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It's been a year and I'm about ready to kick CPAP to the curb
#1
It's been a year and I'm about ready to kick CPAP to the curb
I've had on and off insomnia for years.  I've done all of the sleep hygiene stuff (anti-blue light glasses, keep the room dark, white noise,  exercise, etc) to no avail.  Figured CPAP would be the magic solution but the insomnia is no better, maybe even a bit worse.  The insomnia just seems to randomly come and go.  A typical week has me sleeping an average of 5 1/2 hours, which I can feel ok on, but there are usually a couple of poor nights of sleep (less then five hours).

Some weeks are worse than others.  This past week, there were 3 nights where I only had 3 hours of sleep, and 3 nights where I had only 5 hours or so.  I felt tired and run down for much of the week.  There was one night where I slept 7 hours and actually felt great the next day.  

I can't seem to find a pattern.  It randomly comes and goes.  I might sleep okay for a couple weeks and then sleep poorly for a couple weeks.  I typically eat and exercise the same way each week.  Some weeks are okay, some weeks (like this week) are bad it's frustrating because it feels like a wasted day after being drained from a poor night of sleep especially if it's an off day.

I rarely have trouble getting to sleep.  It's waking up in the middle of the night (sometimes a few times) and not being able to fall asleep for hours, if at all, that is the problem.  

I've tried all kinds of different settings on the CPAP.  The people here have been very helpful.  While my AHI has improved during this time and is usually very good (hovering around 1), there is no difference with the insomnia itself.  Would it be safe to say that is a totally separate issue and I've pretty much maximized the benefit of the CPAP machine?

How do I know if I still need CPAP?  I sometimes question if the effort and expense is even worth it especially given that it has done nothing for the insomnia.  I was diagnosed with mild sleep apnea and that was when I was over 20 pounds heavier.  The doc said  I may no longer needed it after I lost weight.  Would I need to do another sleep study to know for sure?  I've done a couple of them and barely get any sleep.


For the record, here are some recent charts in case there is anything that stands out.


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#2
RE: It's been a year and I'm about ready to kick CPAP to the curb
It would be best to have the instrument as long as the APAP increases pressure, which is evident, to fight obstruction.
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#3
RE: It's been a year and I'm about ready to kick CPAP to the curb
Have you had all your blood work done including thyroid ?
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#4
RE: It's been a year and I'm about ready to kick CPAP to the curb
(04-20-2024, 10:25 AM)G. Szabo Wrote: It would be best to have the instrument as long as the APAP increases pressure, which is evident, to fight obstruction.

Fair point.  I have sinus congestion issues on top of this.  I'll use Neomed spray before bedtime that helps quite a bit but nothing works like Afrin (or a sinus rinse).  Tried Afrin on Thursday night and was surprised that it didn't really make much difference in the AHI despite sleeping well that night.  However, I have used Afrin in the past and didn't sleep so well so I could never really draw a correlation between clear sinuses and good sleep.  Very strange how this insomnia is random and I have even tracked my sleep and have not been able to find a pattern.
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#5
RE: It's been a year and I'm about ready to kick CPAP to the curb
(04-20-2024, 10:33 AM)Nightynite Wrote: Have you had all your blood work done including thyroid ?

Yep it's all good, which also baffles me.  

I'll sometimes take magnesium as that is supposed to help with sleep but magnesium levels are good as well.
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#6
RE: It's been a year and I'm about ready to kick CPAP to the curb
The only thing I could think of is it could be exercise-induced. I exercise 5 days a week and keep my calories below maintenance. In a typical week (which this week was not), I tend to sleep poorly toward the end of the week. Cheat day is Saturday. Maybe something to do with cortisol going up due to a shortage of carbs and waking up in the early AM. Sometimes I'll wake up hungry but usually not.

I slept poorly post surgery a couple years back and did no exercise so I can't really say for sure there is a correlation there either.
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#7
RE: It's been a year and I'm about ready to kick CPAP to the curb
(04-20-2024, 10:38 AM)drago7579 Wrote: I'll sometimes take magnesium as that is supposed to help with sleep but magnesium levels are good as well.

