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4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
#1
4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
Hello Folks,
First time on here. I’ve been active on CPAP talk but not on here yet.
 
Started on CPAP in April 2014. After getting over the initial adaptation period, I thought I was a CPAP pro until recently.
I could really use some support right now.
 
I’ve been dealing with a new episode of insomnia (sleep dread) since beginning of November. This is probably the 4th time experiencing this over the last 15 years or so. Last time was in early 2013.
I have no doubt it’s anxiety based and has always occurred during periods of high stress for me. (death of parent, high stress at work, etc).
 
The first time was around 2002. I woke up from a deep sleep in a panic. It totally freaked me out. Immediately after that, I couldn’t lay down to go to sleep. I would feel the panic and have to get up.
I went into a quick downward spiral of anxiety and depression (which is not like me). I immediately scheduled and appointment and got into see a sleep specialist.
 
They discussed sleep hygiene and put me on a strict schedule, which I followed to a “T”. They also prescribed me with a 5 day supply of Ambien to help me reset my pattern.
It worked like a charm!
 
I started running, praying, etc.….. anything to help me feel better and cope with the cloud that appeared. I even started counseling. I had no idea what the heck had just happened and I faced it head on.
 
I got past this pretty quick but it was a scary time.
 
Next time was around 2008. My wife had lost her job and found another that took her out of the state for 6 months. She would come home for the weekend 2x’s a month but it was hard.
 
I was home alone with my young son and we had our house on the market. That was a rough time for a lot of people. I was working, keeping the house in show condition, taking my son to/from school, teaching in the evenings on some nights, missing my wife, etc.
 
Then it happened again. BOOM!  Wake up in a panic!  “Oh, no. Not this again”!
 
Called my GP and he prescribed me with Clonazepam (.50mg  2x per day). I only ever took .50mg at night before bed. Sometimes only .25mg. I only took as needed and never long term.
After some time and work, and getting my wife back, things went back to normal and I stopped taking the meds altogether.
 
2013 saw another episode after my Mother passed away. I recognized it for what it was but it always feels like it’s the first time and like it’s never going to go away.
This time I sought out CBT. During the CBT I experienced a health concern during a stress test. I was in great shape and had adopted a running lifestyle. I was overweight but was running about 15-20 miles per week and feeling really good. The stress test noticed an arrhythmia that is potentially deadly.
 
Long story short – hospital, tests, more tests, nothing found but to be safe, here are your new restrictions which include no running and we want you to have a sleep test because sleep apnea can cause arrhythmia’s.
 
So sleep test it is and what do you know….. I have OSA.
 
So it’s about 6 months since my last sleep anxiety episode occurred, my CBT is winding down and I’m feeling and sleeping much better.
Here, strap this thing under your nostrils and sleep tight!
 
Wow, this is hard!
 
Anxiety, claustrophobia, noisy, I’m suffocating…… I hate this thing!  Took me about 3 month’s to adapt but I did.
 
I grew to really appreciate my new friend and was really sleeping well. I had some ties where it felt like I was fighting the pressure but once my breathing calmed down, it was like it wasn’t there.
I believe undiagnosed OSA was a major factor in the sleep anxiety I began experiencing (and the development of some claustrophobia).
 
Since day 1 – not 1 night without CPAP. Maybe 1-2 naps without it but that’s it over a 4 year period.
 
Until November, 2018.
 
This time there was seemingly no external stresses that I was aware of. The only thing I can think of was I was on week 5 of a 6 week – 6 days per week workout program and perhaps the stress from trying to maintain the accumulated stresses of life at this time (combined with poor sleep hygiene) triggered it.
 
BAM!!  Wake up buddy, it’s me again!
 
Oh boy, here we go.
 
Pull out the old Clonazepam script and let’s get this thing under control quick. Well, I thought I would anyway.
 
The meds helped for a while but I really don’t like taking them and I know I need to address this tendency towards anxiety to a greater extent.
Unfortunately, I underestimated it and it’s wreaking havoc again and caused me to really fear going to bed and hate my CPAP.
 
