the fact that you are dreaming is good
it means you are getting REM sleep which is much needed
Ernestine, you may certainly have some depression. Losing a job you loved is a major stressor. Add to that the insomnia and poor quality of sleep, the OSA... A consultation with a psychiatrist- if you don't have insurance contact your local Community Services Board and see if they can help- might be helpful. I wouldn't even speculate what the suggestion from a psychiatrist might be, but I do think it's worth a try. Good luck.
To add something. I was surprised that one of the things mentioned on a placard in my doctors office that improved sleep would be a result of CPAP. I don't necessarily think this is the case. Perhaps the sleep is healthier, but many of the sleep problems we had before our diagnosis and use of the machine carry over. There are many reasons our sleep is disturbed that CPAP won't help. Stress, depression, insomnia, being a caregiver during the night, shift work, to name just a few. I bought some sleeptime tea yesterday and have resolved to work on my sleep hygiene a bit more.
I really agree with what Mary says. CPAP is not a panacea, which is something I learned a bit to my regret. I thought that once I knew the reason I was always so tired, all I had to do was slap on my mask, turn on my CPAP, and off to dreamland with getting lots of wonderful sleep to power my day.
That said, I've learned that good leep hygiene is really important and makes a difference. Really. In addition, something that is wholly underappreciated is the powerful effect of exercise on how we feel.
Below is a YouTube video that Rock posted some time ago. Please watch it, particularly those of you coping with depression, which can be -- and is -- so devastating.
Lots of interest and discussion here. I myself having been on c-pap for 16 years had a marked improvment in how I felt. I probably improved about 80%. The depression went away, the bone tired that I had went away, but I still need a nap most days, or I'll be quite sleepy if I have to sit down at a desk at work in the afternoon. I don't remember feeling that way years before c-pap, but that was a symptom for the five, or so years leading up to the OSA diagnosis. C-pap doesn't cure everything, but it certainly works very well. I don't know what kind of shape I'd be in by now if I didn't have it, or if I wound even be still alive by now without it.
Hi Ernestine and others
Your advice is excellent.
I just want to plead to people to use the new electric candles and not to resort to wax candles.
Especially before bedtime, wax candles can be a real fire hazard.
Thanks and have great and safe sleep.
I was misdiagnosed at a sleep disorder clinic as having insomnia when, in fact, I have SA. The clinic never ordered an overnight because it was so sure that all I have (had?) is garden variety insomnia. That said, the doctors did convey useful sleep hygiene tips. I suspect that they would help you, so I'll pass them on.
In addition to keeping to regular bedtime and waking hours, including on weekends, observe the following:
- No alcohol four hours before bedtime.
- No eating (other than a small, non-sugary snack) for 3 to 4 hours before bedtime.
- Close down your computer 60 to 90 minutes before bedtime.
- Lower your lights (for a while, I even resorted to candlelight!) an hour or so before bedtime.
- Do things that calm and relax you an hour to 90 minutes before retiring. Examples: read, listen to music, pet your dog or cat, chat with a family member or call a friend, etc.
- Go to bed when you're drowsy.
Don't forget the basics like: a dark room, cool ambient temperature, and a comfortable bed and bed clothes.
These are small things but all together, I've found that they make a difference.
Ernestine Webster said:
i was wondering the same thing about going in for a followup sleep study, as you know i have been on cpap for about 8 months now and am still having problems falling asleep even with going to bed as soon as i take the ambien, thinking i may be growing a tolorance to this sleep aid i started taking 300 mg of the Gab, capsule that was prescribed by my sleep doctor , i have been going to the same sleep doctor for the entire time of 8 months and he is always wanting to change mask which i keep telling him it is not the mask it is me but i still do not know why i still have problems falling asleep . i still see no difference in the quanity of sleep i get. the quality of sleep is better . i wonder if i should see a different sleep doctor and have another sleep study done. i have no doubt i have sleep apnea because of the way i feel when i get up in the mornings but i have insomina as well and really do not know where to turn to find out what the problem is with that.
Many sleep meds can cause scary dreams. Gabapentin didn't do that to me, although it made me moody/grumpy (but didn't get me to sleep well either), but Ambien gave me absolutely disgusting (rather than scary) dreams after about a week and half of use. Different brains, different brain chemistry issues. If Gabapentin gives you bad dreams, talk with your doctor about using a different med. I've been on several, currently using Restoril (temazepam), but it's effect is lessening over time (been on it for about a year), so time to go back and see what comes next. I have RLS (restless leg syndrome) extreme SA (AHI at clinic 18 months ago was 63).
From my experience (have had a CPAP for about nine years) - a CPAP doesn't help me get to sleep, it improves the quality of sleep. Insomnia is 'orthogonal' to SA - you can have one, the other, or both. My specialist tells me that I have good 'sleep architecture' when I can get to sleep and am on my CPAP. The downside is that my body gets me absolutely wired at night time, partly related to thyroid issues. I had low thyroid and was taking levothyroxine, which also made me wired. I started taking iron, and my thyroid kicked back in, so I no longer take levothyroxine, but now my own thyroid levels make me wired. I used to go out and walk for a couple of hours a night (or more) when this happened, and then could sleep. Several years ago I developed RA (rheumatoid arthritis), with complications in my feet make my nightly walks impossible. Hence, the sleeping meds.
