five weeks today: Good, Bad, and Ugly

It was five weeks ago tonight that I started using CPAP.

It's been a wild and not particularly comfortable ride these past five weeks. But things seem to slowly be improving. So here's the update:

The Good
I lucked out with a choice of mask. I've read numerous threads of the long searches for comfortable masks that many folks have to do before finding something that works for them. I'm one of the lucky ones: My first mask (Swift FX) fits me very well. Yes, I had a few adjustment issues---I went back to CPAPXpress (my DME) to talk about them pretty early on. They worked with me----replacing the longer FX strap for the shorter FX for Her strap solved my main mask problem. I'm still swapping the the XS pillows they gave me to try with the original S pillows. So far I can't say that I can tell much difference between the two sizes. Leak rates for both sets of pillows are nice and low and similar enough to not worry about. AHI rates for both are similar enough to worry about. In other words, I've had about the same percentage of good nights with both sets of pillows and the bad nights are easy to explain in terms of things, such as the head cold I'm just about over, that are independent of the pillows.

Getting used to staying asleep with the mask on has not been as hard as I expected. I've been lucky: Right from the start I've been able to sleep through the night without pulling my mask off. When I do consciously wake up at night (which still happens at least a couple of times most nights), I do not have any need/desire to yank the mask off. And I wake up with the mask on every morning. Of course this is most likely a result of my being lucky in finding a mask that fits me so quickly.

AHI numbers are really good most nights. About half the time the S9 reports my AHI as below 1.0. Most of the rest of the time, the AHI is below 1.5. In the last 35 nights, I've only had two nights where my AHI was above 2.0---one of those the AHI was something like 2.6 and the other the AHI was something like 3.4. And both those nights were when the head cold symptoms were really, really bad and I knew before looking at the numbers that I'd had a rough night with lots of tossing, turning, not being able to stay asleep, etc.

Compliance is 100%. Of course this is largely a result of my not having problems pulling the mask off at night and the fact that my data shows the therapy is doing some good. And an extremely supportive husband. And support from the folks on this forum.

Bedtime insomnia, though not beaten, is under control for the most part. On most nights I'm getting to bed before 3:00 AM (although last night it was 3:00 *sigh*). And on most nights, once I go to bed I can get to sleep in a timely fashion instead of becoming more alert from fighting with the hose and mask just to get comfortable enough to fall asleep.

Daytime sleepiness and daytime exhaustion is very slowly beginning to get better. The first 2 1/2 weeks I was experiencing excessive daytime sleepiness (for the first extended period of my life) and daytime exhaustion that far exceeded anything I've ever experienced---including the exhaustion of being a mother of a newborn who had gone through a difficult labor. I'm still not feeling normal most days, but at least I'm now functioning during most of the daytime and on most days I no longer feel like I might fall asleep while I'm driving.

My body (but not my head and brain) feels much more relaxed and less tense these days. I suppose this could be the CPAP. But it's probably more likely because I've started doing yoga again. Most nights I need to do 30-60 minutes of yoga before bedtime in order to get sleepy enough to ward off the bedtime insomnia devil. My legs, arms, back, and neck are all benefiting from all the yoga that I'm doing all the time.

No more stuffed goose dreams. The change from straight CPAP at 9cm to APAP running 4--9cm seems to have taken care of the worst of the aerophagia symptoms that developed very early on.


The Bad
I still feel worse that I did before starting CPAP. While the daytime sleepiness and exhaustion is slowly getting better, it is still far worse than anything I had before CPAP. Before CPAP, I only had daytime sleepiness if I'd been up all night doing grading, which happens a couple of times a semester. And I never worried about falling asleep at the wheel. I didn't feel like I might fall asleep at my desk. And I certainly didn't spend the whole day yawning uncontrollably. Now, five weeks into CPAP therapy, all those are still happening to me on bad days. On good days, I'm merely very, very tired all day long.