Some nights I’m 75% ok and some nights I’m 100% not wearing that thing.
 
I started a Yoga and Meditation Class and I have just started an online CBT-I course until my name comes up on the waiting list for the CBT-I center at the university hospital my doctors are at.
 
So here I am looking for support and helpful hints to help me get over this hump.
 
One of the main issues I experience that causes my anxiety to kick in is this:
 
When I’m successful at getting my scared butt to lay down and sleep (and yes, I’m sleepy and nodding off) my mind goes to my breathing – but not in a good way. It notices it like its keeping an eye on it so it doesn’t stop (I guess).
 
As I’m nodding off it feels like I stop breathing and it wakes me up. I get tense and have to work at reframing my thoughts to a happy place. Then the cycle repeats.
Before too long, I’m so frustrated and tense there’s no way I’m laying down anymore.
 
I with then go into a spare bedroom and relax, maybe watch a little TV. Once I’m nodding off, I go back to bed and the cycle repeats.
So then I go into the spare room and sleep without my CPAP. This usually lasts maybe 3-4 hours until I keep waking up from not breathing and then I go and get back in bed with my CPAP. Even then, I’m not a peace with my CPAP and it takes some work to quiet my mind.
 
I’m working through the CBT-I, working on my sleep hygiene, Yoga, meditation, mindfulness, etc.
 
If anyone has any advice – especially from personal experience - I’m all ears.
 
Even though I’ve been through this before – it feels almost like the first time again.
 
My OSA is very much under control with CPAP. I have an average AHI of less than 1.
 
I’m 6’ 230# - Muscular build.
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#2
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
I have the same issue. I think way too much about my breathing and become way too conscious of sleeping/breathing/cpap machine etc.. The effort to sleep prevents me from sleeping. I started going to the gym and that has helped me be more tired at night. I also have been doing the Sam Harris Waking Up app for meditation and that has helped some as well.
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#3
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(01-18-2019, 10:57 AM)JCWarrior Wrote: Some nights I’m 75% ok and some nights I’m 100% not wearing that thing.

You can't do that. You have to commit to using it all the time you're asleep, every time you sleep.

I fell asleep on the couch one time without my CPAP machine and when I woke up I was in a state of panic. Like you, anxiety has been a part of life on and off for a long time. Sleeping without the CPAP machine is about the worst thing anyone can do for anxiety.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
You need as reliable and comfortable a routine in your life as you can engineer.  When you begin to feel that some things are slipping out of your grasp, your amygdala lights up and you go into fight-or-flight mode. Your adrenal glands dutifully pound some adrenalin into your blood stream and you're ready to fight to the death.

I'm not saying you're not happy, and that things aren't good.  But there are mental triggers, including dreams, that still generate the panic response and the arousal that accompanies it.

This is brain chemistry at work. You may need therapy, or a different type of intervention, even something like acupuncture.  

You aren't alone in this.  I have had some anxiety that has played havoc with my sleep, but it has always abated after a few days.  My father is much worse.  He's about to turn 90, though, and I can't say the anxiety has done him lasting harm.


BTW, your greatest weapon against your brains is....wait for it....your brain.  Self-talk, rationalization, and some other tricks can teach you to relax and get back to sleep, even if it's a write-off for that night.
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#5
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(02-16-2019, 08:46 PM)Sleepster Wrote:
(01-18-2019, 10:57 AM)JCWarrior Wrote: Some nights I’m 75% ok and some nights I’m 100% not wearing that thing.

You can't do that. You have to commit to using it all the time you're asleep, every time you sleep.

Although that's true, in some cases including JCW's it's much easier said than done.  I can sympathize, even though I'm lucky not to have the anxiety problem.

