Having Trouble Sleeping past 4 or 5 am

[bbrs074]

I just started CPAP Therapy a week ago. I haven't had too many problems going to sleep, and my Mask Fit and AHI numbers have been nearly perfect (Fit 100%, AHI ave 0.7). My problem is I can't seem to stay asleep very long. 6 hours is my record, but usually it's 3-4 hours. Yes, maybe the quality of the sleep has improved, but since I'm getting so little I still wake up tired, and feel tired most of the day. Anyone else have this problem? Anything you might suggest that helps you sleep longer?

[Pugsy]

Sometimes the body is just so used to poor sleep that once we start giving it good sleep with effective therapy the body thinks it doesn't need to sleep longer because these shorter hours of sleep are better than longer hours without cpap.
Sometimes the body is just used to short nights...habit mainly. I found this to be the case for myself. It took several months for the time asleep to grow from 3 to 4 hours to 5 hours...then 6 hours and then to 7 hours.
I think it was probably 3 months before I was sleeping more than 6 hours on a consistent basis.

Only suggestion...give it time and try to isolate any known reason for the wake up that might be fixable....like pain, thirst, comfort, etc.
If it persists or is just a huge problem...discuss with your doctor perhaps adding a bit of sleep aid to help stay asleep a little longer. Like a mild OTC sleep aid to start with.

Also take a look at your sleep hygiene in general to make sure you aren't doing something that is making the situation worse...like me...watch TV or use the computer way to late into the night...that's bad hygiene.

[kteague]

This is all still so new to you it's hard to know how things are going to settle in. It may be that the newness of all the sensations isn't enough to stop you from getting some some sleep when you're exhausted, but once you passed the initial sleep from exhaustion, when passing through the lighter sleep phases, it may not be enough to keep you unaware of the new sensations. Are you able to go back to sleep at all? You're right, the hours you are getting aren't enough to feel rested. There's a few things you can look at to see if you can help yourself. Are you on any meds or supplements that might be disruptive to sleep? Alcohol? Some things are known to help initiate sleep but mess with the sleep stages as the night goes on. Did your sleep study make any mention of limb movements? For some people jumpy legs can disrupt sleep. Some health issues interfere with sleep, like thyroid dysfunction, pain, etc.

Are you napping to make up the extra hours (with your machine of course)? Napping is a debatable issue. Some are in a position to force the issue and stay awake all day to make them more exhausted at night, and hopefully sleep longer. If your duties can't tolerate the misery of a sleep deprived adjustment phase, one may need to nap just so the body can began to heal and you can be functional, then work on your sleep schedule later. I tend to lean toward getting whatever sleep one can whenever one can early on, but for some that just prolongs the adjustment. Everyone has to figure out what works for them. If a person's sleep has been messed up for a long time with frequent arousals from sleep apnea (even if waking is not remembered), it may be the brain has to relearn healthy sleep patterns. Keep providing yourself an environment conducive to sleep and the problem may correct itself over time. Good luck.

[Pesser]

Anyone else have this problem? Anything you might suggest that helps you sleep longer?

I have this same problem and I have been on XPAP for a year. I feel better but I always feel like I need more sleep. My maximum sleep used to be 5:30 hours; now I am at 6:00 hours. I hope I make it to 7. Keep trying it does get better!

[Pugsy]

Couple of questions I forgot....do you take any meds of any kind and if so, what ...and do you have any other health conditions?

[LSAT]

OTC Melatonin...check with your doctor for dosage recomondations. Most drug stores sell 3mg 5mg 10mg, but usually less than 3 is enough.

[bbrs074]

Hi folks! I appreciate all of the thoughtful replies so far .... I like the idea of discussing OTC sleep aids with my Doctor. Maybe there is something mild out there that can help increase my sleep duration without causing other issues. I also appreciate the advice that this is just going to take time, and I need to be patient. As for medications ... I do take medications related to stents that I had implanted in 2002. I'm taking Metoprolol, Ramipril, and Atorvastatin (generic Lipitor). I also take an 81 mg Aspirin, and Vitamin D supplements. The ENT Doctor prescribed Nasonex nasal spray (too expensive) and Omeprazole (for acid reflux). I don't know if any of these would affect my sleep pattern. I am a very light drinker, and try not to have anything but water within 3-4 hours of bedtime.....I really don't think alcohol is a factor. I avoid caffeine after mid-day, and no caffeine at night. My wife watches TV regularly in bed till Midnight or 1 AM. This is a obvious problem, and I am going to attempt to get her to move to the family room for her late night TV (wish me luck ).