The mental fog that developed during my first few days on CPAP is still there. I am still finding it difficult to concentrate on tasks such as grading. At meetings it takes a great deal of effort to be able to follow the conversation concerning the agenda. I've been totally unable to learn my students' names this semester. And on many days, I still don't think my class lectures are up to my pre-CPAP quality. I can't keep track of meetings and appointments at all, even with the help of a calendar. And my short-term memory seems to be completely shot. I really hope this fog lifts and my mind starts to function at its pre-CPAP level sometime soon. Or at least before the beginning of next semester---I really don't want to go through another semester that's this rough as far as the teaching goes.

I feel much more out of shape than I did before starting CPAP. What I mean by this is that pre-CPAP, walking up the stairs to my third floor office did not leave me out of breath, but now it does. Before CPAP, biking the five miles to work was both a reasonable and fun thing to do; now I'm way too tired (and out of breath) to even contemplate a five mile bike ride. Trying to find the energy to plant the daffodil bulbs this fall has been impossible---every time I do anything that's even a bit physical, I seem to get out of breath really, really quickly. And this was NOT happening this summer before I started on CPAP.

The Ugly
I am still eagerly awaiting the day when I wake up feeling bright-eyed and bushy-tailed. Most days now I at least wake up feeling about as rested (not but not as refreshed) as I did back in the pre-CPAP days. On a few days, I've even woken up feeling much more rested than I used to. But even now, I still occasionally wake up feeling less rested than I did on a typical pre-CPAP morning. But what I miss is that pre-CPAP there were those (occasional) great days that I would wake up feeling bright-eyed and bushy-tailed---not as many of them as I'd like, but there were some of them. Haven't had a single bright-eyed and bushy-tailed day since starting CPAP.

I don't like how much effort and work I have to put in every night just to go to bed. In order to manage the insomnia, I have to work pretty hard at strictly managing the whole "bedtime" ritual and it has to start something like two or three hours before I want to try to go to sleep. Have to wash my face early since washing my face wakes me up and I don't get as good of a seal if I don't wash my face. Have to watch the food: the insomnia devil is likely to wake up if I eat anything within two or three hours of going to bed. Which makes it really rough on MW nights since I have a night class that doesn't get over until 9:00 and I don't get home until 9:30 and I'm always STARVING after that class. If I want to be in bed by midnight, then there is

No TV after 10:00 I want to try to be in bed by midnight.
No reading the newpaper or books or magazines after 10:00.
Need to be off the computer by 10:00 (oh how I fail on this one most nights).

About the only thing I can do in those last couple of hours before bedtime is yoga, cleaning the kitchen, or listening to music in a dark room. And I don't have the energy to clean the kitchen on a lot of nights. [It's much, much easier to force myself to do yoga when I'm exhausted than it is to do the kitchen.]

I still miss talking with my husband at night with the light out when we're cuddling. I have not been able to force myself to roll over and put the mask on in the dark when I want to go to sleep yet. And I'm afraid that if I lie in the bed talking with my husband in the dark, I will fall asleep without the mask and machine on. Maybe someday I'll be able to do this, but not just yet. *sigh*

Headaches and neck aches. The number and severity of my numerous headaches is just about the same with CPAP as it was pre-CPAP. There has been a shift in type of headache, however. At this time of year, pre-CPAP my most common headache was allergy-related sinus headaches. Those are not really that much of a problem any more, probably due to the filtered and humidified air every night. But I'm getting a huge number of tension headaches. In fact, I'm waking up with a tension headache almost every morning. And a neck ache. I think both are caused by the fact that I've yet to find a genuinely comfortable position to sleep with the CPAP hose. And the fact that I'm "wiggling" less in my sleep. I'm a natural wiggler---I am constantly wiggling my toes, legs, and neck and back when I'm sitting at desk all day since that's what keeps me from getting stiff. And before CPAP, I always wiggled a lot in bed at night too---both before and after falling asleep. But now, once I find a semi-comfortable position in bed, I'm really reluctant to wiggle because wiggling usually "breaks" something like where the FX's exhaust flow is going. So when I'm still awake but trying to fall asleep I put up with alot more muscle discomfort by staying still in order to not "break" the CPAP stuff. And I suspect that I'm doing a lot less wiggling in my sleep as well: I now seem to be consciously awake every single time I need to turn over at night, and that was not true pre-CPAP.

Hi robysue,

Im going to try to reply inside your quote... in bold and blue.....

robysue wrote:It was five weeks ago tonight that I started using CPAP.

