Ten Weeks of Treatment/Still not Sleeping Enough

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
MMcG
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Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Tue Nov 16, 2021 4:17 am

Almost ten weeks on CPAP treatment and thankfully things have gotten a lot better. I'm now averaging about six hours of usage and perhaps waking briefly every couple of hours. But that's still not enough sleep for me. What happens to me when I wake around 5-00 am in the morning is that I get an urge to remove the mask. But then I can't get to sleep again and, even when I do, it's usually just for an hour or so and I can often wake up feeling nauseous and with a headache, despite feeling fine at 5-00 am. I suspect I'm having a lot of events during that last hour. But here's the problem. I've tried leaving the mask on a few times, sometimes for more than an hour (until after 6-00 am), and eventually just gotten up feeling tired and frustrated. I just wonder if I would be better getting up at 5-00 am and see where that leads me. Just wondering if anyone else here has had similar experiences in the first few months of treatment. Any helpful advice would be most welcome too.
Last edited by MMcG on Wed Nov 17, 2021 2:08 am, edited 1 time in total.

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ChicagoGranny
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Re: Ten Weeks of Treatment

Post by ChicagoGranny » Tue Nov 16, 2021 12:35 pm

MMcG wrote:
Tue Nov 16, 2021 4:17 am
I'm now averaging about six hours of usage and perhaps waking briefly every couple of hours. But that's still not enough sleep for me.


I'm always happy to get six hours of sleep. It wasn't like this when I was using CPAP ten years ago. It's an age thing.

MMcG
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Re: Ten Weeks of Treatment

Post by MMcG » Wed Nov 17, 2021 2:06 am

ChicagoGranny wrote:
Tue Nov 16, 2021 12:35 pm
MMcG wrote:
Tue Nov 16, 2021 4:17 am
I'm now averaging about six hours of usage and perhaps waking briefly every couple of hours. But that's still not enough sleep for me.


I'm always happy to get six hours of sleep. It wasn't like this when I was using CPAP ten years ago. It's an age thing.
I'm averaging six hours of "usage", which usually translates to a little over five hours for me (because of waking every two hours or so and taking time to get back to sleep). It feels like I'm about an hour short of the amount of sleep I need. There seems to come a time usually around 5-00 am when I can neither sleep with the mask on or off. I'm guessing that maybe after several years of disturbed/damaging sleep, my brain is still adjusting to the changed circumstances. And perhaps it just goes "ping!" at 5-00 am, thinking it's more like 8-00 am.

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Pugsy
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Pugsy » Wed Nov 17, 2021 9:54 am

Google "sleep maintenance insomnia" and start reading.
That's when we either wake up too many times during the night and/or have trouble getting back to sleep.
Fragmented sleep, no matter what the cause, will simply make us feel like crap but figuring and the cause and fixing it....not always easy to do.

5 or 6 hours of sleep simply isn't enough for most people even if it wasn't fragmented with too many wake ups.
Heck 8 hours of sleep isn't enough when it is highly fragmented because we end up not getting the normal progression into each sleep stage and the needed/normal amounts in each sleep stage. Often deep sleep or REM sleep just doesn't happen in the duration for the restorative powers of sleep to work their magic and those stages are critical to feeling decent.

I found a good explanation of why each sleep stage is so important while researching the effects of alcohol on sleep.
https://thesleepdoctor.com/2017/11/15/t ... hol-sleep/
Just substitute "anything" for alcohol and realize that anything that is disturbing sleep or causing frequent wake ups is unwanted.

Good quality sleep is so much more than treating OSA optimally. Trust me....been there and done that myself and a battle I am currently fighting....and I know the causes and still can't fix it. I used to average 7 to 8 hours of decent (for me) sleep but now a good night is 6 hours and more often I am waking up after 4 or 5 hours and simply can't get back to sleep.
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MMcG
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Wed Nov 17, 2021 11:06 am

Pugsy wrote:
Wed Nov 17, 2021 9:54 am
Google "sleep maintenance insomnia" and start reading.
That's when we either wake up too many times during the night and/or have trouble getting back to sleep.
Fragmented sleep, no matter what the cause, will simply make us feel like crap but figuring and the cause and fixing it....not always easy to do.

