trouble falling asleep

[tiredandscared]

Hello again.

I've done pretty much everything that can be expected to become therapy compliant. Eliminated leaks, carefully followed mask instructions, turned off the ramp feature to avoid unnecessary increases in airpressure that causes awakenings, used the mask during the day to get accustomed to it, and used remzzz to eliminate discomfort. It's still impossible to fall asleep with the device. I can count the times, I've been able to fall asleep briefly on one hand. And while they were restful and I woke up clear in the head. They were brief and are hard to reproduce.

Any ideas what I should do at this point. I feel like I've tried just about everything. Any ideas on what I should try next?

[49er]

Hello again.

I've done pretty much everything that can be expected to become therapy compliant. Eliminated leaks, carefully followed mask instructions, turned off the ramp feature to avoid unnecessary increases in airpressure that causes awakenings, used the mask during the day to get accustomed to it, and used remzzz to eliminate discomfort. It's still impossible to fall asleep with the device. I can count the times, I've been able to fall asleep briefly on one hand. And while they were restful and I woke up clear in the head. They were brief and are hard to reproduce.

Any ideas what I should do at this point. I feel like I've tried just about everything. Any ideas on what I should try next?

My apologies if this has been mentioned but what about listening to a podcast that won't keep you awake?

49er

[tiredandscared]

Hello again.

I've done pretty much everything that can be expected to become therapy compliant. Eliminated leaks, carefully followed mask instructions, turned off the ramp feature to avoid unnecessary increases in airpressure that causes awakenings, used the mask during the day to get accustomed to it, and used remzzz to eliminate discomfort. It's still impossible to fall asleep with the device. I can count the times, I've been able to fall asleep briefly on one hand. And while they were restful and I woke up clear in the head. They were brief and are hard to reproduce.

Any ideas what I should do at this point. I feel like I've tried just about everything. Any ideas on what I should try next?

My apologies if this has been mentioned but what about listening to a podcast that won't keep you awake?

49er

I can try. Not sure if it will work though. The main problem that I have is that the mask that works for me basically is a little leaky. And it has a lower seam that presses against the philtrum.

[Michelle-OH]

Prior to cpap did you fall asleep easily? I have never fallen asleep quickly and I haven't found that to change with the cpap, don't know if it's supposed to help with falling asleep, but it definitely helps me stay asleep.

[tiredandscared]

Prior to cpap did you fall asleep easily? I have never fallen asleep quickly and I haven't found that to change with the cpap, don't know if it's supposed to help with falling asleep, but it definitely helps me stay asleep.

Yes. Prior to getting OSA. Sleeping took 10 minutes max.

[Sir NoddinOff]

I can't remember you mentioning but did you ever look over your med's situation. Sometimes swapping out different types can help. It did for me regarding heart meds. Also: Do a special scrutiny of OTC sleep aids and anti-anxiety meds or tranqs. These usually need to be tapered off... especially if used daily. Caffeine is another thing to look at. Too much alcohol before bedtime is not helpful for sleep quality, also eating before bedtime can be a problem for some people. Both these last two things I had to change big-time.

Lots of members have found relief by making some changes on the above items, so come back with some likely candidates and let's sort thru them.

[Gasper62]

I use low doses of Ambien to put me to sleep. It works well for me. I'd probably lay awake for 1-2 hours without it, that is unacceptable for me. And yes, I know all the wannabe doctors on here will line up to advise against it. To them I say, "don't take any yourself". My board certified neurologist prescribes it for me. Good luck with your therapy.

[PoolQ]

A couple things:
"turned off the ramp feature to avoid unnecessary increases in air pressure " not exactly what ramp does. IF you are having trouble falling asleep BECAUSE your starting pressure is uncomfortable, ramp lets you set a lower pressure and the ramps to your starting pressure in an amount of time that you set. For you the because part is relevant-yes or no?

There is a reason that you are not falling asleep and it has something to do with CPAP-given. Something is making you uncomfortable: starting pressure?, Humidity or lack of?, temperature coming out of the hose?, EPR setting?

Take one of these and make a small change then sleep on it, better, worse, or the same. make a note of what you are doing (you will not remember as many changes as you will be making). If you can't tell do another night, if it's obvious worse set it for a step in the other direction. If it's better try another step until it gets worse and back up to a good spot.

