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To AffableStrawberry

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Sierra +0 points · almost 6 years ago Original Poster Sleep Patron

Your post disappeared, possibly because of some of the language. I had prepared a response to your question and previous post from 2 months ago. Here It is:

First, I am sorry you are feeling so bad. Wanting to sleep but not being able to is very frustrating. Probably two of my worst sleeps in my life was the night of my sleep study, and then the first night on the CPAP. Once I get anxious I then can't sleep.

I found your original post from two months ago. For some reason it is locked and you cannot reply to it. I am a new member here, and don't recall seeing it. I copied it and pasted it below. Here are my thoughts on your issues.

  1. On the issue of wearing a CPAP there are some things that can be done to improve comfort; the mask, the initial start pressure, the type of ramp, and the minimum pressure. If you would post what type a machine you have and let us know what these pressure settings are we may be able to make some suggestions for improvement.

  2. On the issue of feeling reasonably comfortable with the CPAP, but now not being able to sleep it would seem that there may be an issue of insomnia and the CPAP possibly just being one of a number of factors. I have posted a link below to a site which was formed to help people with insomnia and wanting to address it without any sleeping pills or a very minimum dose. The site was initiated by a pharmacist in Canada who became concerned that too many sleeping pills are being used and in addition to other side effects many of the older patients are using them to the extent they become disoriented, have falls, and are breaking their hips. He advocates the use of Cognitive Behavioural Therapy for Insomnia, or CBTi. There is a lot of good information at the site. In particular check out the CBTi page. There are a number of tools on the right hand side which are helpful in evaluating where you are now, and what things might need to be changed. It takes some time to work through all the material at the site, but I certainly found it worthwhile. The guy is not selling anything. Besides being a pharmacist, he is a professor at the university, and I suspect gets grants and uses grad students to help develop the site. Here is the link:

SleepWell - CBTi

"Hi. Im new to the forum. Ive been reading about people with similar issues but not quite the same so i decided to ask for help here.

Ive been using cpap for about 4 months now. I was diagnosed with very severe sleep apnea so obviously been feeling great since i started this therapy.

Now, since last thursday, every time i put on the mask, boom, im not sleepy anymore. I would have it on for maybe 4 hours and nothing. I would take it off and then i could fall asleep in less than 15 minutes. I slept without the mask on thursday friday and saturday, and I obviously felt like shit the entire weekend, like sleepy and groggy all the time, like i used to before.

Anyway on sunday i read i shouldnt do that, so i was like well yeah makes sense, lets try to sleep with mask on or lets not sleep at all. The thing is, in a few hours its gonna be 48 hours since i last slept. I can be almost passing out from sleep yet when i put the mask on, boom, not no more.

Questions: am i going to be awake for the rest of my life? What might have caused this?

Important info: the mask feels comfortable and if i showed you my results youd see it was going great before this. I would like to avoid taking pills. Please dont tell me "for some people it takes years to feel comfortable using cpap", i believe this isnt just a "comfort" type of issue since i had been using it successfully for the past 4 months and nothing had changed. My doctor isnt exactly the most professional doctor there is, so even though ive tried telling him about this, he hasnt been of much help. I need yours.

Thanks in advance."

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snuzyQ +0 points · almost 6 years ago Sleep Commentator

As you have already found, our brains are very good and quick at making associations. The associations that your brain has made in this case are: mask = insomnia, and, no mask = relaxation and sleep.

Your job now is to get your brain to make a new association which will negate the old associations. This new association should be; mask = relaxation and sleep. Now troubleshoot...what can you do to make this new association happen? If this were me, I think I would handle it this way: I would put on my mask while still up and awake (but nearing bedtime) and read a book (something I find very pleasant). I would read until my eyes began to get tired and I started to feel sleepy. Then I would have a "chat" (silent thinking) with myself: "Wow...I'm feeling really sleepy with my mask on...I don't want to fall asleep in this chair/sofa/recliner...I think I'll go to bed now and hook up (with my machine)". Once in bed and hooked up, with my machine on I would continue the "chat". "My mask is on and my machine is going and I'm feeling very sleepy. It's safe for me to go to sleep now. I'm so thankful for this mask and machine for how it makes me feel so rested in the morning. I will always sleep with my mask on...this is my lifeline...what a blessing. CPAP is my best friend ever.....I'm feeling really relaxed now...It's OK to go to sleep this way...I like this." I would keep the conversation going until sleep sweeps me under and my very last conscious thoughts are something, anything, positive about my CPAP treatment.

If I found myself wide awake after this restful "talk", then, without judgement in any way, I would just get up out of bed and out of the bedroom (with mask in hand), go get a cup of soothing tea and linger over it, put the mask back on and grab my book once again. The book must not be a wild adventure story...just something fun and relaxing. Then, after putting my mask back on, I would read until my eyes got heavy again. Then back to bed. Repeat this as many times as you need to until you finally fall asleep with your mask on and your machine running. Your desire/need for sleep will overcome you...with your mask on.

Repeat this process each night until your brain transitions with the new association: mask = sleep, comfort, relaxation, sweetness, a good refreshing night, etc.

Never, ever, fall asleep without your mask on and your machine running. It isn't safe for you to do that anymore. Tell yourself that over and over again. Believe it...because it's true.

Our brains are amazing tools and are quite malleable. You may be surprised at how fast your brain picks up again on this way of sleeping. The keys in working with it are patience and persistence. You must outlast your brain. You can do this!

Please be advised that these posts may contain sensitive material or unsolicited medical advice. MyApnea does not endorse the content of these posts. The information provided on this site is not intended nor recommended as a substitute for advice from a health care professional who has evaluated you.