Having A Rough Patch With Getting To Sleep - Need Support

[JCWarrior]

I've been acclimating pretty well up until this week. Struggled at first but felt I was getting over the hump and adjusting to CPAP. I caught some gnarly bug last week and had a cough and sniffles. I thought I was going to be miserable trying to sleep. Ironically, I slept really well. Maybe it was the cold medicine helping me get to sleep.

I've never had any issues staying asleep. My problem has been getting to sleep and I was getting over that pretty well. For some reason, as my cold got better and I stopped the medication, I'm having the worst problem with getting to sleep. I'll start to drift into sleep and then snap out of it. Sometimes it's an urge to take a deep breath, sometimes it's the feeling I need to clear my throat or sometimes I feel myself drifting and wake up. This cycle begins to make me anxious and then I feel claustrophobic and get up. Then repeating this makes me even more anxious.

I spoke with my sleep doc (via email) to see if I should use Ambien short term to help me adjust. He said I could but this may cause other sleep issues and suggested I try Melatonin or Benadryl. I am on my 3rd night of 3mg of Melatonin. I'm not 100% certain if it's helping but it seems to help a bit. I think it's making me feel spacey the next day but this could just be that I'm not getting enough hours of sleep during the night lately.

Tonight, I woke up about 2:30 AM because I pulled the mask off my nose a bit. After readjusting my mask and getting comfortable, I felt the urge to use the bathroom so I got up and took care of business. Oddly enough, it felt like it was time to wake up but I still had a good 3.5 hrs to go before my alarm.

When I laid back down, I felt anxious again. This usually doesn't happen on the rare occasions that I do need to get up and then go back to bed. I usually fall back to sleep well. So I decided to get up and here I am typing when I should be sleeping.

It's the anxiety of getting to sleep that is upsetting me the most.

My sleep reports have been very good. Over a 30 day average I'm averaging an AHI of .44, sleeping 7.24 hrs. Average Leaks of .2. No issues staying asleep, starting to feel refreshed, not falling asleep on the drive home from work, etc.

Now this!!

I'm certain I am upsetting myself because I am afraid of having a relapse of sleep anxiety that I experienced 3 times in my life. Each of these periods of high anxiety caused me to literally feel afraid to go to bed. I would lay down and had to get up. This led to feeling depressed and very anxious. The last time I started having panic attacks. These periods coincided with stressful times in my life such as when my mother passed away. I think the sleep anxiety was brought on by this stress. I actually went to therapy and it helped. Took some meds for a short time as well to help me sleep and that helped as well.

Now, after being diagnosed with OSA, I sincerely feel it was a contributor to developing this sleep anxiety.

Regardless, now I feel some of those old feelings coming on and it's starting to get in the way of adjusting to CPAP.

I started sleeping without the ramp feature on my S9 Elite and adjusted to that very well. All in all, I don't really have any complaints with CPAP. Now it's just the anxiety getting in the way.

When I get anxious, I feel the need to sigh more often. This urge is worse, the more anxious I am. This is a little harder when I can't breath through my mouth and it can trigger or elevate my anxiety level when trying to go to sleep.

I'm also experimenting with Pur-Sleep Aromatherapy. I think it helps but I'm still having this issue.

Thanks for letting me rant. Any and all advice is very much appreciated. It's 3:51 AM. Gonna be a long day tomorrow. I think I might take an Ambien tonight.

[49er]

Hi JCWarrier,

Regarding sleep anxiety, I know the standard advice is to come up with strategies to do what you can to eliminate it. But personally, I have found for negative feelings that it works best to embrace what you are experiencing as I have found that it makes them disappear alot more quickly. Kind of like a paradoxical effect.

Even though this doesn't have to do with sleep, you might find the thread on anxiety very helpful as it promotes the same themes of acceptance.

http://www.paxilprogress.org/forums/sho ... hp?t=49645

The recipe for success contains the following:

Acceptance - You must accept fear, anxiety and panic. Welcome it.
Courage - You must face the fear without running or avoiding.
Persistence - You must do it over and over as often as possible.
Patience - You must allow time to pass.

Additionally, have you tried listening to a podcast when you lay down to go to sleep? I rarely have problems falling asleep but when I do, I have found that tactic incredibly helpful.

