Can't sleep and have sleep apnea!
by Bob
(Santa Barbara, CA, USA)
If you're a sleep apnea patient and struggling to fall asleep, then the answer from this page may interest you.
Here is Bob's story about his sleeping issue:
My main problem is staying asleep. I have tried Ambien and Lunesta.
They seem to be too short term. I tried Clonazapam in the past but had terrible side effects from it.
I think if I could find something to really knock me out, I could keep my CPAP on. As it is, when I wake up I take it off.
Another thing that bothers me is that I am very congested in my throat. Lots of mucus in my throat and I am constantly clearing. Checked for sinus condition and that is not an issue.
Lack of sleep is really becoming a major issue. I am so weak and fatigued I can hardly stand up. I have had three sleep tests by different doctors and all say I have Obstructive Sleep Apnea. All my other tests, including one on my heart, are normal.
Answer
I've always thought that
sleep apnea and insomnia is the worst combination possible for a patient with sleep disorders.
Sometimes patients who know that they have apnea are scared to go to sleep - psychophysiological insomnia - which is a type of insomnia that is associated with excessive worrying.
Stress from CPAP
Most often, the roots of this excessive worry are problems that have started during the
adjustment period to CPAP.
Here are some questions that I have for you, related to the time when you tried to sleep with the CPAP for the first time:
- are you afraid to go to sleep, worrying that you will stop breathing?
- do you have problems with your CPAP mask? A lot of patients have issues with leaks, or fear of suffocation (claustrophobic feelings).
- did you have any other problems during the first nights of using the CPAP?
Answering to these questions will reveal a hint of your cause of insomnia, and it's a good start in your way to a better understanding of your problem.
I recommend you to read the article about
CPAP claustrophobia, which contains tips to help you accept the mask on your face without panicking.
Insomnia Caused by Health Problems
Furthermore, insomnia can be caused by unexpected health problems, such as:
If you have other causes of insomnia, you really need to
tackle insomnia first and then deal with CPAP therapy.
Your CPAP Mask May Worsen Insomnia
No matter what is the cause of your insomnia, you need a perfect CPAP mask for your face. That's because adjusting your mask when you should be sleeping is likely to make your insomnia
worse before it gets better.
How CPAP Can Make Your Insomnia Worse?
You've got two things going on: CPAP adjustment is bad enough by itself. But in this case, the CPAP adjustment appears to be feeding the insomnia symptom (which you already have) that will have to be dealt with on its own terms at some point as well.
And hence you're trapped in a cycle that's feeding on itself:
Adjusting to CPAP mask feeds the insomnia which makes it hard to adjust to CPAP, which feeds the insomnia, which makes it hard to adjust to CPAP, which feeds the insomnia, which makes it hard to adjust to CPAP, which feeds the insomnia, which...Bottom line... You'll never break out of this cycle and adjust to CPAP if you don't start working on the insomnia as an issue that deserves attention all by itself!
In particular, to deal with the insomnia you need to focus serious attention on your sleep hygiene.
Dealing with the insomnia directly will help you deal indirectly with some of the
CPAP adjustment issues simply by allowing you to worry less about sleep overall.
I hope it helps!
Remy Thierry
Founder of Sleep Apnea Guide