Falling asleep with a six foot hose attached to your face is not exactly instinctive. So it’s no surprise that many people have some trouble getting to sleep and staying asleep as they start their C-PAP therapy. After all, there’s so much to get used to:
- Sensory Overload- Triggered by the air blowing into your nose, the noise the machine makes, and the sensation of the mask on your face can be so irritating. Then possible leaks are waking you up. On top of that you have to deal with aerophagia, a dry mouth, a dry nose, and skin problems triggered by the mask. Need I say more?
- Mask Problems- A properly tightened mask is important but is it too tight? Or is it too loose? Mask leaks blowing into your eyes or onto your lips; exhaust flow from the mask bouncing off the covers and back into your eyes or onto your chest; removing the mask in your sleep; wanting to remove the mask so that you can get to sleep; worrying about leaks so much that you are not able to properly relax to get to sleep; and worrying about dislodging the mask to the point of feeling like you can’t move around in bed as much as you’d like.
- Under Pressure- There is a feeling that your breathing is so abnormal that you can’t relax enough to fall asleep. You have difficulties with exhaling against the pressure, trouble with feeling like you can’t properly inhale or can’t get enough air through the mask. Especially during the ramp period (if you use the ramp). Your feeling like the machine is pushing you to inhale when the exhale relief system is turned on; too much air in your mouth, swallowing air, aerophagia, etc.
- Humidifier Issues- Including rain-out; congestion caused by too little or too much humidity; air feeling too warm, too wet, too cold, too dry. Your concerned that the humidifier may run dry.
- Hose Issues- Finally getting tangled in the hose when you want to turn over; disliking the feel of the hose when your arms or chest bump up against it; weight of hose pulling the mask out of position; feeling tethered or trapped by the hose. It may feel sometimes your being slapped by the trunk of an elephant.
With all this to get use to maybe you are having trouble falling asleep. But like the proverbial question, “which came first the chicken or the egg?” The question researchers are asking is, “which came first insomnia or sleep apnea?”
It has been recognized for some time that underlying medical conditions like sleep apnea may be the cause of insomnia. The startling results of a pilot study published in “Sleep” conducted by prominent sleep doctor Barry Krakow M.D and three colleagues in December 2012, reveal that link may be stronger than first thought.
The study was run to help answer an intriguing question: what causes an insomniac to wake up at night? There has been a lot of research on the various reasons an insomniac cannot get to sleep but the question of why an insomniac wakes up after finally falling asleep has not been studied the same way.
To look at this question, Dr. Krakow and his colleagues first removed from the study group all the patients that failed screening for sleep apnea. 20 patients that passed screening (in other words, they did not appear to be suffering from sleep apnea based on physical traits or based on their answers to the Epworth Sleepiness Test) were used in the study and the results were startling:
- 18 of the 20 patients were found to be suffering from sleep disordered breathing that was causing them to wake up after falling asleep
- 11 of those patients were found to be suffering from obstructive sleep apnea with an average AHI (Apnea–Hypopnea Index) of 14.4 (an AHI of 15 is considered to be moderate sleep apnea)
So if you are an insomniac who wakes during the night you should consider asking your doctor to be tested for sleep apnea. Please also read about the importance of practicing good sleep hygiene to minimize symptoms of insomnia.
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Click Here To Read Sleep Apnea Guide.