Can't seem to wake up in the morning

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
gkeenan
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Can't seem to wake up in the morning

Post by gkeenan » Wed May 10, 2006 7:39 am

Hi again. It seems like there is no happy medium for me. Ok, now that I THINK I am sleeping through the night I am having a terrible time waking up int he morning. When I was not using the CPAP machine I was up and running at 4AM...now I sleep unitl 5 (I"ve never had to use an alarm until now) and can't seem to really wake up until after 6! What's going on?

G


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krousseau
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Post by krousseau » Wed May 10, 2006 8:16 am

What time do you go to bed-how many hours in bed? Are you dreaming? Daytime drowsiness or are you fine once you wake up? How is your mood (depressed feelings after a new diagnosis is common)? Other illnesses/conditions (especially diabetes)-if yes is it well controlled? Get a good mix of exercise and relaxation during the day?
So in other words you have a lot of potential culprits. If the fatigue extends through the day and interferes with your life or driving get a followup with the doctor who rx'd your XPAP to make sure everything is working as it should. If you monitor your own treatment and know it is on track-see your primary care provider to get checked out. If you are OK and function well once you wake up it may just be that you need more wake-up time in the AM. Recently saw something on the internet about people who jump out of bed-throw on some clothes on the way to their cars and start driving. Even in non disordered sleep it is apparently like driving under the influence of alcohol-the brain takes a little more time to come to a fully awake state. I notice now that sleeping 7-8 hours a night it takes me more time to get going in the AM. If I have a pretty leisurely 90 min before I have to leave in the AM it's fine. If that time gets hectic-lets just say I do not thrive on adrenalin.
Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law

gkeenan
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Post by gkeenan » Wed May 10, 2006 9:22 am

Hi Krousseau. Well, I am usually in the bed at 8:30...with the Yankees playing lately I don't get to sleep until around 10. I was dx over 5 years ago, I would not know how to determine if I am dreaming. I am for the most part an upbeat person...no depression, I do not have diabetes, I workout at least 3 times a week, usually 5 times, it is 11:20AM and I could just curl up and take a nap.

G

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Wulfman
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Post by Wulfman » Wed May 10, 2006 10:33 am

G,

Could be that your body is trying to re-coup some of the sleep/physical debt you've acquired over the years and it's enjoying the extra oxygen it's recently discovered. At some point, it will let you know when it's caught up.

Best wishes,

Den
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krousseau
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Post by krousseau » Wed May 10, 2006 10:45 am

Is it possible you are spending too much time in bed-8:30 PM to 4 AM is about right 8:30 to 6 is long. Some people can watch TV in bed for others it can condition them to staying awake in bed or not sleeping well. Or you may not be getting adequate treatment to get to restorative sleep levels. We may not remember dreams but we are usually aware that we have dreamed. If you are not aware of having dreamed it might indicate your treatment isn't adequate or that you have some variety of insomnia in addition to OSA. If you think/know your CPAP treatment is adequate look into the insomnia info on talkaboutsleep.com-there is a huge amount of info there-and lots on restricting time in bed. Or see an insomnia specialist-insurance may pay for it as a mental health benefit. My situation is not the same as yours- switching to daily outdoor exercise (exercise, fresh air & sunshine), and restricting time in bed are really helping me to get off of Ambien.

Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law

gkeenan
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Post by gkeenan » Wed May 10, 2006 12:26 pm

Ambien! I did not know we could use that with Sleep Apnea...I was told initially not to take anything to aide with sleep! I'm calling my doc not...but if I can't wake up won't that make it worse?

G

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krousseau
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Post by krousseau » Wed May 10, 2006 1:12 pm

The Stanford Sleep Disorder Clinic MD's are writing the Rx for the Ambien CR. Reportedly it is a non narcotic and non benzodiazepine sleeping medication and doesn't depress respirations-that's what the clinic docs said and have researched that statement on the internet on medline. If you search the internet widely you will find all sorts of negative information on Ambien-most of it is anecdotal info from individuals. Is any of it true-probably some of it is. Educate yourself before you start and explore other options before you start. Most of all arrange to make sure your CPAP treatment is adequate.
Here is my interpretation of what I have read/heard and learned in my use of Ambien/Ambien CR. what is true for me might not be the same for you.

It has a short half like so shouldn't make waking up any harder-you do have to give yourself 8 hours before you have to be fully alert and functional. Memory can be affected while it is in your system-so you don't remember getting up to go to the bathroom or saying goodnight to someone. When it reaches your system it starts woking-so don't take it on the way home from work-or take it and think you are going to then take a shower. Take it and go to bed-some say go to bed then take it.

Is it addicting-not normally but it can be for people who have had past addictions to drugs or alcohol don't know if it is a true addiction. If you take it nightly for longer that two weeks you can have a rebound insomnia whrn you stop-then you have the choice of a few nights if insomnia by stopping it cold-or tapering it by 1/4 dose every 2-3 weeks.You may not be thinking of using it every night though.

Is it for long term use-not approved by FDA for long term use but the maker did not apply for long term use in the first place-since they now have competition from Lunesta that does have FDA approval for long term use (which BTW is only like 6 months) The makers of Ambien have reformulated it (Ambien CR) to get a longer acting form and will be doing the testing needed to get FDA approval for long term use. It has been in long term use by many people since it first came out. I would rather take Ambien which has been in use by so many people for so long than a newer drug like Lunesta.

I took Lunesta once and had a really bad taste in my mouth for 24 hours-plus it did not help my sleep. Not much of a trial but I wouldn't be able to get past the taste thing.

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Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law

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Linda3032
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Post by Linda3032 » Wed May 10, 2006 4:30 pm

G, another possiblility is that your machine isn't set quite right yet. Since you haven't listed what equipment you are using in your profile, we can only guess.