You need to work out these combination issues with your doctors. In addition to my sleep doc, I have been seeing an Integrative Medicine doc, and the supplements have made it possible to get off several of my meds by actually correcting underlying conditions. My GERD is gone, so don't need PPIs - was on Prilosec for several years - my thyroid is working, so don't need levothyroxine - my RA is improving, but still working on it. Insomnia is still an issue for me, but working on it - none of the supplements that I've tried work for me, almost anything that modifies GABA, and any SSRI causes me to be moody or unable to work (can't get things done). Valerian makes me grumpy. L-Tryptophan makes me more wakeful (so much for the stories of Turkey making us sleepy!'Supplements' are not necessarily better (or worse) than 'drugs' - supplements like these are really drugs with different label. Mineral supplements like magnesium can help sleep too, especially if you are not getting enough of it in your diet (which most of us aren't).
Find a good doctor that you can work with (that is a tall order, I know!) and see if you can correct the underlying conditions causing your insomnia, and you may be able to get away from the stronger sleep meds (and their side effects), or at least use them less.
I'm still not there yet - but taking it one step at a time.
Ernestine Webster said:
Terry Vella said:
I am a similar position as you. I have insomnia from all the stress in my life. Was taking 30 mg temazepan and still not getting to sleep till midnight or later then had to get up at 4. It god not help that I need to be on my stumick (sp?) to get to sleep. Have never gotten along with my cpap and after an issue during a surgery (mind woke up but the body did not) I really have an issue with anything on my face. with help from God I am slowly working out the stress but still don't like anything on my face. I would try different masks but once you use one you have bought it.
Ernestine Webster said:
Terry Vella said:
Richard, this is the URL for a mask trial program. For $14, the cost of postage each way, you can try out a mask for a week. It's a relatively inexpensive way to try out different masks. I tried out the quattro fx and didn't have to wait long at all to get one in the mail. If you like the mask, buy it the least expensive place, or wait for insurance to pay for a new mask. Hope this helps.
If you want less face coverage (I can understand that, it took my mother several months to get used to regular CPAP use, she didn't like anything on her face either), you might try nose pillows. I use the 'Breeze SleepGear' (Puritan Bennett- oops, "Covidien' now!), which only touches my nostrils - the rest of the set is on my head (they make a 'DreamSeal' version that covers the nose instead of nose pillows, I've used that one too. There are other nose pillows as well, some have a small band that goes around the head. You may find that once you have CPAP running that you can sleep on your side, sleeping on your stomach is sometimes a reaction to the apnea - your airway might be more open when on your stomach. The Breeze is excellent for side-sleeping (the reason I started using it), but might require customising a pillow to use when on your stomach. It's air vent is directly forward, and you don't want to cover it up or you will breathe too much carbon dioxide.
Definitely try different masks and even different CPAP machine settings to see if you can find a combination that works for you. It can take a while to get used to any CPAP configuration.
Some doctors may have 'sample' headgear that they will lend (or give) you. My wife, who is a recent CPAP user, just got a new mask from our sleep doc, as the first mask wasn't sized correctly.
If you have to buy gear, it's usually less expensive over the net, at sites like cpap.com and cpapwholesale.com than at most local providers - for equipment not covered by my insurance, some of the differences are staggering! When out of town and one of my nasal pillows went missing, the local provider charged me $50 for a pair of pillows! They apologised profusely while taking my money... CPAP isn't 'optional' for me, I must use it every night, so I paid the $50. The price on the net - $10. Sigh. I now make sure that I always have spare nose pillows in my CPAP bag!
Mary Z said:
Have you been evaluated for anxiety? Even GAD which is Generalized Anxiety Disorder?
I deal every day with anxiety (am medicated for it) but a couple years ago I was hit with it so bad (for about 6 months) that I couldn't leave the house without crying, I hid important things when I went to bed, I couldn't watch anything on TV other than comedies (literally nothing but comedies), etc.
But my reason for bringing it up is because I had severe troubles falling asleep during that time frame and when I did finally fall asleep the slightest noise, or flash of light, would wake me up and I was then awake for the rest of the night and then dragging myself out of bed.
I do take Ambien regularly and during that time frame they had me on two different forms of Ambien, one "regular release" and one "extended release" and even that didn't help.
Based on what you've gone through lately you could be experiencing anxiety (instead of or in addition to depression) over what's going to happen, and you might not even realize that you're experiencing anxiety, and that might be what's causing troubles with falling asleep.
Also, I read that doing gentle yoga (easy stretching moves) can help. There are also some "sleep CD's" (couldn't think of what else to call it but I have mine on my iPod and I put it in my iHome to listen to it) that you can play low in the background (I'm not talking the sound of waves or that sort of thing) and it slows you down and hopefully helps you to go to sleep. I use "Chakra Chants" by Jonathan Goldman. :)
Just a thought... :)
Best of luck with it!!
Ernestine Webster said:
Terry Vella said: