Help! Can't fall asleep with CPAP

[IrinaF]

I was diagnosed with sleep apnea and obtained a CPAP machine. Every since I started using it,
I am unable to fall asleep. It has nothing to do with anxiety or comfort. I feel as though I get hyper or more alert
while using CPAP. They have decreased my pressure settings twice but I am still not able to fall asleep. Any thoughts or ideas?

[BlackSpinner]

sign up and log in and tell us what equipment you are driving.

One thing that helps many people is to wear it while watching a good movie or tv show. This tells your brains that that thing on your face is safe and it doesn't need to be vigilant to keep you alive and breathing.

[Julie]

Hi - we would need lots more info to help you (and would like to). What is your usual routine re evening activity - what do you eat or drink close to bedtime? Do you exercise? Stay on the computer (or any bright place) just before bed? Have you tried drinking something like chamomile tea before sleeping? And what are your pressure settings? Do you use the ramp?

What full name and model # are your machine and mask?

[IrinaF]

I am using Philips Respironics machine. Initially I was using Swift FX nasal pillows system but now started using Wisp minimal contact mask (which is more comfortable). My pressure setting was initially set to 8 but was lowered to 6.
I have good behavioral habits prior to sleeping and I think the problem lays with the machine as I am able to fall asleep normally without it. I only have a difficult time falling asleep with the machine on. I have already tried for getting used to it for 3 months but I am still unable to fall asleep. Has anyone else had this experience? Any way to explain this?

[robysue]

I have good behavioral habits prior to sleeping and I think the problem lays with the machine as I am able to fall asleep normally without it. I only have a difficult time falling asleep with the machine on. I have already tried for getting used to it for 3 months but I am still unable to fall asleep. Has anyone else had this experience? Any way to explain this?

As the honorary president of the CPAP&Insomnia Club, I bid you a sad welcome to our club. And I hope your membership in the club is short.

It takes some people a very long time to learn how to fall asleep with this strange contraption sitting on their faces. I had an extremely difficult time falling asleep for the first six months, and even now, bedtime is not a pleasure for me. It seems as though I have to maintain a pretty constant watch for the insomnia monster.

Some suggestions:

1) If you have not contacted the sleep doc's office to let them know what's going on, start there. They may not be much help, but they still need to know about the problem.

2) You may find reading through my Taming the CPAP-Induced Insomnia Monster will provide some useful tips. Not everything will seem applicable to your particular situation, but some of it will likely resonate with you and it will give you a starting place.

3) You may want to think about whether you're willing to take a sleeping aid on a short term basis. It may be that taking a prescription sleeping pill for a short period of time will get you over a hump. If you don't want to take it every night, you can also consider taking it on a night after a really bad night so that you don't have two really sleepless nights in a row.

4) You need to do some serious thinking about what you think the problem actually is. There are a lot of things to get used to with PAP therapy and what to do really depends on what's causing the problem. Once you can accurately and preciscely describe what things are keeping you from falling asleep with hose attached to your nose, then you can start prioritizing them and tackling them one at a time.

In my case, I think there were two main causes for the insomnia: I had severe aerophagia and a lot of pain that had to be dealt with through pressure adjustments and (eventually) a switch from CPAP to APAP to BiPAP. But I am also simply a highly sensitive person and all the sensory stimuli coming from the machine was (and remains) a huge issue for me. And hence the first three months of PAPing were a hellish nightmare. And unfortunately the only real fix for "sensory stimuli problems" was using the dang thing night after night after night in spite of the insomnia until my body finally started to learn how to ignore the worst of the stimuli if I was able to get to sleep within 15 minutes or so. And then I also had to deal with the insomnia itself and reteach my body how to fall asleep within 15 minutes of going to bed. That required several more months of cognitive behavior therapy for insomnia and the judicious use of prescription sleeping pills. All in all, it took me almost a year before I felt like I was sleeping as well or better with the PAP machine than I had slept before starting PAP.

Now? I still hate the dang machine. But I had three nights of sleeping PAPless this summer and revisiting what my pre-CPAP sleep was like now does make me realize that as much as I dislike this crazy therapy, it does indeed do something positive for me in terms of allowing me to sleep more calmly (less thrashing around) and I wake up with no hand and foot pain, unlike the old days, as well as it just makes me feel (marginally) better during the daytime in terms of lack of pain and increased energy.

[49er]

I was diagnosed with sleep apnea and obtained a CPAP machine. Every since I started using it,
I am unable to fall asleep. It has nothing to do with anxiety or comfort. I feel as though I get hyper or more alert
while using CPAP. They have decreased my pressure settings twice but I am still not able to fall asleep. Any thoughts or ideas?

Hi IrinaF,

Would listening to podcasts or an audiobook help?

In my situation, they help me get to sleep initially. They don't help unfortunately in getting back to sleep when I wake up prematurely.

49er

[SleepWellCPAP]

I would say that suggestion number three listed by the honorary president of the CPAP&Insomnia club would be my recommendation as well.

Sleep aids on a short term basis, have helped many of my clients overcome their initial acclimation period successfully.

Good luck!

[markdh]

I was diagnosed with sleep apnea and obtained a CPAP machine. Every since I started using it,
I am unable to fall asleep. It has nothing to do with anxiety or comfort. I feel as though I get hyper or more alert
while using CPAP. They have decreased my pressure settings twice but I am still not able to fall asleep. Any thoughts or ideas?

