no sleep ..even with medicine

[kb1]

Since i have had my cpap (just over a week) i have a very hard time falling asleep .. when i do get to sleep ..i wake up without the mask on. .so i called my doctors office at the sleep center .. he prescribed Rozerem 8mg ..
i have had two nights on it so far .. NO LUCK .. - just want sleep ..
wondering how long i should wait before telling the doc the medicine he gave me is working like a sugar pill..?

[sunnyway]

You may need a full face mask. If you are ripping off your mask, it may mean that you are mouth breathing, which defeats the purpose of the CPAP because of air leaking from your mouth. You feel like you are smothering and unconsciously pull off the mask. A full face mask covers nose and mouth. A total face mask covers the whole face, from chin to forehead.

I tried a dozen or more masks, starting with the minimalist nasal pillows working my way to nasal masks, full face masks and and finally to total face masks, which I find to be the easiest to wear, with the least stress, claustrophobia, rubbing, squealing, farting, etc.

I think DME's should start newbies with the big total face masks because of ease of use, and let them work backwards if smaller masks are preferred instead of vice versa. It would have saved me a LOT of money. The total face masks just look scary, but they really are comfortable to wear and are totally transparent.

Respironics makes two total face masks. I prefer the FitLife but use both types.
FitLife Mask
https://www.cpap.com/productpage/respir ... dgear.html
Total Face Mask
https://www.cpap.com/productpage/total- ... onics.html

I use Lunesta rather than Rozerem. I've used a 3mg dosage for about 2 years now. It works well for me. However, if your mask or apnea events are waking you up, no sleeping pill is going to do the trick. It may take a week or two for the sleep medication to really help, but it can take months before you adjust to the CPAP. Keep at it! It does get better! Using the right mask can make all the difference in the world. Keep following this forum for good advice from its members.

A little aromatherapy like PurSleep can help you adjust. https://www.cpap.com/productpage/Pur-Sl ... -Pack.html

A fleece cover like a SnuggleHose cover over the hose makes it less objectionable and reduces "rain-out". https://www.cpap.com/productpage/snuggl ... cover.html They even make Snuggle covers for the straps for one's headgear.

[robysue]

I'm very sorry to welcome you to my insomnia while getting used to CPAP club. I've been doing CPAP for three weeks and have been fighting some severe insomnia for most of that time. [If you really want, search for posts that I started using the search engine.]

Since you're willing to take sleep meds, I'd suggest calling the doctor again tomorrow. But also try to speak to a nurse or the doctor about other non-medical things you can do to manage the insomnia.

My advice is to do some serious work on sleep hygiene. Have you ever had a serious bout of insomnia before? Here are things that I do to try to maximize the chances that I will fall asleep rather quickly when I finally do go to bed whenever I'm battling a bout of insomnia:

1) Pay attention to your body. Do NOT go to bed until you are feeling sleepy. NOTE: feeling exhausted and tired is not the same as feeling sleepy. If your brain is NOT sleepy, then lying in bed will likely make you MORE AWAKE and MORE ANXIOUS.

2) Kick the TV out of the bedroom. If reading tends to wake you up, do NOT read in bed. Do NOT browse the internet on a laptop in bed either. Use your bed only for sleep and sex. If you're doing anything else in your bed, you're letting your brain get away with believing that being in bed does not mean you are supposed to be asleep. If you're really feeling like the insomnia is getting the best of you, try to do NOTHING in the bedroom at all except sleeping and sex. Or at least avoid your bedroom during the evening.

3) Get all of the CPAP stuff ready well before bedtime: If you have to wash and assemble your equipment, don't wait until bedtime to do the assembly. Fill the humidifier up well before bedtime. Wash your face and brush your teeth well before bedtime since that can also make your mind more alert and less sleepy.

4) At least an hour before you plan to go to bed, cut out all tv, web browsing, work related reading, and reading in general if it wakes you up. For that last hour or two before you go to bed, try to do something quiet and relaxing in a different room other than your bedroom. Or at least do something mindless that allows your brain to start working on shutting down for the night. I'm doing a whole lot of yoga and kitchen cleaning during this time frame.

5) After you go to bed do NOT watch the clock. If possible, turn the clock away from you and move it where it's difficult to reach.