Move on to the next comfort feature. If you really go after it, I found that some I did at the start could be tweaked again as some of the later settings changed the sweet spot for the first ones.

Some you will be able to tell right away, change it, put the mask on, lay down for a couple minutes and see if you notice a difference without having to spend a night or more figuring it out.

A lot of work, maybe, but it sure worked for me

[tiredandscared]

A couple things:
"turned off the ramp feature to avoid unnecessary increases in air pressure " not exactly what ramp does. IF you are having trouble falling asleep BECAUSE your starting pressure is uncomfortable, ramp lets you set a lower pressure and the ramps to your starting pressure in an amount of time that you set. For you the because part is relevant-yes or no?

There is a reason that you are not falling asleep and it has something to do with CPAP-given. Something is making you uncomfortable: starting pressure?, Humidity or lack of?, temperature coming out of the hose?, EPR setting?

Take one of these and make a small change then sleep on it, better, worse, or the same. make a note of what you are doing (you will not remember as many changes as you will be making). If you can't tell do another night, if it's obvious worse set it for a step in the other direction. If it's better try another step until it gets worse and back up to a good spot.

Move on to the next comfort feature. If you really go after it, I found that some I did at the start could be tweaked again as some of the later settings changed the sweet spot for the first ones.

Some you will be able to tell right away, change it, put the mask on, lay down for a couple minutes and see if you notice a difference without having to spend a night or more figuring it out.

A lot of work, maybe, but it sure worked for me

My biggest issue is a design flaw on the elan cloth mask I'm using. Its lower seam presses on the space between the lip far too much for comfort. And it's not possible to have a good seal without doing this. It makes the entire ordeal uncomfortable. Also the exhalation ports cold airflow irritates my lip.

[Gasper62]

Sounds like you need to keep looking for your 'ideal" mask. I used 5 different ones before I finally settled on the F10.

[BlackSpinner]

Of primary importance is to sleep, leaks are secondary. Sleep with the leaky but comfortable mask for a few weeks, let the machine deal with it. Get used to sleeping with a mask for long lengths of time. Then when you have that going for you, then start tweaking to get the perfect mask. Do not focus on perfection, you will not find it. Imperfect sleep is better then no sleep. A leaky mask is better then no mask or no sleep.

[tiredandscared]

Of primary importance is to sleep, leaks are secondary. Sleep with the leaky but comfortable mask for a few weeks, let the machine deal with it. Get used to sleeping with a mask for long lengths of time. Then when you have that going for you, then start tweaking to get the perfect mask. Do not focus on perfection, you will not find it. Imperfect sleep is better then no sleep. A leaky mask is better then no mask or no sleep.

My going to do this. I'd have gotten another mask. But most masks are made with silicone/latex. If anyone knows of any that off-gas pretty quickly but are relatively comfortable. I'd try them. I'm using the elan soft cloth mostly out of allergies to chemicals.

[BlackSpinner]

Of primary importance is to sleep, leaks are secondary. Sleep with the leaky but comfortable mask for a few weeks, let the machine deal with it. Get used to sleeping with a mask for long lengths of time. Then when you have that going for you, then start tweaking to get the perfect mask. Do not focus on perfection, you will not find it. Imperfect sleep is better then no sleep. A leaky mask is better then no mask or no sleep.

My going to do this. I'd have gotten another mask. But most masks are made with silicone/latex. If anyone knows of any that off-gas pretty quickly but are relatively comfortable. I'd try them. I'm using the elan soft cloth mostly out of allergies to chemicals.

Good - My sleep doctor put everyone on at a pressure of 7 before titrating them. He firmly believed that the first month was all about adjusting to sleeping with a mask, not about getting your therapy maximized. He was also very enthusiastic about people controlling their own therapy and pressures. He put his hand on a 3inch thick folder as he said that - imply he had more interesting things to deal with.

[Sir NoddinOff]

Sounds like you need to keep looking for your 'ideal" mask. I used 5 different ones before I finally settled on the F10.

I had exactly the same experience and ended up with the ResMed F10... sometimes you just have to cut your losses after a valid mask test period and try different types. I probably tried eight different ones over a year's time. Sticking with a test mask for a few weeks, or up to a month, is certainly not unreasonable.