5 or 6 hours of sleep simply isn't enough for most people even if it wasn't fragmented with too many wake ups.
Heck 8 hours of sleep isn't enough when it is highly fragmented because we end up not getting the normal progression into each sleep stage and the needed/normal amounts in each sleep stage. Often deep sleep or REM sleep just doesn't happen in the duration for the restorative powers of sleep to work their magic and those stages are critical to feeling decent.

I found a good explanation of why each sleep stage is so important while researching the effects of alcohol on sleep.
https://thesleepdoctor.com/2017/11/15/t ... hol-sleep/
Just substitute "anything" for alcohol and realize that anything that is disturbing sleep or causing frequent wake ups is unwanted.

Good quality sleep is so much more than treating OSA optimally. Trust me....been there and done that myself and a battle I am currently fighting....and I know the causes and still can't fix it. I used to average 7 to 8 hours of decent (for me) sleep but now a good night is 6 hours and more often I am waking up after 4 or 5 hours and simply can't get back to sleep.
I'm in my mid 60's now but even when I was a young man, I was always first up in our house. But a pattern set in for the last couple of years which was sleeping for about five hours (without waking) and then struggling to get back to sleep (maybe awake an hour or more) but then having some disturbing dreams and waking with nausea and a headache after a couple more hours sleep. I now know, following my sleep study, that my sleep was not just non-refreshing but unhealthy. Since starting using CPAP (APAP really) ten weeks ago, it's been an uphill struggle, which went from barely sleeping at all for the first few nights to getting to where I am now. I reckon, allowing for short arousals, I'm getting as much sleep now as I was getting before CPAP (excluding the morning nightmare bit). But it's quality sleep with very low AHI's. Part of the problem now is that when I wake after about 6 hours usage, I'm actually quite alert and my mind just becomes over-active.

As regards medication, the only late medication I take is a statin for cholesterol reduction (has to be taken just before retiring). But I've been on that for over twenty years without any problems. I've also been taking a low dose beta-blocker around lunchtime for the last year or so (to control blood pressure - was up a little). As regards alcohol, well that's a rare treat these days! But, I will do some research on sleep maintenance insomnia. Thank you.

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Pugsy
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Pugsy » Wed Nov 17, 2021 11:42 am

MMcG wrote:
Wed Nov 17, 2021 11:06 am
Part of the problem now is that when I wake after about 6 hours usage, I'm actually quite alert and my mind just becomes over-active.
I understand the brain being in hyper drive...been there and done that as well.

What I don't hear from you is "I feel great and get up after the 6 hours and I am a happy camper all day long".
Maybe your body is now happy with 6 hours of sleep....why not give it a chance?
Your body won't lie to you. When I wake up with the brain being in hyper drive after 5 hours...later during the day my body tells me that wasn't such a good idea. :lol: :lol:

BTW don't assume that just because you have been on any medication for years and years that it doesn't cause any unwanted side effects now. Ever think that maybe your body might have changed in the last 20 years???
It's been my own personal experience that the body changes how it metabolizes any medication as we age. Sometimes good changes and sometimes bad changes.

It's also been my experience that most of the time we don't have one single problem messing with our sleep or causing unwanted fatigue or problems sleeping. It's usually a combination of little things that add up to being a more significant problem. This is where the hard work of figuring out what might be going on and what we can do to change it ...if we decide it needs changing.

Getting a nice low AHI doesn't guarantee all our sleep problems are fixed and we feel like superman or superwoman.
I wish it did because getting nice low numbers is actually fairly easy. Now feeling them either in terms of hours of sleep or energy levels during the day.....that's the hard part.

Sit back and evaluate your goals and what you want to accomplish. Your topic/subject line states "still not sleeping enough"....so I assume you aren't happy with the amount of sleep. You still complain of frequent wake ups that you remember so that tells me that I bet you are having more arousals/awakenings that you don't remember. I see this every day on my reports.

