waking up IN SPITE OF cpap

Okay Ive been on cpap treatment since last September and have finally arrived at a setup that works for me. I recently got a lt for her with the nasal pillows and its very comfortable. I have a heated hose to do away with the rain in the face and use a ResMed M with ramping feature and a FisherPaykel heated humidifier. BUT here is my question?? why in the world can't I maintain sleep even with the appropriate cpap therapy AND ambien?? I consistently wake up after about four hours and my sleep is over for the night (unless I take another Ambien which horrifies my medical folks!!) I originally had sleep studies done because my PCP thought my body was "afraid" to sleep due to apneas. Oh I have RLS also, for which I take Requip. Anyway the first night in the sleep lab I did not sleep at all; I know everybody says that but my tech was beside herself because she had never had a patient fail to sleep at all. A second test with Ambien did reveal sleep apnea and a setting of 14. I tried a number of different combinations of machines etc until I arrived at my current setup. BUT still I cannot sleep more than four hours. Needless to say, Im a basket case since the sleep problem has been going on for about two years. I'm beginning to feel desparate that I will never sleep more than a few hours again. I am not on any antidepressants, perhaps that is an issue, but am continuing to work with my sleep dr to try to find a solution.
Any ideas?? This is awful

If your doctor is horrified that you need to take another AMbien, why doesn't he/she prescribe a time released Ambien?

Have you tried taking 3m of melatonin a couple of hours before you go to bed? You didn't say how old you were, but I understand that the older we get the less melatnoin our bodies make naturally.

Best of luck to you. If you have a mask that fits you have won half the battle.

Bev

I'd like suggest two very different - contrasting - ways of looking at this:

1. You're waking up because something it the therayp is not approriate yet.
Which brings up the question what makes you say it is. I understand it's comfortable - and I'm glad it is -- but how do you know you apneas are properly treated? What kind of machine do you have? Do you get your nightly treatment results from the machine's LCD?

2. (An opposite explanation) Bear with me: The therapy is appropriat, but you're getting much too upset by waking up after 4 hours.
For some of us, the first response to good therapy is waking up too soon; as though our brain or body feel so rested that they respond as though the night was over. You sound like you get terribly upset when that happens, too upset to fall asleep again. Suppose I were a Martian, and didn't know what sleep was about. Could you explain to me more specifically , and very concrtetly why waking up after 4 hours is so dreadful for you in your world?

O.

Patricia - the point ozij and many folks make is that you need to use data from your machine to make sure your treatment is optimal. It's possible that your treatment is actually off the mark. The sleep study is just the beginning. You can tell from all the remarks at this site that most people don't find that their initial settings, masks, machines, etc are doing what's best for them.

That said, is your therapy making you feel more rested? As Ozij says, you may just be getting a lot more rest during 4 hours than you are used to.

One thing that may help is something called Cognitive Behavior Therapy for Insomnia (CBT-I). It's all over the internet. You work at adjusting your attitudes and behaviors about sleep. One of them is called "De-catastrophizing" It just means that you recognize that sleep deprivation is not the end of the world. It's discouraging and when long-term, it's limiting. But you shouldn't let yourself get upset by it, because upset is only making the problem worse. Seriously, I have had lots of insomnia and sleep loss for 30 years, and I am still dealing with poor sleep despite CPAP therapy, but I can knuckle down and avoid catastrophizing. Thus, I know it's possible to make up your mind NOT to let it bother you.

Ultimately, CBT-I has a lot better track record for insomnia than drug therapy. Yoga helps, too.

You mention that you doctor thought you had trained yourself not to sleep due to apnea. Did you ahve a lot of insomnia before CPAP?

