Sleep aids and fragmented sleep patterns

[Pugsy]

I am asking for ideas on things to help me sleep just a little deeper and not have so many awakenings. I have some pain issues and those along with general apnea related awakenings keep me from getting as much recuperative sleep as I need.

Last night cheated with Valium 5mg, got 9 hours on the machine. Still had several awakenings throughout the night but not to the level where I had to get up except once to go to the bathroom.
Ambien CR works great also but I know that I cannot depend on it or Valium, so I won't go down that road.

I get to sleep easily. It is staying asleep that is the problem. When I turn over in bed my back hurts enough to wake me. Short version is that I have had multiple pelvic fractures along with fractured sacrum. Lots of arthritis in there now. I can't lay in one position long without increase of pain. I take Ultram for the pain and sometimes I sleep well with it and sometimes I am up cleaning house all night with it. It is a crap shoot which I get. I can't take NSAID's due to GI distress.

So ideas on natural sleep aids???? I did try Melatonin (1 pill) but about 20 minutes later I had vertigo so bad I was bouncing off the walls and this lasted pretty much through the next day. I do believe I did sleep a little sounder. The side effects the next day were awful though.

And yes, I do have a good supporting mattress but I was thinking of adding one of those memory foam toppers for it. Not the awfully expensive ones but a middle of the road one. Anyone using something like that to help with pain?

Thanks
Brenda

[mars]

Hi Pugsy

I too have back fractures and arthritis in the spine, and dealing with the pain is todays major problem.

Apart from pain killers I am looking at Chi Kung, but it is early days as to how effective it will be. And some days I am in too much pain to do very much. But there are Chi Kung exercises which one can do sitting down.

I am hoping the end result will be less pain, a more functional back, and less interruptions in my sleep.

Perhaps preventing yourself from turning over might be of more immediate help. There are a number of ways you can do this. I just shove a small pillow in between my back and the bed.

cheers

Mars

[DreamStalker]

Unless you do get a "good" memory foam matress/topper ... you may be better off not wasting your money and instead save up to get a "good" one. Good one will be very dense and heavy. Alternatively, you may want to look at all natural latex matresses used by folks with fibromyalgia (sp?).

You can do some research here ... http://memoryfoam.com/

I purchased mine from them about 4 years ago back when you could order the materials and build your own.

[Sleepy Taz]

Pugsy,

If the pain is waking you up you might want to try advil which helps reduce swelling and stop the pain before it starts. My doctor reccomended 600 milligrams which he said was like taking codeine tylinol without the codeine. Each night I take 3 advill about an hour before going to bed and my old age aches and pains do not bother me even when I wake up in the morning. You will want to consult with your doctor on this as you may have other issues that may make this an unwise choice for you. Good luck and let me know if this helps!!

[LoneStar]

Folks with back pain are told repeatedly to "get a good, firm mattress." Well, yes, you don't want to be sleeping in a hole, so to speak, or sink in up to your eyebrows, but a firm mattress may actually exacerbate your pain.

If you wake up with pain in your shoulders or hips, it's because your body weight is mostly on these two areas causing pressure points.

A good quality memory foam mattress would help, as would one of the Sleep Number (air mattress) type beds. Another option is a bladder-type waterbed (not the tube-type). A final option is to get a thick down mattress topper.

But if funds are tight, a cheaper memory foam mattress pad would help in the short run, the thickest you can afford.

Be aware that some people feel they cause you to retain more body heat. My husband and I have slept on one. While comfortable, we were both very hot. We ended up getting a waterbed which we've been very happy with. My husband has a lot of joint pain.

Lisa

[Hawthorne]

I have Rheumatoid Arthritis and some back pain issues. I have used memory foam toppers in the past and even a Tempurpedic bed. I didn't get relief from either of those. The Tempurpedic bed was very bad for me. It caused more pain than it helped!

Nothing has helped me as much as those "egg crate" like toppers with zones or sections that offer different support for different parts of the body - legs, hips, back, and neck. They are various prices and mine is high end in price. Don't ask how much I paid for it! I've had it for so many years I can't remember what it cost!

I also have a very good medium firm mattress with a pillow top.

Works well for me!

[Pugsy]

I wish I could take Advil or Motrin but any of the NSAIDs cause immediate abdominal pain. A mere small dose of any of the OTC levels cause such GI distress that I want to go to the ER and get a demerol shot. LOL I worked in a medical clinic for 20 plus years and have tried most of the NSAIDs. Even one that has anti GI distress medicine built in won't work. I was having painful vomiting on day 2 of it.

