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avi123 wrote, "That Trazodone is as lousy as Ambien, Restoril, Valium, and the rest of the thousands of Benzo, and Non- Benzo stuff, which need careful withdrawal time from."

Yes, I read about that online just after I started on the Trazodone, that the withdrawal effort can be hard. I stopped taking it for a few days after I read that, but the insomnia got worse again, so out of desperation, I went back on the Trazodone. Thanks for the words of of caution.

To show how desperate I got, I even went off the APAP for 2 nights in a row a few nights ago, the first time I've tried that since I started with CPAP in 2002. The first night I stopped all meds as well, but then "au natural" could not fall asleep until after 3 AM and then woke up like ready to go at 6:30 AM, but the much less sleep than I needed made me groggy all day. Next night tried again no APAP, but took all my meds like Trazodone, and got around 6 hours sleep. Felt better than the previous day, but by then I was feeling what I thought must be the negative body and mind effects of two nights of no APAP, like I must have had more apnea episodes, and lost needed rest from that. So back on APAP last night, but I switched back to my previous mask last night as an experiment, the Resmed Mirage Ultra nasal mask, but that was not without problems, dry throat woke me up at least 6 times, so tonight I'll be back on my Mirage Quattro mask that I switched to on Dec. 9 last year as a way to deal with mouth breathing. Had tried experiments with mouth taping with old nasal mask, but not for me, and advice I read on this forum lead me to go get the Quattro from my provider. That mask seemed wonderful to me when I first started using it. Then when the insomnia started getting worse in mid Dec I suspected the mask, but my machine readings were so good (AHI < 2 consistently, low leaks, mask fit felt better, etc.) that I just thought it couldn't be related to my worsening insomnia, and I currently feel that most likely it was not.

That's why I used the word "desperation" above because it finally drove to try no APAP at all for 2 nights, then try the old nasal mask for a night. But I think that I just proved to myself the obvious, since I have sleep apnea, I need to be on the machine. And I think I've further proven to myself that my Quattro mask is the most comfortable and effective one for me.

Through all this past 3 months of trying things to help promote better sleep, I even tried a sleep eye mask with my Quattro mask to keep out light, and ear plugs to reduce noise. At first I was happy with the results until I started waking up from the irritation of rubbing the mask into my eye while on my side, and waking up as the ear plugs would start hurting my ears.

I should note that when I finally went to the doctors about this on Jan. 13 they tested my blood pressure and it was, at its highest reading, 190/105. So they put me back on Atenolol at 25 mg, which has brought it back down to more like 134/77, but this is annoying to me since I had gotten my doctor to agree to take me off Atenolol at my annual checkup a year ago since I had gotten my diet so much better, and had a numbers just below the 120/80 marks. So then I thought that the high blood pressure spike, whatever brought that on is still not known, might have been contributing to the insomnia. And maybe it did, but now that I have it under better control, I'm frustrated that i am not seeing the insomnia problem go away.

Well, I must apologize for taking over Mr. Bill's original thread topic. I should have started my own thread probably. I came online here this morning to do just that, then saw this thread and contributed here instead, and now I am going on and on. I should try to report back on my results from tonight's sleep session, so anyone, please let me know if OK to continue in this thread, or better to start a new thread of my own? Obviously, I'm confused as well as desperate, a small attempt at humor, but partly true by my current mental state. I think I have the title in mind for my proposed new thread, "Desperately Seeking Good Night's Sleep," which seems like an oxymoron to me from the references to CBT, as in, the emotion of desperation would seem to me to be the opposite of the mental state one ought to aspire towards to better achieve the gentle release into peaceful, restful sleep.

Eh, Jeffster, don't sweat the small stuff. All of us here are pretty good at stealing one another's threads from time to time. But it is better, if we think of it, to start our own thread so that we get replies more directed to what we wanted to question or discuss. Hopefully, anyway, if someone doesn't steal the thread ....

Jeffster,

You write:

Two months ago my doctor gave me Trazodone to use as a sleeping pill, a 50 mg pill, with the instructions to try 1 and go to 2 if needed, 1 hour before bed. It does help put me to sleep, but not always stay asleep, and in the morning I feel like I have lost some deep sleep (or REM?) benefits. So I am still working through all this to try to attain the elucive good night's sleep I need.