6) If you've been lying in bed for what you think is as long as 20 minutes or so OR if you're now feeling WIDE AWAKE (but exhausted) and no longer feeling sleepy, then it's time to get up out of bed and do something quiet and mindless until you start to feel sleepy again. Sitting in comfortable chair in a quiet dark room listening to very quiet music works for me. When you start yawning and feeling like you just might fall sound asleep in the chair, that's the time to go back to the bedroom and try going to bed again. Repeat this process as many times as needed: Whenever you wake up and feel like you cannot get back to sleep in a timely fashion, get out of the bed and go into another room and do something very quiet and very boring until you're feeling sleepy again.

7) As much as is humanly possible, try to get yourself up at your normal time no matter how late it is when you finally get to sleep. Also as much as possible, try to avoid all daytime naps until the insomnia is under control.

Cut out all caffeine after lunch time. Cut out all alcohol too. Don't eat anything for at least two or three hours before bedtime too.

As for learning to sleep through the night without taking the mask off: Don't beat yourself up on this---lots of folks have that problem. If you wake up in the middle of the night and the mask is not on, then put it on before you return to sleep. And if you can't stand the thought of putting it on or thinking about putting it on makes you get MORE ALERT, then get out of bed and sit in a comfy chair in the dark until you start to feel sleepy and then go back and put the mask back on and try to go to sleep. And reward yourself for any small successes that you have with the mask.

One commonly suggested idea for acclimating yourself to how the mask and the CPAP air feel is to desensitize yourself to the machine: Well, well before bedtime (like during the DAYTIME), you can drag the CPAP and mask out to your living room or family room, put it on while your in a comfy chair, and then read or watch TV for several hours. But don't try to do this within four or five hours of your bedtime because then when you put the CPAP on when you want to go to bed, your brain might still be thinking CPAP means WAKE UP.

Finally, are you having any leak problems with the mask? And can you get any efficacy data off your machine? That may also help you make yourself keep putting the mask on whenever you wake up with it off.

Good luck with the insomnia. It will get better with some hard work on sleep hygiene and maybe a change in sleep meds.

And good luck with adjusting to CPAP too!

[kb1]

Thank you for your reply:)
It may be my mask .. i tried on three at my triation .. the full face seemed confining ..the nasal mask seemed like it would really bug me .. so i used the nasal pillows and i slept through the night .comfortable..
so i was really confused as to why this one would not be hard to use..
i seem to nap good with it on .. but at night .. my body aches and i have a hard time trying to fall asleep .. (not sure why my bady hurts so bad a night ..it just does ) i put my mask on .. roll over and try to sleep .. like i said when i fianlly do get to sleep i wake up and my mask is off. not sure what the difference is from the one at the triation.
i know that i am not a mouth breather with the mask .. that would definatly wake me up!
It may take a very long time for my mind or my body to accept this .. meanwhile all i want is a good night sleep.
I am going to give this medicine a few more tries before i call my doctor.
if by Tuesday next week i have not slept well..i am calling.
a full face mask would scare me i think. . i wonder if the DME would allow me to try a night with it to see?

[kb1]

robysue -
Thanks for all the sleep coaching:) All are good ideas .. i am going to try those methods out and see if that helps.
wow .. so much to re-learning ow to sleep .. it is almost as bad as stop smoking programs .serious.
Thanks again .. i really gained a lot from your post:)

[robysue]

kb1,

I too had no real trouble sleeping with a nasal pillows mask during my titration. [The tech couldn't even get a nasal mask on me because I kept sneezing uncontrollably.]
I'm still using a nasal pillows mask and my leak data is decent. So I know that's not my problem at night.

My serious problems started about 3 days into therapy when I had a really disastrous night trying to get to sleep and being more and more frustrated. After that, I was dreading bedtime and my brain was definitely thinking deal with CPAP = WAKE UP AND BE ALERT.

Read my tips on how to deal with the insomnia because until you start to make some kind of progress on it, adjusting to CPAP will be that much more difficult. Right now I still have bedtime insomnia, but I'm dealing with it pretty aggressively. And even though one part of that aggressive treatment sounds counter-intuitive, the fact that I no longer even try to go to bed until my brain is really, really, sleepy is what's allowing me to actually get to sleep pretty quickly once I finally do go to bed. And I have some hopes that the worst is over since last night I was able to go to be by 1:30AM (my old pre-cpap bedtime was around 12:00 or 12:30).

Don't beat yourself up about taking the mask off. Try to worry a bit less about compliance on CPAP and work hard on managing the insomnia.

Wishing you lots of sweet dreams and plenty of sleepy sheep to count tonight.

