Unsure if my apnea is causing my severe insomnia

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AmbitiousAmethystSalamander4124 +0 points · 9 months ago

Hello,

Sorry for the very long venting out post but I'm desperate for help and hoping to find some sort of relieve on this forum.

I'm a 38 year old male. I'm kind of a gym rat. I've been going to the gym 3-4 times a week since I was 15 years old. I run approx 9 miles every week and lift weight including body weight exercises. My height is 5 foot 10 and I weigh 175 pounds. So I'm not puffed up with muscles like body builders. I'm very lean with very low to zero body fat. In short, I don't have weight issues (neither excess fat nor excess muscles). However, Iv been suffering from severe insomnia for over 5 years now.

My insomnia has taken on many forms: -50% of the time I would fall asleep immediately but then wake up after 3-4 hours and then cant fall asleep again and just power thru the day. -20% of the time I would fall asleep immediately but then wake up after 6 hours of sleep feeling very exhausted and un-refreshed but still cant sleep again. -15% of the time I would go to bed at around 11pm but then cant fall asleep till 4 or 5am. Once I fall asleep I would wake up without an alarm after only 3-4 hours. -15% I would fall asleep immediately, wake up perhaps once to pee but then am able to fall asleep again and total about 7 and half hours of sleep. Once I wake up I feel like absolutely great. Well rested and refreshed.

I underwent two sleep studies in which the results were that I have mild sleep apnea. Of course, like many insomnia patients I barely got 3-4 hours of sleep during both tests and had to take ambien to fall asleep which doctors say amplify apnea symptoms so I have little faith in the results to begin with.

I tried using CPAP many times (perhaps on 60+ nights) with no avail. I would just lay in bed with the cpap on for hours without being able to fall asleep. I tried it over many years with different masks and cpap devices. I just cant fall asleep. Having a mask on my face doesnt bother me. I actually feel that Im breathing better with it but I just simply cant fall asleep with it on. Sometimes I would fall asleep for a few minutes but would wake up again and not be able to fall asleep again the entire night. I also tried the mouth appliance with the same result. Just lying in bed for hours without being able to fall asleep. What makes this worst is that if I try the CPAP lets say for an hour or two but then decide to give up and take it off its already too late because at that point Im so wound up and frustrated that I cant fall asleep again that entire night. So deciding to put on the CPAP is becoming a decision of: do I try the cpap again which has a 100% chance of me not sleeping tonight or do I not use it and gamble with the sleep chances I listed above.

Oh, and I also went thru sleep therapy treatments twice with two different doctors at Stanford sleep clinic (supposedly a good brand) also with no avail. I maintain a good "sleep hygiene" like not napping during the day, not drinking alcohol at night, using the bed for sleep only, not exercising after 6pm, not using my phone or computer at night ...etc. In fact starting 8 pm I start to wind down my day by being home on my sofa just watching dumb tv: i.e no news, no movies, just light stuff like cooking shows, HGTV, animal documentaries ...etc

Despite the sleep test results I have doubts whether sleep apnea is really the culprit behind my sleep problems. Most articles online about sleep apnea report that apnea patients are not even aware they have a problem to begin with. This means they can go their entire life sleeping 7+ hours every night. They discover they have apnea either because their partners complain about the loud snoring, or because they feel sleepy and un-rested during the day.

Obviously this is not my case. My wife never complained about my snoring. Maybe that's because she is a very good sleeper so I started using a snoring i-phone app to record my snoring and it reported low to mild snoring volume and duration and ranked me in the bottom 30% of those that used the app (i.e. 70% of people that used this app snore louder and longer than me). Furthermore, my snoring is usually only in the first 2 hours or so of falling asleep but then dies out afterwards. Around the time I wake up at 3-4 am there is almost very little to no snoring.

If indeed I do have sleep apnea why is that on the 15% or so nights that I am able to get 7+ hours of sleep I wake up feeling ABSOLUTELY great and 100% refreshed. Shouldn't I feel un-rested and tired even if I slept for 7+ hours like other apena patients?

If indeed indeed it is sleep apnea that is waking me up in the middle of the night why is it that I cant fall back to sleep again afterwards. I get it that Apnea can wake you up cause you cant breath but does it also prevent you from from falling back to sleep again and make you sit in bed for hours wide awake?

Again, sorry for the long post but it's Saturday morning and I only had 3 and half hours of sleep last night despite it being a weekend so feeling very frustrated and agitated. Appreciate any advice or commentary even if it is just to make me feel that Im not alone with this.

Thanks

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wiredgeorge +0 points · 9 months ago Sleep Enthusiast

Funny, after all the detail, the sleep study results were missing; AHI and SPO2? You appear to be a chronic worrier and a machine can't cure that. No word about WHY a mask doesn't allow you to go to sleep even though you say you are not claustrophobic and seem to breathe better. Some root cause analysis of your issue seems to indicate almost all the information needed to take a stab at a reason is missing. Not being critical, just need some actual pertinent facts to be able to make any sort of assessment. You went to a Stanford clinic and two docs examined you but they had nothing to say? They were stumped? Odd.