It's been a wild and not particularly comfortable ride these past five weeks. But things seem to slowly be improving. So here's the update:

The Good
I lucked out with a choice of mask. I've read numerous threads of the long searches for comfortable masks that many folks have to do before finding something that works for them. I'm one of the lucky ones: My first mask (Swift FX) fits me very well. Yes, I had a few adjustment issues---I went back to CPAPXpress (my DME) to talk about them pretty early on. They worked with me----replacing the longer FX strap for the shorter FX for Her strap solved my main mask problem. I'm still swapping the the XS pillows they gave me to try with the original S pillows. So far I can't say that I can tell much difference between the two sizes. Leak rates for both sets of pillows are nice and low and similar enough to not worry about. AHI rates for both are similar enough to worry about. In other words, I've had about the same percentage of good nights with both sets of pillows and the bad nights are easy to explain in terms of things, such as the head cold I'm just about over, that are independent of the pillows.
A lot of the battle is finding the right mask, so you are past half way there girl! Getting used to staying asleep with the mask on has not been as hard as I expected. I've been lucky: Right from the start I've been able to sleep through the night without pulling my mask off. When I do consciously wake up at night (which still happens at least a couple of times most nights), I do not have any need/desire to yank the mask off. And I wake up with the mask on every morning. Of course this is most likely a result of my being lucky in finding a mask that fits me so quickly.

AHI numbers are really good most nights. About half the time the S9 reports my AHI as below 1.0. Most of the rest of the time, the AHI is below 1.5. In the last 35 nights, I've only had two nights where my AHI was above 2.0---one of those the AHI was something like 2.6 and the other the AHI was something like 3.4. And both those nights were when the head cold symptoms were really, really bad and I knew before looking at the numbers that I'd had a rough night with lots of tossing, turning, not being able to stay asleep, etc.

Those are really good numbers for where you are right now
Compliance is 100%. Of course this is largely a result of my not having problems pulling the mask off at night and the fact that my data shows the therapy is doing some good. And an extremely supportive husband. And support from the folks on this forum.

Bedtime insomnia, though not beaten, is under control for the most part. On most nights I'm getting to bed before 3:00 AM (although last night it was 3:00 *sigh*). And on most nights, once I go to bed I can get to sleep in a timely fashion instead of becoming more alert from fighting with the hose and mask just to get comfortable enough to fall asleep.

I know its hard to get to sleep too, but I found after cpap, that I was backing up my falling asleep time a few minutes every night..
from four am, to three thirty, to three... then after a few months, I was going to bed at ten pm.. and actually yawning! So the cpap
regulated my insomnia quite a bit, but it took a long time..

Daytime sleepiness and daytime exhaustion is very slowly beginning to get better. The first 2 1/2 weeks I was experiencing excessive daytime sleepiness (for the first extended period of my life) and daytime exhaustion that far exceeded anything I've ever experienced---including the exhaustion of being a mother of a newborn who had gone through a difficult labor. I'm still not feeling normal most days, but at least I'm now functioning during most of the daytime and on most days I no longer feel like I might fall asleep while I'm driving.

Well, little by little this should get better if you learn to sleep deeply thru your treatment

My body (but not my head and brain) feels much more relaxed and less tense these days. I suppose this could be the CPAP. But it's probably more likely because I've started doing yoga again. Most nights I need to do 30-60 minutes of yoga before bedtime in order to get sleepy enough to ward off the bedtime insomnia devil. My legs, arms, back, and neck are all benefiting from all the yoga that I'm doing all the time.

I noticed that I was a lot less wired when I wasnt so full of cortisol, and I wasnt doing yoga, so I know it was the cpap which
had the relaxing effects..

No more stuffed goose dreams. The change from straight CPAP at 9cm to APAP running 4--9cm seems to have taken care of the worst of the aerophagia symptoms that developed very early on.

I had some terrible aerophagia when I started too, so unpleasant, but it stopped when my body learned how to breath with the machine, glad yours
is mostly gone.. we dont need you to be a stuffed goose till thanksgiving!