Regarding melatonin, actually, the current research shows that it is better to start with a very small amount (under 1mg) and very slowly increase the dose. If you feel that taking it continue to be problematic, you might want to give this a shot.

Finally, I am wondering if perhaps the cold medicine you took is causing rebound insomnia. The probability is very small but since you seemed to be doing well prior to taking it, that is why I was wondering. So perhaps, if you were to patiently wait it out a few other weeks and stick to good sleep practices, you might find your sleep normalizing.

Hang in there.

49er

I've been acclimating pretty well up until this week. Struggled at first but felt I was getting over the hump and adjusting to CPAP. I caught some gnarly bug last week and had a cough and sniffles. I thought I was going to be miserable trying to sleep. Ironically, I slept really well. Maybe it was the cold medicine helping me get to sleep.

I've never had any issues staying asleep. My problem has been getting to sleep and I was getting over that pretty well. For some reason, as my cold got better and I stopped the medication, I'm having the worst problem with getting to sleep. I'll start to drift into sleep and then snap out of it. Sometimes it's an urge to take a deep breath, sometimes it's the feeling I need to clear my throat or sometimes I feel myself drifting and wake up. This cycle begins to make me anxious and then I feel claustrophobic and get up. Then repeating this makes me even more anxious.

I spoke with my sleep doc (via email) to see if I should use Ambien short term to help me adjust. He said I could but this may cause other sleep issues and suggested I try Melatonin or Benadryl. I am on my 3rd night of 3mg of Melatonin. I'm not 100% certain if it's helping but it seems to help a bit. I think it's making me feel spacey the next day but this could just be that I'm not getting enough hours of sleep during the night lately.

Tonight, I woke up about 2:30 AM because I pulled the mask off my nose a bit. After readjusting my mask and getting comfortable, I felt the urge to use the bathroom so I got up and took care of business. Oddly enough, it felt like it was time to wake up but I still had a good 3.5 hrs to go before my alarm.

When I laid back down, I felt anxious again. This usually doesn't happen on the rare occasions that I do need to get up and then go back to bed. I usually fall back to sleep well. So I decided to get up and here I am typing when I should be sleeping.

It's the anxiety of getting to sleep that is upsetting me the most.

My sleep reports have been very good. Over a 30 day average I'm averaging an AHI of .44, sleeping 7.24 hrs. Average Leaks of .2. No issues staying asleep, starting to feel refreshed, not falling asleep on the drive home from work, etc.

Now this!!

I'm certain I am upsetting myself because I am afraid of having a relapse of sleep anxiety that I experienced 3 times in my life. Each of these periods of high anxiety caused me to literally feel afraid to go to bed. I would lay down and had to get up. This led to feeling depressed and very anxious. The last time I started having panic attacks. These periods coincided with stressful times in my life such as when my mother passed away. I think the sleep anxiety was brought on by this stress. I actually went to therapy and it helped. Took some meds for a short time as well to help me sleep and that helped as well.

Now, after being diagnosed with OSA, I sincerely feel it was a contributor to developing this sleep anxiety.

Regardless, now I feel some of those old feelings coming on and it's starting to get in the way of adjusting to CPAP.

I started sleeping without the ramp feature on my S9 Elite and adjusted to that very well. All in all, I don't really have any complaints with CPAP. Now it's just the anxiety getting in the way.

When I get anxious, I feel the need to sigh more often. This urge is worse, the more anxious I am. This is a little harder when I can't breath through my mouth and it can trigger or elevate my anxiety level when trying to go to sleep.

I'm also experimenting with Pur-Sleep Aromatherapy. I think it helps but I'm still having this issue.

Thanks for letting me rant. Any and all advice is very much appreciated. It's 3:51 AM. Gonna be a long day tomorrow. I think I might take an Ambien tonight.

[JCWarrior]

Thanks for the response 49er. The recipes for success are exactly what I learned and used in CBT to deal with the last period of anxiety/sleep anxiety I started to experience after my mother passed away in December 2012. These principles are effective and I believe in them. I actually used them last evening when I went back to bed and felt anxious. I did make myself stay in bed, masked up with the machine running instead of just getting up quickly to "escape" from the situation. I did calm down but I also felt I wasn't going to go back to sleep.