What I can contribute is a set of three things that I've found, in my semi-old age, work well for me, and I can only hope that they'll be useful to others.  These are all, IMO, of equal importance:
  1. Don't drink alcohol, ever, not any amount.  If you have the habit, even a little bit, kick it.  This is not a moral or AA-cult or religious thing at all; it's purely practical.  If you drink only socially and only a little bit, switch to water on those occasions and see how that works.
  2. "Don't sweat the small stuff ... and it's all small stuff."
  3. As much as possible, stay away from screens, and I don't mean only before bedtime.  Obviously I'm being a little bit hypocritical, using a screen to write this, but OTOH I don't own or use a cellular phone or an idiot box of any other kind, and haven't for many, many years, and I'm not only happy about that, I'm ecstatic.  It can work wonders, believe it or not.  Those who haven't ever tried it, but who are hour-to-hour and minute-to-minute screen addicts whenever they're not sleeping, can't possibly imagine.
OK, speaking of "easier said than done", item #2 in that list is a classic example.  It's so difficult, and if we could all just do that, our anxiety problems would be over.  But although it's difficult, there are some possible approaches to it.  How practical they are in any case is up to the individual.  What it seems to amount to, in my experience, is a sort of de-cluttering of one's life: physically (possessions, a.k.a. "stuff"), economically/financially, socially, and emotionally.  Sounds like "heap big medicine", and it is.  It's serious.biz.  Also very difficult, and emotionally not fun, possibly.  But sometimes it has to be done.  I don't mean becoming a hermit, but just figuring out which connections in your life you need & want, and which others are not good for you, causing anxiety or stress, and should be phased out.

About items 1 and 3:  Those things are poison.  They'll screw you up big-time if you let 'em.  I could babble for paragraphs about personal war stories and general principles and "studies have shown that ..." and so on, but there shouldn't be any need; it really all just comes down to:  If you have the addiction, kick it, and you should eventually be much happier after the withdrawal symptoms have faded away.

OK, for anyone who has done all of that and still has anxiety, I'm afeared I can't help and can only suggest consulting the docs who specialize in such problems. And if one such doc can't help, try another. And another.  Also be wary of "silver bullet via a pill" solutions, which are usually vastly overrated and exist because of the understandable desire of most doctors to have a good outcome with no effort whatsoever by anybody, neither doctor nor patient.  Unfortunately it's usually a fairy tale. Psychoanalysis, rather than a drug, seems more likely to be useful.
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#6
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
P.S., a clarification about screens: I said "screens" because that's the easiest way to lump the evil idiot boxes all together, but it's not about the light that they emit. That is a problem, of course, and that's why there is a common recommendation to put your screen use on hold for an hour or three before bedtime every evening. But it's not mainly about that; it's about the phenomenal anxiety and stress and alienation that they cause.

The best place to start understanding, although this is only a start, is the classic book by Neil Postman from the mid-1980s, Amusing Ourselves to Death. Five stars, A+, very strongly recommended to everyone. An awesome book.
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#7
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(02-16-2019, 08:32 PM)Mindbullets Wrote: I have the same issue. I think way too much about my breathing and become way too conscious of sleeping/breathing/cpap machine etc.. The effort to sleep prevents me from sleeping. I started going to the gym and that has helped me be more tired at night. I also have been doing the Sam Harris Waking Up app for meditation and that has helped some as well.

I do some guided imagry, relaxation and meditation also. I think it's helping.
I'll check out that app.

(02-16-2019, 08:46 PM)Sleepster Wrote:
(01-18-2019, 10:57 AM)JCWarrior Wrote: Some nights I’m 75% ok and some nights I’m 100% not wearing that thing.

You can't do that. You have to commit to using it all the time you're asleep, every time you sleep.

I fell asleep on the couch one time without my CPAP machine and when I woke up I was in a state of panic. Like you, anxiety has been a part of life on and off for a long time. Sleeping without the CPAP machine is about the worst thing anyone can do for anxiety.

I believe it. I've been doing better with keeping it on recently.

