A Newbie's First 2 Nights on CPAP - Feedback Welcomed

Have been diagnosed overall with mild Apnea. It tested severe when I move into REM. Was prescribed and started to use my Resmed S9 two nights ago.

First night very difficult. Took 1 1/2 hours to fall asleep... during which time I experienced what one would call SLR.. which I had not experience before. Most of the discomfort I experience was from initially getting use to the air flow into nostrils, the discomfort from Swift FX Nasal Pillow Mask, and positioning myself comfortably in bed with both mask and tubing. By the morning, the relationship between my nose and the mask had much improved . I woke several times during the night to due to physical discomfort (perhaps an apnea disruption) and to adjust the mask. While I got 7 hours sleep, I woke tired and not well-rested - though my body felt more refreshed from this sleep than I had previously had.

Second night much smoother. Mask now felt much more comfortable... much less like a third party or physical intrusion. Sleep was sound and deep for the first five hours... then woke... I think due to thirst and a need to go to the bathroom. What was interesting about the waking was that it was "clean"... it didn't feel disruptive or with any angst to it. I was able to fall back to sleep within 20 minutes... woke 1 or 2 times more - very briefly to change my sleeping position. I have woken in the past during the night experiencing physical discomfort... my body even feeling achy/stiff. it's been an ongoing condition. (It may be time to search out a more appropriate mattress for my sleep condition.) In the morning when I woke while my eyes felt still tired... my body felt very refreshed, relaxed... no stiffness or aches. I even felt younger... if that's possible It makes me wonder if all the muscle stiffness and aches when rising in the morning has been due or underscored by the body's lack of proper oxygenation.

I'm curious to know.. if being on CPAP prevents one from "wakening" from breadth disruptions totally? Will one eventually experience 8 hours of sleep without ever wakening excluding the need to go to the bathroom and/or extreme thirst? Or is wakening from a disruption distinct from the CPAP preventing the blockage of air flow?

Thank you for listening. Ahhh... the change and shifts in life...

Alex

Chronic pain or discomfort can tend to cause arousals. I don't know if you take any pain meds, but a PM medicine (aleve, tylenol, etc.) might help you.
Sounds as it can only get better for you.
Mary Z.

Thanks, Mary

I'm just starting on the Sleep Program and Care at Mt. Sinai, NYC... I don't take any meds for the physical discomfort... and do have lower back pains/sciatica problems... and have taken advil/motron/tylenol to ease that in the past. But, will definitely discuss with sleep study physician. Also, in the midst of addressing the sciatic medically. The night I had the SLR, the tylenol and walking around helped a lot.

Thanks again for the feedback.

fullrun wrote:I'm curious to know.. if being on CPAP prevents one from "wakening" from breadth disruptions totally? Will one eventually experience 8 hours of sleep without ever wakening excluding the need to go to the bathroom and/or extreme thirst? Or is wakening from a disruption distinct from the CPAP preventing the blockage of air flow?

Hi,

Even normal people can experience a sleep disruption from time to time. CPAP probably will not totally eliminate it, but, barring other sleep problems, it should minimize it.

When you start on CPAP, you essentially have to learn how to sleep all over again. Your body was trained to wake up, sometimes very often, to try to get you to breathe. That is also why many apnea patients go to the bathroom a lot. If your treatment is working, the bathroom trips should diminish, and you will eventually learn to sleep through the night. Before CPAP, I would get up every 60 to 90 minutes to go to the bathroom, but now I don't get up at all. I also used to awake after about 2 to 3 hours in bed, and be up for an hour or two. It took 6 months for that to stop happening to me.

You are off to a great start. Give it some time, and keep an eye on your AHI and leak numbers.

-john-

In time you sleep longer. I was told by my doctor that many people with sleep apnea have problems sleep period. He prescribed a mid sedative, Elavil, for me to take at bedtime. So far its working wonders and has no side effects when waking in the morning.

I will add I have Rheumatoid Arthritis, Osteo-arthritis and Fibromyalgia. I also have low Vitamin D levels.

One we fixed my viatmin D level all my other issues with pain, swelling, exhaustion and the problems with my immune system went away. I was able to stop all of my arthritis medications.