If you are using an Auto, it's possible that the lower pressure is set too low. When I recently switched masks, my 90% pressure went up one and my machine took care of it "automatically". But I had to move my lower pressure up one too because I was waking up tired and couldn't snap out of it. Once I bumped my lower pressure up one, that fixed my problem.

Also, if you have a cpap at a fixed pressure, perhaps it isn't quite what you need. So please list what equipment you are using so we might come up with some ideas for you.


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can't seem to wake up in the morning

Post by sarah » Sat May 13, 2006 9:19 pm

When I don't use my bipap machine, my blood pressure goes up when I sleep and I wake up very easily, but with the machine my blood pressure will be real low and then I have a hard time waking up.


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Post by chdurie2 » Sat May 13, 2006 11:47 pm

krousseau:

my pharmacist told me that ambien does contain narcotic ingredients and that it is addictive. i don't know about ambien CR. you might want to ask your pharmacist about this if you have not already.

caroline

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gkeenan
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Post by gkeenan » Mon May 15, 2006 7:26 am

krousseau, when you wake up are you awake or groggy? I need to be able to get up and get going in the morning...but I will ask my doc about this at my next appt.

I was up at 3:30 this morning AGAIN got up and jumped on the bike...did a full hour...but now I wish I could crawl back into bed.

Gail

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krousseau
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Post by krousseau » Mon May 15, 2006 9:04 am

Read the package insert-do an online search-check with another pharmacist-it just is not a narcotic-narcotics contain natural opiates or synthetic opiate like substances.It is a regulated drug so if the person to whom you were talking equates regulated drug with narcotic that might be why he/she made the misstatement. He/she may not think you would understand the distinction. It is also technically nonaddicting-in that you do not develop a consuming physical addiction and require more and more drug. They have deliberately and non deliberately stopped the drug with many people-most people will have a few nights of rebound insomnia; some people the rebound insomnia lasts up to a week. I took it for a two months after surgery for a broken ankle & fibula two years ago-stopped it when the script ran out and nothing happened. If a person has a history of addiction to narcotics, abuse of mind altering drugs, alcohol abuse it is more likely they will misuse Ambien too. When taken with other sedating drugs, painkillers, alcohol the effects of each drug increased the effects of the others. Though they were giving me morphine and ambien (for a short period).
Suggest you don't try to wear yourself out with exercise in the middle of the night the effect won't hit until AM. Exercise if good if you finish at least 3-4 hours before trying to sleep. Afternoon is the best time to exercise.
I do not awaken groggy-I give it a full 8 hours to work. And I get up in time to have an hour to shower-dress-eat. I do not need caffiene to get me going. Conceivably the effects could last longer in some people so if you start it start on a weekend or day when you don't have to be going somewhere in the AM-so you can see how you react. You don't have to take it every night. Try taking it the nights you have to be alert and functional the next day. After my initial two months with it I got another RX to use two nights before long trips-to make sure I was rested before driving. If you work weekdays you could try Sun-Tues-Thur.
And again make sure your CPAP treatment is optimal and you are doing all the other tings you can to get a good nights sleep.

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gkeenan
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Post by gkeenan » Mon May 15, 2006 10:09 am

thank you

Gail

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Post by chdurie2 » Mon May 15, 2006 11:39 am

krousseau:

actually, krousseau, the pharmacist didn't do a lot of thinking for me. she explained that many people think of ambien, as non-addictive, because you don't generally require more and more of the drug. however, it does contain narcotic ingredients, which is why, in my state, anyway, it is a controlled substance. many people -- not you, obviously -- have problems going off of it.

i have also taken "real" narcotics, by your definition, and have not required more and more as time has gone on. i had no problem going off ambien as long as the doctor gave me a substitute, and again, with "real" narcotics, although i did not require more, i did have a problem of trying to sleep without them. so with both ambien and with "real" narcotics, it required some work for me to get off them.

i think it may depend on the person how actually addictive vs. potentially addictive any of these drugs are. i have taken xanax for anxiety off and on, just taking it when i need it, and not every day, haven't had a xanax and months and had no problem stopping their use.

but i think that generalizing to everyone about any one person's experience with a narcotic-containing substance is a mistake.

Caroline

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krousseau
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Post by krousseau » Tue May 16, 2006 1:07 am

Caroline
Yes ambien is a controlled substance-that is what I meant by regulated but that alone does not mean it contains a narcotic. Xanax is also a controlled substance-I think they are both Schedule IV drugs on the controlled substance list. Anyway, it has one active ingredient-Ambien. The rest of the ingredients are inactive and are whatever they use to make it into a tablet and the coating. Ambien CR has two layers-a coated tablet within a coated tablet. I think one of the reasons for it being a controlled substance is that it does have a high potential for abuse and diversion (giving it to or selling it to others). You are right that different people react differently to medications-thats the reason why with meds like Ambien I suggest people start them on a weekend or when the next AM is free. Before prescribing your MD should know you well enough to know if you have any medical conditions that would interfere with normal metabolism of specific drugs. In the end each person does decide for themselves to take something or not. And taking it does not mean a person stops other ways of treating insomnia. For me using the Ambien has allowed me to sleep while starting CPAP, then work on my chronic insomnia in other ways (cognitive/behavioral therapy) while tapering the Ambien. So yes it is taking some work-I didn't mean to imply it didn't. Just that if it was a narcotic I had to get off of I'd check into a drug detox/treatment program for medical supervision and therapy.

Here is one website about ambien-there are many.
http://www.rxlist.com/cgi/generic/zolpid.htm

And like I said before--Before starting any sedative make sure your treatment is on track and you are practicing good sleep hygiene.
http://www.talkaboutsleep.com/sleep-dis ... ulness.htm

Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law