Brand new user, is this normal?

I am a 68 year old female recently diagnosed with mild OSA. My only perceived symptom was severe morning headaches, but it turns out I was also fatigued but didn't know it. My normal sleep schedule had been fall asleep at 9:00 PM, then wake up anywhere between 1:00 and 4:00 AM and be unable to go back to sleep, feel very foggy and tired until I got up and drank a lot of coffee.

I've been using the machine for 12 nights now. For the first week I slept a solid 8 hours. If I got up to pee I went right back to sleep. And from that very first night to my surprise I woke up feeling very alert and refreshed and like I didn't even need coffee! (I had it anyway because I love the taste.)

But for the past few nights I have gone back to my old schedule, going to sleep at 9 and waking up at 2 or 3 AM and not be able to go back to sleep. So I'm getting 5 or 6 hours of good sleep which is enough for the machine to be happy, and I still feel very good during the day, but not quite as good as I did when it was a solid 8.

I was wondering if anyone else had this experience, and if it's a case of a honeymoon period that has gone away. Could it be that the first week was because I had been chronically fatigued and my body needed to "catch up"? And now the new normal is going to be just 5 or 6 hours? I was afraid that the fantastically great feeling those first few days was too good to be true.

I am trying to think if something is bothering me about the setup. The mask is not uncomfortable but I find myself fooling with the hose, like does it go this way or that way and am I going to roll over on it or pull it too hard and pull the machine off the table, stuff like that. Also I have to adjust blankets to keep the vent from blowing on my hand because it makes my hand too cold, then I have to make sure the blanket isn't blocking the vent. This stuff doesn't seem to bother me first falling asleep, only with the middle of the night wake up.

The pressure is set from 4 to 20 and doesn't seem to bother me, no leaks, the noise doesn't bother me. The reports are 100/100 and zero AHI so I've no reason to think it's not working right. It's the fussy arrangement of the hose and vent that seems to bother me, OR maybe I don't go back to sleep because I'm just not tired anymore.

I know the answer is give it more time and see if it settles out but I'm just curious if anyone else had something similar when starting out.

Any particular reason you go to sleep so early?

Julie wrote: ↑

Tue Feb 11, 2025 9:39 am

Any particular reason you go to sleep so early?

That's a great question! It's been a habit for a long time. I always wash dishes after dinner and had always been completely exhausted when I'm done, by 7:30 or 8:00 it was all I could do to collapse and watch a show. In addition, the doctor has me on a medication that is sedating and I'm supposed to take it at the same time every evening. I take it at 8:00 and it kicks in an hour later. And then on top of that my husband has always gone to sleep at 9:00 so I do too. However we sleep in separate rooms because he snores (he claims I do too), but we stay on the same schedule, although there's no real reason we have to. My natural self in youth was to be a night owl.

I can see where I have a vicious cycle of waking up too early, which makes me exhausted early in the evening, so I go to sleep early. Before CPAP I actually had to fight to stay awake til 9. But since starting CPAP I have not been so drained in the evening. I am still alert and have energy all the way up til time to go to sleep, even these nights I've not gotten the full 8 hours. I'm thinking that getting the deep sleep without apnea arousals is really benefitting me.

It's uncomfortable to wake up when it's still dark out, the husband isn't awake, and I have to kill several hours before the sun even comes up. Is your thinking that if I stay up later then I might stay asleep longer because I'm more aligned with natural circadian rhythms?

Think it's worth a try...

GrandmaA wrote: ↑

Tue Feb 11, 2025 9:04 am

I didn't even need coffee! (I had it anyway because I love the taste.)

I recommend you wean yourself off caffeine including in sources like chocolate. You can still drink decaf coffee, but it's a good idea to drink no decaf after two p.m. Decaf contains residual amounts of caffeine.

GrandmaA wrote: ↑

Tue Feb 11, 2025 11:32 am

the doctor has me on a medication that is sedating

Which medication and what is the dose?

