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CPAP nightmare
So after 4 nights of 8+ hours on this thing I have experienced my first failure. Until tonight I've been able to lie in bed awake connected to the CPAP without anxiety, but for some reason tonight I can't handle it. Every time I start to fall asleep with the pressure on, I stop breathing and jolt awake. I turn ramp on and it's worse. Don't even want to get back in bed because I know the stupid machine is waiting there for me. Last night I had 900 micrograms of melatonin and it knocked me right out. Tonight I've taken both melatonin and Benadryl and neither is helping. It's 1 AM and I'm dreading sleep.

I'm gonna futz around on this computer for another hour and try again. I was REALLY hoping the CPAP would magically cure my chronic insomnia, but alas. Someone please tell me this is a normal part of breaking in the CPAP, and it will get better.
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I feel your pain. xPAP therapy is designed to treat sleep apnea -- the cessation of breathing -- using positive pressure. It does nothing to treat chronic insomnia or panic/anxiety/claustrophobia issues. As to your specific issue, it is not uncommon when starting therapy to have some anxiety which can manifest itself in various ways. The key to dealing with xPAP issues is to first discuss your problems with your sleep doctor and respiratory therapist and then soldiering on. Since this is affecting your daily life, I would suggest calling the doctor ASAP.

I am not trying to be rude, but you may want to also consider visiting a psychiatrist (the one with an M.D.) to help you with some coping mechanisms for combating anxiety. Some have tried medication, CBT, mindfulness, and clinical-grade hypnotherapy with varying results. Perhaps experimenting with aromatherapy to provide alternate neural distraction might work.

Maybe someone else in the forum will have more specific ideas. Best of luck.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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Try moving your machine (remove water first) to an area where you can sit up and read or watch TV for an hour or so before bed. Wear the mask with pressure on. You will be surprised how fast the time will go by and help you to a acclimate to the feel of it faster.

I know your anxiety is real and I sympathize. I had some of the same issues when first starting out. I'm very claustrophobic, and would have a panic attack once I got in bed.

But I also realized that untreated apnea would kill me eventually. I had to talk myself out of being anxious.

I would suggest that you have a serious talk with your doctor about the anxiety and insomnia you are experiencing. Perhaps he/she can give you something (short term) to relax.

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No offense taken. I do see a psychiatrist. I've been on and off Lorazepam but I think it may be time to start up again. At least to help me over this hump.
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I used to suffer from chronic insomnia. It would take hours before I went to sleep, then I would wake up and be awake for an hour or more before getting back to sleep. Repeat until morning. What worked for me was sleep compression therapy. You might want to consider it. My recollection was that the first week was horrific. Try to not have to work. Eventually my brain gave my mind a good talking to. Now when I go to bed, I go to sleep.
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(09-11-2016, 01:12 AM)bernerbits Wrote: Every time I start to fall asleep with the pressure on, I stop breathing and jolt awake.

The same thing happened to me. I figure it's my brain adapting to the notion that it's no longer necessary for it to wake me up every few minutes to breathe. It had been doing this for decades, so the habit was well entrenched. Being a survival necessity, it was the most important of jobs. For the last four nights it's been able to take a vacation, but now it figures the vacation is over and it's time to go back to work.

Something like that, anyway.

The important thing is that you commit to always sleeping with the machine. If you fall asleep without it your brain will just say "See, I knew it was important to keep waking this guy up. No more vacations for me."

If you use the machine every time you sleep, all the time you are sleeping, your brain will eventually get the message that it's okay to let you sleep.

You will adapt. The biggest advantage you have is being human. We are incredibly good at adapting.
Apnea Board Moderator

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hi bernerbits,

how are you doing today? what happened the rest of the night?

after having four nights with no panic and 8+ hours sleep on the machine, you had one night of panic. Must have been a miserable night, I feel for you. I don't suffer this myself but I have close family members who suffer major panic disorders.

It's interesting how panic attacks can come on you while doing something that was no problem the days before. And if I'm right, it can also happen that the next night might have no panic and then some other random night it might return.

I wonder if it might be worth contemplating what was different about last night from the preceding nights. Perhaps there was a trigger unrelated to the CPAP therapy which you can identify and perhaps eliminate.

Waking up suddenly in a panic you find yourself strapped into this unnatural machine. But the machine was there without the panic as you were drifting off to sleep.

If it's possible to separate the machine from the panic it would be very helpful. Is it possible that something else is going on which is wrongly being associated with the physical experience with the machine/mask as you wake up in a panic.

I hope that reflecting on the four good nights with no panic and restful sleep can help prevent another night of panic.

I know that once the panic sets in rational thought is not much of an option, but during the day today maybe reflecting on the good days, and perhaps spending a little time on the machine when it's not time for bed will separate the panic from the mask.

that is what I would be doing today.

Another thing might be to compare the data in sleepyhead for the good vs bad nights to see if there are any hints in the data.

good luck bernerbits.

Saldus Miegas
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When I fisrt started CPAP therapy, about a dozen years ago, I had at least two episodes that I remember well. Both times I jolted awake, feeling suffocated, and tearing off my mask. This happened within the first 2 or 3 months, and hasn't happened since.

I suspect my breathing was fighting against the incoming pressure, and closed my throat. I told myself it was a one time deal, put my mask back on, and went back to sleep.

This stuff happens, try not to worry too much about it.
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Nothing about CPAP is "normal". For me it took a while to trust the machine, that it would work and I would breathe. If the starting pressure is too low you can feel starved for air. All the above suggestions are good ones. CPAP is not a light switch, but it does work
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So the precipitating factors of last night were: First, I took a nap with the CPAP when my kid was napping earlier in the day. I went for a run at 3 in 90 degree humid weather. Overdid it and got a little heat exhaustion which caused an anxiety attack when I arrived at home. Then the power went out and I didn't eat dinner because we couldn't cook and the anxiety had me pretty well paralyzed. So I had the nap interfering with sleep, heat exhaustion, the anxiety, and the hunger.

I pulled the mask off at 2 AM and crashed. I could no longer lie in bed peacefully; minutes were feeling like hours and I was overcome with feelings of anxiety and dread. So I slept 2-6, which is 4 hours, hey, half the night, but my untreated sleep efficiency is 50%. So more like 2.

Today was rough. I had a busy day with an active 2-year-old, so I was pretty much on the go for 14 straight hours, exhausted the whole time.

So tonight after the kiddo was down I hooked up the CPAP while watching TV. Turned screens off and took melatonin at 8:30, read until 8:55, CPAP on the whole time to get used to it. Brush teeth, into bed at 9, feeling pretty relaxed and calm. So I start to drift off pretty rapidly (was falling asleep easily enough throughout the day) but then the "air hunger" sets in and each time I'm pulled back awake. This happens 4 times and I'm able to keep calm. It's normal, I tell myself, it will be OK. I am not in danger. But my brain isn't listening and it wakes me up each time I start to drift off. Now the anxiety washes over me as I entertain the prospect of going to work on 2 sleepless nights. It's 9:30, so I get out of bed. I take Valerian root to calm myself down, and with nothing better to do, come on here to post an update, which brings you all back up to speed.

I'm going to try and meditate in the dark to get my anxiety down before I go back to bed and try again. Hoping the Valerian calms me down enough to at least rest peacefully in bed - like I was able to do until last night! The problem with anxiety-induced insomnia is it snowballs. I'm calling a therapist and my psychiatrist tomorrow as soon as the offices open.
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