4 years on CPAP, and still dealing with sleep hygiene issues

[CollegeGirl]

This month was my four-year-a-versary on CPAP. Really, really hard to believe. I never would have made it without you guys.

My treatment is still going well - my average AHI per night is what it always was - between 0 and 1 - usually 0.

There's one problem, though: I'm still exhausted. I feel as though it's my fault - that it's my own moral shortcoming. I just can't seem to make myself go to bed on time. A good friend pointed out to me that I feel the same kind of guilt for this that I used to for being tired pre-cpap. I'm wondering if there's any chance in heck this is physiological, too, in some way.

My usual week goes like this: Friday night - sleep in. Usually somewhere between 9 and 12 hours depending on how tired I am. Saturday night - same thing, usually more like 8-10 hours, though. Sunday night - stay up too late. Monday night - go to bed ridiculously early because I'm so tired. Tuesday night - stay up too late. Wednesday night - bed early. Thursday night - stay up too late. I think you see the pattern. There's SO much wrong with a sleep "pattern" (can't even really call it that) like this I can't even start to describe it. I've been staying up waaaay too late for the last 15 years of my life.

I have a few theories as to why I do this:

1) I'm a moron.
2) I had undiagnosed, untreated, severe sleep apnea for 25 years of my life. I wonder if subconsciously my body learned sleep was dangerous, so it doesn't want to let me go to sleep until I absolutely can't resist it any longer. It's been four years of safe sleeping now, but maybe my subconscious still hasn't gotten the message.
3) I'm still constantly fatigued, even when I've had adequate sleep. I think this is likely because I have such bad sleep hygiene. But fatigue is also a symptom of hypothyroidism, which I was recently (about six months ago) diagnosed with. My doc says my dosage is right now, but I've been on this same dosage since I started six months ago, and I'm not feeling any better, fatigue or mental-fog wise. So I'm thinking I'm just so exhausted (whether it's from the thyroid or the bad sleep hygiene), that when I get home I don't have the energy to do what I need to do to go to bed. It takes less energy to read or surf the net than it does to get my clothes together, make my lunch, etc for the next day.

I'm at a loss here. I'm at the end of my rope. My boss is starting to notice, and I'm up for my second promotion in the 18 months I've worked there, and don't want to blow it.

My life has gone back to sleeping in the handicapped stall on my lunch break - which is what I used to do pre-cpap. Something tells me this is more than carryover teenage rebellion. I just don't know what's wrong.

Anyone else go through this?

[track]

Go to bed at the same time every night you dummy. Now if you were working a 16 hours a day I might feel sorry...but it's pure laziness to just sit on your butt and not go to bed. I know..I have done the same thing many times. I understand...as you do...though that if I am tired it's no ones fault but my own. As for being tired on cpap...so am I. Cpap isn't a cure all...far from it.
A little self discipline...something we can all use more of...will get you to bed at the same time every night. I envy your ability to sleep for 9 to 12 hours....that would be heavenly.

[SharkBait]

A good book gets me to bed on time every night. I love to read. Wasn't always that way, but it is now. Every night (unless there's something going on like my son's baseball or something like that) I head to the rack at around 9:00 PM. If it was just to go to sleep, I would probably put it off and find something else to do until around 11 or 12... I do not have a TV in my room. I've got one in three other rooms in the house, but not in there. I'd stay up until after Letterman if I had a TV.

On most nights I don't make it 20 minutes before I'm sawing logs. A nice long book usually lasts me weeks unless I'm spending time on an airplane and in airports...

[yorkiemum01]

Sharkbait is my soul twin...........grab a good book bout 10pm and 20 mins later my eyelids are falling.
LOVE to read, in bed, but never make it more than half an hour, and religiously do it every night, same time
regardless of 'work' night or not. Even on my 'off' days (I work 12-14 hr shifts, plus 2 hrs commute,
4 days a week), I must maintain a close to norm schedule, sleep and wake hours. (and never, never nap)
Sure, I'll slip in an extra hour without the alarm going off, but my body wont allow me much more
than that once you set your routine. It's not hard to do...give it a shot.

[TSSleepy]

First, I have a lot of sympathy for your situation. I've only been on CPAP five weeks, but I can see how many of my bad sleep habits came about from untreated sleep apnea. And now I'm having to re-evaluate those habits, now that I am being treated.

For me it's easier, because I have a negative feedback loop. I always felt tired and crappy, so sleep hygiene didn't matter. But now I feel much better on therapy, and I really PAY if I don't follow good sleep hygiene.

But my advice is that there are really two possibilities:
A) You're screwing yourself up, by not going to sleep and getting up at the same time every day.
or
B) There's still something physiologically wrong with you.