The whole idea of NSAIDs is to decrease the inflammation causing the pain, thus decrease the pain. I can do aspirin which is an NSAID, for short periods only as it has been known to cause GI bleeding in me. Tylenol doesn't help with the back/pelvis pain. I am sort of caught between a rock and a hard place.

Pain treatment with meds like my Ultram or Tylenol with Codeine or Lortab is that they mask the pain. They don't really address the cause of the pain. I used to tell patients that it makes you not care that you hurt. It is an oversimplification but fairly true. Narcotics are also potentially habit forming (physically and mentally) because some people like the "good" feeling that comes with the not caring that they hurt.

I have a make shift pillow of sorts to try to stop me from rolling over onto my back. It is marginally successful and I plan to go to the city tomorrow and look for a more substantial pillow. I do need to reposition from my side but if I had something that stopped me at about a 45 degree angle, that would satisfy need to move and also stop me from going flat on my back, plus give my back the support it needs. Been looking at those pillows for pregnant women, they look interesting. I will also look at the memory foam toppers. I have a king size bed. Cost for that size in the "good" range gets quite high. Maybe they will have a sale on something. With the cost of my M series machine and the software, I am pretty much tapped out right now. If I knew for sure that the high dollar toppers would help, then I gladly would save for it, I just don't know and they are not returnable...... at least from the store in town.

Thanks for the input
Brenda

[FatiguedMe]

Hi Pugsy,
What about checkin online or in town at a health supply store for a wedge? I know some people use them for gerd, but I am sure you could position it for keeping you off of back. Not sure of the prices, but google Wedge Support Pillows.

http://www.makemeheal.com/mmh/product.do?id=10043

That link is what I am talking about!
Good luck and keep us posted.
AKA Dustbunny

[Pugsy]

http://www.1800wheelchair.com/asp/view- ... ct_id=2334

I think a pillow along the lines of the one above might be worth looking at. Way too much money for that particular one but it is all I could find right now for an example. When I was an x-ray tech we used something very similar when we had to do certain views of the lumbar spine. It would prevent complete rollover onto the back but yet offer support and not be near as annoying as waking up with tennis balls in your back. The whole idea being to continue sleeping and not fragment our sleep anymore. A possible problem I see would be fixing it so it wouldn't slide out and away from the body.

My step father used one very similar that we got from the army surplus store last year. Unfortunately my mother tossed it when he passed away. I will go look tomorrow when I go to the city for unrelated doctor appointment.

I do have a down/featherbed topper. I haven't used it in quite a while. Worth digging it out and trying again.

Memory foam toppers keep heat in?? OMG, I am just now finishing up with the hot flashes that we get with menopause. I still use a fan even in the winter. My husband says he has permanent burn scars from the heat I generated.

I will report on my experiments as they come about. I am in a catch 22 situation. I have long sleep latency (getting to REM sleep), I need the recuperative powers of REM but it is also when my apnea is significantly worse, and then we add in the frequent awakenings and it makes it hard to get much REM sleep.

[riverdreamer]

Have you tried muscle relaxants to help with your sleep? I have used Soma for many years to either go to sleep, or get back to sleep. I don't seem to have developed any tolerance, and can take it or leave it, only using it when needed. It does only seem to have about a four hour window of effectiveness, but sometimes that is just enough to get me a long enough night of sleep. There is also a new, long acting form of Flexeril called Amrix, that lasts for 24 hours.

Another option is Lidocaine patches, if your pain is pretty localized. I find they are very effective, just a bit expensive with the Rx coverage I have. For back issues, you might need to use 1-3 patches at a time.

If you can just get a few nights of good sleep, you may have some improvement in the pain, which will help you sleep.

On the mattress topper issue, I have a thick wool topper. I couldn't do the memory foam, due to the chemical odor, and also didn't want to tolerate the heat. The wool, amazingly enough, is not hot. It wicks away excess moisture, and creates a more comfortable sleep. Mine started out about 6" deep, though it has packed down some. Cuddle-Ewe is one brand, I think mine was called Surround-Ewe.

[Pugsy]

To Riverdreamer:
I took Soma for probably 15 years after the accident which broke all my bones. It did very well at night, with no daytime hangovers, initially but became rather ineffective or so I thought because about the time I complained about it not working well was when my BP started to rise along with my weight and what we now see as likely sleep apnea onset. I was given Valium and a diagnosis of "anxiety". LOL So for 3 or 4 years I took one Valium at night.

