Still can't sleep

[zinnia]

I've read lots of posts here and it seems that everybody is different in their C-Pap journey but the general advice is to hang in there. Some posts are downright discouraging and I feel like scrapping the whole idea. I am on Day 21 and this is not easy. I have a history of insomnia and still can't sleep with the C-Pap. I use it everynight and during the day to get my body used to the mask. I am also swallowing air. Respiratory therapist thought I was breathing through my mouth but this happens if I have the mask on and am sitting up watching television. My goal is to sleep through the night or at least get to sleep, get off B/P meds and lower pulmonary hypertension. I'm looking for feedback. Thank You.

[MrsRinPDX]

Zinnia, hang in there. I know we expect immediate changes, but the body doesn't move that fast, especially after years of abuse (sleep apnea). I certainly don't think you're alone.

[Soothest Sleep]

Hi, Zinnia,

First, a short overview of aerophagia (swallowing air) and its resolution is available here: https://www.sleepapnea.org/treat/cpap-t ... solutions/

The cpaptalk archives are full of posts about aerophagia, so that is a place to begin reading of others' experiences.

Then, it is possible to tweak your therapeutic settings, if you are comfortable doing that on your own, and have determined that doing so may improve therapy. You'd need to get the Provider Manual for your machine, and also the Sleepyhead software (free).
To order the provider manual: http://www.apneaboard.com/adjust-cpap-p ... tup-manual, scroll to Section Three to find your machine, scroll to near bottom of page for info on ordering.
Sleepyhead: https://sleep.tnet.com/resources/sleepyhead

Please update your Equipment Profile, so your machine/mask/etc. will show at the bottom of each of your posts. This will prevent you from being asked for that information every time you request some help, and speed up the process.
At the top left of the cpaptalk page, click on User Control Panel, then Profile tab, then Edit Equipment. Use the drop-down menus to make your selections. If your equipment isn't listed, type in the information to the Additional Comments box.

Besides just fitting and getting used to the feel of the mask on one's face and how to breathe with or against the air pressure, there is a large quantity of information to absorb about how the machine works, how to change comfort settings or therapeutic settings, how to deal with insurance/DME/doctor issues, and get some needed sleep! It can be overwhelming and discouraging.

Achieving successful treatment is do-able, and yes, each of us has a slightly different journey. But it's a wide road with lots of company, so don't give up. Take a problem-solving approach; be as specific as you can when you offer up a problem for review on the forum; try new remedies one at a time and record results so you can track progress or develop further problem-solving strategies; read the archives.

Keep on!
Jean

[kteague]

Yes, the adjustment period can be beyond discouraging. Please keep in mind when reading here that by it's very nature this forum is a place for those needing help with their CPAP, so what you'll find is mostly struggling newbies and some oldies who hang around to give back. Maybe reading the thread of success stories at the top of the page will help with the discouragement.

Without specifics of your treatment it will be hard for you to get targeted suggestions. Please enter your equipment in your profile, and let us know your settings. Are you having any mask fit problems? You mention having a history of insomnia. One would hope that the OSA was contributing to the insomnia, and that therapeutic treatment will help you sleep better. For that to happen you need to ascertain that your settings are optimized. Subpar treatment can be a factor in insomnia. Insomnia can come from so many causes. If it persists even with good CPAP treatment, you'll need to figure out if there are any other identifiable factors. There are some forum members (sadly) very experienced and informed on the topic of insomnia. They could talk with you more about it.

About swallowing air - What is your pressure? If your machine has a feature for exhalation relief, if you're not using it you might find it helpful. Hopefully with more information some of the good folks here will be able to assist you in your pursuit of better sleep.

[Julie]

You also talk about having pulmonary hypertension and lowering your BP, but those are two different issues. Lowering your 'regular' BP (that many of us see happen with Cpap) is not necessarily going to help your pulmonary hypertension and you may want to talk to your MD again about those two. And I hope you are not taking into account anything much that occurs when you're awake and/or sitting up. The machine is never accurate when you're awake as your breathing pattern is quite different to when you're asleep, and aerophagia and mouth breathing are also two separate issues, not particularly fixed by the same methods. You do need to deal with all these problems one at a time so you can be sure of what 'fix' is addressing which issue. Aerophagia (swallowing air and belching) is not necessarily related to mouth breathing, though they may occur coincidentally, but again have different answers.

