Being On Call and having interrupted sleep

I was diagnosed with sleep apnea 2.5 years ago, and I felt like CPAP saved my life. I used the machine religiously for over a year. Then I started a new job where I am on-call for 7 days straight out of 28. During those 7 days, I hardly get any sleep. I may get to sleep for one hour if I am lucky, without getting interrupted during the night time hours. On M-F, I am guaranteed sleep from 8am to Noon, but by then, I am so zonked, I can't even think about doing my pre-CPAP ritual (washing face, cleaning mask, adjusting mask, etc, etc). To try to make a long story short, I tried to wear the mask in the beginning, but it seems like I would just go through all of the trouble to get everything in place and start to just fall asleep, and I would get called in. So in the long run, I wouldn't wear the mask during the 7 days that I was on call. Then it slowly started bleeding into the 3 weeks that I'm not on call, because it's just such a hassle to do it all (whine, etc, etc.) Here it is a year later, and I have all of my original symptoms back. I've got to get back on CPAP, but I am having the hardest time making myself do it.

I need some motivation (a swift kick in the butt, maybe?), and maybe someone else who might be in a similar situation with being on-call and having interrupted sleep with the CPAP, and how you handle it?

Thanks for any advice and butt-kickings you can provide!

do you call in, dial in or physically go in?

All I had to do was dial in. Basically if the call came in after midnight... I took time off the next day and slept then.

I used to have a job like that where I was on call for 5 nights a week. It was before BiPap, and I can imagine how hard it would have been to do that job with nightly interruptions while using the machine. So I understand what you are saying here.

However, I assume that an hour or two of CPap sleeping is better than an hour or two of non CPap sleeping, right? Can you shorten your routine at night? Does your mask need adjusted nightly? Can you use face wipes instead of actually washing your face at the sink? Does the mask need washed daily? I do mine once a week. I would try to shorten that nightly routine so that you can get in as much sleep as possible. Good luck!

I have to physically go in. I actually have to work from 2pm until 10pm, and then I am "on-call" from 10pm until 8am, so my only guaranteed sleep is from 8am until noon, when I get up to start getting ready for work. Also, on the weekend of that 7 days, I am on-call 24/7 (no guaranteed sleep at all). It sucks, but the $$$$ is too good to let go right now (plus it would be hard to find another job in this economy).

That sounds miserable. At least when I was on call, it was only at night, so on days off I could sleep during the day.

Okay, one swift kick in the butt coming your way. Feel it yet?

I used to have to work on call in the medical field. Work 7 AM to 3 PM then on call till next morning when I had to be back at work at 7AM. This was all when I was young and before CPAP thankfully. I used to dream about being called in and wake up feeling like I had. Lots of nights I did work all night and even had a toddler to care for. Hated being on call. Anyway....

Shorten your CPAP readiness as much as you can so you won't be able to slack. Some CPAP treatment is better than no treatment. When you aren't on call don't slack. Can't afford to slack.

Tell yourself that if you slack the rest of us are going to come to your house and give you a real swift kick in the butt... My husband can tell you that I might be small but I am one mean woman...

kaydacat wrote:I have to physically go in. I actually have to work from 2pm until 10pm, and then I am "on-call" from 10pm until 8am, so my only guaranteed sleep is from 8am until noon, when I get up to start getting ready for work. Also, on the weekend of that 7 days, I am on-call 24/7 (no guaranteed sleep at all). It sucks, but the $$$$ is too good to let go right now (plus it would be hard to find another job in this economy).

Please check if your employer is not violating any of these U.S. Labor Laws. Being "on call" is in your situation as being at work.

http://www.law.cornell.edu/uscode/uscod ... -000-.html

I, too, work in the medical field. My employer might be breaking labor laws, but it is a small independent start up company without many employees, many of whom are my friends. I would not want to cause any problems for the owner or my friends, and like I said, I do like the money. I am going to re-start my CPAP therapy tonight. My 7 days starts Monday. I'll get in 2 good nights of CPAP, and then fight my way through next week. We'll see how it goes. When I'm on-call, I dream about getting called in, too. That 7 days is pure dread, but I am saving my money, and I have a good job prospect that will be available in about a year, where i will only have to work 45 hours a week (no on-call, and no weekends!!!). I just have to wait for the clinic to finish being built!!!!

I agree with those suggesting to minimize your routine and not do more than you have to do when time to don the mask. I was not on cpap when I did on call for a home care staffing agency. No fun, but yeah, I liked the extra money, especially when I didn't get called.