[49er]

Hi folks! I appreciate all of the thoughtful replies so far .... I like the idea of discussing OTC sleep aids with my Doctor. Maybe there is something mild out there that can help increase my sleep duration without causing other issues. I also appreciate the advice that this is just going to take time, and I need to be patient. As for medications ... I do take medications related to stents that I had implanted in 2002. I'm taking Metoprolol, Ramipril, and Atorvastatin (generic Lipitor). I also take an 81 mg Aspirin, and Vitamin D supplements. The ENT Doctor prescribed Nasonex nasal spray (too expensive) and Omeprazole (for acid reflux). I don't know if any of these would affect my sleep pattern. I am a very light drinker, and try not to have anything but water within 3-4 hours of bedtime.....I really don't think alcohol is a factor. I avoid caffeine after mid-day, and no caffeine at night. My wife watches TV regularly in bed till Midnight or 1 AM. This is a obvious problem, and I am going to attempt to get her to move to the family room for her late night TV (wish me luck ).

bbrs074,

For what it is worth, in the past, Nasonex caused insomnia. Recently, I took it again and my sleep seemed alot worse although to be honest, this time, I can't really prove a direct link to the med because so many other issues are going on.

Regarding your situation, beta blockers are also known to cause insomnia so you might investigate whether metoprolol might be a culprit. Not sure about your other meds but definitely review them.

[Pugsy]

Metoprolol...Side effects, especially with higher doses, include dizziness, drowsiness, fatigue, diarrhea, unusual dreams, ataxia, trouble sleeping,
http://en.wikipedia.org/wiki/Metoprolol

Ramipril....saw only fatigue and nothing all that much about sleep..one site mentioned nervousness but that is most likely not a factor at night..it would be a big stretch.

Atorvastatin...don't see it being a problem

I doubt your meds are 100% of the problem but the metoprolol might be impacting things slightly...I know you can't necessarily just change it and most likely what would be needed to replace it would also potentially do the same thing. It's the nature of most of those type of meds.

Often when people have trouble sleeping it isn't any one thing that is the sole problem. Often it is a combination of little things that add up to a bigger problem. That's why it's so hard to fix bad sleep.

A question I forgot to ask earlier...the wake ups during the second half of the night...was this a problem prior to cpap use or did this problem start just with cpap use?

[bbrs074]

My wake ups in the early morning preceded CPAP Therapy. I've had this issue for perhaps 15 - 20 years! I likely have suffered from mild to moderate sleep apnea for at least 20 years, but was only recently diagnosed. I've been thinking that I may have a "body clock" issue ... my body is so used to waking early that it is very difficult to change irregardless of the CPAP Therapy.

[Pugsy]

Ahhh...long term sleep maintenance insomnia....google "sleep maintenance insomnia" and start reading.
That's when we have trouble staying asleep. It's going to be a big long battle to fix.
I have a little bit of it myself but in my case I know the reason....arthritis pain that causes frequent wake ups during the night.
Between me and my doc and my bed and some meds...we keep it manageable but it's rare I don't wake a half a dozen times with pain and need to change sleeping position.

[Sir NoddinOff]

Here's a good long article on sleep disorders related to things other than apnea events. Read it over and maybe discuss it with your sleep doctor. Medications are discussed in some depth:

http://cirrie.buffalo.edu/encyclopedia/en/article/43/

[bbrs074]

Update: After a little over a week, I'm up to nearly 7 hours sleep! ... progress. I don't have a statistically significant sample yet, but I seem to be headed in the right direction Now, if I can just get my wife to turn off the TV before mid-night. Again, thanks for the replies. I decided any kind of OTC medications are a LAST resort and likely not needed. I'll talk to my cardiologist and see if it makes sense to cutback on the Metoprolol pills. I'm slowly loosing weight (which should help). Now I just need to give it some time. I definitely feel better and more "alert" than before CPAP, which I assume is the whole point.

[Julie]

Terrific! But do work on your wife , she must realize that it's a serious situation and if she has to watch, do it in the living room.