CPAP Troubles (or My Sleeping Adventures as a Fighter Pilot)

June 13, 2010 2:10 AM

Why am I waking up 3x or more with CPAP?

So I've been diagnosed with obstructive sleep apnea a few weeks ago after I had terrible headaches throughout the day.

I now own a CPAP machine with the nasal mask, but one of my previous symptoms still remains. I am still waking up a few times during the night! I thought the CPAP was meant to cure this very thing?

I am generally aware of my surroundings, as if I just woke up normally and was ready to start my day.

This is roughly the 6th night I've used the CPAP for sleep.

How can this be, hive mind?

posted by anonymous to health & fitness (12 answers total)

Hmmmm. I used to work as a polysomnographic technologist (try and fit that in one of those little "profession" boxes on paperwork!), and I use CPAP myself, so I am not completely blowing smoke here...

First off, you mention this is your sixth night on CPAP. Are you on a single pressure machine or a BiPAP (which raises and lowers pressure in sync with your breathing)? Also, are you ramping up pressure slowly or just going straight to the recommended pressure?

Shooting from the hip, I would council you not to worry. It often takes people far more than just six days to adapt to using a CPAP. Personally, it took me about two and a half to three weeks to just stop taking the mask off while asleep, much less actually sleep undisturbed. I'll check in later to see what you say.
posted by Samizdata at 4:51 AM on June 13, 2010

You could be bypassing your mask, too. Do you sleep with anyone? My ex used a BiPAP, and I quickly learned to wake her when she bypassed or her mask was leaking.
posted by QIbHom at 5:54 AM on June 13, 2010

All I can say is that it takes time to get used to sleeping with a mask and a tube hanging from your face. Took me a good three weeks before I got used to it.

Patience.
posted by DieHipsterDie at 6:45 AM on June 13, 2010

All I can say is that it takes time to get used to sleeping with a mask and a tube hanging from your face.

Oh ye fishes and little gods yes!

I started CPAP in late November, it wasn't until late January that I was used to it.

It's normal to take it off in your sleep, develop leaks etc.

A few tips

1) I found wiping down my face and mask down thoroughly with baby wipes (I use Huggies fragrance free with aloe vera, but try a few and see which is gentlest on your skin) just before putting my mask on hugely reduced the amount of leaks that I sprang.

Your face is covered in sweat and oil (even if it seems clean) which stops you getting a good seal between the mask and your face - this means that when the pressure ramps up after you fall asleep, you can spring leaks.

2) Frequent waking up can mean that your pressure is too low, and you are still having some apneas. Talk to your sleep clinic and they can rent you a diagnostic machine, which will adjust the pressure through the night to work out what the minimum pressure that stops your apneas is.

In my case, I started with 9 units of pressure, but it wasn't until the sleep lab switched me to 11 units of pressure that I stopped waking up at night to find that I had taken my mask off.
posted by Year of meteors at 7:22 AM on June 13, 2010 [2 favorites]

It took me months to get my CPAP working well for me. I wasn't uncomfortable with the mask, but I had terrible problems with leaking (I still wear the same type of mask and rarely have trouble with it now, it doesn't seem like rocket science but for some reason it took a long time and a lot of trial and error). I had heard all of these stories from people whose lives were changed overnight! by their CPAP but I had a pretty long period of sleeping worse with it on than off, and it was frustrating and hard to stick with it. I threw my mask at the wall in the middle of the night once, I was so frustrated.

You may still be waking up but for different reasons. I hope you'll find that with a bit more time this problem will resolve.
posted by not that girl at 7:24 AM on June 13, 2010

Oh God yes, be patient. It can be a monumental struggle to make CPAP work, and each person will have their own unique set of challenges. Not all of them have easy fixes, and finding the right help for your set of circumstances can be nigh-on impossible (even with all kinds of forums) - you may have to get creative on your own.

You didn't mention anything about claustrophobia so I'm assuming that's not a problem. Good on you for getting used to it so soon; I had to try just about every kind of mask before that problem went away.