Mouth breathing is usually addressed by either a full face mask, taping, a chin strap (not as effective) and/or a soft cervical collar. Aerophagia by (possibly) lowering your min. pressure setting by 1-2 cms, or on occasion raising the head of your bed on 4-5" blocks (that is also very helpful in dealing with acid reflux), but there is more to it as others have suggested.

As far as insomnia goes, what have you tried in the past to try and help - changes to how many hrs or which ones you sleep? Not staring at bright screens for some time before bed? Being sure no meds or caffeine are making things worse? Have you tried meditation or some OTC pill?

I realize you may know about many of the things I mentioned already, but it does help to address one at a time - during which time you may still not sleep or feel better until the rest are improved, but at least you might get a better handle on individual ones. Not sure if any of this is helpful or old hat to you, but hope getting them sorted helps.

[49er]

I've read lots of posts here and it seems that everybody is different in their C-Pap journey but the general advice is to hang in there. Some posts are downright discouraging and I feel like scrapping the whole idea. I am on Day 21 and this is not easy. I have a history of insomnia and still can't sleep with the C-Pap. I use it everynight and during the day to get my body used to the mask. I am also swallowing air. Respiratory therapist thought I was breathing through my mouth but this happens if I have the mask on and am sitting up watching television. My goal is to sleep through the night or at least get to sleep, get off B/P meds and lower pulmonary hypertension. I'm looking for feedback. Thank You.

Hi zinnia,

Could your blood pressure meds be causing insomnia? You might want to see if anything you are taking is included on the AARP list.

https://www.aarp.org/health/drugs-suppl ... omnia.html

[ShiftWorker]

Hello Zinnia,
I have been diagnosed with sleep onset insomnia, after talking to my sleep Dr. she suggested that it appears from my sleep study that i stop breathing or breath extremely shallow when transitioning to sleep, this of course wakes me up. The good Dr. thinks that my brain has been trained to not want to sleep because I will wake in a panic. Getting used to sleeping with my Xpap and mask has been hit or miss, but either way I do not go to sleep easily. I do find however that when I am able to fall asleep with the mask on, I feel much much more rested the next day. For my journey I need to retrain my brain to thinking that falling asleep is good, this will only happen with time, I've been at this for about four months and still have trouble falling asleep with the machine on, I pay for that the next day so i try again, night after night. I know I am in for the long haul, i didn't get this serious sleep disordered breathing thing overnight, it wont be fixed overnight.

[zinnia]

Thank you everybody for your comments. I added my equipment profile (didn't know how to do this so thank you) and I checked the links sent. All the comments are appreciated and helpful. Back to my C-Pap journey again tonight.

[raysgirl]

"The study “Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension,” suggests that continuous positive airway pressure (CPAP) is effective in the treatment of patients to significantly improve cardiac function, sympathetic activity and quality of life. The treatment can help reduce pulmonary artery pressure, increase left ventricular function and functional capacity, and decrease norepinephrine levels."

Sleep apnea is common cause of pulmonary hypertension so stay in there. I am being very compliant for the same reason. I also have COPD, although that likely has a different cause. To me, anything that improves any function is worth it.

I do not get a good sense of whether you find the mask uncomfortable or what that issue is. I am also an air swallower, but only (usually) when I have to use my mouth to breathe. I have a different idea for you and I doubt you will find anything in literature, at least I didn't. Try, instead of the mask, wearing a chin strap during the day. Look at everyone you can find online before choosing one. Force more nasal breathing during the day and maybe you will do more at night. You could also ask about switching to a nasal set up but you will need a chin strap, too, at night. The mask, full face mask, I have, generally assists in keeping my mouth closed at night.

It does sound like you may have some insomnia mixed in here and any discomfort will probably exacerbate that, but anything really sedating will exacerbate your apnea, so it's kind of a Catch 22. Avoid any electronic screens for at least an hour before sleep unless they offer nightshade. Keep away from ALL stimulating drinks during the day. Switch to herbal teas and maybe something with honey and chamomile before bed. Ask your doctor about adding Melatonin to any routine you do have.

Keep up trying to be compliant. Call your local hospital and speak to respiratory therapy and see if they have ideas. If your DME actually has a respiratory therapist he/she might have some ideas. Don't be afraid to reach out. And please do not give up!