.

[Handgunner45]

I would never suggest that someone not follow their doctors advice, but..... When first started on CPAP, I talked to my GP about my concerns with falling asleep with the mask. She had no problem writing me a script for Lunesta. I only take it about once or twice a month on my really bad nights, but I do take Tylenol PM nearly every night. My numbers are actually better when I take the Tylenol than they are without it. I even asked the Sleep Tech when I had my sleep study about the Tylenol and was told that it would not be a problem. If you are able to monitor your numbers, then I would say "go for it" if it will help you to sleep, after all, that is what this is all about.

[Wulfman]

Did you ever get a copy of your sleep study (polysomnogram)?
It should show some sort of a dialogue of what pressures they put you through and what was happening at those pressures.
In my case, I was also prescribed a pressure of 18. For me, it was just a little too intense to start out with......so I dropped it to 10 and found that not only was it easier to start my thereapy with, but I did very well at that pressure.

Main difference is that you don't have a machine that will give you your nightly statistics.

My suggestions are to ask your doctor if you can drop your pressure down to something that will allow you to get underway with your therapy and move up from there......OR......get a machine and software that will allow you to monitor your own sleep statistics.

My philosophy with my pressure re-setting was that I was going to be using more pressure than I had been pre-CPAP and if necessary, I would adjust from there.

Good luck,

Den

[oceanpearl]

I would check into a BIPAP.

[TerryB]

I too will not recommend going against your Dr.s advice, but is it possible the recommendation not to use sleep aids was given after the diagnosis but before the treatment? The sleep aids (IMHO) to not change the conditions of your apnea, they just make it less disturbing to you so you don't arouse because of the apnea. Since you are treating with the machine, it takes care of the apnea so you don't have to be easily aroused.

I too take a home brew xxPM, actually two generic naproxin sodium and two generic anti-histamine. I have a Rx for Roserem, but sometimes Abe and the beaver get to carrying on too much with it.

If you get rest and your numbers are good I would not be afraid of the sleep aids but talk to your MD.

TerryB

[jskinner]

I would resist the temptation to use sleep aid if at all possible. They will only make your apnea worse. My suggestions would be as follows:

1. Increase the length of the Ramp. Not sure but it might not be possible on that machine.

2. Switch to an AutoPAP so that you could start out at a lower pressure and build up as needed.

3. Switch to a BiPAP or BiPAP Auto that allows for a lower exhalation pressure.

If you can't do any of the above at least lower your pressure until you get used to it as has been suggested. Using the machine more at a lower pressure has got to be better than not using it at all...

[oldgearhead]

I would resist the temptation to use sleep aid if at all possible. They will only make your apnea worse. My suggestions would be as follows

I think some of the latest studies say the newer sleep aids actually lower
AHI. The other thing the studies uncovered is the "falling alseel at the whell"
problem, asociated with them.

[Snoredog]

I've had trouble with my CPAP treatment since I began last Monday. I simply cannot fall asleep with the mask on. My pressure is at 18 and the ramp up from 4.0 is too short (I wish it were like 45 or 60 minutes instead of 20). I end up lying there after a long time no longer feeling sleepy and if I couldn't fall asleep when I was actually sleepy, I would never fall asleep feeling the way I do after sitting there for an hour.

So in ten days of use, I've only had the mask on longer than six hours once, and that was the first night when I was so keyed up that I took Simply Sleep an hour before falling asleep. Otherwise, I don't use it (but I always try for an hour or two), or it came off after a couple of hours. It's gotten to the point now that I'm giving up more easily.

I had problems with leaks for the first week and went to the doctor and I got a new mask (smaller size). The new mask fits better and leaks less but, as I told the doctor, I'm not going to fall asleep with this mask on at this pressure. The doctor thought my problems stemmed only from the leaks so he thought, and I hoped, a new mask size would work. (And I took your advice concerning switching to a BiPAP but my doctor wouldn't bite. And trying to get a new mask without paying for it was a struggle, but that's another story for another time).

At this pressure, I have to think about breathing. Otherwise, it's so overpowering that I actually stop. I know it won't happen when I fall asleep but I can't distract myself from concentrating on my breathing and feeling overwhelmed. And since I can't fall asleep with anything that's going to distract me otherwise (TV, radio, etc), I have one thing and one thing only to deal with: this horrible mask.

So finally to my point--the doctor said no sleeping aids, but my results from the night I took Simply Sleep were good (my AHI was under 5.0, down from ~45). I mean, my apnea can't be much worse than it is untreated and I can't imagine this hurricane-force gale being blown down my throat every night won't compensate for anything the sleeping aid is doing.

But I would like to hear from you guys on the issue.

It is NOT a matter of your doctor "biting", if your doctor doesn't understand the benefits it would offer to your therapy you need to find another doctor.

I would:

1. Obtain a copy of your PSG (you have a legal right to a copy).
2. Obtain a copy of your current prescription (you have a legal right to a copy).
3. KEEP complaining about the 18cm pressure, KEEP asking for the BiPap, at that 18cm pressure it is warranted and your doctor is either inexperienced in treating your disorder or is a quack.
3. Obtain the information above. If your doctor continues to NOT listen, simply tell them you are wanting to seek a 2nd opinion, go to absm.org and search for another sleep doctor in your area.

Most insurance policies state that you must first "trial" cpap before Bipap will be covered. You have already done that, you have too high pressure for basic cpap and reason you are having so much difficulty tolerating it.

The machine will only work for you if you can USE it. If the pressure is so high with no exhale relief (Cflex isn't very effective at that pressure) where you cannot tolerate it. Then go back and tell your doctor you are not using the machine because you cannot tolerate the high pressure. If they won't switch you to a Bipap then say seeya!

[zhotster]

[quote="Handgunner45"]I would never suggest that someone not follow their doctors advice, but..... but I do take Tylenol PM nearly every night. My numbers are actually better when I take the Tylenol than they are without it. I even asked the Sleep Tech when I had my sleep study about the Tylenol and was told that it would not be a problem.

[meister]

I went through many nights in the beginning just laying there the entire
night and listening to each and every breath. I didn't sleep one minute.
I tried about everything. Finally a combination of Tylenol PM and 1 mg of
Melatonin worked, but I also found that 2 Valerian root would work, 2mg
of Lunestra would work, one Ambien CR would work. Some nights I
can get through on Trazadone (50mg), or a Sonata, or a normal
Ambien. I never take anything more than two nights in a row because
I don't want to get addicted or build up tolerance. Being a man,
a couple of hours of heavy sex works too, but it wears out the other
partner.

[Swolcott]

I agree with what many have said. I also use an generic Benadryl every 3rd night if I have no slept well. My pressure is at 10. I can ramp from 4 but feel like I am suffocating at the 4 so I have only used that a couple of times. I know I would have used it more when I started if it had been set a little higher.

I agree that there is nothing wrong with seeing a different MD if needed. Maybe try your primary MD if you are going to a specialist or a specialist if your primary MD is perscribing.

Good Luck
Sam