Before starting CPAP, I was waking up 4 - 5 times a night. Sleeping longer than 2 hours at a time was a rare event. I started CPAP the end of March and was still waking up 4 - 5 times/night for the first few weeks. I have a data capable machine. As I learned more from browsing the CPAPTalk forum, analyzed my nightly data, and made changes based on my nightly events and the knowledge I gained from forum posts, my number of nightly awakenings started to drop. I am down to 2 awakenings a night. I usually sleep for 3 - 4 hours, wake up, go to the bathroom, sleep for 2 hours, wake up, go to the bathroom, and then sleep for another 2 hours before getting up in the morning. I average 7.5 hours of time-in-bed (with CPAP) each night and most nights believe that I am sleeping for about 7 hours. The changes that, I believe, helped me the most: 1) finding a mask that was comfortable, fit my face, and that I could adjust to minimize my leak rate - I tried five masks before settling on my current one, 2) following Muffy's sleep hygiene recommendations such as a) going to bed and getting up at the same time - plus or minus 10 minutes, and b) consolidating my sleep time - I no longer take an afternoon nap, 3) taking a single Tylenol before going to bed and when I wake up at night - I think one of the reasons that I was waking up so often was related to pain although I never felt any pain other than a low level of discomfort, 4) spending the 1 1/2 hours preceding bedtime reading and relaxing rather than on my PC, 5) finishing dinner before 8PM and not snacking afterwards - my fixed bedtime is now 11PM, and 6) incorporating most of the comfort recommendations that I learned from the forum "pros" such as Rested Gal, Muffy, Wulfman, SWS, and others: hose management, humidifier (using passover currently), using pillows to keep me sleeping on my sides rather than my back, using a small flashlight when I get up during the night rather than turning on the lights, alternating sleeping on one side and then the other so my neck doesn't get sore, using a saline nasal spray before bedtime and when I wake up, and numerous other small but, I believe, important contributors to my improved sleeping.

I keep track of all the changes that I make so that if I experience an improvement in my sleeping, I have a good, and sometimes, quantifiable, means of knowing what made the contribution. Far and away, the most important things that I had going for me was my reading the posts on CPAPTalk for hours each day and having fought for and received a data capable CPAP. Best of success in your continuing efforts to sleep longer each night.

Hey, whats this about checking my "stats" nightly??? And yes, I had insomnia before cpap (which is what caused my dr to order sleep studies)
I have a REMstarPlus M Series with CFlex. Perhaps I need some education???? Looking at my utlization, my hours of therapy are not impressive. Perhaps I need to be more persistent about wearing this thing inspite of being awake????

there are long acting ambien type meds such as clonazepam that work longer and might get you into the habit of longer sleep, if taken sensibly, these meds are safe

also try to have daytime naps using CPAP

I had insomnia before getting diagnosed and still ahve it but Ive learned to live with i9t and it doesnt concern me

Hello and welcome. I think I understand what your doc is saying. I think we instinctually know to avoid that which is unpleasant or dangerous - hence insomnia with untreated OSA. I also think our brains tend to be habitual and as with any pattern that needs retaining to break, sustaining sleep my take some time to reprogram. Notice I prefaced all that with "I think" as I don't have any science to back up my opinion. From reading posts in the past on here, I'm not alone in my opinion.

I agree that knowing your therapy is effective is number 1. If getting a data capable machine is not an option, you could ask your doc to order a trial period of a couple weeks on an autopap which could pinpoint any trouble areas.

I have RLS and PLMD and I'm currently on Requip. It is not very effective. Sustaining sleep is a hard thing for me. Each night when I go to bed I have no idea if it will be a tolerable night or a miserable one. A dreaded wake up after 1-4 hours in could signal long hours ahead, or I might get lucky and fall back asleep for a couple more hours. The risk I run is trying to go back to sleep and getting stuck in this place of "almost" where I can't cross over into sleep yet can't wake myself enough to get up and stop the torment. These times are characterized by agitated tossing and turning and a single thought getting stuck in my head and repeating hundreds of times over. If my wake up was associated with me being aware of changing the position of my legs, it's a pretty safe bet I'm better off just getting up. If any of what I described sounds familiar to you, I'd be suspicious of limb movements being the culprit in your sleeplessness. Has your sleep doc done a followup study with you on the machine and on the Requip? That's what my doc did - more than once.

Good luck with finding answers.

Kathy

There are machines that can show you how well your apnea is controlled - the Plus is not one of them.

You can get lots of important further education here:viewtopic/t35702/Where-A-CPAP-Newbie-Should-Start.html

And yes, you should try not to spned any time in bed without the cpap.

O.