How many people have trouble falling asleep?

[MoonBear]

Hi,

I am on my third night of cpap, and have been lucky to sleep for three nights straight. I am writing because I have had severe insomnia for many years. And on medication for as long. I have been taking Ambien, over-the-counter AND melatonin to sleep for years.

While the research on Ambien shows that it does not allow the deepest levels of sleep, Tere are times when you just need to weigh the risk/benefit. The cpap Is such a huge adjustment that it makes sense to me that your body would be on alert when you get into bed with the equipment until time has passed, and things improve. I had cut back my neds to .25 of my dosages before starting cpap, but am now back to the regular 10mg dose. I am not sweating this for now. My pulminologist wants me off of all sleep meeds, and it is my goal, but I will do it very slowly.

On iTunes, there are several good sleep programs. There is also an album called Bedtime Beats which is a really nice collection of classical music, which is very soothing. Try these options; they occasionally help even me.

One huge caveat about Ambien - both basic and CR. They originally said it was NOT addictive. This is not true. Withdrawal
can be very tough for some people. There is a way around this, and it is by getting off of it extremely slowly, much slower than the doctors say. Like.25 of your pill (you'll need a pill splitter) for a three weeks to a month at a time. This is only necessary if you're on the drug for more than three or four weeks.

I now believe that my really terrible insomnia for the past ten years was my body's way of saving my life. There were too many times to count with zero sleep in two or three nights. Even with what I find to be the heavy weight of the mask, I have been able to sleep for two nights. Believe me, this is a huge win for me.

Finally, I want to tell you that your strategy of waking at the same time every day is THE way to conquer it. As I have my
own business, I set hours for work from after 1 pm and work into the night when possible energetically. I realized, too, that for me the mask is not unlike a scuba mask - heavier but not nearly as tight. So when I put on the mask I regulate my breathing as you do when you snorkel to a very even rate. That, and seeing coral reefs and dolphins, is helping to get more relaxed; I know that doing this night after night will eventually create a new neuropathway, which will help associate relaxed sleep with the mask.

Oh, and you could try Jon Kabbat-Zinn's "body scan" CD; ggole his name and the name of his book. This CD is so soothing it's hard to stay awake for most people when they listen to it at night; it is not intended to be a sleep CD (just the opposite; it's about being present), but it is profoundly relaxing. His companion book, "Full Catastrophe Living," is an excellent read, and if you follow his program, you will learn to suffer when you can't sleep, but be as calm and relaxed as
possible.

I think you are very smart to ask the questions, and also smart to be kind to yourself and use the drugs as you need them for now. Use it all and know when the time is right, you won't need the help anymore. That is what I am trusting for myself as a beginning. Good luck to you, and I hope you sleep well tonight.

Namaste,
MoonBear

[dtsm]

When I first started, had difficulty falling asleep with the mask, the noise, the smell, the sounds, yuck! I also had habit of getting up 2-3 times at night, ostensibly to urinate but in retrospect, probably due to apnea.

Sleep center advised trying cpap with mask for 20 minutes first few nights, if not, take off and try to use if and when you get up at night. Do this for a few nights, and extend time from 20 minutes to 30 minutes to 40 minutes. Some folks, just takes longer to get used to things.

For me, this didn't work very well so - i went to bed without cpap but set alarm for 12 midnight, made my first bathroom run, came back, put the mask on and invariably, able to fall back to sleep. I had to do this for about 2 wks before I was able to fall asleep with my mask....

Another medication to try might be klonoprin - which sounds counter-intuitive since it's contra-indicated for sleep apnea patients. Makes you more relax and in theory causes more blockage of soft tissue [so might need higher pressure setting]. Check with your doctor, a half a tablet 0.25mg for a few nights might just be enough to get you over the initial hump.

[carbonman]

I'm in the process of reading "Sound Sleep, Sound Mind" by Dr. Barry Krakow.
Tony

Tony - I actually just bought that book and received it yesterday. I haven't had time to read any of it yet - but plan to. It looks very interesting.

