Mild Sleep Apnea and Insomnia

Hi there! Thanks in advance for reading what may be a long post!

History: I have been suffering from insomnia for the past 8 months or so. Not falling asleep, but staying asleep. It started out as stress and was just a few days a week and then as the days and months went on and on, the insomnia got worse. Every night falling asleep like normal and waking every 2 hours or so. I have been waking for NO REASON AT ALL. No pain, no hunger, not to pee, not to catch my breath, NOTHING I CAN THINK OF.

So I get a level three sleep study done and they say I have MILD OSA. (AHI OF 9, RDI OF 16 AVERAGE) (AHI OF 14, RDI OF 33 DURING REM). So because it was higher during my REM, they said to try CPAP.

I thought if this mask lets me stay asleep all night, let's do it! (DREAMSTATION WITH WISP MASK). Obviously the first night was just annoying getting used to it but the next night, I just wore it 30 minutes before bed to get used to it, and fell asleep fine.

I tried this for TWO WEEKS AS A TRIAL. Yet, EVERY night, I still woke up multiple times through the night FOR NO REASON. I even checked the mask pressure during the times I woke up because I heard that could wake you up but it was always at the lowest. In fact, I noticed that while I was awake and trying to fall back asleep during the night, that's when the damn mask would start to increase the pressure! Hello mask! I'm breathing fine! If it was breathing events waking me up to begin with, wouldn't the mask of helped?

I am now currently waiting to see a specialist to try a Level 1 in hospital study as I'm not sure how I feel about the results/accuracy of this one.

SO, MY QUESTION IS, Should I have given the machine longer? I didn't want to buy it if it wasn't working. And I only have MILD Apnea so they say you shouldn't even try the machine. What's your guys opinions on this? Help me! (Also, I have no pre-dispositions to sleep apnea as in I am a normal weight, small neck, etc)

Thanks!!!
Bella

Hey xxyzx,

Nope not self diagnosing or in denial. That's why I'm here asking questions.

It did say my AHI went down to 3.1 which is great but it didn't help me STAY asleep. That's my question here to find out if the apnea is waking me up every night or something else. Hence why yes, my doctor is running tests. And no it's not stress related, would be a lot easier if it was.

And from everything I read, they don't usual start mild osa with cpap which is also why in asking the questions to get other people's opinions.

Thank you for your insight

Do you take any medications of any kind? If so, what?

Hey Pugsy!

Only birth control pills. Same ones for 7 years!

And the occasional Tylenol/Advil.

Okay...was hoping the sleep maintenance insomnia might be related to medication side effects but I guess we aren't that lucky here.

Insomnia of any kind can be really difficult to isolate the cause and then to fix it. While sleep apnea is one potential culprit it certainly isn't the only culprit out there. Especially frustrating when we can't figure out why or blame something. I have sleep maintenance insomnia issues myself but in my case I know the cause...and it's still a battle every night.

Should you have given the cpap more time???? I dunno. The cpap can only fix the bad sleep if the bad sleep is related to the OSA. It can't fix bad sleep that is caused by something else and there's a mile long list of other potential culprits.

You mention 2 hours though...and your OSA is a bit worse in REM...and the first REM sleep stage will usually come about 90 minutes or so after the first sleep onset and then REM comes along more frequently and lasts longer as the night progresses.
It wouldn't be impossible for the REM apnea events to be playing a factor in the wake ups.
Google "sleep stages" and look at the hypnograms of normal sleep cycles and see if you can spot any correlation to REM sleep stages and your wake ups.
Also it's normal to wake up after a REM cycle...entirely normal but most of the time we just turn over and go back to sleep and have no memory of the wake up. But some people become more fully alert and then they have trouble getting back to sleep and they start worrying about waking up and the insomnia monster gets some food to keep him hanging around.

You might read RobySue's blog and see what she has done and she recommends a couple of books you might also look at to see if you can spot something that might help.
http://adventures-in-hosehead-land.blog ... er_19.html

Thanks Pugsy, I'll definitely look at the link.

My sleep study was only 5.7 hours as I was awake most the night but only got 10 percent REM haha not very good I hear.

I was just so hoping I would put the mask on and sleep like a baby haha!

Thanks for the info!

thisisbella wrote:I was just so hoping I would put the mask on and sleep like a baby haha!

I totally understand how you feel. Been down that road myself.
It took me probably 3 to 4 months to start sleeping more than 5 hours with the mask and machine. It's just not normal to have that alien plastered on my face.
It's been a little over 8 years now and it's still hit or miss in terms of how much sleep I end up getting but it's not from the cpap or sleep apnea though. It's from other stuff.

I don't know if 2 weeks is enough of a trial though.
But then my OSA was a lot worse in REM than yours is...so I don't know what I would have done in your shoes...plus my oxygen levels went down the toilet and I was having some of the typical OSA symptoms along with the crappy sleep.
If your O2 levels stayed up and you aren't having any of the other typical symptoms....maybe the insomnia is unrelated to the mild OSA.

Ugh I can't even imagine that many years. I wore it like ah its not so bad but to think about it in the long term, then it doesn't seem so good haha.

Yeah I think it was 18 percent I was under 90 and like 2 percent under 85 but never below 80 (which isn't saying much haha) but I didn't even think I would be diagnosed with it as I have no symptoms really! It only recorded snoring for 2 percent lol. Even the sleep clinic guy when he was getting me ready for the test told me not to worry it's highly unlikely -rolls eyes-

Yeah I know two weeks isn't long but it was a free trial haha. So if I can't find any other reasons I'm not sleeping I can always invest in the machine but why buy it if my insomnia isn't related to the OSA right?

That's my thinking anyways lol.

If you spent much time at all below 90 % O2 then that's fairly significant.
88% for just a few minutes will buy someone an oxygen tank and insurance will pay for it.

You can explore your other options and if you decide you want to try cpap again you can always get your own machine on your own if you wish and your insurance doesn't want to pay for it.

Read those books that RobySue mentions in her blog. They are really good. She's our resident insomnia expert here but she's taking a break from the forum right now so I don't expect she will stop by your thread to offer her input.

Talk to your doctor about the oxygen level stuff. I would feel better about your putting off cpap if you had told me your O2 levels never went more than 2 or 3 % below your baseline which I would assume should be in the high 90s unless you have other lung issues going on.

Oh no that's not good lol! My doctor is referring me to a lung specialist (I think? Some specialist) that she wants me to see before doing an in hospital study so I guess we will see what happens there. I also did a chest X-ray and an echo as well (arythmias noticed, but I do have a heart murmur) but all that came back clean.

I will read the blog and pick up some books!

thanks for all your help and insight!

Few things... I take "mild" sleep apnea seriously. Just read on here recently a report being discussed, something about mild OSA can cause more severe symptoms in women. If you multiply your AHI times the hours slept, that number is usually sobering in view of the potential for sleep stage disruption. Add possible higher AHI during REM and desats, it all sounds worthy of treatment to me. And for me, any significant desat is too much. So what if it was only once or twice a night? How many episodes are too many? For someone with heart issues or at high risk for stroke, it's a factor I would want eliminated.

Is there any reason to think you could have restless legs or periodic limb movements disrupting your sleep? Restless fitful sleep with lots of movement during sleep can be symptoms.