Here are just a few of the things I had to do in order to keep my mask on (after spending a couple of months overcoming the claustrophobia of a full face mask):
- Wearing gloves to stop me from taking the mask off (initially I was doing this automatically)
- Finding the right position for my hands so I'd be less likely to 'paw' off the mask in my sleep
- Getting the pressure right (when mine was too high it caused gas painful enough to wake me up)
- Getting the hose in the right position (enough play for it to move when I turn, but not too much to sag onto my head; at the right angle to be over me instead of beside me... this took weeks to figure out)
- Getting the humidity right (not so little as to wake up with a dry nose, not so much as to have condensation dripping on you)
- Shaving my mustache, suspending the hose above me and even applying chapstick to get a better mask seal
(And those are just ones I remember off the top of my head.)

Some of the things that can still cause me to wake up:
- Too much stress in the day
- Too much mask noise
- Uncomfortable bed
- Other existing conditions (too much protein or dense food after dinner means it'll be a rough night)
- Too much caffeine (just grabbing a chocolate chip cookie and forgetting to pick a decaf tea sometimes does it)
- Wrong temperature in the room (warmer is better for falling asleep; cooler is better for staying asleep)

Since it's only been a short time that you've been on CPAP, I'd venture to guess you're not completely acclimatized to this new sleep environment. A changed sleep setup takes time to become the new normal; give it time to 'sink in'. And make sure you're doing as much as possible to practice good sleep hygiene.

If there's any particular problem among this list that you have, write back - I can get more specific about what worked for me.
posted by Hardcore Poser at 7:34 AM on June 13, 2010

I wouldn't worry too much. I began using a CPAP in November, and I remember waking up two or three times a night during the first couple of weeks.

Your body is accustomed to certain sleep habits that you've developed over your entire life. You've just introduced something that is a new and sudden difference.

Since your body moves through a few cycles of light/deep/light sleep at night, you're probably waking up during the light parts of your cycle, because your body feels the new, weird thing on your face and brings you to consciousness.

You mentioned that you use a nasal mask. Is it a nasal mask like this, or a nasal pillow mask like this? When I had my sleep study, every type of mask bothered me except the nasal pillows, which I currently use (Opus 360 model in the above link). It took me a little while to get the straps adjusted just-so.
posted by Fleebnork at 8:16 AM on June 13, 2010

I was waking up all night for several years and my doctor encouraged me to do a sleep study. I feel certain I would have wound up with a CPAP machine. I never could find time to get to the study and I remained fatigued during the day...Recently, I stopped drinking caffeine altogether. (I was drinking both a lot of coffee AND diet colas). Immediately, almost on the very first night of "no caffeine"--I stopped waking up all night. You should consider my story if you drink caffeinated drinks. People underestimate the effect caffeine has.
posted by naplesyellow at 8:50 AM on June 13, 2010

@naplesyellow, it's a bit off topic, but no one should end up with a CPAP machine without first trying simple sleep hygiene like cutting out caffeine, not taking naps during the day, and doing a quiet routine of activities prior to bed (not watching TV or using the computer), and not doing those things in bed, only getting in bed to sleep.

sleep studies cost like a thousand dollars (and CPAPs at least a couple of hundred), it would be a waste to do one on a person who had not tried the easy stuff yet.
posted by treehorn+bunny at 7:46 PM on June 13, 2010

You can't just go buy one and start using it. You have to get a sleep study first. Once you've had a diagnosis based on the sleep study, your doctor would write you a prescription for a CPAP machine, or if a CPAP were unnecessary, diagnose things like cutting back on caffeine.
posted by Fleebnork at 11:52 AM on June 14, 2010

treehorn+bunny, you're missing the fact that the poster has been diagnosed with obstructive sleep apnea. Dietary changes and bedtime routines are never going to cure that.
posted by desjardins at 3:12 PM on June 14, 2010

I agree with everyone else that it just takes time.

It'll take a while, but eventually you'll figure out all of the dozens of little things (hose position, how the straps around the head are positioned, the tightness of the mask, etc).

I think it took me about a month to figure everything out. In the very beginning I really had a hard time falling asleep and I'd take off the mask out of frustration. As the days went on I adjusted everything a bit and eventually it got easier and easier. But, now that it's all good, I get a "Pavlov's dogs" type reaction as soon as put on the mask. I almost fall asleep instantly.

It might suck now. But, when it starts working, you'll feel so good you wonder how you lived a single day without it.
posted by sideshow at 9:18 PM on June 14, 2010