And when you think of it like that, you really have only one course of action:
Force yourself to go to bed and get up at the same time every day for 3-4 weeks and see if it gets easier and you feel better.

If it gets easier and you feel better, then force yourself to have good sleep hygiene for the rest of your life! But if it doesn't get easier and you don't feel better, then there's probably still something going on with you and you'll need to figure out what that is.

And believe me, I think it's entirely possible that there is still something else going on with you. It's really easy to blame a person's problems on their behavior, but most people actually don't work like that. Usually people behave a certain way because they have a problem.

If you really want to be sleeping with good sleep hygiene, and have tried to sleep with good hygiene, and you feel guilty about not succeeding, and recognize that it is negatively influencing your life, but you still can't sleep a normal schedule...there's probably really something else wrong with you. Tracking it down might take awhile, but stop beating yourself up about it.

[Debjax]

I wonder if subconsciously my body lear ... any longer

Oh, yeah, I think this is very much the case I had....Before CPAP, when I went to bed each night, my heart would be pounding like a jackhammer, in true "fight or flight" mode...tried to discuss it with several docs, they just told me that it was "nothing", really. But I mean it would POUND. I also was a "could not go to bed until really early...the next morning" person, did not want to go to bed, and would make excuses to not do so until the wee hours....

I had to break the "wee hours" think a number of years ago, hubby just wouldn't have it. It was hard, but I finally was able to do it, but it was about then the heart pounding started. I have been thinking over the last few months, and wondering the exact same thing...was my subconcious aware that we were going into a fight for life and reacting accordingly, thus the pounding heart. 'Cause, since about a few weeks after starting CPAP, it doesn't do that anymore.

You have to undo years of conditioned sleep responses, and have not really tackled it yet. You have to tackle it now, and you have to retrain your system. It CAN be done, I know, I was there. It will be hard, but you HAVE to force yourself to go to bed "on time". You may lie there awake for awhile the first nights, but eventually, your body WILL adjust and learn that it can get regular rest. Bribe yourself if you have to. Go to bed all week on time, treat yourself on Saturday, something nice, lunch out, movie, SOMETHING special....but no regular bed time, no treat.

Now, if you will excuse me, it is my bedtime, and I so want to go and get some of that really wonderful sleep that I am blessed with these days...

[SharkBait]

Sharkbait is my soul twin...........

Hope this doesn't freak you out, but when I'm reading I also have a 4 lb yorkie nestled up against my leg...

Her name's Macy and she's 7. I bought her for my kids but since I work out of my house I was given the chore of potty training her and it took about 6 months. By then she was pretty much hooked on being over here with me and my two Brittanys and she quickly was able to take over herding Brittanys like she was a sheep dog so they would move out of the way and she could go for a ride in the car.

I was never much for small dogs but this 4 lb critter is the best dog I have ever had and it's not even close.

[/hijack]

[DoriC]

CollegeGirl, my best friend is hypothyroid and when she wasn't feeling any better and even though her blood tests became normal, her Dr told her to take an extra 1/2 of her thyroid pill and that did the trick. No more fatigue and other symptoms but of course she doesn't have apnea. Just a thought though. Also, I notice that when my hubby stays up later than usual he doesn't sleep as well. Just another thought.

[tooly125]

Hi CollegeGirl,

Glad to hear that your doing well at work,with the way the economy has been it's important for those who have a job to hold on to it!
I have a few suggestions for you to consider:
1) When you put your clothes away after doing laundry put them away as complete outfits apropriate for work every thing on one hanger or drawer which ever works.(note: I realize this is from a guys point of veiw and that this is probably much more dificult for a woman!)

2) When you make or buy supper have enough left over to put in a tupperware container now you have a lunch ready to grab and bring to work.(hopefully you have a microwave at work).

3) A lot of alarm clocks have two seprate alarms if you have one of these set one alarm for your wake time and the other for your sleep time, assuming that you can hear the alarm in your bedroom from wherever your hanging out in the house when the sleep time alarm goes off you will have to get up,go in the bedroom to shut it off now all you have to do is stay there!!

4) As suggested do your reading in bed.

5) do you have a Laptop? if so unplug it and only allow yourself to use it from the battery, when the battery runs out computer time is over.

I hope some of these are helpfull.
You need to force yourself to go to bed and wake up at the same time for at least a couple of weeks so you can get an answer if it's really your sleep hygiene thats your problem.
If it is your hygiene then you know what you have to do, if it's not then it's time to stop beating yourself up about it and go see a doctor.

Good luck you can do it!!
Tooly

P.S. now shut off the computer and get to bed

[oldschoolcpap]

...Something tells me this is more than carryover teenage rebellion. I just don't know what's wrong.

Anyone else go through this?