It helped me to take 5-10 mg of extended-release melatonin before bedtime.
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#8
RE: It's been a year and I'm about ready to kick CPAP to the curb
when you wake up in the middle of the night, are you thinking about stuff? like any worrying about work or family or worrying about not sleeping itself?

if you do a CBT-I class they will tell you to try to disassociate the bed from any negative feelings about sleep. so this means if you wake up and can't fall asleep again for 20mins, to get out of bed and do something relaxing - read a book, coloring book, knitting, etc. something that doesn't take a lot of cognitive effort - don't get out of bed and start working on your taxes. only when you start to feel sleepy again should you get back into bed. the idea is that you try to train yourself that the bed is for sleeping. likewise no reading in bed, no electronic devices in bed, etc. and when you get up in the middle of the night, preferably read a real book to cut down on the blue light from the screen of an iphone or ipad.

another thing they tell you to do is to schedule a time during the day to worry about stuff. every day, like maybe an hour before dinner, start writing down all of the stuff that's bothering you and think about it then. try to work thru all your problems and prospective solutions then, the goal being that when you are finished, you think to yourself, "ok, i have a plan, i know what i need to do about this stuff."

another technique they have is to write kind of a 'worry cascade' that starts with 'i'm worried that i won't function well at work if i don't sleep well' and continuing to 'going to be disciplined at work'... and ending with 'homeless and in jail', which is supposed to illustrate to you that your fears are totally unfounded. the likelihood of such an absurd outcome is very low, and seeing it written down is supposed to help you realize that it's not realistic.

these things seem silly but they do help some people. of course if your problem is not psychological, they won't help.
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#9
RE: It's been a year and I'm about ready to kick CPAP to the curb
(04-20-2024, 10:43 AM)G. Szabo Wrote: It helped me to take 5-10 mg of extended-release melatonin before bedtime.

I will sometimes take Magnesium Glylcinate or Citrate.  I would take it with dinner but that is typically a good 4-5 hours before bedtime.  Just started taking it before bedtime (even it says to take it with a meal) but there wasn't much of a difference.  I don't think it's extended release though though so will have to give that a shot.  Thanks for the suggestion.
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#10
RE: It's been a year and I'm about ready to kick CPAP to the curb
(04-20-2024, 10:48 AM)joeblough Wrote: when you wake up in the middle of the night, are you thinking about stuff? like any worrying about work or family or worrying about not sleeping itself?

if you do a CBT-I class they will tell you to try to disassociate the bed from any negative feelings about sleep. so this means if you wake up and can't fall asleep again for 20mins, to get out of bed and do something relaxing - read a book, coloring book, knitting, etc. something that doesn't take a lot of cognitive effort - don't get out of bed and start working on your taxes. only when you start to feel sleepy again should you get back into bed. the idea is that you try to train yourself that the bed is for sleeping. likewise no reading in bed, no electronic devices in bed, etc. and when you get up in the middle of the night, preferably read a real book to cut down on the blue light from the screen of an iphone or ipad.

another thing they tell you to do is to schedule a time during the day to worry about stuff. every day, like maybe an hour before dinner, start writing down all of the stuff that's bothering you and think about it then. try to work thru all your problems and prospective solutions then, the goal being that when you are finished, you think to yourself, "ok, i have a plan, i know what i need to do about this stuff."

another technique they have is to write kind of a 'worry cascade' that starts with 'i'm worried that i won't function well at work if i don't sleep well' and continuing to 'going to be disciplined at work'... and ending with 'homeless and in jail', which is supposed to illustrate to you that your fears are totally unfounded. the likelihood of such an absurd outcome is very low, and seeing it written down is supposed to help you realize that it's not realistic.

these things seem silly but they do help some people. of course if your problem is not psychological, they won't help.

I do find that I start thinking about stuff if I can't get right back to sleep.  I usually do the 20 minute thing.  Sometimes I will get tired and fall back asleep pretty quick.  Sometimes it will take 2-3 hours.  Sometimes I can't get back to sleep at all.  I have no TV in the bedroom and good about not using electronic devices in bed.  I hear ya on cutting down the blue light when using an e-reader and bought a small "red light" from Amazon and use that while wearing blue light filtering glasses.  

That's a good idea to schedule some "worry time".  I find that sometimes the stuff I'm worrying about is silly stuff that I should not be worrying about at all.  

That writing technique is an interesting one.  I'm always jotting down notes and things like that so something that I will have to try.

It's all worth a shot as I'm grasping at straws at this point.  Thanks for the suggestions!
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