5 days so far...they said try to keep it on for 4hrs

So, I generally am a heavy sleeper - meaning, I go to bed, 15 minutes I am out, 7 hrs later I am up - no recollection of anything in between. No waking up, no dreams, nada. Obviously I have not been sleeping well, getting to REM and all that for a long time - so now I am a newbie on the CPAP team.

I get the machine, strap it on - ramp set to 6cfm for 25 minutes and then BLAM 14cfm. Works pretty good, I'm out in 15 minutes like usual, but I'm not making it past 2-3 in the morning without waking up.

Once I wake up, I check the clock and do a quick calc and figure I am better off ditching the mask and getting right back to sleep vs. trying to go back to sleep with the facehugger on.

So far, 5 nights I've managed to keep it rolling 6hrs (best night was the first one) 4hrs, 3.5hrs, 4hrs, 2.75hrs.

My goal is to shoot for at least 4hrs of sleepy-bye per night with the facehugger on for at least a week continuous - not sure what the problem is with waking up at 0-dark thirty every night. Will continue to try and make it through the night of course, it's still early, but am thinking I might be a part-time CPAP user - 1/2 the night on, 1/2 the night off.

Question: think 4hrs is enough? I like to sleep face down a lot - hard to do with the machine, figure if it's gonna wake me up 4-5hrs in every night, might as well take what I get and spend at least part of the night sleeping 0ld-school.


Mac

You and I sound quite similiar. I loved to sleep on my stomache. I would sleep on my side too. I too wake up between 3-4 hours after putting on the mask. I am getting to the point though where I force myself to try and go back to sleep with it. The other night I was wide awake with it on for 1hr after sleeping 4hrs with it. That's when I finally took it off. I figured bad sleep with it off is better than no sleep with it on. Don't give up on it until you've tried going back to sleep for a while.

I know it so much more comfortable with the thing off but the benefits outway the freedom. Since switching masks recently I actually have a night on the books clocked in at 8hr 15min. I couldn't believe it. I just try and make it longer and longer each night. It sucks waking up but I can tell a difference after wearing the thing.

You're facehugger comment reminds me of Tom and Jerry episode where Tom gets an octopus or something stuck on him face. Don't know why but it reminded me but it did.

I see you have an APAP. What's the pressure setting(s) on it?
Do you have the software to see what's going on?
What time are you going to bed?

It could be any number of things that are waking you up at that time.....not the least of which is that you're getting better quality sleep even though it's for a shorter period of time. That phenomenon has been reported many times over the years......and it's usually at about that time of night. If you're using a range of pressures, it could also be that you're hitting some stage of sleep and the machine is mis-interpreting your breathing......then bumping the pressure up and that is what is waking you.


Den

Please look at your mask and let us know exactly what mask you are using.

My best guess is that your mask springs a leak at a certain pressure. In turn, that drives the pressure higher still, and you are leaking which wakes you. If we know what mask you are wearing, we can help you figure out how to break that cycle. Also, have you purchased the software so you can get a good look at your data? That would be an enormous help.

To answer your question, NO, 4 hours a night is NOT enough. Apnea is a "death of 1000 cuts". Each apnic event, in and of itself, is not too much, but they add up to a LOT of cumulative trauma to your body. You have to get to the point where you can comfortably use the machine every night, all night, otherwise, you are not really doing yourself much good.

The disruption to your sleep and the discomfort are temporary. We can help you knock out the problems one at a time and soon you'll be sleeping comfortably ALL night. You're doing well to get where you are so far, but don't settle for that half-assed approach. You know that's NOT going to work.

McSnoresalot wrote:So far, 5 nights I've managed to keep it rolling 6hrs (best night was the first one) 4hrs, 3.5hrs, 4hrs, 2.75hrs.

Overall, a downward trend. Not a good sign.