Flexeril flat knocks me out and I cannot function for 3 days so it is out of the question. I hadn't thought too much about going back on a muscle relaxer because they also relax the very things that cause the airway to collapse. I will discuss it with the sleep doctor if I ever hear from them again. I have not heard of the Amrix.

I do well during the day with just the one or two Ultram for pain. It is more degenerative disc and arthritic spurring pain instead of muscle spasm pain. Once I get moving in the morning I do very well considering. It is only at night when nothing else is there to distract me that it hurts just enough to wake me.

We add all that together and we have a long history of fragmented sleep habits. Almost 20 years since the accident and the slow deterioration of my lumbar and cervical spine. It is rare that I have what I call severe pain on a daily basis. I am sure that there are a lot of people with much worse. I can deal with the daytime stuff, it is just the nighttime stuff that is so tiresome. And yes, if I could get a handle on getting better rest, it would help the circle of pain during the day and subsequent nights. I just need to have some good nights to start the circle with.

[BeanMeScot]

I use a body pillow to sleep on my side. It is perfect to throw my top leg across. I then have a smaller pillow that I put under my upper arm.

[danib]

wow you sound so much like me. it's freakin me out. i had an accident 20 years ago, car accident, & have a bad back because of it that causes pain. i have addiction issues & stomach issues, so tho sleep aids help they are not a frequent option for me. i dont think. i dunno, i am just starting to look into them. i have UARS & get very little REM, waking frequently. i am seeing a sleep specialist on the 15th. i so far have not been able to wear a mask because the full face causes me neck pain & the smaller version i cant use cuz i'm a mouth breather. mouthpiece also caused me pain, & i was told i am not a candidate for Pillar. or any other surgery. so now what?

[riverdreamer]

I do well during the day with just the one or two Ultram for pain. It is more degenerative disc and arthritic spurring pain instead of muscle spasm pain. Once I get moving in the morning I do very well considering. It is only at night when nothing else is there to distract me that it hurts just enough to wake me.

You really might consider the Lidocaine patches, then. Non-addictive, it is similar to the stuff dentists use to numb you for dental work. I find it very helpful for nerve pain and that kind of achey arthritic pain. Your doctor may have samples, as the sales reps seem pretty free in handing out samples. That way you could check if it works for you, or not. You wear the patch for 12 hours, plenty of time to help you sleep. They are good sized, about 4" x 6".

Hope you find something! I am all too familiar with that "just enough pain to keep you awake." Managing it makes all the difference.

[Pugsy]

To Riverdreamer:
I will see if I can sweet talk my mother out of one of her Lidocaine patches. She uses them on her feet. OMG they are so expensive though. Most of my pain is in the SI area, one patch would take care of it. Will let you know.


To danib:
I understand the neck pain from masks that are secured with a strap around the base of the skull. I have a plate in my neck which really limits neck movement. The straps limit what little movement I have so....... until I find something that doesn't hurt my neck I have to do the nasal pillow mask. I am not a full fledged mouth breather but I do appear to open my mouth especially when I am on my back so right now I am concentrating on finding some way to keep my mouth shut. I couldn't find any Polident strips so I got Polygrip paste. It is not nearly as nasty as I thought it might be. Last night I tried blue painter's tape. Not bad at all but I took it off during a coughing spell and didn't retape. The tape is less messy. I will try it again tonight. If you can't do the other masks, then this pretty much is your last choice. For me, it was my first choice.. the nasal pillows. I will work hard to make them work.

When I started this sleep apnea journey I told myself I would do whatever it took to feel better. I now understand why so many people tape or paste their mouths shut. The nights I have done it, I have woke up the next day with NO HEADACHE and I feel better. That is enough for me to keep doing it until I maybe stumble on a chin strap or get my mouth retrained to stay shut or my body to stay on its side.

I am still early in my treatment but I have finally seen some improvement and I am greedy, I want more. I have a positive attitude. It will work, I just have to fine tune it to work with my physical needs. I have been so lucky, no air swallowing, no panic attacks, no claustrophobia, no problem adjusting to pressure, never needed ramp, and probably don't need C Flex at 1.
Only problems have been leaky mouth and fragmented sleep itself. Not bad at all considering what some people are experiencing. Plus I stumbled across this wonderful group of people here that offer support, encouragement and ideas.