Still waking up 4-5 times a night

TLDR: Day six of therapy, past two days of stats show fantastic results, but I'm still waking up several times a night.

Another newbie here, last night marks day 6 of sleeping with a CPAP device. Concerned is probably too strong a word but definitely curious to see if anyone else has run into the same issues. I've been reading these forums everyday this week since Tuesday and it's helped immensely with coping with this new reality. It's also really helped my motivation to understand the stats as well as the resolve to go to bed with the mask on each night and how to adapt to any issues that pop up.

I was originally diagnosed with a 41 RDI with my O2 stats dropping to as low at 79% during my initial sleep study. Of course I tried to tell myself that it was one of the worst nights of sleep I've had, what with being hooked up to everything and I can't possibly be that bad normally. Even so, I went to the second study with trying to sleep with a mask, and went through about 4 masks with the tech until I found that I could get to sleep with the pillow style masks. Even with those, it felt like I couldn't breath properly and woke up several times that night with it on. The tech must have had the heat and humidity cranked up on that machine as well, as when I woke up that night, it was so warm I really had a hard time breathing with it. It really felt to my inexperienced mind that I was just re-breathing my own exhaled CO2 back from the tube and that paranoia really made it difficult to sleep. When I awoke and mentioned awakening with it and the other worries the tech could only say that I was opening my mouth while sleeping which I now attribute to him encouraging me to sleep on my back with the mask on. I am by nature a side sleeper.

DME delivered the equipment and mask personally to my home and showed me how it all works, and she mentioned off hand that a lot of patients pull their own data off the machine to understand how the treatment is working. The Dr's script had a full face mask on it and I explained to her I couldn't sleep with that. She was very gracious and delivered a pillow style mask the next day. That first night I pity partied with myself pretty hard. The thought of "this is my life now" as I sat propped up on pillows with an uncomfortable thing on my face and a ridiculously large chin strap/head band as I was taking the tech's words to heart about my mouth opening in the night.

Unfortunately I'm one of the ones that has not noticed an immediate "wow I'm so awake" sensation after wearing these. I have however been noticing the subtler aspects of it. So started on a Saturday night, and by Tuesday after work I didn't feel like I needed a nap at all. In fact I wasn't tired at all. At night when I'm watching TV to wind down, I'm not struggling to stay awake, or just out right falling asleep, I'm actually having to make note of the time and go to bed to try to make sure I get at least 7 hours or so of sleep. I'm not sure if it's in my head but I swear my legs (especially thighs) feel more...awake? They almost feel lighter, and I swear even walking feels easier as days with CPAP pass by.

At this point I can get to sleep fairly well with part of it just having the TV on while I wear the mask to get my consciousness off of concentrating on breathing through with the mask. I've been monitoring via SleepHead and have found I can forego the chinstrap and I do not show any leaks. This combined with tucking the tubing behind my pillows and headboard makes going to sleep so much easier. I've gone to amazon and had a much more comfortable strap delivered in case of a night I might need it. Last night over 7 hours I only had TWO events through the night, clocking in a AHI of 0.28. I'm quite excited by that. With beginning to feel the slow improvements and reading probably way too much of the stickied success thread, I'm feeling ready to completely just accept the treatment and rest easy knowing I'm not hurting my body anymore.

This finally brings me to the point of the post. I find myself still waking up 4-5 times a night, which is about what I would call a normal night pre-therapy. Typically it's just a roll over, move the tubing off my face, and I'm back asleep in mere moments. However I do remember these events and am really interested to know if there another adjustment I need to be making, or is it simply give it more time and eventually it'll work itself out. Of note I'm only at a pressure 5 for my therapy. Seems I just need a bit of pressure to keep my own tubes open (yes you can bet I'm now determine to lose some weight to see if I maybe able to ever sleep well without the machine).

Do you take any meds of any kind? If so, what?
Do you have any issues with comfort in bed? Like body aches, pains or discomfort with the mattress or bed pillow?
Actually it's normal to have a few wake ups during the night and not normally a problem unless large numbers are occurring and/or we have difficulty getting back to sleep.
They could be brief arousals happening after REM stage sleep has passed and wouldn't be an unusual happening.

