New CPAP user - REAL trouble falling asleep

diagnosed about a month ago with severe obstructive sleep apnea, I've had trouble sleeping for years and I now have a Phillips Remstar

I'm having some really tough times adapting to the CPAP and not falling asleep even after wearing the machine for 2-3 hours (even after taking a lunesta)

look for some tips from the pros on the best approach to getting used to the CPAP. I've tried keeping it on watching TV before I go to bed to get more comfortable with it but so far no joy.

it's been about 4 weeks of battling with "getting used to it" and so far I haven't been able to ever fall asleep with it on. I've tried several different masks, increased the ramp up time to 40 min, lowered pressure from 12 to 8 (which was frustrating because it took two weeks to get a new prescription)

determined to ring in the new year with more than 3-4 hours of sleep per night which has been a long term problem

any tips? hoping to get the CPAP to be a trusted sleep ally rather than preventing sleep apnea by curing the abililty to sleep at all!!!


thanks for any tips for a CPAP noob.

more questions first...

Which model of the Phillips Respironics machine do you have (will be listed on top of the machine)?

Do you know if you're using CFLEX or AFLEX?

And what mask?

Are you uncomfortable because of the machine or mask, or simply not able to fall asleep? If there are specific discomforts (i.e. mask hurts, leaking, feeling like you're not getting enough air or getting too much air), we can help.

If it's a more generic issue that you simply can't fall asleep, that's trickier. Do you have any sense why you can't fall asleep?

There is a lot of good info on "sleep hygiene" that I'm sure you'll get posts about or you can search for it on this site. And there are a lot of tricks that may help. It's always worth consulting with your doctor about this. Medications are a double-edged sword. They MAY help you fall asleep, but they can also disturb your sleep. So talk over the pros and cons carefully with your doctor if sleeping meds are prescribed. Make sure the doctor doing the prescribing is your sleep specialist because a PCP will not be as "up" on the nuances of how sleep meds can affect sleep in this situation.

First, you need to register on this forum in order to participate fully. Once you register, go up to the User Control Panel (top left) ---->Profile---->Edit Equipment and then choose your gear from the pull down menus. Choose to show the choices in TEXT, not pictures. This will put your equipment at the bottom of each post you write and helps us give you better advice and help. Those with the same machine, mask, etc., will be able to share their expertise with you.

Guest wrote: I'm having some really tough times adapting to the CPAP and not falling asleep even after wearing the machine for 2-3 hours (even after taking a lunesta)

I bid you a most sad welcome to my CPAP-induced insomnia club. If you do a search for insomnia or for posts by me in particular, you'll find a wealth of information by many, many posters who've been here far longer than I offering me tips on my own CPAP-induced insomnia.

look for some tips from the pros on the best approach to getting used to the CPAP. I've tried keeping it on watching TV before I go to bed to get more comfortable with it but so far no joy.

it's been about 4 weeks of battling with "getting used to it" and so far I haven't been able to ever fall asleep with it on. I've tried several different masks, increased the ramp up time to 40 min, lowered pressure from 12 to 8 (which was frustrating because it took two weeks to get a new prescription)

determined to ring in the new year with more than 3-4 hours of sleep per night which has been a long term problem

any tips? hoping to get the CPAP to be a trusted sleep ally rather than preventing sleep apnea by curing the abililty to sleep at all!!!


thanks for any tips for a CPAP noob.

Overall, I think you are doing a few things right and a few things wrong and many things somewhere in the middle. It's the same with me, quite frankly, and I'm now some 3 months into my own CPAP+insomnia battle that has morphed from bedtime insomnia to can't stay asleep insomnia and that is now beginning to morph back into bedtime insomnia. So days and weeks, I think I've got the insomnia beat; and other days and weeks, it comes back with new reinforcements for another round of warfare.

One main over all tip: Get serious about sleep hygiene. If you don't know what sleep hygiene refers to, first start by searching this forum and reading through some of the numerous hits you'll get. Also if possible, talk to your sleep doctor or his/her nurse or PA or your PCP (or his/her nurse or PA) about establishing good sleep hygiene. For me, the most critical parts of good sleep hygiene are:

• I do NOT go to be until I am feeling SLEEPY---and feeling sleepy is not the same as feeling tired or exhausted. If I find myself lying in bed for more than 40 minutes or so, I'm usually no longer sleepy enough to get to sleep and I try to force myself to get up and go into a different room to do something very quiet and very relaxing and very soothing. For me, that usually means sitting in a quiet room and listening to quiet music in the dark---if I'm smart enough to focus on good sleep hygiene instead of backsliding into bad habits of web browsing, watching tv, or reading, all of which tend to stimulate me rather than make me sleepy.
  
  I try to AVOID eating too close to bedtime. Likewise I have to avoid watching TV too close to bedtime. I cannot read in bed (even though others do, I CAN'T because it wakes me up). I AVOID exercising too close to bedtime. In all these cases, "too close to bed" is a bit flexible, but it's usually one to two hours, except for eating. I try to avoid all eating for at least 3 to 4 hours before bedtime if at all possible.
  