The Bad
I still feel worse that I did before starting CPAP. While the daytime sleepiness and exhaustion is slowly getting better, it is still far worse than anything I had before CPAP. Before CPAP, I only had daytime sleepiness if I'd been up all night doing grading, which happens a couple of times a semester. And I never worried about falling asleep at the wheel. I didn't feel like I might fall asleep at my desk. And I certainly didn't spend the whole day yawning uncontrollably. Now, five weeks into CPAP therapy, all those are still happening to me on bad days. On good days, I'm merely very, very tired all day long.
Have you ever noticed waking up dreaming since you started cpap? I too was more tired than I have ever been in my life on cpap, and discovered
I never was waking up dreaming on it, so I had not learned to relax and sleep with it.. I hope in time you will find a ryhthem with your machine
and get some restorative sleep soon.. The mental fog that developed during my first few days on CPAP is still there. I am still finding it difficult to concentrate on tasks such as grading. At meetings it takes a great deal of effort to be able to follow the conversation concerning the agenda. I've been totally unable to learn my students' names this semester. And on many days, I still don't think my class lectures are up to my pre-CPAP quality. I can't keep track of meetings and appointments at all, even with the help of a calendar. And my short-term memory seems to be completely shot. I really hope this fog lifts and my mind starts to function at its pre-CPAP level sometime soon. Or at least before the beginning of next semester---I really don't want to go through another semester that's this rough as far as the teaching goes.



I feel much more out of shape than I did before starting CPAP. What I mean by this is that pre-CPAP, walking up the stairs to my third floor office did not leave me out of breath, but now it does. Before CPAP, biking the five miles to work was both a reasonable and fun thing to do; now I'm way too tired (and out of breath) to even contemplate a five mile bike ride. Trying to find the energy to plant the daffodil bulbs this fall has been impossible---every time I do anything that's even a bit physical, I seem to get out of breath really, really quickly. And this was NOT happening this summer before I started on CPAP.
I had the same problem, was totally wiped out.. and I think it was because I wasnt sleeping deeply with the machine. Sometimes it takes a longer
time to get used to it.. I think its harder for insomniacs, because most of us are disturbed so easily.The Ugly
I am still eagerly awaiting the day when I wake up feeling bright-eyed and bushy-tailed. Most days now I at least wake up feeling about as rested (not but not as refreshed) as I did back in the pre-CPAP days. On a few days, I've even woken up feeling much more rested than I used to. But even now, I still occasionally wake up feeling less rested than I did on a typical pre-CPAP morning. But what I miss is that pre-CPAP there were those (occasional) great days that I would wake up feeling bright-eyed and bushy-tailed---not as many of them as I'd like, but there were some of them. Haven't had a single bright-eyed and bushy-tailed day since starting CPAP.

Neither have I, but I can tell you it did adjust my sleeping time, and stopped all the heart issues, and I learned not to sleep on my back so I could
turn my pressure way down.. I have seen people come back here after a year, and say.. IT FINALLY WORKED.. and that is what kept me going..
I think light sleepers and insomniacs take a heck of a lot longer to adjust to this therapy.. but you are moving in the right direction little by
little.. you really are...........
I don't like how much effort and work I have to put in every night just to go to bed. In order to manage the insomnia, I have to work pretty hard at strictly managing the whole "bedtime" ritual and it has to start something like two or three hours before I want to try to go to sleep. Have to wash my face early since washing my face wakes me up and I don't get as good of a seal if I don't wash my face. Have to watch the food: the insomnia devil is likely to wake up if I eat anything within two or three hours of going to bed. Which makes it really rough on MW nights since I have a night class that doesn't get over until 9:00 and I don't get home until 9:30 and I'm always STARVING after that class. If I want to be in bed by midnight, then there is

No TV after 10:00 I want to try to be in bed by midnight.
No reading the newpaper or books or magazines after 10:00.
Need to be off the computer by 10:00 (oh how I fail on this one most nights).