As its honorary president, I bid you a sad welcome to the CPAP & insomnia club.

From reading your second (long) post, it sounds like you have some real work cut out for you given the Trazondone as well as the adjustment problems with the CPAP. Can't really help you with what to do to properly withdraw from the Trazondone without triggering rebound insomnia. It sounds like that's what happened when you tried to not take it for a couple of nights because you write:

Yes, I read about that about that online just after I started on the Trazodone, that the withdrawal effort can be hard. I stopped taking it for a few days after I read that, but the insomnia got worse again, so out of desperation, I went back on the Trazodone.

If you plan on continuing the Trazondone (either short term or long term), it's still a good idea to work on your sleep hygiene. One common problem that insomniacs have is that their sleep hygiene has allowed both their body and mind to learn to firmly associate Being in Bed with It's ok to be WIDE Awake. Good sleep hygiene is designed to try to reinforce the basic, but powerful idea that your body and brain need to build a strong association that Being in Bed = Time to be Asleep. Practicing good sleep hygiene will help the medicine work better

On the other hand, if you want to get off the Trazondone, you may well need help getting off it. In that case, a heart-to-heart talk with your sleep doctor (or his PA or nurse) is in order: Let him know how you feel about taking Trazondone every night, that you are worried that you are becoming dependent on it, that you had rebound insomnia when you tried not taking it for a couple of nights, and that you don't want to be on it long term. And that you need his help in devising a strategy for weaning you off the med as well as an alternate strategy for dealing with the insomnia. Read (or re-read) the threads that I linked to in my original response to Mr. Bill about one non-drug way for attempting to treat insomnia. It likely won't work for everybody: It certainly won't work without some real self discipline and patience. And you'll need some kind of supervised strategy for eliminating the Trazondone as well.

That mask [the Quattro] seemed wonderful to me when I first started using it. Then when the insomnia started getting worse in mid Dec I suspected the mask, but my machine readings were so good (AHI < 2 consistently, low leaks, mask fit felt better, etc.) that I just thought it couldn't be related to my worsening insomnia, and I currently feel that most likely it was not.

.......
Through all this past 3 months of trying things to help promote better sleep, I even tried a sleep eye mask with my Quattro mask to keep out light, and ear plugs to reduce noise. At first I was happy with the results until I started waking up from the irritation of rubbing the mask into my eye while on my side, and waking up as the ear plugs would start hurting my ears.

......
So then I thought that the high blood pressure spike, whatever brought that on is still not known, might have been contributing to the insomnia. And maybe it did, but now that I have it under better control, I'm frustrated that i am not seeing the insomnia problem go away.

While the HBP may have been contributing to your insomnia, the nasty little truth about insomnia is that once it starts, it's a hungry beast and will feed on literally any kind of stress, anxiety, physical discomfort or worry that occurs at or near bedtime or during the night when you wake up. So getting the HBP under control has denied the insomnia one source of food, but given the number of things that you've written about the insomnia, I strongly suspect there are several other issues it is feeding upon. And it won't "go away" until most (or all) of those issues are dealt with.

Among other things, I strongly suspect that you've been experiencing sensory overload when you use the APAP and that the sensory overload from the APAP is one of several things the insomnia is feeding upon. Some of them you eventually get used to. Some of them you need to actively find a workable solution to. Some are in-between in that you need a temporary semi-solution that works well enough to let you get used to the problem.

About the ear plugs, though: Sometimes the worst of the noise from a CPAP is conducted through the hose to your bed pillow or covers and then directly to the back of your head and into the inner ear without passing through the ear drum. In this case, using ear plugs can make the noise WORSE since the plugs block all the ambient noise, and what's left is the conducted noise.

I know that my own insomnia was triggered by the sensory overload from starting CPAP at a pressure that was ever so slightly too high for me to tolerate (and didn't actually need). Like you, I had no problems with leaks and great AHI numbers, but felt about 100 times worse on CPAP than I had before. And I've spent much time working on ways to help me deal with the sensory overload. Some of them are better than others.

