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Bernerbits' ongoing CPAP/meds/insomnia saga
I'm renaming the thread because seeing the title puts me on edge a bit (still working up to that therapeutic Zoloft dose). Also because things are getting better, incrementally.

Continued from here: http://www.apneaboard.com/forums/Thread-...are?page=9
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If anyone is curious, here's my sleep journal. I may get around to recording Sleepyhead data into it as well.

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Did the Ambien CR and Melatonin XR again last night on the advice of my neurologist. No protracted night wakings. However, sleep was VERY fitful.

I crashed almost instantly on the couch in front of the TV at 7:30 - attempts to stay up and watch TV shot my anxiety through the roof.

Melatonin at 8:30, Ambien and in bed at 9, asleep at 9:30, woke up briefly on CPAP at 11, and again at 1, having to get out of bed. Went to the guest bed to rest and fell asleep again for 2 hours, got back in bed at 3, slept another half hour or more, went back to the guest bed at 4:10, laid awake anxiously until 4:30. Probably about 7 1/3 hours of varying quality sleep, 3 1/2 of them on CPAP.

Other possible factors causing the fitful sleep, besides the early bedtime, may include the half-hour nap I took at 12:30 PM, and putting my CPAP humidity down. I read yesterday that it sometimes causes the breathing difficulties that started the CPAP insomnia in the first place.

My sleep therapist recommends a hot shower at 7:30 followed by light physical activity to restrict my sleep and improve sleep quality. Neurologist wants me up on the therapeutic dose of Zoloft ASAP, and is working on a prior auth for Lunesta which gives 6 hours of sleep instead of 4.
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Thanks for the update Berner Bits.

I also have issues with wanting to go to bed too early as I feel I have an advanced phase syndrome pattern which you might want to look up by the way to see if it is applicable. Anyway, if I did what your sleep therapist suggested, it would put me to sleep. Smile Hopefully, the suggestions will work for you.

Best of luck.

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I've studied sleep phase disorders and it seems similar, but I'm pretty confident this issue is drug-induced. The pattern started last week with Ambien causing night wakings and shifting my wake time earlier.
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I did as my sleep therapist advised and took a hot shower after putting the kid to bed, with the goal of staying awake until 7:45. This had the intended effect of severely restricting my pre-bedtime dozing to just half an hour. I went to bed at 9:30, taking my Ambien CR and Melatonin XR. Sleep was fitful again but I managed about 5 1/2 hours -- I think; I got rid of all clocks so it was hard to monitor wake times and durations -- and I got out of bed much closer to my target wake-up of 5 AM. I've had at least 5 1/2 hours of varying quality sleep per night for 4 days, which is progress. Reduced CPAP last night but still more than last week.

Goal is to consolidate 7 hours of sleep from 10-5 and use the CPAP for all of them.

I moved up to the 50mg therapeutic dose of Zoloft yesterday morning. I did not have any anxiety on it until around 11, which mounted until 1ish when I had to take a half-pill of Ativan to function. This managed my anxiety for a few hours and I just dealt with it the rest of the evening. Ativan use is mostly decreasing which indicates a downward trend in anxiety as well.

Hoping the Zoloft is therapeutic and the Lunesta prior auth comes through soon. Getting on a FFM next week which should help with the breathing issues. As I discovered last night I am still waking up needing to take a breath while falling asleep; the Ambien is just depressing my nervous system enough to allow me to fall asleep despite this. May turn pressure up to 8 and see if that helps the breathing. I understand some people with this issue may need BiPAP?

Overall... difficult but hopeful.
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Glad to hear things are progressing Berner Bits. Very happy for you.

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Argh! I just figured out why CPAP was so bad last night. I was wearing the medium nasal pillow mask by mistake instead of the large.
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Wow. I don't want to jinx the rest of the day, but my anxiety is MUCH better today. Still there but very subdued. Haven't needed Ativan yet. Finally getting a therapeutic effect from the Zoloft!

I've been on Ambien for 10 nights now. I'll give the Zoloft another week to really take hold in my system then talk to my sleep therapist next week about starting a slow taper.
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Fantastic. Really happy for you. Smile
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