About the only thing I can do in those last couple of hours before bedtime is yoga, cleaning the kitchen, or listening to music in a dark room. And I don't have the energy to clean the kitchen on a lot of nights. [It's much, much easier to force myself to do yoga when I'm exhausted than it is to do the kitchen.]
Is there anything else you like to do to relax at night, a hobby? painting or drawing, easy puzzles? something to mix up your routine without
hyping you up?I still miss talking with my husband at night with the light out when we're cuddling. I have not been able to force myself to roll over and put the mask on in the dark when I want to go to sleep yet. And I'm afraid that if I lie in the bed talking with my husband in the dark, I will fall asleep without the mask and machine on. Maybe someday I'll be able to do this, but not just yet. *sigh*

I know what you mean... I have discovered my my third yawn, its time to put the mask on, so I get the talking and cuddling in before that..
sometimes I put the mask on my pillow, so its right there ready to go, and that seems to work really well.. he usually falls asleep when I am
in mid sentence anyway!
Headaches and neck aches. The number and severity of my numerous headaches is just about the same with CPAP as it was pre-CPAP. There has been a shift in type of headache, however. At this time of year, pre-CPAP my most common headache was allergy-related sinus headaches. Those are not really that much of a problem any more, probably due to the filtered and humidified air every night. But I'm getting a huge number of tension headaches. In fact, I'm waking up with a tension headache almost every morning. And a neck ache. I think both are caused by the fact that I've yet to find a genuinely comfortable position to sleep with the CPAP hose. And the fact that I'm "wiggling" less in my sleep. I'm a natural wiggler---I am constantly wiggling my toes, legs, and neck and back when I'm sitting at desk all day since that's what keeps me from getting stiff. And before CPAP, I always wiggled a lot in bed at night too---both before and after falling asleep. But now, once I find a semi-comfortable position in bed, I'm really reluctant to wiggle because wiggling usually "breaks" something like where the FX's exhaust flow is going. So when I'm still awake but trying to fall asleep I put up with alot more muscle discomfort by staying still in order to not "break" the CPAP stuff. And I suspect that I'm doing a lot less wiggling in my sleep as well: I now seem to be consciously awake every single time I need to turn over at night, and that was not true pre-CPAP.

I totally understand that your wiggling has been curtailed.. this is also why you may not be sleeping as well as you could be, because youre
subconcious is still trying protect your mask and position.. thats something you never had to worry about sleeping before.. thats a big responsiblity
to have while you are asleep, and your body knows it.. so, maybe tell yourself before you go to sleep, that you are going to protect your mask
WHILE you wiggle.. its amazing what your brain can get your body to do while you are asleep.. it knows not to fall of the side of the bed right?
well it can also know... "hey there, when I want to wiggle, wiggle! But protect the mask!" I do this with the outside hand if Im on my side, you
can learn to be a good mattress or pillow smoosher and protect those nose pillows and still flop around in the bed like a fish

you are doing really well for everything you have been thru.. hang in there!

elena

elena88 wrote: A lot of the battle is finding the right mask, so you are past half way there girl!

That is why I feel so lucky to have won the mask sweepstakes on my very first try.

robysue wrote:Bedtime insomnia, though not beaten, is under control for the most part. On most nights I'm getting to bed before 3:00 AM (although last night it was 3:00 *sigh*). And on most nights, once I go to bed I can get to sleep in a timely fashion instead of becoming more alert from fighting with the hose and mask just to get comfortable enough to fall asleep.

I know its hard to get to sleep too, but I found after cpap, that I was backing up my falling asleep time a few minutes every night..
from four am, to three thirty, to three... then after a few months, I was going to bed at ten pm.. and actually yawning! So the cpap
regulated my insomnia quite a bit, but it took a long time..

What's been rough for me is that this bout of insomnia was directly caused by starting CPAP. It started on Night 3 with the stuffed goose dream....
And I've had bouts of insomnia before---with every major stress-inducing crisis of my life comes a bout of insomnia. And I mean major stress, not day-to-day stuff. Stuff like the death of a close family member or dealing with the aftermath of a serious car crash is what has triggered weeks or months long bouts of insomnia in the past. I'm glad that this bout is now under control. I can deal with that. But it's been two steps forward and one step back: I had to eat last night when I got home from the gifted math class at around 10pm 'cause I was really, really starving. And the world series was on and I didn't have the will power to walk out of the room. And so on and so forth. So the yoga didn't get done in time for me to get to bed in a timely fashion. Fortunately, I could sleep until 8:30 this morning and I'm feeling pretty decent since 5 1/2 hours of sleep is enough for me to function more or less.