GrandmaA wrote: ↑

Tue Feb 11, 2025 9:04 am

I know the answer is give it more time and see if it settles

I never give that answer. When things aren't working properly, let's get to work diagnosing and correcting.

I know you said your AHI is zero, however I would like to see the detailed data. A pressure setting of 4 - 20 (manufacture's default) works well for only a small subset of CPAP users. If you want to put a little time and effort into looking at detailed data, let us know.

Please complete your equipment profile - ucp.php?i=ucp_profile&mode=equipment_in ... Ny4wLjAuMA..

ChicagoGranny wrote: ↑

Tue Feb 11, 2025 12:04 pm

I recommend you wean yourself off caffeine including in sources like chocolate. You can still drink decaf coffee, but it's a good idea to drink no decaf after two p.m. Decaf contains residual amounts of caffeine.

In retrospect I was self medicating with caffeine to keep myself awake, but didn't realize it. I have already noticed a reduction in the automatic drive to go get another mug of coffee, so I am kind of reducing the amount without even trying. To give it up completely will be a challenge because I love it so much. Same with chocolate unfortunately but I've gotten to the point I don't eat much chocolate for caloric reasons (I want to lose about 30 pounds), upcoming Valentine's Day excepted.

Which medication and what is the dose?

I'm on postmenopausal estrogen replacement and it comes with progesterone which is sedating. It's 200 mg.

I never give that answer. When things aren't working properly, let's get to work diagnosing and correcting.

I know you said your AHI is zero, however I would like to see the detailed data. A pressure setting of 4 - 20 (manufacture's default) works well for only a small subset of CPAP users. If you want to put a little time and effort into looking at detailed data, let us know.

Please complete your equipment profile - ucp.php?i=ucp_profile&mode=equipment_in ... Ny4wLjAuMA..

I didn't answer the humidifier question because I'm not using it and the software question because I don't know, I haven't figured everything out yet. I need to do that and figure out how to post data.

In the meantime I appreciate all the answers. You've already given me some things to think about.

Machine: Luna G3 APAP

Unfortunately, the two best CPAP software programs do not support that Chinese machine brand. There is software available, but I don't know if it is suitable for a good titration.

ChicagoGranny wrote: ↑

Tue Feb 11, 2025 3:23 pm

Machine: Luna G3 APAP

Unfortunately, the two best CPAP software programs do not support that Chinese machine brand. There is software available, but I don't know if it is suitable for a good titration.

Ha ha, wouldn't you know it. That might explain my confusion about the data, and the difficulty I had uploading to the company and that's a whole other story. My main concern was them getting what they needed to get the insurance to approve it.

I'm also figuring that technically I have an APAP but it seems people just use CPAP conventionally kind of referring to OSA air pressure treatment in general, so I have been doing so. If I talk to an ordinary person, meaning somebody who doesn't deal with this stuff, about it they know what CPAP is but wouldn't know APAP.

There is a software that works with the Luna 3.
https://www.youtube.com/watch?v=G1ufMJK4WP0
I know nothing at all about it or how it works.

GrandmaA wrote: ↑

Tue Feb 11, 2025 8:02 pm

If I talk to an ordinary person, meaning somebody who doesn't deal with this stuff, about it they know what CPAP is but wouldn't know APAP.

Yep, I do the same. The smart-ass in me says I should start saying APAP to mystify some nosy people.


APAP, bilevel, and fixed pressure are all types of CPAP machines.

I might have found the answer! Only one night but fingers crossed.

Note that in my OP, I said, "The mask is not uncomfortable". Note that I did NOT say, "The mask is perfectly comfortable and doesn't bother me at all".

What actually was happening was that I was aware of the mask, and tolerant of it in general but it was intermittently irritating me. Not all the time but once in a while, the "sharp" edges were moving slightly with my breathing. I would re-position it, or just adjusted my head position on the pillow until it stopped, and so I thought that was a minor fixable thing.