Hi IrinaF,

Would listening to podcasts or an audiobook help?

In my situation, they help me get to sleep initially. They don't help unfortunately in getting back to sleep when I wake up prematurely.

49er

That's what I do too. I have it set to turn itself off after 30 minutes. Most nights that does the trick. A dull book really helps here.

Of course, then there are nights like last night, but nothing's perfect.

[IrinaF]

Thank you so much for your support/advice and for sharing your story.
If you have anything else to add feel free.
I really appreciate it!

[nightnight]

It took me a long time before I got used to the machine - too long.

I had to go with the BIPAP machine, for the continuous pressure was OK for inhaling, but not for exhaling.

My routine now is to set the TV on and set the timer to shut off in an hour..... I find that I fall asleep in 5-10 mins. However, if I do not fall asleep in 30 mins, I then do not use the machine that night. I do not force myself to use the machine. This will happen about 1- 2 times a month.

[avi123]

I was diagnosed with sleep apnea and obtained a CPAP machine. Every since I started using it,
I am unable to fall asleep. It has nothing to do with anxiety or comfort. I feel as though I get hyper or more alert
while using CPAP. They have decreased my pressure settings twice but I am still not able to fall asleep. Any thoughts or ideas?

Yes, I can.

When I started CPAP, 2.5 years ago for plain OSA, I started to take half a tablet of 10 mg Zolpidem at 11:30 pm as soon as I mounted the mask on my face. This allowed me to fall asleep within 15 min but the sleep lasted for 3 to 4 hours. Then I got up to go to the BR and took another half a tablet (5 mg) which let me sleep for 3 more hours. For the hangover, the next morning, I took two tablets of Tylenol and for the ingested air I took Pepto Bismol.

After I sort of got used to the CPAP I have decided to withdraw from the Zolpidem.

Because I was taking a relatively low dose. Otherwise, see here what would be involved with withdrawal if I was taking larger dose(s):

http://www.non-benzodiazepines.org.uk/zolpidem.html

Presently, I take 0.5 mg of Xanax, once daily for my anxiety, at 6 p.m.. I also take at that time 300 mg of Gabapentin for my Peripheral Neuropathy, and also for sleep.

But recently I went back and I am taking now also 10 mg Zolpidem, at midnight when I go to sleep.

I usually sleep for 7 hours, with one or two wake ups for urinations.

A Consumer Reports on Health from 2012, reported the following survey of about 10,000 responders with sleep problems:

Source:


Best sleeping medication:





In your case if you agree to try taking Zolpidem I suggest that you start with a 5 mg tablet (half a 10 mg tablet) just before you mask.{You need Rx to buy it} and If you don't fall asleep within 30 min then take additional 5 mg. If you then don't fall a sleep within 30 min don't take any more. Do the above mentioned feedback instead. Of course you could reverse the process and do the feedback first and then if you don't fall a sleep let's say within an hour then try the Zolpidem.

There are several medical articles about the good benefits for those with Central Sleep Apnea Syndrome taking Zolpidem for sleep (Google it).

My present Sleep Doc (Holds MD in Neurology plus MD in Sleep Medicine from Duke Medical Center) can't understand why other sleep docs say not to take Zolpidem b/c it delays REM. So what if it does delay REM (unless you need to get up early to go to work. Well, if it so then go earlier to sleep)?

[chunkyfrog]

If sensory input is disturbing you, is it possible to intentionally listen to the sounds?
Try to memorize the sequence of sounds; listening for subtle changes.
I find that if a sound is bothering me, it helps to meditate on that very sound.
Of course, I had to learn how to do that with tinnitus; but it works with any sound.
Eventually, it becomes background. It seems weird, but it can work.

[Tgladden86]

IrinaF,
Don't worry about it I have my cpap now for about 25 day's and I still take my off at first can't sleep it on. Now what I did was Trained my body into it by when I was laying in bed I put on the same mask as you and just lay there in till I fell asleep. Or what my Sleep doc told me was if I felt tired lay down with the mask on and watch tv just to get used to the mask.

[ems]

I find that if a sound is bothering me, it helps to meditate on that very sound.
Of course, I had to learn how to do that with tinnitus; but it works with any sound.
Eventually, it becomes background. It seems weird, but it can work.

Doesn't seem weird to me. I do exactly the same thing also due to tinnitus.

[49er]

3) You may want to think about whether you're willing to take a sleeping aid on a short term basis. It may be that taking a prescription sleeping pill for a short period of time will get you over a hump. If you don't want to take it every night, you can also consider taking it on a night after a really bad night so that you don't have two really sleepless nights in a row.

4) You need to do some serious thinking about what you think the problem actually is. There are a lot of things to get used to with PAP therapy and what to do really depends on what's causing the problem. Once you can accurately and preciscely describe what things are keeping you from falling asleep with hose attached to your nose, then you can start prioritizing them and tackling them one at a time.

I totally agree with RobySue's advice about number 4. Hopefully, it won't take you as long it has taken me to figure this out:) Unfortunately, it takes alot of trial and error and many hits and misses but it is really important to make this attempt.

Which leads to my thoughts about number 3. That is good advice for alot of people but because it sounds like you may have similar type hypersensitivities that I have experienced, you might find as I have discovered in trying various med and OTC sleep remedies that they don't help with mask tolerance. Obviously, your mileage will vary.

49er