robysue wrote: I still feel worse that I did before starting CPAP. While the daytime sleepiness and exhaustion is slowly getting better, it is still far worse than anything I had before CPAP. Before CPAP, I only had daytime sleepiness if I'd been up all night doing grading, which happens a couple of times a semester. And I never worried about falling asleep at the wheel. I didn't feel like I might fall asleep at my desk. And I certainly didn't spend the whole day yawning uncontrollably. Now, five weeks into CPAP therapy, all those are still happening to me on bad days. On good days, I'm merely very, very tired all day long.

Have you ever noticed waking up dreaming since you started cpap? I too was more tired than I have ever been in my life on cpap, and discovered
I never was waking up dreaming on it, so I had not learned to relax and sleep with it.. I hope in time you will find a ryhthem with your machine
and get some restorative sleep soon..

Pre-CPAP I did a lot of dreaming. And not nasty, dreams of choking or drowning: No, pre-CPAP I had frequent, good dreams that I would only momentarily remember upon waking and only some of the time. But I knew I was dreaming and I knew the dreams were good ones. [And oddly enough, during my baseline sleep study my AHI/RDI was LESS in REM than in NREM. Go figure.]

Since being switched to APAP with the lower pressure range, my dreams have started to return to normal. That's a relief since early in my use of CPAP, I didn't feel like I was dreaming normally: In addition to that nasty force-fed goose dream, I also had a dream where I felt like I was being suffocated. And when I was dreaming, I was waking up knowing the dreams hadn't been good ones. And then there were the nights where I felt like I had not gotten into either REM or Stage 3 sleep at all. At least those days are behind me.

Is there anything else you like to do to relax at night, a hobby? painting or drawing, easy puzzles? something to mix up your routine without
hyping you up?

Alas, that's the problem: My hobbies (except for yoga) tend to make me wake up. Love reading, but it makes my brain wake up. Love doing crosswords and sudokus, but they leave me more awake. Love playing solitaire either on the computer or with real cards, but it wakes me up. Love baking, but it makes me want to eat whatever is coming out of the oven when it's fresh and hot. Love playing with the cat, but that really wakes me up and makes me WIDE awake, which is great in the morning. Problem is quite simply that my brain has an on-going constant conversation/narration about things that are going on when I'm awake. And almost ANYTHING makes the verbal part of the brain start yakking away. It's related to how my memory has always functioned: My mother would tell me I was born with a tape recorder in my head---the ongoing conversation is my way of "recording" everything. But it does cause problems when I need the brain to settle down and quit thinking so I can go to sleep.

At least this is an old, familiar problem. It will slowly resolve itself now that the insomnia is under control. Slowly, but surely I'll "forget" and accidenty do some reading or bedtime browsing or tv watching or any of those other things that wake me up right now, but go to bed because I'm sleepy at bedtime and sleep. I can already tell that on about half the nights that's beginning to happen. But it's not yet reliable.

I totally understand that your wiggling has been curtailed.. this is also why you may not be sleeping as well as you could be, because youre
subconcious is still trying protect your mask and position.. thats something you never had to worry about sleeping before.. thats a big responsiblity
to have while you are asleep, and your body knows it.. so, maybe tell yourself before you go to sleep, that you are going to protect your mask
WHILE you wiggle.. its amazing what your brain can get your body to do while you are asleep.. it knows not to fall of the side of the bed right?
well it can also know... "hey there, when I want to wiggle, wiggle! But protect the mask!" I do this with the outside hand if Im on my side, you
can learn to be a good mattress or pillow smoosher and protect those nose pillows and still flop around in the bed like a fish

Well this is what's actually causing the problems right now: Everytime I want to wiggle, the brain wakes up and says "protect the mask" and the body decides that not wiggling is the easiest way to get the brain to shut up and let it fall asleep. But I think you're right: Eventually my subconscious will figure out how to either become more tolerant of the exhaust flow not being prefectly aimed into the right spot and learn that or it will figure out how to protect the mask without giving up on wiggling. There's been some evidence this is happening already. At the beginning I was absolutely terrified of something blocking the exhaust flow while I was asleep---to the point of altering how I pulled the covers up at night. After a while I started to notice that I was waking up with covers in a more normal position for me and that I was automatically and unconsciously creating a spot for the exhaust flow to go even if the blanket was up near my head. I've also noticed that I'm a whole lot less concerned than I was at the beginning that I'll pull the hose so hard that I'll pull the machine off it's table or that I'll roll over on the hose and cause it to collapse.