I second this motion.

I have been using Krakow's Sleep Dynamic tools for over a year now.

They are not easy.
They take practice.
They take a very conscious effort.

They work.

From my experience:
Get the clock out of the bed room ASAP.
Do Close my day about an hour before bed.
SOLO technique as soon as you are comfortable in bed.

TFI (thought-feelings-image) balancing is by far the most effective tool to get to sleep
and get back to sleep if you wake up.
I have learned that if I feel especially anxious or troubled or stressed before bed,
I will actually pull up my photos and pick a particular ride.
I look at the pics to refresh them in my mind so,
when I need them in bed, they are right there.

Sleep Dynamics are worth the effort and will serve you much better than drugs.
This is about your mind not your body.
Unleash the power of that awesome brain that is now getting the oxygen it needs.

I would really like to know how you progress w/the tools.

[Bokes]

I have same problem and started on ambien a couple months before sleep study and then CPAP. Still on ambien 10 mg and takes at least an hour to get to sleep. My prescription ran out so tried not taking and got zero sleep that night. Called Dr for re-fill next day and have been on it since (6 mos).

My sleep Dr. said there is no evidence of any harm to taking ambien for extended periods (?) - seems odd to me.

My problem now is CPAP is loud , leakage etc. and am going to try a pillow system.

Also - seems like I could sleep in M-F but on week-ends I find I am fully awake at 5-6 AM ! Must be in my head!

[digitaleagle]

Bokes

Sorry to hear about your insomnia. I know from experience that it can be very frustrating. I took Ambien for about 2 -3 weeks before I "kicked the habit"

My personal feeling is that it is not good to be on Ambien long term. I found I started building a tolerance to it. (Meaning it worked less and less the more I took them)
It also has the possibility of causing a rebound effect - meaning you might not be able to sleep for a while once you are off of it. (That's supposed to be short term, but who knows - YMMV) That really doesn't apply to your situation.

About the time I went to the Dr. to talk to him about not getting to sleep - I guess I started to get more relaxed in using the CPAP. I use the ResMed Swift FX sleep pillow system and really like it. (Well - not really - but it's about as good as it get's with CPAP for me) You might want to check it out. If you do get it Make sure you do the velcro job on the back strap, - it did wonders for me in keeping the gear from moving out of my nose. I also put some Lanolin on my nose nares to help the seal and got one of those snuggle covers for the hose. I run the hose up and over my head board and down to my pillow. Seems to give me freedom to move without getting tangled up. The first night I used it I knocked the CPAP machine on the floor. Yikes.

You might try 3mg of melatonin about an hour before you go to bed. Seems to help me. Or - maybe it's just psychological - but what ever works right? I think it is pretty safe to take as much of that as you want. Your brain actually produces it out of your pineal gland. It is the sleep hormone that swings during your sleep cycle. Or is supposed to.

For me it was me getting anxious with the gear on. It was like I got super sensitive to everything going on with the therapy. Now I seem to relax and go right to sleep when I strap it on. Weird - but it changed for me just that fast. I guess my brain gave up fighting the thing. I made progress after a few days with the FX pillows. The nasal mask was driving me nuts - way too hot and heavy feeling. Some nights I don't realize I even have anything on with the Swift FX.

I'm glad I'm over the dependency on the drugs and can sleep again. I wouldn't say I'm 100% there - but it is getting better with time.

My sleep Dr. didn't seem to be too concerned that I was taking Ambien long term either and actually gave me more. My GP gave me some Lunesta. I only tried one - but it made me sleep a lot better than Ambien one night. I got a little of that metallic taste in my mouth but it wasn't bad. You might talk to your Dr. about switching meds to something that works for you. It sounds like the Ambien doesn't. I have taken Elavil or Amytripiline (sp?) and I sleep like the dead with that stuff. It is slow to put you to sleep (you need to take it like 2-3 hours before you intend on sleeping), but once it kicks in, you will want to sleep for the next two days. (That's the problem with it for me - it just makes me way too groggy the next day) It's another option though as some people don't get the hang over effect. I was taking 25mg. It's actually an older antidepressant with a side effect of making you sleepy. There are others that do the same thing.