Yes! You are not alone. When I am unhappy with things in my life (especially my job) I rebel against good sleep discipline. When this happens to me, I start examing my life for what's making me unhappy enough to no longer care about going to bed. It's usually work related. The keys are not to beat yourself up over it and then to try and face the problem. Deal with that bad client or coworker. Or if it's really just a salt mine, dust off your resume and say sayonara. Just be careful not to jump without trying to resolve issues in your current workplace first. While the new job buzz can be nice, your problems may follow you if you didn't deal with them.

But it's entirely possible there's something else going on. Apnea tends to invite other problems to play. I have narcolepsy in addition to my sleep apnea (nice combo those two *sigh*) Depending on how your tiredness sets in on you during the day, you could even be experiencing something like hypoglycemia (over production of insulin) causing your blood sugar to crash leaving you feeling exhausted.

There are lots of medical possibilities. But Doctors sometimes need to be pushed to look outside the box.

Even drinking extra caffeine in attempt to compensate for your tiredness could be causing you instead to be more drowsy. Stimulants and depressants are actually one and the same. Which effect you get depends a lot on dosage and your own biochemistry can affect things too.

But sometimes in life, we just rebel against our own better judgement. If that's the case, give yourself a break and don't beat yourself up over it. Instead try to figure out what's causing you to rebel and deal with it.

Best of luck.

[Wulfman]

??????

http://en.wikipedia.org/wiki/Circadian_rhythm

http://healthlink.mcw.edu/article/922567322.html

http://www.webmd.com/sleep-disorders/gu ... ders-cause

http://www.stanford.edu/~dement/circadian.html


Den

[Paul56]

If you work week is Monday thru Friday then it is particularly important that you put in enough "sac" hours Sunday thru to Thursday night... and preferably hit the sac at about the same time each night.

It is also preferable to keep up the same routine on the weekends but sometimes there are compelling reasons, or so we think, to stay up late.

I know if I stay up late on a work night that I am out of sorts the next day and dragging myself around.

[BeanMeScot]

I am also hypothyroid. I know that what doctor's consider "normal" can also be too high for people, just like doctor's consider an AHI of 10 fine but most people don't feel better until they are under 5. I would find out what your actual TSH level is and check online for the levels people feel best at (I think it was around 2).

Also, some people do better on Armour than a synthetic thyroid horomone. You could also try that although I would try forcing yourself to go to bed at the same time every night first.

[whatrdreamsmadeof]

I am so much your twin. That said I would kill for more than 6 hours of restless sleep, I know for me I put off going to bed because :
A. I too am a Moron
B. I suffer from depression so I guess I have the mentality that if I go to bed, another workday is coming, Duh, I am greatful to have a job.
C. I will lay there and obsess about the craziest things.
D, Addicted to TV
E. I'll be exhaused when I wake up anyway.
Do you think you my have depression or anxiety, sleeping long hours 8-10 may be a symptom of it.
I wish you luck, and if you find the answer PM me please.
Take care, Ellen

[kteague]

Hi CG. We were partners in sleep crime "back in the day" weren't we! Getting this earlier bedtime right has been a struggle for me too, but my sleep doctor is adamant I get this right. And I know if I'm not doing those things I can to help myself, I shouldn't expect her to keep listening to me complain about how bad I feel. She says the quality of my sleep will be better if I go with the body's natural hormones. Have been reading about how even what and when we eat affects hormones that affect sleep. And of course we can't ignore the roles of nutrition and exercise in how we feel and function.

I spent so many years not sleeping at night that it seems like normal to me. When my limb movements are reasonably controlled, I do much better, but when they are acting up and I get off schedule, I'm right back to square one. Then the only thing that works for me is to force the issue again by picking a good time period to get up early and forego naps - no matter how bad I feel during the days. By the 3rd night I am too glad to go to bed early. But I can relapse with one night of staying up too late.

Or you could do like Blarg and move to the other side of the world and your hours will be in sync with their clock. You know what I've wondered about that is if he actually did start sleeping at night or if his light/dark signals and circadian rythms are really off and he was soon out of sync there too.

But all that said, CG, I can't help but think that your sleep is not the lone culprit in how you feel. How often are they checking your thyroid levels and where in the normal range are they falling? Years ago a doctor told me that he didn't agree with traditional views on thyroid levels in that just getting someone into the normal range is not sufficient. He said even if somebody tested in the normal range, if it was on the lower end of that range and they were still symptomatic, their levels should be brought to the higher end of that range. Also, if one normally was at the hgher end of the range when their thyroid was healthy, having it drop to the lower end is not normal for that person and may produce symptoms. Sounded reasonble to me, but what do I know?! Do you think it would a reasonable step to be evaluated by an endocrinologist just to see if they can pinpoint anything?

Hope you work thru things and feel better soon.

Kathy