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PracticalPurpleSalamander2479 +0 points · 9 months ago

Hi, I was diagnosed with mild apnea as you. I went through 2 different Sleep labs. My first Sleep Lab test occurred over 5 yrs. ago. I did not complete the tests because I could not tolerate the masks and the force of the air. Upon the recommendation of my Primary Physician earlier this year, I underwent my 2nd. Sleep Lab test. The years between my 2 tests I was able to cope with my apnea by using nasal strips and nasal liquid irrigations. My apnea had always bothered me by my right nostril stopping up! I also have had, for several years, an air fan and or a window open for greater air circulation. Very often this was all I needed to get more sleep. Upon my request my Primary Physician referred me to an ENT physician. It was my belief that perhaps my right nostril needed to be surgically enlarged internally. After consulting with this ENT specialist he flatly stated that there would be certain possible side affects and risks for this surgery. After naming a few of these, I decided this surgery was not for me! He also told me that the surgery would not cure my Sleep Apnea!
After this I quickly decided to consult my Primary doctor in regards to taking another Sleep Lab test. She mentioned that the equipment, including the masks, had greatly improved since my last CPAP test. The Sleep Lab test only took one night instead of the two that I had taken before. The CPAP equipment had improved greatly. However I still could not tolerate the CPAP masks! After the test, the Lab Specialist Physician, referred me to a local Dentist who specializes in Oral appliances. This past April my 1st. appointment involved assessment and impressions. I was fitted with a Somno-Med devise a month later in May. Follow up so far has only required me returning just for one appointment to check the appliance. The technician will be calling me to see how things are going soon. The cost has been expensive even after my insurance paid for their part. It took me at least a week to get used to applying this appliance at night. I don't use nose strips any longer. I only occasionally have to use liquid nasal irrigation. I still use my bedside fan and sometimes my overhead fan. Overall I believe that the oral appliance is much better alternative for my Sleep apnea than the CPAP. I can't always distinguish whether I am having a Sleep Apnea attack or if I just awaken to go to the bathroom. At any rate my life is much better!

I am not sure if sleep apnea treatment will help your insomnia. You have said that the CPAP didn't work for your mild Sleep apnea, perhaps you should consider the Oral Appliance. There is plenty of info online if this interests you. Take care! And best wishes!

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snuffie3456 +0 points · 9 months ago

Hi Guys, Remember that weight is a correlation and not proven to be the only cause of sleep apnea! I am a triathlete, and have severe sleep apnea (AHI 34).
This is my own pet peeve. I get really tired of people assuming that you are obese when you have OSA. I know 9 people who use CPAPs, and only ONE of them is overweight.

As far as insomnia goes, there are certainly multiple reasons for not sleeping well. It can be VERY frustrating, but I've read that it can take several months for your brain to adapt to new "sleep architecture" when using a CPAP. I have found at this point that I can't sleep without it, but I don't necessarily feel better the next day than I ever did.

One good outcome with the CPAP is that I tend to wake on my own around 6 or 6:30 am without the alarm clock. This allows me to get up more easily for those early morning workouts. Before the CPAP, getting up was a real slog, and I was mixing coffee instead of water with my protein powder in the morning.

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sleeptech +0 points · 9 months ago Sleep Commentator

You are right Snuffie. Weight is probably the most common contributing factor to OSA, but it is far from the only one. There are a great many OSA sufferers who are not overweight at all. Especially in South East Asia, interestingly.

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SleepyMommy703 +0 points · 9 months ago

Good point. I was 5'2" and 120lbs when I was diagnosed. But I'm also confident I had it my entire life and was always a skinny kid. I also only snored until they took out my tonsils when I was 15. Never snored after that despite still being a mouth breather and having mild-moderate sleep apnea.

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NiceSilverBison1316 +0 points · 9 months ago

Yeah, me too. I'm 6'6" and weigh 175 pounds and I still have sleep apnea. Weight is certainly not the cause of my sleep apnea.

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Borristhefish +0 points · 9 months ago

I have insomnia. Have had it as long as I can remember. I have been using my cpap for 5 years and my insomnia still exists. The problem I have is just anxiety. With out enough sleep my anxiety gets worse. I have taken prescription medicine to help me fall a sleep. I have found for me that my cpap comforts me. Why because its one less thing to worry about. I still have nights that I just lay there and keep watching the clock. I will not take my mask off as my 02 will drop to low. I personally listen to music when I can't sleep. I try and avoid music with words as that Connect's me with memories as that triggers stress. I found that their is a group that is instrumental only that plays songs that I like, my mind wonders and that helps most if the time. I also checked my medicines to make sure that one was not stimulating me. Consult a Dr as insomnia is a bothersome issue that a MD can address.

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OptimisticLimeFlamingo6906 +0 points · 9 months ago

I’ve been going through similar insomnia as you recently. I find if I wake up and can’t go back to sleep, I get out of bed for awhile and then go back to bed and can sleep for 2-4 hours longer. I’m lucky in that I am recently retired so don’t have to get up for work anymore. But, I also had this issue when I was working. Laying in bed is not the best option. Getting up for an hour and then going back to bed is better. I also found that using my CPAP machine helped me not wake up as often. Prior to using the machine, I was waking up every 2 hours.

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BlueDove +0 points · 9 months ago

I have also struggled with insomnia for decades. Also stress and anxiety, at about your age. I was in chronic pain from a car accident, and not sleeping well. Trying to work in sales, raise several kids, and care for an ill parent was killing me. And I didn't want drugs as an answer.

My doc referred me to a stress management clinic run by several doctors. It was a wonderful experience. I learned how to destress using many techniques, including bio-feedback and self hypnosis. It took about 5 months, but it was a life saver. After a hypnosis induced 45 min. nap, I felt like I had slept all night. And I learned how to keep from internalizing stress. My son is now your age, and suffered much of the same issues, until he went to the clinic.

Stress hits us all differently, and learning better coping mechanisms is a healthy response. I discovered many new ways to make my life better, cope with the pain, and became a much better parent, wife and person. We don't live our lives in the hunter-gatherer way our bodies have evolved, so many adaptive techniques can be helpful, and necessary in our current culture. We often become our own worst enemy.

Please consider trying this, as its another tool to make our life better. I wish you the very best!

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.