Finally there is some very real truth to the "give it time" thing. 10 weeks isn't really all that long in the grand scheme of things. It wasn't until about 4 months into therapy that my brain stopped waking me up just to tell me there was an alien plastered on my face and blowing air up my nose...and yes sometimes I was wide awake when the brain alerted me...but I was able to go back to sleep. Sounds like you want to go back to sleep but can't...and that's what you need to figure out on as to best way to figure out the cause and then the fix (if possible).

My own personal opinion about the "give it time" thing...yeah, might as well do that because we have to use the machine anyway but there's no reason to not investigate other potential problems while we are "giving it time".

Do some experimenting and keep detailed logs about your actual sleep time and wake ups and what happens later in the day if/when you do just get up and start your day with 5 hours of sleep.
When it happens to me I know I can pretty much look forward to a really strong need to nap late in the afternoon.
With 4 hours of sleep...I feel like death warmed over and usually have a lot of nausea as well.

In my case I know the causes of my nights with short hours of sleep....pain and stress.
The stress is new this past year....issues with my 89 year old mom.
The pain...not new but it has worsened the past few years as I have aged and the usual meds simply don't work as well.

Don't discount medication side effects just because you have been on a med for 20 years. It wouldn't be impossible for it to now play a part in the poor sleep quality. Maybe not 100% to blame but it may play a part.
Statins are well known to mess with sleep quality as well as how we feel during the day.
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MMcG
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Thu Nov 18, 2021 7:17 am

Pugsy wrote:
Wed Nov 17, 2021 11:42 am
MMcG wrote:
Wed Nov 17, 2021 11:06 am
Part of the problem now is that when I wake after about 6 hours usage, I'm actually quite alert and my mind just becomes over-active.
I understand the brain being in hyper drive...been there and done that as well.

What I don't hear from you is "I feel great and get up after the 6 hours and I am a happy camper all day long".
Maybe your body is now happy with 6 hours of sleep....why not give it a chance?
Your body won't lie to you. When I wake up with the brain being in hyper drive after 5 hours...later during the day my body tells me that wasn't such a good idea. :lol: :lol:

BTW don't assume that just because you have been on any medication for years and years that it doesn't cause any unwanted side effects now. Ever think that maybe your body might have changed in the last 20 years???
It's been my own personal experience that the body changes how it metabolizes any medication as we age. Sometimes good changes and sometimes bad changes.

It's also been my experience that most of the time we don't have one single problem messing with our sleep or causing unwanted fatigue or problems sleeping. It's usually a combination of little things that add up to being a more significant problem. This is where the hard work of figuring out what might be going on and what we can do to change it ...if we decide it needs changing.

Getting a nice low AHI doesn't guarantee all our sleep problems are fixed and we feel like superman or superwoman.
I wish it did because getting nice low numbers is actually fairly easy. Now feeling them either in terms of hours of sleep or energy levels during the day.....that's the hard part.

Sit back and evaluate your goals and what you want to accomplish. Your topic/subject line states "still not sleeping enough"....so I assume you aren't happy with the amount of sleep. You still complain of frequent wake ups that you remember so that tells me that I bet you are having more arousals/awakenings that you don't remember. I see this every day on my reports.

Finally there is some very real truth to the "give it time" thing. 10 weeks isn't really all that long in the grand scheme of things. It wasn't until about 4 months into therapy that my brain stopped waking me up just to tell me there was an alien plastered on my face and blowing air up my nose...and yes sometimes I was wide awake when the brain alerted me...but I was able to go back to sleep. Sounds like you want to go back to sleep but can't...and that's what you need to figure out on as to best way to figure out the cause and then the fix (if possible).

My own personal opinion about the "give it time" thing...yeah, might as well do that because we have to use the machine anyway but there's no reason to not investigate other potential problems while we are "giving it time".

Do some experimenting and keep detailed logs about your actual sleep time and wake ups and what happens later in the day if/when you do just get up and start your day with 5 hours of sleep.
When it happens to me I know I can pretty much look forward to a really strong need to nap late in the afternoon.
With 4 hours of sleep...I feel like death warmed over and usually have a lot of nausea as well.

