Awareness while using CPAP machine/Lack of NREM3 and REM sleep

Good timezone,

This month I started sleep therapy with a Resmed AirSense 10 AutoSet, AirFit F20 mask, and AirFit™ P10 nasal pillows. The first couple of nights I kept the humidity and heating on automatic. I have been trying to narrow down the best temperature and humidity setting. That is not why I am reaching out, since I have been using the machine and when I took the home test, it seems I am not getting beyond either NREM 1 or 2. Since Thursday I have tried GABA and melatonin to see they will help. There feels to be a little bit of full sleep, then I am back to being aware of everything going on. None of the factors like tightness or air pressure seem to be at play like the quote below and I will find out more when I see my sleep doctor for a followup in a week.

I’m having difficulties falling asleep with my CPAP machine.

If you’re having difficulties falling asleep with your CPAP machine, it’s critical to know why. Are the straps too tight? Do the mask and hose keep you from your favorite sleeping position? Is the noise too loud? All of these things could be keeping you from sleeping.

If the straps are too tight, you could try loosening them and see if you still have a good seal. It may be more comfortable that way. If the mask and hose are keeping you from your favorite sleeping position, consider getting a CPAP pillow, which is specifically designed to make your preferred sleeping position compatible with CPAP.

Since most of the noise that’s involved with a CPAP machine comes from the mask, investing in a mask that has a low decibel output may make it easier to fall asleep.

The crux of the issue is I am wondering if the lack of NREM 3 and REM sleep is normal for starting the sleep therapy or am I one of those statistical outliers whose brain deciced that now that it has proper flow it is time to be active.

Not getting a good sleep when first getting used to a CPAP is somewhat normal. Very few just put the mask on and go right to getting a restful sleep each night.

As far as the machine goes, here are a few tips that I have found helpful:

1. Use the heated hose and leave humidly control in auto with the temperature set at 27 C.
2. About 15 minutes before bed scroll down to near the bottom of the menu and put the machine in Warm Up mode. It warms the water so you will get good humidity right away.
3. Make sure your ramp start pressure is high enough. I would suggest a minimum of about 7 cm. If the pressure is too low it can be somewhat suffocating.
4. Use the Auto Ramp feature so the pressure stays constant until you go to sleep.
5. Set the EPR at 3 and for Ramp Only. That will reduce pressure on exhale by 3 cm. So if you set your minimum pressure at 7 cm, it will cycle between 7 cm on inhale (more pressure on inhale makes breathing easier), and 4 cm on exhale (less pressure is easier). The reason for Ramp Only is that reducing pressure on exhale reduces the effectiveness of the machine, and it is best to use it just for comfort when going to sleep. After you go to sleep you will not notice that extra pressure on exhale.

Hope that helps some. It takes some time to get used to a CPAP. Not sure of the specific impact on REM sleep as I don't monitor that. You can get a lot of help if you download SleepyHead and monitor your sleep data with a PC or Mac. You need a SD card reader to transfer the data from your machine to your computer.

How I envy you guys in the USA! I wish I had access to a sleep doctor. Please tell me more.

Yes I agree with you totally. I’m in Cape Town SA and the sleep doctors here don’t know much. Each time I see them it seems they just want to sell you something new. Don’t know what I’d do without this forum.

Hi SleepyJules

I don't have a sleep doctor, as I said. All that the NHS can offer is a physiotherapist. It's a sure indication that the NHS is desperately short of cash. I'm looking at my alternatives. I'm trying to find a private sleep doctor. They do exist. Just need to locate one who is reasonably local.

Having read Prof. Matthew Walker's book 'Why We Sleep', it has confirmed without doubt the importance of sleep for those with mental health issues - people like me. But, of course, it applies to every man, woman and child on the planet!

JPC