If I had stayed in bed there is a very good chance I would have fallen back to sleep. The feeling is just so uncomfortable and you feel like trying to close your eyes and sleep is torture.

Your 100% correct though.

I will stick with it. Have too (in my opinion). I have been 100% compliant since day 1 of starting CPAP. If I'm in bed trying to sleep or sleeping, I'm on CPAP.

My wife is concerned I will become dependent on CPAP and will not be able to sleep without it if I am ever in the position where I needed to. Maybe she's right, dunno. I do know that unless mu OSA goes away/is cured (which is not highly likely) I'll be on CPAP for the rest of my days (or nights that is).

I have not tried listening to podcasts. I could consider this but I don't think my wife would be able to sleep well. I'll discuss this with her. She's VERY supportive. During the restless nights I've had this week, she's just moved to our spare bedroom. I hate when that happens though. She tells me she doesn't mind if I turn the TV on if I need to but I know it affects her sleep quality so I prefer not to.

I'll try lowing my dosage of melatonin to see how that works as well.

Thanks again.

[49er]

Hi again JCWarrier,

How about using earbuds to listen to podcast so you don't disturb your wife? You might find by doing this, it will encourage you to stay in bed and fall asleep. Glad the CBT principals are helpful.

Regarding her attitude about sleeping with a cpap, you are right about OSA not disappearing and that you will be on cpap for the rest of your life or an acceptable effective alternative treatment.

Thanks for the response 49er. The recipes for success are exactly what I learned and used in CBT to deal with the last period of anxiety/sleep anxiety I started to experience after my mother passed away in December 2012. These principles are effective and I believe in them. I actually used them last evening when I went back to bed and felt anxious. I did make myself stay in bed, masked up with the machine running instead of just getting up quickly to "escape" from the situation. I did calm down but I also felt I wasn't going to go back to sleep.

If I had stayed in bed there is a very good chance I would have fallen back to sleep. The feeling is just so uncomfortable and you feel like trying to close your eyes and sleep is torture.

Your 100% correct though.

I will stick with it. Have too (in my opinion). I have been 100% compliant since day 1 of starting CPAP. If I'm in bed trying to sleep or sleeping, I'm on CPAP.

My wife is concerned I will become dependent on CPAP and will not be able to sleep without it if I am ever in the position where I needed to. Maybe she's right, dunno. I do know that unless mu OSA goes away/is cured (which is not highly likely) I'll be on CPAP for the rest of my days (or nights that is).

I have not tried listening to podcasts. I could consider this but I don't think my wife would be able to sleep well. I'll discuss this with her. She's VERY supportive. During the restless nights I've had this week, she's just moved to our spare bedroom. I hate when that happens though. She tells me she doesn't mind if I turn the TV on if I need to but I know it affects her sleep quality so I prefer not to.

I'll try lowing my dosage of melatonin to see how that works as well.

Thanks again.

[mobychick]

1)Regarding your wife's concern that you could become dependent on Xpap.

I think it is hard for someone without sleep disordered breathing to understand the issues involved. What was your AHI in your sleep study? Mine wa30 - 40 - moderate. I would like to ask those people who talk about "addiction to xpap" if they are addicted to not being suffocated in their sleep 40 times an hour. Perhaps I would give them a practical demonstration by sitting next to them all night with a pillow to hold over their face 40 times an hour once they drift into sleep. Then ask them why they feel anxious about my presence!

You say your wife is supportive regarding your therapy. To be totally frank, and please forgive me if this offends you, if she understood the issues she would not talk about "addiction to cpap". Would she read this?


http://www.betterhealth.vic.gov.au/bhcv ... pnoea?open
or this
http://healthysleep.med.harvard.edu/sle ... nsequences

2)You don't show your equipment in your signature. If you do, there are people on the board here who can help you, if you wish, to access and understand your sleep data in more detail. That would help you identify and solve problems as they arise.


3) Now, regarding your problem, I had the same problem recently when I switched machines, and I solved it by increasing the lower setting on my machine. You could go through your sleep dr to do this of course, but it would be good to pick the brains of the experts on here first in my experience (we have more time to mull things over here, collectively, than your Dr has). Another factor affecting you could very well be the humidity - I need a high humidity to feel comfortable, but others find a high humidity gives them a suffocating feeling.

