Can't stay asleep all night

[JJJ]

Twenty years ago I would go to bed and the next thing I knew it was morning. Over the years I started waking up in the middle of the night. First it was just once in a while. Then more often. Then sometimes I would wake up twice during the night. This progressed slowly until, at the time I was diagnosed with OSA at the end of March, I was waking up three to four times a night.

The sleep doc and the DME people all assured me that I would sleep so well with CPAP therapy that waking up in the middle of the night would become a thing of the past. I can report that CPAP therapy has improved me to the point where now I wake up only four to six times a night.

Benadryl helps a bit, but not nearly enough. Melatonin improves my sleepiness at bedtime, but does nothing for waking up in the middle of the night. I've also tried all the herbal remedies, but none have any effect. A long time ago I tried Ambien, but it caused amnesia, so that's out. Besides, I don't want to take pills.

Luckily I almost always go right back to sleep. It's just that I can't help but think that my sleep would be more restful if I could really stay asleep all night long.

Have others here experienced more awakenings after starting CPAP than before? My AHIs are good and I feel better, but it seems that I am going backwards. Is it common for people to wake up more often after starting CPAP?

Does anyone have any suggestions for ways to stay asleep besides what I have already tried?

[zonk]

Have others here experienced more awakenings after starting CPAP than before? My AHIs are good and I feel better, but it seems that I am going backwards. Is it common for people to wake up more often after starting CPAP?

Does anyone have any suggestions for ways to stay asleep besides what I have already tried?

Since starting CPAP therapy I don,t get up at night to pee like half dozen of times before CPAP, actually there is a link between sleep apnea and nocturia. I don,t eat anything after 6 pm and have a set time to go to bed before 10.30 pm.

[BabyDoc]

Like you, in spite of effective APAP, I, also continue to awaken several times a night. My AHI is usually less than 2. When I examine my sleep data, I don't see any relationship with my events and the awakening. Like you, I am relatively new to my therapy, so it could be normal, during the early stages to have awakenings. The important thing that keeps me encouraged is I feel so much more rested with my therapy, inspite of the awakenings (I still get up 7 or 8 times a night and fall right back to sleep after using the bathroom).

What surprises me, however, about your story is you think you are going backwards. I don't know why you are awakening more, now, than before therapy. If you were having more central apneas because of a too high pressure setting, that might explain it. But you say you AHI's are good. So that shouldn't be your case. Are your nasal pillows comfortable for you?
Are you hearing leaks or other noises that could be arousing you? Are you awakening because of mouth breathing on occasion? If so, you might try a chin strap and see if that makes a difference for you.

Finally, I don't know of any medication that can prevent awakenings, although the ones you have tried can work to help you fall asleep. Be sure you are avoiding caffeine. I find that caffeine, even 10 hours before I go to bed, can have a worsening effect on my awakenings and my need for the bathroom.

[zonk]

Do a search about sleep hygiene, there,re few threads. Few things might affects sleep such as medication, rec drugs, caffeine drinks, alcohol, pain, mattress seen better days, worries, etc.. and money stashed under the pillows . For me if mask start to leak might awaken me up and also if my nose get congested find it harder to go back to sleep, wish if I could find a full face mask works as well as my Activa LT nasal mask.

[SuperSleeper]

I have had some degree of the awakenings as you describe (at times)... I have found that taking 3mg of Melatonin (over the counter supplement) helps me sleep through the night for a full 6-7 hours.

[JJJ]

Thanks for all the suggestions and observations.

Zonk: Few things might affects sleep such as medication, rec drugs, caffeine drinks, alcohol, pain, mattress seen better days, worries, etc.. and money stashed under the pillows.

That's it! It's the millions I have stashed in the mattress! I'll just donate it all to Apnea Board and that'll help, I'm sure. More seriously, I haven't had caffeine in years (and I am religious about reading labels), nor do I do recreational drugs. I travel occasionally where I sleep in various hotel beds, but the condition of the bed and mattress seems to make no difference. I've tried having two or three alcoholic drinks just before bed, and I've tried being a teetotaler for over a week, with no difference in the number of awakenings.