I dont know about "normal" but I am also still waking up and getting out of bed 1 to 3 times a night.. I turn my machine off so I can see when it happened on sleepyhead... It is getting better, before i was up 4 times a night or more... I think its getting better and I hope we all can not wake up and sleep through the night

Day 6 is really very early in the journey, so it sounds like you are doing really well. It is a huge transition to go from poor sleep to "perfect" sleep, whatever perfect means. You probably had sleep apnea for a while before being diagnosed, and it does take a while for a body and brain to adjust to the new reality of sleep. A positive attitude (I can do this, it will help my health long-term, etc). Also, be aware that a full face-mask (FFM) will leak more than a nasal or pillow mask because of the larger area of cushion you are trying to seal to your face. While some people do feel they need a chinstrap with an FFM, they are not essential because the air will still get down into your lungs. Are you aware that you are a mouth-breather? Finally, for now, how many times were you waking up in an average night before the diagnosis? Were you having to go to the bathroom/are you still having to do that? Apnea does cause an upset in fluid management, so many people find the need to get up when they wake up is greatly reduced - but it may take more than a week. Last night I woke several times, but did not have to use the bathroom until it was time to get up.

Keep reading, keep posting, and stay positive - you will do fine.

Pugsy wrote:Do you take any meds of any kind? If so, what?
Do you have any issues with comfort in bed? Like body aches, pains or discomfort with the mattress or bed pillow?
Actually it's normal to have a few wake ups during the night and not normally a problem unless large numbers are occurring and/or we have difficulty getting back to sleep.
They could be brief arousals happening after REM stage sleep has passed and wouldn't be an unusual happening.

I'm taking one over the counter allergy pill just to keep my nose from congestion. This is probably more from paranoia than being needed. I'm going to experiment with not taking it and seeing how the stats look in the morning. No other medications.

The bed is something I probably do need to look at. I'm in a bit of a divut where I sleep. At this point if I sleep on my left side (facing towards into the middle of the bed) I'm much more comfortable than on my right. On my right I will wake up with some back pains.

Good to hear it can be kind of normal. When I do awaken, it really is a switch up position and fall back asleep. No need to get up for the bathroom or anything.

SleepyToo2 wrote:Day 6 is really very early in the journey, so it sounds like you are doing really well. It is a huge transition to go from poor sleep to "perfect" sleep, whatever perfect means. You probably had sleep apnea for a while before being diagnosed, and it does take a while for a body and brain to adjust to the new reality of sleep. A positive attitude (I can do this, it will help my health long-term, etc). Also, be aware that a full face-mask (FFM) will leak more than a nasal or pillow mask because of the larger area of cushion you are trying to seal to your face. While some people do feel they need a chinstrap with an FFM, they are not essential because the air will still get down into your lungs. Are you aware that you are a mouth-breather? Finally, for now, how many times were you waking up in an average night before the diagnosis? Were you having to go to the bathroom/are you still having to do that? Apnea does cause an upset in fluid management, so many people find the need to get up when they wake up is greatly reduced - but it may take more than a week. Last night I woke several times, but did not have to use the bathroom until it was time to get up.

Keep reading, keep posting, and stay positive - you will do fine.

I'm on a pillow mask. I've found anything that goes on the edges of my nose tends to block my nose passages right up. The pillows have worked great, and I've now tried 2 nights in a row with no chin strap + pillow masks and have had no detected leakage in Sleephead.

No bathroom breaks, the awakenings are quick, roll over and back to sleep. My concern is the awakenings seem to be about the same as pre treatment. Again, with a 41 RDI I'm sure I was getting arousal more often but not remembering. So this is all based on what I can remember on awakening each night.

Espi wrote: the awakenings are quick, roll over and back to sleep. My concern is the awakenings seem to be about the same as pre treatment.

Not all awakenings are related to sleep apnea or sleep disordered breathing and the machine can't fix what isn't related to sleep apnea. Sometimes they are just related to other stuff. I do a lot of what you do...wake and roll over and go back to sleep and my primary cause for wake ups is back pain. My therapy itself is excellent but the machine can't fix my back pain issues. Sure wish it could. It's a very rare night that I don't have at least 3 or 4 or more awakenings that I remember. It took me a while to find the right pain meds and bed comfort things to get the 30 to 40 awakenings I was having (on cpap) reduced down to a manageable level.

Since you don't really have any choice but to continue to use the machine you can "give it time" to see if the awakenings reduce and in the meantime you can take a hard look at the usual things that we look at when we wake more often than we would like to.
Meds... look up the side effects to that allergy pill to see if it has any hidden side effects that might be a factor. I take a pain pill during the day that comes with a "may cause drowsy" sticker...but in the fine print of the side effects is "insomnia" and it doesn't make me drowsy...it wires me up so I can't sleep. I am one of the small percent of people who it does the opposite to "may cause drowsiness".
Pain..
Bed comfort..
General sleep hygiene..
Caffeine intake...

Pugsy wrote: Pain..
Bed comfort..
General sleep hygiene..
Caffeine intake...

Thanks for the reply! I'm a bit guilty of caffeine and I've known my bed probably needs a replacement for awhile. Thanks for the responses everyone, I now have other things to keep improving upon