So let's start doing some problem solving here:

You say:

So, I generally am a heavy sleeper - meaning, I go to bed, 15 minutes I am out, 7 hrs later I am up - no recollection of anything in between. No waking up, no dreams, nada. Obviously I have not been sleeping well, getting to REM and all that for a long time - so now I am a newbie on the CPAP team.

I get the machine, strap it on - ramp set to 6cfm for 25 minutes and then BLAM 14cfm. Works pretty good, I'm out in 15 minutes like usual, but I'm not making it past 2-3 in the morning without waking up.

Once I wake up, I check the clock and do a quick calc and figure I am better off ditching the mask and getting right back to sleep vs. trying to go back to sleep with the facehugger on.

So you usually go to bed when? Between 11 and midnight is what I'm guessing.

Ok, two suggestions right off the bat for trying to get the hours up and the goal towards learning how to sleep with the mask on done:

1) Do NOT look at the clock when you wake up. It is COUNTER PRODUCTIVE. All it's doing is adding to your anxiety about being awake in the middle of the night. Move the dog gone clock to somewhere in the bedroom where you CANNOT see it when you wake up in the middle of the night. You don't need to know what time it is when you wake up in the middle of the night.

2) All you need to know when you wake up in the middle of the night is answer to the following two questions:

• A) Do you need to go to the bathroom or take care of some OTHER physical need in order to get back to sleep? If so, get out of bed and do your business. Then come back to bed, mask up, hit the ramp button, and chances are you'll be out in 15 minutes "like usual" if you DON'T worry about being awake!
  
  B) Are you sleepy?
  • If so, hit the ramp button and turn back over and chances are you'll be out in 15 minutes "like usual"---let the fact that your body KNOWS how to fall asleep quickly work FOR you IF you are sleepy.
    
    If you are NOT sleepy, then get out of bed and do something enjoyable, but quiet OUTSIDE of the bedroom for a few minutes until you ARE sleepy. DO NOT LOOK AT THE CLOCK DURING THE TIME YOU ARE OUT OF BED. Then return to bed, put the mask back on, hit the ramp, and chances are you'll be out in 15 minutes "like usual"---if you don't start worrying about the time you are spending out of bed awake in the middle of the night. When you are out of bed, good activities are things like listening to quiet music in a semi-dark room or reading a non-stimulating and NON-WORK related REAL book. Do NOT watch the TV and do NOT web browse or start doing work related stuff.

I know these suggestions sound ludicrous, counter intuitive, and maybe even downright cruel. But they are both standard tools used to fight insomnia. Watching the clock and lying in bed when you are NOT sleepy are guaranteed to feed the anxiety you are currently experiencing about NOT SLEEPING during the time you want to be asleep. And that in turn makes it HARDER to get back to sleep.

In general you might want to work on improving your overall sleep hygiene. A standard enough version of the "rules" can be found at http://www.sleepeducation.com/Hygiene.aspx

My goal is to shoot for at least 4hrs of sleepy-bye per night with the facehugger on for at least a week continuous - not sure what the problem is with waking up at 0-dark thirty every night.

While this is a realistic short term goal, you are NOT likely to feel much difference with only one week of using CPAP for 4 hours each night. It's a baby step in the right direction. And that is how we all get used to therapy at the beginning. All I'm saying is, don't expect miracles to happen from this very modest level of CPAP usage. Don't expect to suddenly feel so much better with only four hours a night that you'll somehow find the motivation to keep using it at this level just because you now feel better. You need to make a conscious decision that you NEED to use CPAP every night for as much of the night as you can tolerate because your health needs CPAP---regardless of how you feel in the short term.

Will continue to try and make it through the night of course, it's still early, but am thinking I might be a part-time CPAP user - 1/2 the night on, 1/2 the night off.