And now, I'm off to

(1) quit the TV, reading, and internet browsing
(2) do an hour or so of yoga
(3) sit quietly listening to some old folk music from the 60s until I get really, really sleepy, and
(4) get to bed hopefully by around 1:00 or 1:30 and be asleep within 20 minutes after going to bed.

Good luck kb1 with your own journey to sleepy-time tonight!

[robysue]

kb1:

it is almost as bad as stop smoking programs .serious.
Thanks again .. i really gained a lot from your post:)

No, it's not as bad as stop smoking---at least what I've seen from near and dear relatives who've fought that battle.

With sleeping, it gets better because you crave something good for you!

Do try the tips---particularly if insomnia is new to you. I say that as someone who has had multiple bouts of severe insomnia at several points in my life, but who can manage my routine occasional insomnia by always falling back of some subset of this list of techniques.

Best of luck tonight and tomorrow and tomorrow until it gets better!

[kb1]

thanks robysue - night:)

[kteague]

Hopefully you're already sleeping soundly tonight, but just in case... Taking the mask off during sleep seems to be reported pretty often on here. I did it for a while too. At one point I started putting a bandaid across the strap and onto my skin so the pain of pulling it off would wake me. But with your situation would that wakeup cause you another session of insomnia? Hopefully this will pass soon. At some point I just stopped taking it off.

[jonquiljo]

he prescribed Rozerem 8mg ..

I don't know of anyone who took Rozerem for more than a couple of nights before tossing it into the trash. It is given mainly because it is not addictive and has no major side effects. A lot of meds that help people sleep tend to increase apnea, so you probably won't find a sleep Dr. that will Rx a stronger sleep med. IMO, it seems that taking a bit of a "stronger" sleep med might help you actually use the machine - rather than give up because you can't sleep. Sorry - I hope you can find a Dr. to help you.

[Calist]

Since i have had my cpap (just over a week) i have a very hard time falling asleep .. when i do get to sleep ..i wake up without the mask on. .so i called my doctors office at the sleep center .. he prescribed Rozerem 8mg ..
i have had two nights on it so far .. NO LUCK .. - just want sleep ..
wondering how long i should wait before telling the doc the medicine he gave me is working like a sugar pill..?

Heya KB1, pm me.

[Julie]

To all who may be out there at this hour (it's early here!) ... I have PM'd kb1, who's fairly new, and suggested that if they're not aware of the whole 'Calist' business to not PM him, or at least not give credence to whatever ideas he may have to 'offer' as I believe if taken seriously he could be dangerous to their health. I also think we should get together somehow, write to Johnny and give him an idea of what's been happening, how upsetting this poster (C) is and that (at least speaking for myself) he could possibly be damaging to patients if they listen to his business. What do you all think?

[robysue]

Thanks julie! I was just thinking of doing the same.

[MidnightOwl]

kb1,

I hope this problem has already resolved itself but if it hasn't I suggest calling the doctor as soon as possible. Another sleep med make work better for you or it's possible that the dosage on the Rozarem can be adjusted. But the most important thing is to figure out what about the CPAP is keeping you awake. Is the mask uncomfortable? Is the noise a problem? Does it have expiration pressure relief that makes you feel like you need to breathe too quickly? Are you lying in a different position to try and avoid the hose? Do you have a starting ramp pressure that's too low? Has it chased your favorite pet out of your bed? If you can figure out what the problem is you can probably figure out a solution (or someone else here can). Using a CPAP does not mean you have to be uncomfortable; if you are something needs to be fixed.

If your sleeping troubles just started when you started the CPAP addressing that is probably all you need but the general insomnia remedies certainly can't hurt. And i'd add to that list an eyemask to elimate all light.

Good luck and I hope this post is totally redundant by now.

Midnightowl

[MidnightOwl]

I also think we should get together somehow, write to Johnny and give him an idea of what's been happening, how upsetting this poster (C) is and that (at least speaking for myself) he could possibly be damaging to patients if they listen to his business. What do you all think?

I think this is a seriously bad idea. One of the arguments most often used against patient forums like this one is that we can't be trusted to decide for ourselves who to listen to. Or that we might be exposed to things that might "upset" us. And that medical professionals should protect us by deciding what we should read. Is it really any different just because it's Johnny deciding? Or some posters deciding for everyone else? That's just substituting one source of paternalistic censorship for another. So by all means PM people with your opinions of Calist's posts. Or contradict him publicly on every post. Or put him on ignore and advise other people to do the same. And let everybody decide for themselves if they want to do that. But don't ask for the board administrator to intervene. It's a terrible precedent to establish.

midnightowl