Middle of the night waking

[MarchWinds]

Over the past few weeks I have been waking at 3:30 am more often than not. So for several days during the week, I feel really exhausted because I am only getting about 6.5 hours sleep.

I try not to sleep in in the morning or nap, since avoiding these things is supposed to help reset your sleep. But last night when I woke at 3:45 and took an hour to get back to sleep, I just could not make myself get up at 6 am, and I slept in until nearly 8 am. It's nice not to feel tired. But of course, I can't do this when I have to work tomorrow.

I don't think it has anything to do with my CPAP. I was having some work stress, and that may have set things off, not sure. Very frustrating.

[quiescence at last]

How long have you been on CPAP therapy?

Exhaustion, I interpret as meaning severe reduction in body energy, versus sleepiness. If you are working with stress but not with hard physical work, then exhaustion is probably that you did not physically work (and a work out, house cleaning, moving boxes, may help.) It may not be because you slept 6.5 hours versus longer.

By the way, my exhaustion level improved noticeably after about one week of treatment. This may not be typical, but I suggest that your therapy should make a noticeable difference (if effective).

So what have your AHI scores been in the last 3 weeks, and did it improve or not over the previous period?

Your profile says you are set at a constant 10 cmH2O pressure. Would you be interested in changing the settings, if you knew more about how a change might impact your results?

QAL

[MarchWinds]

Hi there,
Thanks for you response. I have been using my CPAP for about 6 months, and my AHI is now always under 2. I find the CPAP has helped me sleep better overall. Since using it, I have less asthma and sinusitis, less fatigue and much more resilience when I work out (I do karate 2-3 times per week). My concentration is better (at least when I get enough sleep).

Also, last winter I had three nasty respiratory viruses in a row, and was sick for nearly six weeks. This winter, not a single cold so far.

I have had some work stress lately, which is now settling down, so maybe my sleep will return to normal soon. I find that I need 8 hours a night to feel good, in general. Not sure the CPAP is actually playing a role in the problem.

I also realize that people tend to sleep less well as they age, and I am now 46, so maybe I will have to accept poorer quality sleep in the future?

Jennifer

How long have you been on CPAP therapy?

Exhaustion, I interpret as meaning severe reduction in body energy, versus sleepiness. If you are working with stress but not with hard physical work, then exhaustion is probably that you did not physically work (and a work out, house cleaning, moving boxes, may help.) It may not be because you slept 6.5 hours versus longer.

By the way, my exhaustion level improved noticeably after about one week of treatment. This may not be typical, but I suggest that your therapy should make a noticeable difference (if effective).

So what have your AHI scores been in the last 3 weeks, and did it improve or not over the previous period?

Your profile says you are set at a constant 10 cmH2O pressure. Would you be interested in changing the settings, if you knew more about how a change might impact your results?

QAL

[retired_guy]

I also realize that people tend to sleep less well as they age, and I am now 46, so maybe I will have to accept poorer quality sleep in the future?

Jennifer

"Sleep less" means that once you are an old geezer, like me, then an average nights sleep is 7 1/2 - 8 hours. For a young, not yet dry behind the ears person such as yourself, maybe 8 - 8 1/2 would be more like it.

As to the future? With CPAP I find the quality of sleep has increased about a zillion fold. That's the whole point of this stuff.

I think you are experiencing a short term issue. Those things come and go, and very often are related to our "busy" minds not letting go of the day's activities. So you sleep awhile, and your mind says "ok, that was fun.... Time to wake up and stress out." When this happens don't make too much out of it. Because if you do, you might be teaching your body to wake up so it can do what you are expecting for it to do.

So if you do wake up and cannot go back to sleep, get up, log onto the computer and read old Apnea board threads. You'll get sleepy quicker than anything.

[MarchWinds]

That's the best advice I've had in a while. Thanks, retired guy.

I also realize that people tend to sleep less well as they age, and I am now 46, so maybe I will have to accept poorer quality sleep in the future?

Jennifer

"Sleep less" means that once you are an old geezer, like me, then an average nights sleep is 7 1/2 - 8 hours. For a young, not yet dry behind the ears person such as yourself, maybe 8 - 8 1/2 would be more like it.

As to the future? With CPAP I find the quality of sleep has increased about a zillion fold. That's the whole point of this stuff.

I think you are experiencing a short term issue. Those things come and go, and very often are related to our "busy" minds not letting go of the day's activities. So you sleep awhile, and your mind says "ok, that was fun.... Time to wake up and stress out." When this happens don't make too much out of it. Because if you do, you might be teaching your body to wake up so it can do what you are expecting for it to do.

So if you do wake up and cannot go back to sleep, get up, log onto the computer and read old Apnea board threads. You'll get sleepy quicker than anything.