When I have a cold/congestion I use a full face mask. Sometimes I have to not use Xpap at all if I have bad congestion, and then I just resign myself to a few nights of crappy sleep feeling like I'm suffocating (and yes, I AM suffocating, there is no air getting to my lungs!!!!!! It is NOT and addiction ) and then it takes a couple of weeks recovery from the sleep deprivation.

Finally, something my Dad used to say. He was in the Arctic Convoys during WW2 (he did 6 of them, serving on Destroyers). He saw men fall like trees fast asleep on duty because they were so sleep deprived - they just fell from standing, and the rest had to step over them till the emergency was over. Once we get tired enough, we sleep - but without our xpap, our sleep quality is very poor.

Good Luck! and wishing you every success, xpap therapy will make a huge difference to your quality of life and to your health.

[packer]

aroma therapy helped me greatly when I was have trouble early on. for me Pur Sleep was the one single thing that helped the most

now years later the smell is the cue for sleep- I put on mask and out within minute or two

lots of threads on here about using scents

Packer

[Pugsy]

There is no physical dependency on cpap like I think your wife is thinking...meaning you couldn't breathe without the machine at night. Your muscles won't atrophy or anything like that. Nothing like what happens to people who are on real ventilators for long periods of time.
You breathe just fine during the day without the machine.
You will still be able to sleep and breathe without the machine during the night...you just don't want to sleep without it because of what the untreated sleep apnea does to your body.
Been on cpap now 5 years...last summer I went on a trip and forgot to take the long hose and didn't realize the error until 11 PM so too late to do anything about it. I slept without the machine. Wasn't the greatest of sleep due to the untreated apnea events but I slept.

CPAP machines don't breathe for you like a ventilator does. All they do is blow a little air into your airway so that the tissues don't collapse. You are still breathing 100% on your own. Did you know that even at full cpap pressure of 20 cm that the machine can't even inflate a balloon? I know it feels like a hurricane sometimes but it really isn't very forceful in the grand scheme of things.

[JCWarrior]

I think it is hard for someone without sleep disordered breathing to understand the issues involved.

Agreed.

What was your AHI in your sleep study? Mine wa30 - 40 - moderate.

I think it was 34.5 (going from memory) and my doc called it "severe".

You say your wife is supportive regarding your therapy. To be totally frank, and please forgive me if this offends you, if she understood the issues she would not talk about "addiction to cpap". Would she read this?


http://www.betterhealth.vic.gov.au/bhcv ... pnoea?open
or this
http://healthysleep.med.harvard.edu/sle ... nsequences

Not offended... I think the same way. I'll send it to her.

2)You don't show your equipment in your signature. If you do, there are people on the board here who can help you, if you wish, to access and understand your sleep data in more detail. That would help you identify and solve problems as they arise.

It's listed in my signature. I'll edit it to include my pressure, settings, etc.

3) Now, regarding your problem, I had the same problem recently when I switched machines, and I solved it by increasing the lower setting on my machine. You could go through your sleep dr to do this of course, but it would be good to pick the brains of the experts on here first in my experience (we have more time to mull things over here, collectively, than your Dr has). Another factor affecting you could very well be the humidity - I need a high humidity to feel comfortable, but others find a high humidity gives them a suffocating feeling.

I changed my settings so it doesn't ramp. I do like this much better. My pressure is set to 10cm.
I'll experiment with my heated hose temp settings. It's set to 80 degrees.

Good Luck! and wishing you every success, xpap therapy will make a huge difference to your quality of life and to your health.

Thank you!

[JCWarrior]

There is no physical dependency on cpap like I think your wife is thinking...meaning you couldn't breathe without the machine at night. Your muscles won't atrophy or anything like that. Nothing like what happens to people who are on real ventilators for long periods of time.
You breathe just fine during the day without the machine.
You will still be able to sleep and breathe without the machine during the night...you just don't want to sleep without it because of what the untreated sleep apnea does to your body.
Been on cpap now 5 years...last summer I went on a trip and forgot to take the long hose and didn't realize the error until 11 PM so too late to do anything about it. I slept without the machine. Wasn't the greatest of sleep due to the untreated apnea events but I slept.