In my case I know the causes of my nights with short hours of sleep....pain and stress.
The stress is new this past year....issues with my 89 year old mom.
The pain...not new but it has worsened the past few years as I have aged and the usual meds simply don't work as well.

Don't discount medication side effects just because you have been on a med for 20 years. It wouldn't be impossible for it to now play a part in the poor sleep quality. Maybe not 100% to blame but it may play a part.
Statins are well known to mess with sleep quality as well as how we feel during the day.
Thanks for the lengthy reply, Pugsy. It's very helpful and reassuring. When I look at my Oscar data on recent nights, I see nothing happening prior to waking. As regards events which might have woken me but which I don't remember, I get a couple of RERA's most nights, 2-3 CA's, no OA's and maybe 5-6 H's. Other than that the most common flag is flow limitations, but there's not too much of that either. Actually, my Oscar data is starting to look a bit boring! My technician reckons that because I've probably had undiagnosed sleep apnea for years, my brain is still adjusting to the new experience. But I've yet to wake up feeling fully refreshed. I'm hopeful it will happen and the shared experience by you and others here is very helpful and encouraging.

Just a quick response to medication. Now that I remember, when I started on statins first, I struggled getting to sleep. Whatever I started on wasn't particularly effective either. I switched to "Innegy", a mix of a statin and something else by MSD. It immediately solved the sleeping issues, but also reduced my cholesterol levels hugely. It's now out of patent, so I take a generic which is actually manufactured in Clonmel, Ireland (only a few miles away!). I've forgotten to take it occasionally and haven't noticed any improvement in sleep patterns. So I doubt that it's an issue. BTW, I keep a very detailed log of not just my sleeping experience but also what I have to eat and drink during the day as well as activity, etc. I've been doing this for a long time even before the sleep apnea diagnosis (hoping to find something which was making me feel unwell).

So I reckon, it's just a matter of just hanging in there.

Ray4852
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Ray4852 » Thu Nov 18, 2021 7:18 am

I average about 6 hours sleep overnight. this is a big improvement for me. over the years I average 4 hours sleep. my Job had a lot to do with it. I started my cpap treatment 8 week ago. I feel like a new man already. I get up everyday around 5 also. if I want to sleep to 7am, I listen to a podcast, in 10 minutes I'm sleeping. try it. it might work for you.

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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Pugsy » Thu Nov 18, 2021 7:29 am

MMcG wrote:
Thu Nov 18, 2021 7:17 am
I've yet to wake up feeling fully refreshed.
Oh...that little thing...I expected cpap to make me into a new person who loved getting up in the mornings with bucket loads of energy. A real morning person.....only problem with that expectation was I have never ever in my life been a morning person and I know I didn't get OSA until menopause reared it's ugly head.
I was expecting the cpap to change me into something I have never been....unrealistic expectations. :lol:

There are lots of reasons we don't/can't sleep long enough or solidly enough besides OSA.
That's why there is a multi billion dollar "sleep help" industry.

Good luck, try to be patient and while giving it time....also investigate other possible causes for the less than optimal sleep quality.
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by clownbell » Thu Nov 18, 2021 10:18 pm

People sure are different. Some require more sleep than others. Some want a warm room, some want it cold. Some see immediate positive results, others don't see good results for months. So my advice would be to hang in there. In my case, it seemed that I would take two steps forward and then one step back. It took about 6 months before things "clicked" all at once with consistent results -- except for those once-in-a-while crappy nights, I just shrug my shoulders and move on, and then in a day or two things get back to normal. Patience is the key. Keep at it. Singles will get you there, don't look for home runs.
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MMcG
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Fri Nov 19, 2021 1:37 am

Ray4852 wrote:
Thu Nov 18, 2021 7:18 am
I average about 6 hours sleep overnight. this is a big improvement for me. over the years I average 4 hours sleep. my Job had a lot to do with it. I started my cpap treatment 8 week ago. I feel like a new man already. I get up everyday around 5 also. if I want to sleep to 7am, I listen to a podcast, in 10 minutes I'm sleeping. try it. it might work for you.
Thanks for the feedback, Ray. Hard to understand how anyone could survive on just four hours sleep over a prolonged period! Although I believe Margaret Thatcher, former UK PM, claimed to need only four hours sleep. I did that for about four weeks when I started CPAP therapy and was walking around like a zombie most days! Thanks for the podcast tip - I think I'll try it.