[trish6hundred]

Hi MarchWinds,
WELCOME! to the forum.!
If you find that you wake up with a start, and just can't get back to sleep, get up for a bit and read or do something relaxing.
Much success to you as you continue your CPAP therapy and hang in there for more suggestions.

[DariaVader]

I second what RT said. If I wake and can't get back to sleep right away, i get up and read forums or some other non-exciting stuffs. I also drink warm chamomile. After I begin to feel drowsy, I go back to bed. I think it is a matter of clean sleep hygiene to get up rather than lay there awake.

[TorontoCPAPguy]

Welcome to the forum. Your issue is either psychological or physical. To try and eliminate the physical aspects I would, personally, check my blood oxygen through the night. Something may have changed. I have experienced this firsthand. You want a decent recording, rechargeable pulse oximeter like the Contec CMS50E and you want to use some green/blue masking tape to keep it steady on your finger for the night to get an accurate picture of your SpO2 and heart rate through the night. If you were able to, I would also suggest an automatic BP meter (I have a hospital grade BP meter that is automatic and records). What we are looking for is drops in blood oxygen or desats. A single night sleep study may or may not show this. Several nights of monitoring WILL show it hopefully. If your SpO2 is dropping below about 90% your body is going to arouse you in order to get you to breathe deeper and get that SpO2 back up. Generally, this coincides with a racing pulse, a spike in BP. Do you awaken slowly or do you awaken with a start, or gasping for air, or feeling like you are short of air, or in a sweat, or with a racing pulse? All indications of complications with sleep apnea or possibly another affliction. Such as Atrial Fibrillation, which is documented as being associated with sleep apnea, and which wants immediate attention for two reasons. First, your sleep is going to be disrupted by lower SpO2 levels. More urgently, AFIB is setting you up for a massive stroke and you need to get diagnosed and get on blood thinners. You want to be referred to a TOP NOTCH cardiologist/electrophysiologist that will be able to diagnose AFIB or other arrhythmias quickly and efficiently and will know how to deal with same (more so than just a cardiologist).

The OP is correct in that as we grow older we simply do not seem to sleep solidly through the night due to needing to empty our bladder or other more nefarious reasons. In my case it was the sleep apnea and damaged lungs due to acute pneumonia in 2009, compounded by Atrial Fibrillation. I am lucky that I did not stroke out. Since 2012 I have been on TIKOSYN to keep me in Normal Sinus Rhythm and am now booked for catheter ablation of the offending nerves in the heart that cause same. Another sleep study will be in order once the procedure is done and my heart has settled back down and is properly oxygenating my blood and not pooling blood (stroke risk).

Again, I would do two things immediately. First I would get my GP to refer me to a good cardiologist/electrophysiologist for assessment. MY GP DID NOT RECOGNIZE THE AFIB AS IT WAS NOT CONSTANT. They will put you on an advanced monitor for several days looking for AFIB. Secondly, and simultaneously, I would check my SpO2 and heart rate during the night starting right away. If your pulse rate is spiking and/or your SpO2 is dipping (also called desaturations), I would get myself in front of my doctor immediately or get to an emergency department with printouts of my data. You will be at risk for strokes and the least they will do is get you on Warfarin blood thinner and arrange to have it monitored. Stay away from these new blood thinners that do not require monitoring as they have no antidote and (heaven forbid) you get into an accident or develop a bleed, you will bleed to death. Warfarin has a simply reversal process consisting primarily of massive doses of Vitamin K. The bleeding has a better chance of stopping.

Anyway, my two cents worth. I am not a doctor. You need to see one. What seems such a minor thing could, in fact, be a much larger issue presenting itself. Good luck. Don't get your knickers in a twist about it but get thee to a doctor right away, explain the issue and demand an EKG and referral to a cardiologist as embarrassing as you may think it is. My wife did for me and it has saved my life I have no doubt. And better yet, I am on the road to recovery and ever so close now.

[TorontoCPAPguy]

By the way, if you are okay with this catheter ablation business should you need it, be aware that these days it is still complicated but it is DAY SURGERY of about 4-5 hours in duration. Done in the morning, home for dinner. Done in the afternoon, order in a gourmet dinner to your hospital room (with some for the nurses) and home for lunch the next day. Amazing procedure should you require it.

[me50]

Doc Wils mentioned something about warm milk helping with getting to sleep (also valerian drops). I have never been able to drink warm milk or for that matter drink plain milk cold with cookies or a piece of cake. I can only drink chocolate milk. But, back to the topic at hand. I hope that you figure out what is happening and get it fixed.

Maybe try the warm milk and drops to see if you can get back to sleep fast (I think Doc said for it to work you need to relax and not read or watch tv after the milk).