CPAP machines don't breathe for you like a ventilator does. All they do is blow a little air into your airway so that the tissues don't collapse. You are still breathing 100% on your own. Did you know that even at full cpap pressure of 20 cm that the machine can't even inflate a balloon? I know it feels like a hurricane sometimes but it really isn't very forceful in the grand scheme of things.

Thanks for the info Pugsy. I'll share this with my wife.

[HoseCrusher]

I think you are well on your way to figuring this out and want to encourage you to keep trying and understand that we are here to help in any way that we can.

I don't know if this will help or not, but I will just throw it out there and you can look at it.

In the morning sit down with your wife and ask each other this question...

What can I do today to reduce stress in my life?

You and your wife are in this together so both of you can make a short list of a couple of things that each of you may be able to address today.

In the evening just before you go to bed sit down with your wife again and ask this question...

What did I do today to reduce stress in my life?

The idea is that stress can trigger anxiety and by reducing stress you may find a reduction in anxiety. In a perfect world after about a week you and your wife would be stress free...

Oh well, I can dream...

[knothead]

JCWARRIOR,

I have had many panic attacks the past 24 years, I know how to deal with them now but when I started CPAP(4 years ago), man it hit me right between the eyes with a BIG one. Went to my doc to get some medicine to help with panic. A couple of nights with the med and I was sleeping like a baby. I don't have to take the stuff but maybe 1-2 times a year but I have it on hand just in case, wish u the best in overcoming, this is the best sleep a person could ever get once getting used to it. Been there done that...

[JCWarrior]

JCWARRIOR,

I have had many panic attacks the past 24 years, I know how to deal with them now but when I started CPAP(4 years ago), man it hit me right between the eyes with a BIG one. Went to my doc to get some medicine to help with panic. A couple of nights with the med and I was sleeping like a baby. I don't have to take the stuff but maybe 1-2 times a year but I have it on hand just in case, wish u the best in overcoming, this is the best sleep a person could ever get once getting used to it. Been there done that...

Thanks for sharing your experience. Was it an anxiety med or sleep med?

[ems]

It's the anxiety of getting to sleep that is upsetting me the most.

Hi JC... in light of all the good suggestions you received here, I hope you don't think this is really silly - but - you wrote exactly what I've been experiencing for a long time. What has helped me a lot is this. I put some lovely, soft music on my TV of all things... with glaring light and all... choose a station that plays continuous music, turn off my light and just listen to the music, with mask on of course. Within a few minutes I start to relax and feel sleepy and sometimes drift off. Then after a while I turn the TV off and fall asleep.

I know this may not make your wife happy... maybe try those ear thingies?? Good luck and all that.

[JCWarrior]

I think you are well on your way to figuring this out and want to encourage you to keep trying and understand that we are here to help in any way that we can.

I don't know if this will help or not, but I will just throw it out there and you can look at it.

In the morning sit down with your wife and ask each other this question...

What can I do today to reduce stress in my life?

You and your wife are in this together so both of you can make a short list of a couple of things that each of you may be able to address today.

In the evening just before you go to bed sit down with your wife again and ask this question...

What did I do today to reduce stress in my life?

The idea is that stress can trigger anxiety and by reducing stress you may find a reduction in anxiety. In a perfect world after about a week you and your wife would be stress free...

Oh well, I can dream...

Appreciate the support & advise Hosehead! I consider it all as I am sure reducing stress would help with my situation.

[JCWarrior]

It's the anxiety of getting to sleep that is upsetting me the most.

Hi JC... in light of all the good suggestions you received here, I hope you don't think this is really silly - but - you wrote exactly what I've been experiencing for a long time. What has helped me a lot is this. I put some lovely, soft music on my TV of all things... with glaring light and all... choose a station that plays continuous music, turn off my light and just listen to the music, with mask on of course. Within a few minutes I start to relax and feel sleepy and sometimes drift off. Then after a while I turn the TV off and fall asleep.

I know this may not make your wife happy... maybe try those ear thingies?? Good luck and all that.

Not silly at all. I appreciate any and all advice I can get.