BabyDoc: Are your nasal pillows comfortable for you? Are you hearing leaks or other noises that could be arousing you? Are you awakening because of mouth breathing on occasion? If so, you might try a chin strap and see if that makes a difference for you.

Since there is an increase in the number of awakenings after starting CPAP therapy, the logical conclusion is that something about the therapy is causing more awakenings. I have used four different masks, with no difference in the number of awakenings. I hardly hear the machine. The only thing I can conclude is that it must be a change in my body brought about by better sleep. But that makes no sense at all.

Zonk: Since starting CPAP therapy I don,t get up at night to pee like half dozen of times before CPAP, actually there is a link between sleep apnea and nocturia. I don,t eat anything after 6 pm and have a set time to go to bed before 10.30 pm.

When I awaken I rarely need to use the bathroom. I don't think nocturia has anything to do with it. I have also tried eating late and not eating for hours before bedtime, but it seems to make no difference.

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I should add that since starting CPAP therapy I have naturally been monitoring things more carefully. I can't find any correlation between awakenings and events like apneas and hypopneas, or anything else in the data as viewed in SleepyHead.

However, I have observed that I generally stay asleep for the first two and a half to three hours or so. Thereafter I awaken about once an hour or less. My understanding is that a complete sleep cycle is about an hour and a half, so I get two good cycles at the beginning of the night. But if I wake up every hour or less for the rest of the night I can't be getting any more complete cycles.

[mjbearit]

JJJ,
Before getting back on my machine, I would get up in the middle of the night on a regular basis. I just had no interest in sleeping at all. I hated being in bed because I was frustrated I guess. Pain wakes me on a regular basis, but pain is pain. Not much we can do about that. Since being on my machine again, things have gotten better, but one thing I have found much easier to do is to just lay there when I wake up. Even if an hour or more goes by, I just lay there. Eventually I drift in and out of sleep for the rest of the night. But the thing is I feel like I just don't need as much sleep because my sleep is better. I know I do so I just lay there forcing myself to be in bed until my alarm goes off, even if I am awake the whole time. I think the pain will always wake me up, but at least now I don't feel the need to get up, I am not frustrated and I feel like I am making progress in getting myself trained. Kinda like teaching a kid what bed time is! I have hopes that eventually every night will be like the good nights where I wake up, but then go right back to sleep. Hang in there. It was a long road to get to the place you are now, you are not going to change habits overnight just because you have a machine! However, having that machine should, hopefully, eventually, make it possible to change those habits!

[Babs_Le_Grand]

Well i don't think you have pure OSA! check your RERA and CA indexes, and if you can locate your waking times on the graph of the flow on sleepyhead and check what type of breath cessation you are experiencing. CPAP can remove OSA totally, i have an OSA index always les than 1, however CA index + RERA can go over 5 and this enough to wake me up. Analyze your machine data based on the above.

[southernlady]

Okay, I had the same kind of insomnia (and that is what it is when you can go to sleep but not stay asleep).

After trying sleep aids...I finally looked up the side effects of all the medications I was taking. Turns out that one I was taking to HELP me sleep has a side effect of waking up in the middle of the night and not being able to get back to sleep.

Docs are taught to "when you hear hoofbeats, think horses" but not all of us are horses...some of us are zebras.

Liz

[kitley]

Welll, I have had awakenings for the last 15 to 20 years...usually 10 or 15 per night, and sometimes unable to go back to sleep. Started CPAP towards the end of April. I woke up even more...I think due to not being used to all the new equipment. It gradually got better. A month ago I switched from nasal pillows...due to leaks waking me up.....to a nasal mask. Now, if I do wake up, I seem to go right back to sleep most times. My AHI was under 0.50 on pillows, and went up to about 3.50 on the nasal mask. After a week or so my AHI are nearly always under0.40. I must also say that my leak rate on either the pillows or the nasal mask, is never over 16. But, I new the leaks were waking me most times. Maybe I am just really sensitive to leaks??? and maybe you could be too???