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Insomnia and stomach sleeping affecting my use of CPAP therapy

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SweetDreams +0 points · almost 7 years ago Original Poster

Dear Friends,

I'm new to this forum and to this topic so kindly excuse me if this has been discussed hundreds of times already.

I was diagnosed a year ago with moderate sleep apnea. Been using the ResMed AirSense 10 with AirFit P10 for Her pillows (extra small) for about six months. I think the ramp goes from about 5 cm to 9 cm in about 10 minutes. I don't understand the reports ResMed sends me but it looks like I have about 2 to 4.5 events per hour most nights when using the machine--not sure what that means.

Long story short (kind of): I feel that my sleep has degraded since I've been using the equipment. I'm exhausted all the time! It's not the equipment, per se; I'm quite comfortable with it before I try to actually fall asleep. Reading a book before bed hooked up to the machine, for instance, is no problem.

These are my issues:

Insomnia: I'm already prone to insomnia and have been waking up three to five times a night for years. When I wake up, exhausted, at 1 a.m., I'm just not inclined to keep the mask on. The only way I can get back to sleep is to burrow my head/nose deep into my pillow (on stomach)--and that means the mask just doesn't work. It's up to whether or not I get those few last hours of precious sleep--or attempt to be diligent and wear the mask. (Another way to get thru the night is to take sleeping pills--but I don't want to rely on those. I use them about once a month when I'm at the end of my wits.)

Side and stomach sleeper: As I mentioned above, I tend to burrow my head deep into my pillow and sleep best when sleeping on my stomach. The mask doesn't work when I do that. (It leaks, etc.) I've been reading that folks with apnea often sleep on their stomachs (before correction with machine) so perhaps this is something I should relearn.

Bottom line? I recently went away for a week without the CPAP machine and had the best sleep I've had in months. (At least it seemed that way.)

I have a lousy insurance program with a doctor who is not a specialist--so I don't feel there's a lot of help to get there.

Any advice?

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wiredgeorge +0 points · almost 7 years ago Sleep Enthusiast

Welcome! Couple of things I can say as I am not a doctor and can't give advice on insomnia. The report from ResMed you see has a number of items and is pretty easy to understand. AHI stands for Apnea–Hypopnea Index. This is the number of times per hour you STOP breathing per hour of at least 10 seconds. There are two negatives associated with apnea events and first is that your blood-oxygen saturation can drop to where it is damaging to organs and contributes to MANY other medical problems. The second is that your sleep is disrupted and you don't achieve deep sleep; in other words you are cat-napping. Folks who complain of frequent wake ups during the night are probably not sleeping deeply.

When you read your daily feedback from ResMed via the myair tool, try to look up meanings for yourself. Most can be googled. You will need to self-educate by research and asking questions if your professional support isn't what it should be. I know, been there; done that!.

As far as your sleep habits, you probably need to change these. I know that isn't what you wanted to hear but you have already figured out that the mask and sticking your face in your pillow or lying face down doesn't work. Before therapy, I was a side sleeper and have relearned my sleep posture. I am now pretty much exclusively a back sleeper. I was in an HMO when diagnosed and received almost no pro help so had to figure things out myself as I am sure you will want to do to make therapy as useful as possible.

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SweetDreams +0 points · almost 7 years ago Original Poster

WiredGeorge: Thankful for your reply. Yes, you are completely right that I need to better educate myself on terminology.

And I hear you saying I have to wean myself from stomach/side sleeping. I will try my best.

But...there's still the question about insomnia and use of CPAP machine. I've been researching this and find there is validation that CPAP can further aggravate insomnia and that for some new CPAPers this can result in full- fledged CPAP-induced (or CPAP-enhanced) insomnia. I started this thread because I think its worth discussion. There's probably only a few of us experiencing this but I'd like to hear from those, if possible, and also hear from those of you with expertise who can offer advice.

Although I now dread going to bed, I'm still wearing the mask. I do my best to get at least 4 hours in it (especially because insurance company is Big Brother watching). But, as I have every night for the past six months, I also know I'll wake up two hours later unable to fall back asleep unless I pull off the mask.

In the end, maybe there's no answer. But like each of you, I was eager to try this thing that was supposed to help me sleep better and healthier. After six months, I'm more tired and grumpy during the day than ever. I sleep even less per night than before. I wake up exhausted.

I don't understand.

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GoodNightsSleepLOL +0 points · almost 7 years ago

I hear what you're saying. I've recently been diagnosed (severe) and have been given the Air Sense 10 with full face mask, I'm averaging about 35 events per hour (for the last week). I'm also a side and stomach sleeper, so I'm trying to learn to sleep on my back which is very difficult when my wife has been prodding me in the side for years to sleep on my side or stomach!

I have the same problems with the face mask (although mine is a full mask), its too cumbersome, leaks happen when it pushes against the pillow lying on your side, it gets hot, sweaty and itchy, I find in my sleep I try to scratch my face under the mask only for the machine go into overdrive which wakes me up.

I too do not look forward to going to sleep and feel like the machine is not helping, indeed quite the opposite.

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SleepDent +0 points · almost 7 years ago Sleep Commentator

I am a dentist working in dental sleep medicine. I have heard complaints like yours many, many times. There is a dirty little secret about CPAP that all of the proponents conveniently fail to talk about. From a mechanical point of view, CPAP is very efficient at opening up the airway. People usually end up with very good (low) AHI scores. Unfortunately for a significant segment of the population with sensitive and hyperactive nervous systems the entire experience is just WAY TOO INTENSE. Hence the continued insomnia. Oral sleep apnea appliance therapy is a much kinder, gentler approach. There are just two reasonably sized trays on your teeth. No mask, no straps, no hoses, no forced air, no noise, no air leaks. Quiet and serene. Almost to a man, patients who have come to me off CPAP with insomnia complaints have been straightened out and can sleep. Should the sleep docs suggest an OA when patients have continued insomnia on CPAP. Sure they should- but this is the real world, not the ideal one. Arthur B. Luisi, Jr., D.M.D.

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SleepyMommy703 +0 points · almost 7 years ago Sleep Commentator

I'm having similar issues. Although the night waking is something I have with or without, since changing my machine it seems to be a little worse this week. I went back to CPAP a few weeks ago and using my Resmed S9 the first night I only woke twice the entire night and went back to sleep immediately. The rest of that week was my usual frequent waking all night. My machine wasn't working properly and apparently wasn't putting out enough pressure though and I can totally tell the difference now having received a brand new AirSense 10. It's taking some getting used to all over again.

But the sleep position is the hardest part. I am a stomach/side sleeper and also like to bury my face in my pillow. I have a nasal mask and can still do my side but I have to turn my head slightly so the mask isn't pulling against by pillow. And it's hurting my neck. I think I need to try a wedge and a new pillow so I can lay on my back in a more sitting upright sort of position. Or I thought about trying a body pillow and see if that helps me get more comfortable.

Hopefully we figure out some way to make it more comfortable.

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