It was three solid months into my therapy before I finally really understood that the insomnia was robbing me of the benefits I should be getting from using the CPAP/APAP/BiPAP to (successfully) treat the apnea. And that's when I started doing the CBT stuff. It's made an improvement, even though tonight, I up well past my bedtime of 1:30 because I'm not yet sleepy. [I also should NOT be on the computer, but we all backslide at times.] By the end of my fourth month, I was finally beginning to feel like my old self---on some days. Now that I'm five months into xPAP therapy and two months into serious ant-insomnia work, I am beginning to feel more normal on most days.

Obviously, I'm confused as well as desperate, a small attempt at humor, but partly true by my current mental state. I think I have the title in mind for my proposed new thread, "Desperately Seeking Good Night's Sleep," which seems like an oxymoron to me from the references to CBT, as in, the emotion of desperation would seem to me to be the opposite of the mental state one ought to aspire towards to better achieve the gentle release into peaceful, restful sleep.

Mind if I steal Desperately Seeking a Good Night's Sleep for the motto of the CPAP & Insomnia club?

You are, however, right that the emotional desperation of wanting a good's night sleep can be counterproductive: A major source of food for most insomnia monsters is worrying about the insomnia. And that's a very hard one to "undo" for most insomniacs. Even worse, however, is worrying about the insomnia while lying in bed NOT sleeping. Read through those links I posted again: Many of the tips of good sleep hygiene and many of the things my PA has me working on are designed to help me avoid worrying about my insomnia while lying in bed NOT sleeping.

People here are talking about two distinct phenomena. One is being reluctant to go to bed with a machine. This is normal and goes away as you get used to it. The second is being a "night owl" - this is also very normal and is the way you are. You can nod off at any time because you have OSA, but you tend to want to stay up - that means you have a late night disposition.

Yes, they have silly medical names for it, but you tend to like the early hours. I have been that way all my life. Going to bed before 3 or 4 seems unnatural and therefore I don't - mainly because I haven't had to in 20 years as I haven't had to have a traditional job. I also married someone just like I am. We go to bed about the same time - and it is a vampire's schedule at best. It is not a disorder like I have heard it called. A disorder is when it is a problem in your life. You have a life where you can live by your own rules somewhat - and you do. Don't let anyone tell you that is not "good sleep hygiene" or bad habits - its the way you like to live. Just make it work for you in terms of your health - and you're OK. Sorry, but bed=sleep is not always a motto to live by. It certainly doesn't sounds like you are staying up in bed with insomnia, etc. You want to read and put down the book and be close to where you are going to crash. But I would avoid the 4.5 hrs of blower time or less if possible. That is a discipline I would try to achieve. Keep the mask on when you are sleeping.

Save the bed for reading and sleeping and have sex in the dining room. And definitely don't fall asleep when having sex! Chances are you won't again for a very long time.

Understand it is simply a hesitation to strap on a mask and go to bed. My bet is that your whole life you have wanted and stayed up late. So simply choose 6 or 7 or 8 hours to sleep and sleep then. You will eventually be accustomed to it - hopefully. It takes time to get used to a mask - sometimes months and years - sometimes never, but hopefully not.

BTW, Trazodone is one of those drugs that really insensitive Dr's give you if they don't want you to have a real sleeping med. It's the side effects of Trazodone that make you sleep - and can turn you into a host of other things - like a zombie. The Dr. just doesn't want to get you "addicted" - what a joke! Stay away from Trazodone and take a real sleeping med if you so desire - preferably one that won't make you feel like you were hit by a hammer the night before.

Trazadone is addictive. It is also a drug that you TAPER OFF of, it is NOT a drug to quit "cold turkey". I had a sleep doctor put me on Trazadone and never mentioned an in-lab sleep study despite she worked the local hospital's sleep lab. Fortunately, I only took 1/2 the dose she scripted. JEEZE LOUISE!!! That half dose made me higher than a kite! My first and only "out of body" experience. Tingling all over. What a buzz. I was weaving like a drunk trying to walk down the sidewalk! Fortunately, I stopped at a close-by Waffle House and had something to eat. After eating is when I realized where I was and what I was doing and managed to make it back to the hotel. I flushed the rest of the little darlings down the toilet!!

I will say that Ambien for a week and then every other night for a week and after that only as needed did help me break the 2 hours asleep, 2 hours awake, 2 hours asleep, 2 hours awake cycle that I was in every night for several years.

