Can't sleep and have sleep apnea!

by Bob
(Santa Barbara, CA, USA)

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.

Oh, if I could just get a good night's sleep!

Answer

I've always thought that sleep apnea and insomnia is the worst combination possible for a patient with sleep disorders. I can't answer to your question from personal experience, because I don't have insomnia. However, I have a friend with sleep apnea who successfully treat his insomnia without medication.

Bob, I know that people are different, and the cause of insomnia in patients with sleep apnea syndrome can vary from person to person. But I can give you some tips from his method of treating his problem.

He thinks that 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.

A large percent of patients that have persistent insomnia and cannot be attributed to environmental or biological clock issues, will find that their insomnia are due to one of 3 physical causes:

• restless leg syndrome


• GERD


• fibromyalgia

So, this nasty insomnia can be a psychophysiological insomnia (if you don't have other problems verified by your doctor). The roots of this disorder are problems that started during the adjustment period to CPAP.

So, did you had problems with the adjustment period? Or are you afraid to go to sleep, worrying that you will stop breathing in sleep? Or maybe you have problems with your CPAP mask. A lot of patients have issues with leaks, or claustrophobia.

Do you have mask problems? If the answer is yes, then I wish I could tell you that there is an easy answer to your current week long struggle with the mask and the resulting insomnia. But there is not. There is no magic bullet. There is no instant solution. Only patience and motivation to try everything until you feel treated can be your answer.


I admit, patience is not my strength. But patience is required to both adjust to CPAP and fight the insomnia. There are no easy or quick answers.

Bottom line... If you don't have insomnia attributed to environmental or biological clock issues, then you probably have a psychological cause - which can be from a CPAP mask adjustment issue.

If this is true, then adjusting your CPAP mask on your face is likely to make insomnia worse before it gets better. That's because 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 a pretty bad insomnia creature 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...

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.

Now, I don't know if have a psychphysiological insomnia due to CPAP mask problems. So I don't see the point to continue on this subject telling you how to treat this type of insomnia.

However, if you are interested in this subject, I can help you overcame your insomnia and tolerate your CPAP without worries.

Tell me in the comments section bellow if you want to learn more.

Oh, and another thing! About the mucus problem from your throat...Have you seen a pulmonologist? Meanwhile, GERD, Acid Reflux comes to mind. Do you know if you have it? Have you been tested for it?


I hope it helps!
Remy