Good luck. I hope it get's better for you. There is nothing worse than not being able to fall asleep.

[digitaleagle]

One other thing that helps me fall to sleep is a god sound machine. I have the Ecotones machine and really like it. It has actual recorded sounds that are very realistic - like rain falling on a roof, surf, fires burning, crickets outside, wind, etc. It also has two different white noises. I turn it up so it drowns out my breathing. Otherwise I think I would go nuts listening to myself. I first bought it to drown out dogs barking outside. I live out in the country and that kept me awake. Once I used the machine I never heard them again. It does just as well with the CPAP.

Just do a google on "Ecotones" and you will find it. I also use aromatherapy - the little discs that you put near the filter on our CPAP machine. Both of these seem to give my brain something that is familiar and soothing when I am trying to fall asleep. (Rather than being on "high alert" due to the CPAP. )

Both were quite inexpensive considering I'm using them long term.

[Jersey Girl]

I have trouble with falling asleep occasionally and now that I have a bad knee (osteoarthritis), sometimes I wake up at 3 am in pain. For me, the tv literally puts me to sleep. I turn it on and I relax enough to begin to drift and then I push the power button. I mask up while watching tv and then slowly drift off...

Regards to all,

Jersey Girl

[Cindy Lou Who]

I had sleep anxiety before starting APAP...always unconsciously looking for 'one-more-thing' I had to do before bed to put off going to bed. After getting my machine it took three weeks to stop waking up during changes in pressure. My range is from 5cm to 12cm. Because 5cm is so low I don't use the ramp feature and it takes awhile to adjust to the feeling of air pouring into me, even after doing this for 8 months.
How do I cope? #1. I remember how exhausted, and foggy brained I felt before being diagnosed. #2. I lay on my back and meditate. Or #3, I pretend I'm relaxing on an isolated beach with a soft warm breeze at my back, waves gently lapping, and warm sand underfoot. This relaxes me enough so I usually fall asleep within 10 minutes of turning off the light.
My husband is at 9cm. He encourages me by suggesting I pay attention to my breathing. The steady in and out relaxes him. He is usually asleep in 5 minutes or less...then he starts bypassing! If it lasts for too long and jiggling him doesn't stop the bypassing or wake him up to adjust his mask...I get out the ear plugs...for me. That usually does the trick. But it means I have to overcome the sensations from headgear, chinstrap, sports mouth-guard and ear plugs. Somehow I get there.
I would rather be where I am, right now, than where I was pre-APAP! That makes any current discomfort bearable.
Wishing you success,
Cindy

[Bokes]

I switched to the FX nasal pillow, used it the last two nights- most comfortable mask I have used yet, quieter and no leakage! Problem I have is I had almost zero sleep last two nights which surprised me due to how well the FX felt. Perhaps 12 is too much air for a nasal pillow system?

Anyway, thanks for all the great suggestions- off to get some Melantonin and a soothing Sleep CD as I suspect I am becoming tolerant of Ambien.

Also, anyone ever tried L Glycine for sleep disorder?

Have a wonderful New Years!

[jazzer4]

The big words with these machines and masks is LEARN TO IGNORE.
Doing jigsaw puzzles before bed is great as once you lay down in bed if you let your mind look for pieces your so bored you go to sleep.

I've been on c-pap for a bit over a year and I have learned to ignore it all.
I also use a small fan for white noise as it really does help me to NOT hear myself breathing.

Ambian may not be physically addictive, but it is mentally addictive. I found that out the hard way.

My daddy's words....you can get used to hanging if you hang long enough. We as people are very adaptable. You will adapt and finally be able to relax and go to sleep on your own. Trust yourself.