(02-17-2019, 01:23 AM)mesenteria Wrote: You need as reliable and comfortable a routine in your life as you can engineer.  When you begin to feel that some things are slipping out of your grasp, your amygdala lights up and you go into fight-or-flight mode. Your adrenal glands dutifully pound some adrenalin into your blood stream and you're ready to fight to the death.

I'm not saying you're not happy, and that things aren't good.  But there are mental triggers, including dreams, that still generate the panic response and the arousal that accompanies it.

This is brain chemistry at work. You may need therapy, or a different type of intervention, even something like acupuncture.  

You aren't alone in this.  I have had some anxiety that has played havoc with my sleep, but it has always abated after a few days.  My father is much worse.  He's about to turn 90, though, and I can't say the anxiety has done him lasting harm.


BTW, your greatest weapon against your brains is....wait for it....your brain.  Self-talk, rationalization, and some other tricks can teach you to relax and get back to sleep, even if it's a write-off for that night.

I've been really following good sleep hygiene with the online CBT-I program I've been following. I've been on the waiting list for the anxiety center at the university medical system I use. They said it would probably be March.

Ironically, I had some questions for the Cleveland Clinic CBT-I app. The doctor actually called me Friday and I explained my situation and that my insomnia is really based on anxiety. She said she would speak with the director of the anxiety center that I am on the waiting list for and yesterday I got a call from them and made an appointment for Monday!

Looking forward to dealing with this.
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#8
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(02-16-2019, 08:46 PM)Sleepster Wrote:
(01-18-2019, 10:57 AM)JCWarrior Wrote: Some nights I’m 75% ok and some nights I’m 100% not wearing that thing.

You can't do that. You have to commit to using it all the time you're asleep, every time you sleep.

I fell asleep on the couch one time without my CPAP machine and when I woke up I was in a state of panic. Like you, anxiety has been a part of life on and off for a long time. Sleeping without the CPAP machine is about the worst thing anyone can do for anxiety.

This.

I related in another thread, 2 weeks ago, our power went out 40 minutes after I went to sleep.  The machine stopping woke me up, I reached over and hit the button to restart, nothing, then realized that the clocks and night light in the hall were dark.
Figuring it would be a short outage as these usually are, I tried to get back to sleep... just unplugged the short hose from the machine but left the mask on.
I'd reawaken every 15 minutes, an hour later I grabbed the Android and reported the outage to the power company.
Tried to sleep...  couldn't.  I'd get up and just go sit in a chair for a few minutes, then back to bed.
This went on all night.
6am, Edison dispatched a crew to determine the cause of the problem.
Continued to try to sleep until 11... nothing more than off and on.
Edison estimated power restored at 3pm.  I didn't want to open the fridge or freezer, so I headed out for "brunch" and some shopping.
2:30, they revised the estimate to 5:30.
NOW I'm starting to stress out that power would not be restored by 9, and I seriously considered packing up and getting a motel room for the night.
Thankfully, the 5:30 estimate was accurate.
-- Rich
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INFORMATION ON FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(02-17-2019, 02:32 PM)JCWarrior Wrote: The doctor actually called me Friday and I explained my situation and that my insomnia is really based on anxiety. She said she would speak with the director of the anxiety center that I am on the waiting list for and yesterday I got a call from them and made an appointment for Monday!

See if they can provide a course of Primal Shrug therapy ... maybe eventually, if you're lucky, progressing to a course of Primal Yawn therapy. It worked for me, and now I'm all groovy and stuff ... like, laid-back, man.

However, the huge downside for most folks these days is that There's No App For That. :run-away-screaming:
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#10
RE: 4 Year’s Of Successful CPAP – Sleep Anxiety Is Derailing Me
(02-17-2019, 04:41 PM)CB91710 Wrote: Figuring it would be a short outage as these usually are, I tried to get back to sleep... just unplugged the short hose from the machine but left the mask on.

I have one of those battery back-ups for short outages.

Quote:This went on all night.

When this happens I pull the battery out of my car. Has happened only twice in seven years.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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