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CPAP Therapy - Why can't I stay asleep?

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sleeplessinwillowgrove +2 points · over 7 years ago Original Poster

I'm 51 years old and was diagnosed with severe OSA in January 2016. I started CPAP therapy in March 2016. I use a ResMed AirSense 10 and my mask is the DreamWear by Phillips. I use the machine every night and most of the time I have a difficult time going to sleep. I can deal with that. However, I wake up after around 5 hours of sleep and cannot go back to sleep no matter what! Has anyone else experienced this? I must admit the therapy has assisted with several sleep issues (fatigue so bad I would fall asleep at work) but I'm constantly tired, forgetting things and not feeling myself at all. I thought I would have adapted to the therapy by now but I'm not and it's starting to affect my work and personal life. My sleep doctor is unbelievably popular and I could only make an appointment for November. I hoping someone in this website community can assist. Thanks for any advice in advance.

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wiredgeorge +1 point · over 7 years ago Sleep Enthusiast

Your story sounds very similar to mine. When I started therapy, five hours or less and WIDE AWAKE. One thing I didn't experience was having trouble getting to sleep. Your machine has a ramp time setting you can change and you may want to vary this time. This ramp time starts at a fairly low pressure and increases it slowly over a time period to the prescribed setting. This is supposed to allow you to get into a restful state so the regular pressure doesn't keep you awake by hitting you in the face. That is something you can play with to see if increasing or decreasing the ramp time helps allow you to fall asleep.

I slept more soundly than ever once I was on therapy and I think 4-5 hours of sleep left me feeling better than 8 hours of AHI events and very shallow sleep. It took me almost a year to slow build up the time I sleep. Now I am at about 6 hours and on weekends (if the dogs don't fidget too much) I can sleep as much as 7 hours. I sleep like a lot; don't move and don't have any dreams I can remember. I too once fell asleep while driving, operating power tools and other fun stuff like that. No more. I never ever saw my sleep doc but the prescription given did the trick.

I think you are on the right track but would suggest monitoring the ResMed feedback data available to you at: https://myair.resmed.com/Default.aspx

This will let you know if you have sufficiently reduced the AHI number to where you are not having as many AHI incidents which may be causing your O2 level to drop for periods during the night. I bought a Pulse Oxymeter (wrist type) on Amazon that records O2 levels while I sleep and then allows download of the recorded data for monitoring the effectiveness of oxygen saturation during the night... in other words, is therapy working as it should.

Best of luck and hope that it gets sorted soon. Discuss the issue with your primary care physician if the sleep doc is that busy and your PCP may be able to suggest an alternative.

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sleeplessinwillowgrove +1 point · over 7 years ago Original Poster

Thanks for the advice, wiredgeorge.

I've actually changed the ramp time from 20 minutes to 5 minutes on my AirSense 10 because I didn't feel like I was getting enough air and I was struggling to breath. Breathing only through my nose was tough, too, since I was so used to snoring and having to breath through my mouth because of the OSA. I now use a head strap to keep my mouth closed. I was first prescribed a nasal face mask (the Pica or Pico) but I was unable to make it work. Either it was too loose and the air blew into my eyes or it was too tight and it cut into the skin on the bridge of my nose, drawing blood.

One of the things that keeps me up is the position of my jaw and my tongue. Sometimes it feels like I'm almost biting my tongue. Maybe, I should try a full face mask but I don't want to have the same experience that I hated with the nasal mask.

Last night, I had a bad night. It took me awhile to get to sleep and then I woke up way early before my alarm went off. I go to sleep at the same time every night and set my alarm for the same time every morning. I felt horrible this morning. I was so tired. One of the first things I did when I started the CPAP therapy was to register on the ResMed website. Of course, I scored a 100 for last night's sleep and the number of incidents per hour was .5. A point five! Why did I still feel bad? My average is about 3 per hour.

I'll check out the Pulse Oxymeter on Amazon. Please let me know the brand name so I can pick it up.

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ImaginativeDesertSandButterfly2260 +0 points · over 7 years ago

I actually had a pretty good sleep with Res Med Cpap nose pillows mask last night. I even too the suggestion of reading with it on but that did make it harder to fall asleep. Once I got to sleep really got about 6 good hours of sleep feel great this morning. Thank goodness no more headaches. I noticed last night I did not fight the cpap machine. I almost got any wrestling match with the headgear. It kept getting twisted but after like 20 minutes I got it fixed right. lol Also I am cleaning my nose pillows every day in water and a little dawn. Every day I pour out old distilled water from humidifier box and replace each evening. Am cleaning things too often or is good practice? This weekend I plan to clean everything and sanitize my humidifier box with 1 to 3 white vinegar. Clean everything else in Dawn and lukewarm rinse and drip dry. Any suggestions in this area?

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DanM +0 points · over 7 years ago Sleep Enthusiast Support Team

Sounds like great improvement, and your cleaning process seems to be right on target. Regarding the Dawn, it is best to make sure you are using just regular soap vs. anything with an antibacterial agent. I have been told by a couple of the manufacturer's representatives that the ingredient in antibacterial soaps will cause the mask seal to deteriorate at a faster than usual rate. Plain old Dawn or Ivory liquid should work well. And glad to hear you're no longer having headaches!

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DanM +0 points · over 7 years ago Sleep Enthusiast Support Team

Hi sleeplessinwillowgrove. I encourage you to talk to your doctor about this continued tiredness and forgetfulness. Glad to see you have already made the appointment. There are definitely other things that can contribute, such as other health conditions and medications. It may also be a good idea to have your doctor check a download from your machine just to make sure there is nothing else going on where your treatment is concerned. Please keep us posted on your progress!

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

sleeplessinwillowgrove - Being on the machine caused me to completely change my sleep habits. I used to snore like a freight train and sleep on my side while doing so. Now I stay VERY still during the night and sleep on my back. I I use two pillows; first is a ramp type TV pillow which is more of a wedge. I put another regular pillow on top and my head rests over the back of that pillow so it tilts my jaw up slightly. I am at about a 15 degree angle. This keep my mouth shut and I find being on the machine allows me to breathe through my nose even if stuffy. I use the two pillows because sleeping on my back using one regular pillow makes my lower back scream with pain in the AM and generally wakes me early.

As far as your results, they are GREAT! I have only had a 100 ONCE in a year as I have only slept 7 hours a couple times and almost never get a single point for mask seal because I use liners. My AHI is normally under 1 with the mask leaking about 100. Today was an aberration as I actually received ONE point for mask seal. Didn't do any thing different... I now consider the mask leaking scores somewhat arbitrary as they bear little relation to my AHI scores. Oh yeah, PULSE OXYMETER is the brand name on the device... check it out on amazon.com - looks like a big, cheap blue wrist watch and comes with software and a USB cable to connect to your computer.

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