My sleep has been fractured for many years just due to sleep disorders. I had to fight thru feeling like it wasn't worth putting the mask on when I knew I'd be back awake and up soon. Some nights I'd have to put it back on a dozen times a night. Only thing that kept me doing it was the memory of frightening episodes when unmasked when I'd wake up coughing, choking, heart pounding, and trying desperately to suck in some air. Yep, worth the hassle for me. Since I use a nasal pillows style mask, I don't have to worry about scrubbing my face, so my nightly routine consists of just putting the mask on - all of maybe 20 seconds. If I had a mask that required lots of fiddling, I might feel differently. But the quality of the sleep you get should make up for the extra few minutes lost. Hey, when your sleep is that broken, you need to give yourself every possible advantage to try and offset the effect.

Instead of kicking your butt, how about a kick to the head and some attitude adjustment...

Well rather than a kick, how about a "Dope Slap."

I am sure you are familiar with the concept of protective equipment. If you are going to handle something that is a biohazard, you first put on a pair of gloves to protect you.

I am going to go a little ways out on a limb here, but many times people who are on call have to respond quickly and make accurate decisions. Now a lack of sleep is a pain, but a lack of restful sleep can cloud your judgment and put you into harms way.

This is where the attitude adjustment comes in. You need to realize that not wearing your mask during the few moments you have to sleep, is just like handling biohazard without wearing gloves. Once you adopt that attitude, you will find a way to get into the habbit of "suiting up" every chance you get.

Let's now take a look at some practical measures that may help.

Various disinfecting wipes are almost as good as washing your mask. Perhaps, during the times when you are on call, you can simply wipe down your mask.

Next you need to set up your machine so that it is as easy and convenient as possible to use. Think of putting a pair of gloves on. The packages of gloves are all over the place, and it just takes a second to change gloves. While it is not practical to have xPAP machines all over the place, I am sure there is something you can do to make your machine more convenient to use.

Finally, I would strongly suggest keeping a sleep log. When you are feeling a little low because of a lack of sleep, you don't need to beat yourself up about your xPAP therapy. If you make time to just jot down how long you used the machine and how you feel when you get blasted out of sleep with the phone call to come running, you will realize that you are taking things into your own hands and making progress. You can be black and white about this (I feel like shit, or I feel great), or you can add a shade or two of gray (I feel medium well done).

Keep your expectations realistic. 7 days of reduced and interrupted sleep are going to take its toll, but if you expect to get the most from every minute of sleep that you can, that is a realistic goal. Remember to get the most from every minute of sleep, you need to use your xPAP machine.

kaydacat wrote: During those 7 days, I hardly get any sleep.

Last summer, I was working over forty hours a week as a Lifeguard. I was doing most of the real early morning opening hours and staying until 1 pm inside a hot, humid pool with screaming kids. It was not a well managed pool, my boss did not know about my condition and she did not know that Lifeguards really should not work more than about 35 hours a week on the stand (fatigue). I took advantage of her not knowing that and had myself scheduled for more than forty a week. But I suffered as a result.

By 11 am everyday I was a zombie. I was not getting enough sleep. Plain and simple. My routine last summer was get up at 4 am, be at the pool to open by 5:10 am, open at 5:30 and stay until 1 pm.

I ended up having to resort to taking prescription amphetamines to stay awake, something I have never done in my life and will never do again.

The summer before that, 2009, I was guarding at another pool that was well managed. They split my shifts up so I did not stay past 11 am and then on other days I would not come in until later. So I never was sleep deprived. And it worked out fine and I never had to take any stimulants.

IMO, there is no solution to your problem. The body was not designed to go seven days with hardly any sleep. If you can swing four to six hours of sleep a night, maybe you could get by by taking an alertness aid such as prescription amphetamines or that other FDA approved one called Provigil for shift work/narcolepsy and residual OSA symptoms.

But no sleep or barely any sleep? For seven days? Forget about it. Find another job. Honestly that sounds crazy to be honest, maybe against the law. Maybe against OSHA regulations. The fact you have OSA makes it twenty times worse.

Mikey

In my opinion, I think you're in an impossible situation and jeopardizing your health. No job is worth that.

10 years ago I had computer overuse syndrome from my job. I almost lost the use of my hands because of nerve damage, and my neck and shoulders were on fire all the time. My doctor told me to quit my job. It took me almost a year to recover, with that year devoted to self care and physical therapy.