I tried Lunesta ONCE. The FOUL taste it left in my mouth until after noon DESPITE REPEATED teeth brushing and mouth washes cured me of ANY desire to take it again alto it worked great for a full 7 hours straight sleep. I love the Lunesta commercials w/the gentle moth (butterfly) but NOT the HOR-EYE-BULL taste the Lunesta leaves behind.

Slinky, robysue, and jonquiljo, thank you very much for the helpful comments following my "long" post.

The good news is that I had what I would call a good night's sleep last night. The bad news is that I did take two Trazodone 50 mg pills (100 mg total) to help me get that sleep. I call it bad news because it seems to me that I will likely take it again tonight, wanting so much another good sleep, while being concerned about getting hooked on this med for sleep. I'm thinking of reducing the dosage to 1.5 pills (75 mg total) tonight, and if that works, then next night 1 pill, and if that works, then .5, and eventually be off it.

robysue wrote, "Mind if I steal Desperately Seeking a Good Night's Sleep for the motto of the CPAP & Insomnia club?"

robysue, please do. I am glad it works for you as a motto. Now that I'm a member of the club, I am happy to contribute in this small way. If and when I start my own new thread with any more info on my insomnia problem issues, I'll likely ues a different title anyway, since it seems to me now that It might make more sense to focus more on the meds, as in, "Let's Talk Trazodone and Other Sleeping Pills."

I have an appointment with my primary care physician on Mar. 16 to follow up on my insomnia problem plus some other issues. If I haven't successfully weaned myself off using Trazodone as a sleeping pill by that time, I will talk with her about alternative sleep medications. But I must say all the other ones I have read about, like Ambien and Lunesta, seem to have potential side effects that really scare me! There's a TV ad for Lunesta that I have seen several times now over the past few months, and it seems like more than half of the commercial is filled with the announcer warning about all the serious side effects. Despite my insomnia problem, those warnings were enough to make say to myself, don't take that one!

jonquiljo, thank you for the comments and they fit me really very well. For me, so far, it really is a reluctance to put on the mask but once on, I'm OK. I got 7 hours last night after three nights in a row of very short blower sleep (3 hrs, 1.5 hrs and 1.5 hrs). I blocked the sleep time but took of the mask that far into the sleep period. Last night I took of the mask again but half an hour later put it back on. So, I got 3 and 4 hours of blower time in one night.

I see a lot of posts talking about using sleep medications. I've never used any. However, seems to me, with central apnea problems, that would be a very bad idea. I was strongly cautioned that if I wanted a glass or two of wine, to have it early in the evening if at all. Because alcohol suppresses the respiratory drive. So far, the only thing that has given me major fits was Tai food (one of my favorites) late one evening.

Mr Bill wrote:jonquiljo, thank you for the comments and they fit me really very well.

Well, as far as sleeping habits go - you and I are alike. It's been suggested that I was a freak all my life, so it really hit home when I met my wife and she turned out to be just like me. And yes, I'd have married her even if she had been a morning person! Even as a small child I remember hating getting up early for things. I always liked to stay up ant night and watch TV. Since it's late and most people are asleep, it just happens you do it in your bedroom. Unless you live alone - it just becomes easier to read or play there.

It crossed my mind that perhaps your mask is not the best for you. Do you think another mask might be less problematic? They really all do differ. I also don't know much about your type of machine, but if settings are wrong on traditional cpap - you tend to avoid it like the plague. Frankly, I changed my numbers to maximize my compliance in the beginning. What "felt" most comfortable was better than taking the thing off.

Have you tried other masks?

I have dealt with this issue for years. Now that I am using cpap therapy, it still haunts me. I dread going to sleep. I know that, if I fall asleep, morning will come too quickly and I will have to face the day. I know, deep psychological issue. Now that I'm using cpap, I actually dread bedtime because I don't want the mask on. I've only been usinig cpap for 2 weeks, but I hate putting that evil contraption on my face. I know that, in time, this dread will pass. I just need to get used to the mask. I sleep very well now that I'm using cpap (thank God for it!) I also used to take Benadryl every night to help me fall asleep and sleep all night. The night I started using cpap, I switched to Melatonin, and what a difference! I sleep well, but without the next day Benadryl hangover. I HIGHLY recommend Melatonin to ayone with insomnia. Just my .02 worth!