MMcG
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Fri Nov 19, 2021 1:46 am

clownbell wrote:
Thu Nov 18, 2021 10:18 pm
People sure are different. Some require more sleep than others. Some want a warm room, some want it cold. Some see immediate positive results, others don't see good results for months. So my advice would be to hang in there. In my case, it seemed that I would take two steps forward and then one step back. It took about 6 months before things "clicked" all at once with consistent results -- except for those once-in-a-while crappy nights, I just shrug my shoulders and move on, and then in a day or two things get back to normal. Patience is the key. Keep at it. Singles will get you there, don't look for home runs.
Thanks for sharing your experience. Good to know I'm not alone! The great thing about this forum, apart from the technical advice, is simply the knowledge that a lot of people struggle. As it happens, last night was one of my best. I had nearly 7.5 hours usage and only woke three times - unbroken three hour stretch in the middle - probably about 6.5 hours sleep in total as I took a while to get to sleep initially and also around 4-00 am. I sort of get the baseball analogy (we don't play it in Ireland), even though my knowledge of the game is just about enough to understand the famous Abbot and Costello routine - that still cracks me up!

Ray4852
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Ray4852 » Fri Nov 19, 2021 7:23 am

Before I started my cpap treatment I was getting up every two hours to go to the bathroom 4 to 5 times per night. now after 8 weeks of treatment I'm down to 4 hours for an 8 hour period. 3 years ago I was treated for prostate cancer. when I was getting up 5 times to visit the bathroom I new I had a problem. my father had prostate cancer I new someday I will get it too. I'm glad I was on a yearly schedule to get a PSA blood test. every man thats in their middle 50s should get a PSA. I'm cured now but I still have to get a PSA every 4 months. 2 to 3 times is excellent for any man in their 60s one way to control your bathroom visit. try not to drink anything 8 hours before you go to bed. if you need a drink, drink water. get a PSA test every year.

MMcG
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by MMcG » Fri Nov 19, 2021 9:02 am

Ray4852 wrote:
Fri Nov 19, 2021 7:23 am
Before I started my cpap treatment I was getting up every two hours to go to the bathroom 4 to 5 times per night. now after 8 weeks of treatment I'm down to 4 hours for an 8 hour period. 3 years ago I was treated for prostate cancer. when I was getting up 5 times to visit the bathroom I new I had a problem. my father had prostate cancer I new someday I will get it too. I'm glad I was on a yearly schedule to get a PSA blood test. every man thats in their middle 50s should get a PSA. I'm cured now but I still have to get a PSA every 4 months. 2 to 3 times is excellent for any man in their 60s one way to control your bathroom visit. try not to drink anything 8 hours before you go to bed. if you need a drink, drink water. get a PSA test every year.
Thankfully, that's not the reason I wake frequently. I usually only have to go the the bathroom once during the night. Also, I have to get an annual blood test because of being on cholesterol lowering medication. My doctor has been including a PSA test in this for the last ten years or so. But, as it happens, big improvement last night. I managed to keep the mask on for nearly seven and a half hours and only woke twice during that time, with one three hour segment in the middle. So maybe I'm beginning to crack this.

Ray4852
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Re: Ten Weeks of Treatment/Still not Sleeping Enough

Post by Ray4852 » Fri Nov 19, 2021 10:44 am

every night I use my cpap 8 hours or more. last night I only had to get up once to go to the bathroom. I woke up at 4.30 am, felt good. had trouble getting back to sleep. had to listen to a history audiobook to put me back to sleep again. woke up at 7 am. I try to get myself on a good sleeping schedule. go to bed at 11 up at 7. I can't break that 4 to 5 am break.