Hi - i notice you have the same kind of nasal pillows I have and this might be a dumb suggestion, but i noticed that you can adjust the pillow part that sticks a bit in your nose, up and down, and this makes a diffference in your breathing good or not as good at night. If you adjusted them in your nostrils, could that help?

also, do you notice that when you wake up in the morning that the pressure seems very mild? as if the machine ramped itself down by the morning?

I enjoyed elena88's reply. I have just a couple of observations of my own, from the perspective of a little over a year.

robysue wrote: Bedtime insomnia, though not beaten, is under control for the most part. On most nights I'm getting to bed before 3:00 AM (although last night it was 3:00 *sigh*). And on most nights, once I go to bed I can get to sleep in a timely fashion instead of becoming more alert from fighting with the hose and mask just to get comfortable enough to fall asleep.

Over the long haul, I think CPAP has helped my bedtime insomnia a great deal. Putting on the mask forces me to draw a definite line across the end of my day. I can't read, watch television, or converse. I have somehow grown to accommodate that fact, and now I fall asleep faster than I ever have in my life. Unlike some people, I have no hesitancy to read or talk in bed. It is the masking up and hitting the on button that signals the end of the day. I'm certainly not saying that it works that way for everyone, but gradually it worked that way for me. I sometimes still lie awake with thoughts going around and around in my head, but it's only when I actually have something big to worry about.

I still miss talking with my husband at night with the light out when we're cuddling. I have not been able to force myself to roll over and put the mask on in the dark when I want to go to sleep yet. And I'm afraid that if I lie in the bed talking with my husband in the dark, I will fall asleep without the mask and machine on. Maybe someday I'll be able to do this, but not just yet. *sigh*

Try it. Enlist your husband's help. Ask him to wake you up if you doze off while talking. My wife does that for me. And if you do fall asleep, your apnea will probably wake you up and you can put your mask on. That may not be optimal, but no one's perfect.

gee, thanks PST!

Well this is what's actually causing the problems right now: Everytime I want to wiggle, the brain wakes up and says "protect the mask" and the body decides that not wiggling is the easiest way to get the brain to shut up and let it fall asleep. But I think you're right: Eventually my subconscious will figure out how to either become more tolerant of the exhaust flow not being prefectly aimed into the right spot and learn that or it will figure out how to protect the mask without giving up on wiggling. There's been some evidence this is happening already. At the beginning I was absolutely terrified of something blocking the exhaust flow while I was asleep---to the point of altering how I pulled the covers up at night. After a while I started to notice that I was waking up with covers in a more normal position for me and that I was automatically and unconsciously creating a spot for the exhaust flow to go even if the blanket was up near my head. I've also noticed that I'm a whole lot less concerned than I was at the beginning that I'll pull the hose so hard that I'll pull the machine off it's table or that I'll roll over on the hose and cause it to collapse.

When I did my titration at home, I did what I called the "mummy position" I just layed there on my back with my hands down by my sides like
an idiot.. I was also terrified of moving the mask, jarring, it rolling over.. I just froze! Of course my numbers were so skewed from doing
this, but nobody asked me what I did during the titration, and most of the time I wasnt sleeping.. and when I did, I leaked like crazy.
I think sleeping with this equipment is like learning to ride a bike.. and first we fall right over, and then we run into trees, off the sidewalk,
crash into bushes.. get skinned and bloodied... then somewhere one day we find our balance... remember that one moment?
OMG, its a miracle! pedaling along faster and faster.. woooooosh.......
But its not easy to get there.... but with a LOT of practice.. we can figure it out.. even while we are sleeping..
so be patient, its coming.. youll get there.. I can tell the training wheels are off already!

elena