I felt 100% better when we fixed my Vitamin D level. Since I have been on CPAP its now 200% better and getting better each day.

I wake up some nites once or twice and fall right back to sleep.

fullrun, Welcome to the forum. You can get a lot of information from people here and read a lot on your own. Please read the CPAP Wiki found on the tool bar at the top of the home page. IMHO the more educated you are about your apnea condition the better able you will be to improve it. Your waking up could, in part, be due to your having an event and the machine giving you more pressure to open up your airway. This was my experience the first several weeks after starting on APAP. I would wake up for no reason....no discomfort....no need to use the bathroom. Then I began to notice more pressure on/inside my nose and would reach down to check the machine. If you press the small silver bar with an 'I' on it, at the upper right side of the display window while your machine is running it will display what pressure it is giving you. Your body will soon get used to this new sensation too...like it is to the mask...and a pressure increase or decrease will no longer wake you.

good luck and sweet dreams.
Cindy

Hi Fullrun.....sounds like you're off to a good start!

One of the more frustrating things (among many!) with xpap therapy is that it can often take time for the positive impacts to be noticeable. However, my own experience with sleeping longer/better is that it is now happening after almost 3 months. I am beginning to think that my decades of insomnia were primarily caused by not breathing. When I first started xpap, I was lucky to sleep 60 to 90 minutes at a time, and it would take me an hour or more to fall asleep again (and many nights I didn't get back to sleep after the first wakening). Now I'm sleeping 4 and 5 hours at a time, and my wakenings are very small if at all--I look at the clock and fall right back asleep. I've even stopped looking at the machine to see what's happening.

In the past week, I've had two nights where I slept 7.5 hours straight through, and my average night now means barely waking up once or twice.

Hang in there--it DOES happen and you will learn how to sleep again. After years of apnea, I think our bodies become very well trained to not let us get into a deep sleep because we stop breathing. It takes time to retrain our bodies to know that it is safe and OK to sleep deeply for longer periods of time.

Weezy

Guest wrote:Do you mean by leak... the number of times I go to the bathroom?

Hi,

I wish it was that easy. What I was actually referring to is mask leaks and mouth leaks. In an ideal world, you would keep a perfect seal on your mask and you would never lose air pressure out of your mouth. In the real world, that is surprisingly difficult. Probably more so for people on high pressure levels (I am at 13/20 on BiPAP), but still an issue even for those on the lower end of the pressure scale.

BTW, I read your posting where you state that your machine starts at a pressure of 4. That is extremely low. In fact, many people have difficulty breathing at all on a pressure of under 7. Is that what you were titrated at in a sleep study? Or did they give you a home titration with the machine set at a very wide range, like 4 to 20? If your AHI is very low using the machine, you might be OK. But I am surprised that you are getting much value at all when running with a pressure in the 4 or 5 range.

-john-

I am beginning to think that my decades of insomnia were primarily caused by not breathing. When I first started xpap, I was lucky to sleep 60 to 90 minutes at a time, and it would take me an hour or more to fall asleep again (and many nights I didn't get back to sleep after the first wakening). Now I'm sleeping 4 and 5 hours at a time, and my wakenings are very small if at all--I look at the clock and fall right back asleep. I've even stopped looking at the machine to see what's happening.

Thanks Weezy -

I can definitely relate to that... I have in the past explained my disrupted sleep and wakenings with having a highly active mind and imagination... as well as from anxieties... and have developed over the years a wakening pattern: the first, after 2/3 hours sleep... this initial wake always being the most difficult from which to return to sleep again... and then a second wake at either 4:30 or 5:30 in the morning... if I fall back to sleep... it usually is undisturbed until I've awoken for the day. It's also been very difficult for me to initially fall asleep at time. But I have in the past attributed all of this to a very active/concerned mind. And some nights- primarily out of physical discomfort - awakenings could be as many as 4 or five

But, now, the immediate result that I see.. which of course may change... is that I fall asleep within 10 to 15 minutes... when I am awakened during the night, it does not take me that long to readjust my sleeping position and fall back to sleep... even tho I am still waking up 2 or 3 times during the night. I've also place myself on a new sleep regiment regarding no naps, no pc or visual excitement an hour before going to bed.. to try to dispense of any concerns and worries... to empty my mind...