Personally, I don't think anybody can be a "part-time CPAP user" long term. Either you wind up figuring out how to sleep with the mask all night and you start doing it. Or that goal of using it some of the time every night slowly but surely erodes away because it continues to be "easier" to sleep without the mask. And let's face it---we're humans and we tend to take the easy way out. And for most of us, part-time CPAP use doesn't tend to actually provide enough improvement in terms of daytime symptom relief to make the hassle of dealing with CPAP seem worth it. The real benefits only seem to show up after you start to use CPAP consistently every night, all night long for several weeks and for some of us, for several months.

So do yourself a BIG FAVOR and MAKE the MENTAL COMMITMENT to make CPAP work for you NOW. And then work hard over several weeks and months to actually make it happen!

Ok, I'll figure out what mask I'm using - some sort of nasal mask with gel something or other.

My machine is an auto, but they set me up straight CPAP at 14 (figure I'll play their game for a while) I have the manual and can do all the set ups, but don't want to piss off the doc this early in the game. Only had it for a week - personally, I think Auto is the only way it's gonna work for me - I have a weekly poker game and other stuff going on so I generally have 2-3 beers 2-3 nights a week. I suspect my pressure settings are going to get dictated in part by my diet and beverage consumption. 14 might be good after a couple of beers - might be too much other nights, find out with an Auto.

What software? I was going to download Encore Pro 2.4 (is this correct?) off of bit torrent this weekend - think that is the right one for my machine, I didn't know where I could buy it if I wanted to - the DME sure in hell isn't going to sell it to me.

One thing I heard is that my machines settings are dictated by the memory card - even if I change the settings to auto, taking the card out and putting back in will re-set it to straight CPAP - unless i change the settings on the card or get the DME to do it.

MaC

Lot of info - "sleep hygene" is a new one to me.

The whole apnea thing has been weird for me - suspect I've had it for a long time, Wifey's been on me about it for at least 10 years. Thing is - no symptoms: no headaches, no daytime sleepyness (well, until the last 6 months) no high blood pressure, nothing.

I blame teenagers for the whole mess - I have a couple of them and their diet SUCKS, despite our best efforts, they manage to smuggle in garbage like: chips, cookies, pizza rolls, ice cream, donuts....etc. In addtion, the fast food consumption has gone up exponentially in the last few years (easier - path of least resistance)

Anyway - I have a tendancy to eat leftovers - ALL of them. Back when they were little kids, leftovers were stuff like green beans, salad, maybe a little piece of steak, not much prepared stuff. Now, leftovers are pizza, pizza rolls, cookies, ice cream.......put on 10 lbs in the last 18 months, dang kids.

Oh well, they start off to college here in another year and a half, try and get the menu back under control at the house, probably help things a bit.

If you think you're having trouble staying awake NOW, wait until you're trying to figure out how to pay for college And youv'e got two???? OY! My eldes is a senior in high school this year, and I have no idea how we are going to pull this off with more limited admissions, tuition and fee hikes. and less scholarip money out there. In California, the average time to get a bachelor's degree has gone to SIX years becuase the kids can't get into the required classes they need. HEEEELLLLLPPPPPPPPPPPPP!!!!!!!!!!!!!!!!! Bye bye, sleep!

OK, Encore Pro will be fine, but you can buy Encore Viewer Software from our hosts at CPAP.com and from other online suppliers. Pro is more robust, because it's really clinical management software (for an entire sleep clinic, not just for one user) and it takes up a lot of bandwidth. But it does have some data Encore Viewer does not, so some people prefer it.

Changing your pressures on the clinician's menu in your machine will NOT be overridden every time you put the card back in, so no worries there. You CAN change your settings with Encore Pro, but it's much easier to do dirctly on the machine.

Another possible explanation for your waking if you are on straight CPAP mode is that perhaps your pressure is inadequate during deep REM sleep. A lot of people never get that deeply asleep during their titration study, so the pressures they are titrated for end up not working when they are sleeping under more normal conditions.

Tonight will be night 15 for me. I wake up almost every night about two or three hours after I go to sleep. I also wake up a couple hours after that, too. So, I usually go to sleep at 10:30 pm, sleep until either midnight or 2:00 am, then fall asleep and wake again at 4:00.