  No caffeine after noon for me. No alcohol after lunch either. Both interfere with sleep. 'Nuff said about them. Giving up caffeine after noon has been as tough for me as dealing with CPAP itself in many ways.
  
  I try to get some additional exercise during the day (far away from bedtime) when I can. Haven't been as good about this as I should be recently. It's a New Year's Resolution though.
  
  If I wake up and genuinely CANNOT get back to sleep in more than 40--60 minutes or so, I start to think seriously about getting out of bed and going into a different room and doing something quiet and relaxing and soothing. It's important to NOT watch the clock though when you're lying there in bed worrying about NOT being able to get back to sleep. So I've taken to making a tick mark on a sheet of paper (so that I can keep track of how many times I am waking up in the night so that I know I'm not exaggerating it when I talk to the doctor's PA about it the next office visit or phone call), but I make a point of NOT looking at any clock so I really have no idea what time it is when I wake up. I also have my iPod sitting in an iHome and I'll hit the Sleep button on it, which I think is set to 60 minutes. My rule, which I've only had to enforce once, is this: If I'm consciously awake when the iPod's Sleep timer runs out, then I have to get out of my nice, warm bed and go out and listen to the main stereo in the dark cold living room until I can't keep my eyes open any more and I feel sleepy enough to go back to bed. You can try this trick if sounds like it might work, but your mileage may vary.
  
  I need to get more serious about enforcing a more constant wake up time. I'm a college professor blessed with an understanding husband who has been tolerant of my sleep deprived state this past fall semester. But part of good sleep hygiene is dragging yourself out of bed at wake up time regardless of how much or how little sleep you've managed to get. I've not been able to do that this fall. Again, this is a New Year's Resolution. I'd put this one off until you start developing the ability to at least get 5--7 hours of sleep at a time (even if the time turns out to be 4 am to noon on a Saturday morning) with the CPAP mask on your face on some kind of a more-or-less regular basis.

Then you need to Get acclimated to the mask. You've already started some of this by watching the TV with it on. But if you're doing this right before you're going to bed, you may inadvertently be training your brain to think CPAP = WAKE UP instead of the needed CPAP = GO TO SLEEP. So you need to try to do the acclimatization activities well before bedtimes AND far away from your bed. Take the CPAP out to your living room and watch your favorite 7:00 and 8:00 tv shows in it and then take the CPAP back to the bed room and set everything back up for bedtime and enjoy the rest of the night CPAP free in the living room. And take care of washing your face, pre-fitting the mask, putting the water in the humidifier and everything else that has to be done for the CPAP machine well before it's time to crawl into bed.

In other words, you want to be able to make it as easy as you can to just crawl into bed, put the mask on (and nothing else), and turn the machine on and turn the light off and fall asleep. But remember: The critical thing is to wait until you are so sleepy you cannot keep your eyes open before you go back to your bedroom and put the mask on and climb into bed.

Good luck and sweet dreams.

Guest wrote:diagnosed about a month ago with severe obstructive sleep apnea, I've had trouble sleeping for years and I now have a Phillips Remstar

I'm having some really tough times adapting to the CPAP and not falling asleep even after wearing the machine for 2-3 hours (even after taking a lunesta)

I would try to postpone going to sleep till midnight and then take the Lunesta and put the CPAP on. I go by these data:

http://www.rxlist.com/lunesta-drug.htm

p.s. I do the same with 5 mg of Zolpidem (generic Ambien)

HOWEVER, doctors say NOT to take sedatives while CPAPing

I thought I was going nuts not being able to sleep for the first three weeks of CPAP. I got all stocked up on sleep medicine from my Dr. and then all of a sudden, (it was like a light switch went off) I was able to start sleeping again with the CPAP and no sleep medicine. I do take 3mg of Melatonin once in a while which seems to help.

One thing I found helpful was the cover for the hose. Since the thing was in bed with me - It didn't remind me I had a hose in bed. Also - the aroma therapy helped a lot. It seemed to have a calming effect on me. You might give that a try. I still don't like sleeping with CPAP but seem to have come to terms with it now. I do look forward to taking that mask off first thing in the morning though.

I'd give it some more time - I'm sure some people take longer than others to adjust to the therapy.

There are a lot of people on this forum that will give you very good advice.

Hi, have you tried just not using the ramp at all? Most of us seem to abandon it after a week or so - the beginning pressure's too low to breathe at and unless your script calls for very high (e.g. 15) pressure, you probably will find you don't need it at all, and starting out at your 'needed' rate may help you sleep instead of counting down.

Part of the issue can be the comfort of the mask. A good cloth liner, such as Quietus Liner, will provide improved comfort which might help with the issue. Give it a try and let me know how it works.

BobbieSue