Thanks for your input... everyone's feedback has really helped me put the process in the appropriate perspective... that there is a curve to this rehabilitation process... and that it doesn't take place overnight... which help enormously in one's tendency to too quickly judge the results...

Thanks, so much.

Alex

Guest wrote:I can definitely relate to that... I have in the past explained my disrupted sleep and wakenings with having a highly active mind and imagination... as well as from anxieties... and have developed over the years a wakening pattern: the first, after 2/3 hours sleep... this initial wake always being the most difficult from which to return to sleep again... and then a second wake at either 4:30 or 5:30 in the morning... if I fall back to sleep... it usually is undisturbed until I've awoken for the day. It's also been very difficult for me to initially fall asleep at time. But I have in the past attributed all of this to a very active/concerned mind. And some nights- primarily out of physical discomfort - awakenings could be as many as 4 or five

Hi,

That is something else that I struggle with from time to time. There are nights where I simply cannot shut off my mind. I do a lot of computer programming. If I get deep into a problem, I find myself running computer code in my head much of the night. Sometimes I get stuck in a loop looking for a bug in the code. I end up asleep, but so active that I don't get restful sleep. If that happens, I now know that I have to step away and do something else for a while.

As far as having a hard time falling asleep prior to starting on CPAP, I think that this might be due to your sleep pattern. Since you didn't sleep well at night, you were catching catnaps all day long. Many of these were only a few seconds long. But the net-net is that you had gotten a few hours of sleep this way, so when you went to bed, that was your least tired point in your day. Since you weren't tired, you didn't fall asleep easily. When you did get to sleep, you kept waking up due to the apnea, so you woke up really tired. That caused the cycle to repeat, and you were doing catnaps all day long.

Since going on CPAP, you are now sleeping at night, so you are awake during the daytime, so you are now tired at bedtime. It really works out better this way--life is more interesting when you are awake for it!

On the topic of mask adjustments -- you will find that after a few weeks, you will be able to make minor mask adjustments in your sleep without you even knowing that it is happing. So, what irritates you now and even might wake you up at this stage in the game will soon become something that you do on autopilot without ever waking up.

-john-

Since going on CPAP, you are now sleeping at night, so you are awake during the daytime, so you are now tired at bedtime. It really works out better this way--life is more interesting when you are awake for it!

On the topic of mask adjustments -- you will find that after a few weeks, you will be able to make minor mask adjustments in your sleep without you even knowing that it is happing. So, what irritates you now and even might wake you up at this stage in the game will soon become something that you do on autopilot without ever waking up.

I remember about 6 or 7 years ago, the inability to sleep got so bad that I went through about a weeks of sleep deprivation... the outcome: shingles.

Part of what the Mt. Sinai Seep Study Clinic has you do is keep a sleep diary... and like you mentioned what I find myself engaged with an hour or so before sleeping really influences the quality of my sleep... so no iMac and no movies ... I love to explore and I love to imagine... work scenarios out... problems out... a loose mind. If I take it to bed it will eventually put me to sleep... but at the cost of initially not being able to fall asleep and that can last, at times, for an hour. Plus even when you dose off, I'm sure the mind is still engaged in working out whatever is was attempting to work out... and that in itself I'm sure contributes to your awakenings in the night.

I'm also discovering that as you go along, you become more aware of things that you need to work out with your mask, the humidity, and the auto-pressure. Last night was the first time that I felt when initially applying the mask that the air pressure was insufficient.. that it was like trying to breathe in a steam room... In the morning when I woke, the air pressure was 9.6. So, I'll call the clinician today and discuss the setting. I love the FX Swift mask, but I still have to work through adjustments regarding leakage when I'm lying with my head in a side position... the pressure moves one of the nasal pillows away from its tight seal. But, like you said, what seems to an intrusion today will become handled and transparent tomorrow. The body and mind is pretty amazing in its adaptability... if you let it be Thanks, John for the guidance and encouragement. Appreciated.
Alex