But I think it would happen and then wake me up more fully during the light phases of sleep, without me realizing that's what was waking me up. Then my fooling around with the hose was just due to me having become more fully aroused and thinking about it. I ended up repositioning the hose, making sure the vent wasn't blowing on my hand, making sure the blanket wasn't blocking my vent, reposition the mask again if necessary, and by the time I did all that I was wide awake and had no idea it was the mask that had triggered the whole thing in the first place.

Yesterday I switched the mask out for a smaller size and, no rubbing at all! No minor adjustments of any kind needed. I slept 8 1/2 hours and did not even get up to pee. I have a vague memory of semi-waking up probably just to roll over, but no memory of repositioning hoses or being bothered by anything related to the CPAP. (APAP ha!) I don't even recall being aware of it.

But there are two other factors that might explain the excellent night. I take methycobalamine (MB12) and I had been dosing every day lately, and yesterday I didn't. I had recalled reading somewhere that B12 would keep you awake at night so I just now googled it and came up with this:

https://pubmed.ncbi.nlm.nih.gov/8914118/

From the article: (My bold)

"Sleep time was significantly reduced under MB12 intake. In this group the change in the visual analogue scales items "sleep quality," "concentration," and "feeling refreshed" between pretreatment and the first week of treatment showed significant correlations with vitamin B12 plasma levels... We conclude that vitamin B12 exerts a direct influence on melatonin. Only MB12 has a positive psychotropic alerting effect with a distribution of the sleep-wake cycle toward sleep reduction."

So! I'm going to reduce the amount of B12 I take and make sure to only take it first thing in the morning.

The other change was that I turned off the heat and allowed the room to be cool (it got into the 40s last night). I think I sleep better when the air is cooler.

The reason I slept so well the first week of treatment despite the mask might have been I'd not taken the B12 much that week (I tend to be irregular about it) or maybe the room was cooler and also making up for years of being constantly fatigued. Maybe a combination of those things.

Second night with the small size nasal mask and again, 8 solid hours. Feel great.

But... I've got red skin everywhere it touched and dry peeling appearance. Not really an allergic reaction (like no itching, no little bumps like with eczema flares) but just looks like very dry skin and I assume it's my skin's reaction to the pressure of the mask for hours.

I can try loosening the straps tonight. But did some reading on the forum here and other places and I think maybe I'm going to end up trying some sort of liner. I see a lot of references to remzzzs. Is this kind of problem a liner might address?

I also read somewhere to put a little coconut oil on the skin during the day. But then I guess I'll have to wash it off with soap before bed, and won't that irritate my skin more? It's winter and my skin is dry everywhere to start with.

EDIT: Probably should have called them before posting. They are sending me a new memory foam mask.

Glad to hear you are making progress with it. It definitely sounds like a liner or slight adjustment to the mask fit may help with the pressure sores. If your skin is quite dry already though, you might want to consider just a basic moisturiser (non-oily type so that you don't have to use soap on your face later) to help.

Certain vitamins and minerals can definitely affect sleep and should be taken in the morning rather than the evening. Magnesium, Vitamin D, some of the Bs, etc. are all ones that should be avoided in the evening.

Let us know how you go with the new memory foam mask.

AusJ wrote: ↑

Mon Feb 17, 2025 5:56 pm

Magnesium ... should be avoided in the evening.

Mg intake was borderline associated with better sleep quality ... Participants in Q4 were also less likely to have short sleep.

... Randomized controlled trials with objective measures of sleep are warranted to establish the potential causal inference.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8996025/

Yes, magnesium can have a beneficial effect on sleep (mainly if you're deficient). However, if you take it in the evening, you increase the risks of magnesium-induced dreams/nightmares. Unfortunately research on this side-effect is lacking, so all we have is anecdotal evidence (mine included) that indicates taking it in the morning is better than the evening to avoid that side-effect.