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Can't Fall Asleep!
I am 100 percent compliant on Day 18 of using my CPAP. My machine works fine, my mask fits fine, my Hose Buddy makes it easy to sleep on my side, taping my mouth closed doesn't bother me, and my AHI is 1.7.

A couple of times I have fallen directly asleep before suiting up and turning on the machine, so I know I am still able to fall asleep.

Unfortunately, when I prepare to go to sleep wearing my apnea regalia, I can't fall asleep. Of course, at some point I must pass out. When I wake up in the middle of the night to use the bathroom, the same thing happens again. I'm averaging a total of about four to five hours a night, and I need eight. I am so exhausted it's getting scary.

Is this difficulty falling asleep typical at first? If so, how long does it typically last? At what point should I talk to my doc? I'm not a pill-taker, so I don't want to get started on medication.

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No two people are alike. However, yes, this new norm takes getting used to.
For people with severe apnea, 4 hours on therapy is better than 8 hours without.

There is no mean time to get accustomed to the new norm. It varies widely.

I am nearing 6 years use. Some nights are 8+ hours with copious dreaming; and some are only 5 to 6 hours.

Yes, you should talk to your doc. Likely your doc will tell you to just stay the course.
Sleep meds can make sleep apnea worse; so your doc will probably not prescribe a sleep med.
Still, your doc is your partner in healthcare; and should be informed of any concerns you have.

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I wasn't looking for a mean but rather hoping some members would share their experiences. A friend told me her first two months were hell! Gah! I hope it doesn't take me that long to fall asleep like I used to.

Fortunately, my apnea is apparently very mild. It's ironic that treatment is resulting in exhaustion far worse than prior to treatment. I'll stick with it for my long-term health, of course. But I hope I can start falling asleep en regalia as soon as possible. This is no fun!
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Get to sleep, use mild sedative if necessary.

Sleeping suitable amount of hours while medicated I have experienced preferable to the alternative which you have described. I even did sleep meds for my lab titration with no regrets.

Once you adapt to the pressure better you can ease off the sleep meds. If you don't want to use prescription sedatives or sedatives with mild tranqs, try two Benadryl.

Use the machine earlier in the evening while watching TV. It aids in adjusting to the pressure.

You also might want to consider setting the Ramp feature for 20 or 30 minutes. You might find it easier to fall asleep during that period.
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Like Ted said, try wearing the "regalia" during the day to get used to it. Wear it with the machine on while watching TV or reading or whatever.

Also, what is keeping you awake? You didn't say. We are assuming it is just the wearing of the gear.

Meanwhile, research "sleep hygeine". Sometimes we need to just get back to the foundations.
Research meditation or meditation sleep music to see if that is something that might help. Even white noise may.
Ask your doc about Ambien. It can be used short term and is not addictive.
Plain old benedryl is another but I found that it made me groggy the next day.
Melatonin is another but it is more for resetting the internal clock than as a sleep aid. You can use that if you go the sleep hygeine/music route.
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Breathe deeply and count to zen.


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I agree with Moderator but Ambien, if taken for long periods of time, as a 'Z' drug, can be habit-forming. Most of these sleep drugs and benzodiazepine tranqs are not supposed to be continuously taken for more than a few weeks. As Moderator stated, short-term is okay.

Take 5mg Ambien at least 2 hours after eating while in bed and ready to retire. It will get you to sleep. Don't freak if you have slight hallucinations in the beginning first night or two-kind of 'fun'. You may not have such side effects at all. You will likely be less groggy next day on the Ambien than the Benadryl, but I've found through use of xPAP that I'm not as groggy next day on the Benadryl as I used to be. Ambien certainly works in getting one to sleep within a relatively short period of time when on CPAP.

Be mindful of sleep hygiene. Don't stay up past your bedtime watching past episodes of 'House' on Netflix streaming as I have done. Set a time and at least be in bed by that time every night.
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Thanks for these ideas! I have actually not been using the ramp feature because if it doesn't pressurize Right away I feel like I'm suffocating and get panicky. I think I'll try suiting up and turning on the machine for awhile before turning off the light. It sounds like that will eliminate the transition. Thanks again!
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(06-20-2015, 10:24 PM)PaulaO2 Wrote: Also, what is keeping you awake? You didn't say. We are assuming it is just the wearing of the gear.

After I suit up, I turn on the machine. The sound doesn't bother me...in fact, the machine is very quiet and gives a little white noise that is good with my tinnitus. I turn over to my favorite side and relax into my usual go-to-sleep position, and nothing happens! I lie there very conscious of the mask. I settle the nozzles of the nasal pillow for comfort and a good seal. I wait. I practice 4-7-8 breathing. And I wait. I roll over to my other side and do the same things. It can go like that for a very long time.

I like your idea of trying better sleep hygiene practices, but since I fall asleep directly when I fail to suit up in time I really think it's the regalia. It's not just the mask, relatively comfortable though it is. It's all the new stuff to get used to. The Hose Buddy has been very helpful by eliminating the nightly snake wrestling. But part of the problem may be a tendency to feel claustrophobic when suited up.
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(06-20-2015, 10:28 PM)tedburnsIII Wrote: I agree with Moderator but Ambien, if taken for long periods of time, as a 'Z' drug, can be habit-forming. Most of these sleep drugs and benzodiazepine tranqs are not supposed to be continuously taken for more than a few weeks. As Moderator stated, short-term is okay.

I agree and don't wish to rely on drugs if I can avoid it. I am very sensitive to all drugs and Benadryl gives me an irregular heartbeat.
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It takes time to adapt to the process, but if you are determined, you will succeed! And you will likely feel much better over time, once you start getting full night's rest with xPAP.

If you have the Clinician's setup menu where you can change the pressure settings, increase your minimum ramp pressure to at least 6cm or even higher, but not too high where you are back where you started without the ramp.
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