Note, I realize this thread isn't about me, but my narcissism compels me to chime in. Maybe McSnoresalot will appreciate not being unusual. I have these exact same machine and humidifier. I also have a nasal mask. Some similarities.

McS, Robysue has some excellent advice. Give it a try! I am going to try ignoring the clock tonight and just relaxing when I wake up. I haven't had real insomnia, just waking up is all.

Typically some Dme's and Sleep labs will give you that four hour mark when you first start therapy. Two reasons for that. Some insurance companies follow Medicare compliance rules that within 90 days the patient must prove that they are using the device 4 hours a night times 30 days.
Secondly, while it is the goal to use it all nite to achieve REM sleep, alot of patients struggle with the mask, high pressures, claustrophbia, etc, the four hour mark is an obtainable goal for first time users.
The best thing the Dr did for you was to prescribe you an Auto. In the future if the Dr deems you can use the Auto feature, you should have less problems during the night.

It might seem counterintuitive, but I've found that sometimes when I'm wide awake at 3am, it helps to get out of bed, set a timer for 20 minutes and do something like play cards or read. After twenty minutes are up, I mask up and I get another three or four hours. [I'm just now seeing that robysue and JerseyGirl made similar suggestions. It's awesome to get confirmation that this works for others too.]

Another one that works is listening to audio books at a very low volume - just barely loud enough to hear. I'm fond of Terry Pratchett. His combination of dry wit and outlandish characters and places make for great 'bed-time' stories that aren't gratuitously violent and take your mind off the gerbil tread wheel that it will sometimes own. If your parents read you bed-time stories as a child, it may even be something your body is conditioned to respond to with sleep. Don't knock it until you've tried it.

It is very important not to do just the minimum mask time. Every time you fall asleep, you should have the mask on. As Janknitz said, it's a death of a thousand cuts. Look at your sleep debt like a credit instrument. You're attempting to buy back your sleep dept. Paying off just the minimum balance will only keep you forever in debt - never paying off the balance. If it's just because it's a hassle and not because of claustrophobia, it will behoove your future to be more proactive in sleep therapy.

If switching a mask will make the difference between discomfort and sleeping through the night, as danimal71 suggests this may be a good option too.

Take care of yourself.

Sorry, can't help myself so....

McSnoresalot writes:
I get the machine, strap it on - ramp set to 6cfm for 25 minutes and then BLAM 14cfm

In my world, cfm means cubic feet per minute. At this rate, I'm surprised BLAM doesn't happen earlier. I assume you mean pressure which has units of cm H2O for our application.

Janknitz wrote:
You're doing well to get where you are so far, but don't settle for that half-assed approach.
and
HEEEELLLLLPPPPPPPPPPPPP!!!!!!!!!!!!!!!!!

Nothing substantive can be added here.

Robysue wrote:
So do yourself a BIG FAVOR and MAKE the MENTAL COMMITMENT to make CPAP work for you NOW. And then work hard over several weeks and months to actually make it happen!

Robysue is rewriting the book on insomnia. I think it is written in blood, so when she writes, I sit at attention and try to absorb each thought.

JerseyGirl wrote:
You NEED this mask. Mask equals peaceful, restorative sleep. Not wearing the mask equals DEATH, or DIABETES, or KIDNEY DISEASE, or STROKE or HEART ATTACK or HIGH BLOOD PRESSURE! Although we may come down with any of these things, let's not welcome them into our lives.

These are my thoughts better expressed.

Hang in there McSnoresalot, it gets better and where you are at with raising kids, you will need the strength cpap will give you.

McSnoresalot wrote: I like to sleep face down a lot

Mac

another suggestion of something to look for in posts on here is the "Falcon position". Supposed to be a way of laying on your stomach masked up (I think)... didn't interest me so I didn't read it completely.