Insomnia and treatment?

[ECM5]

For those who had insomnia before diagnosis, did starting CPAP help?  Are there any sleeping medications that do not worsen apnea?  I ran across an article stating Lunesta (I know there is a generic name which I cannot spell - Eszopiclone!) might decrease apnea by raising arousal threshold but it was from 2011 so not sure of current status.  What about the drug still in clinical trials (by apnimed I think)?  Atomoxetine and oxybutynin?

Just looked up Apnimed real quick guess they are also doing phase 1 trials of atomoxetine and trazodone.

[RainbowFish]

For me the CPAP is a great help.  I would wake up like clockwork at 3 am from a nightmare and often not be able to get back to sleep.  In hindsight it should have been obvious that this was me desaturating, but I sure went through a lot of rationalizations of other causes.  I also had trouble initiating sleep, particularly at higher altitudes.  On a bad night I would typically get 3 hours of sleep, and I seldom got through the night without 5-6 awakenings.

I was very lucky, as I tolerated the CPAP great from the start. (if you mouth breathe much at all and can tolerate a FF mask, I recommend starting with that rather than a nasal, so you can get a successful experience with the CPAP from the get-go.  You can always try and troubleshoot a nasal mask later) And for me everything magically resolved just a day or 2 into using the CPAP.  I now sleep like a log for 7-8 hours straight.  

I have never used meds for insomnia so I cannot speak to their relative merits.  But it is my understanding that most “successful” meds worsen desaturations because you will sleep right through them rather than waking up to breathe.

[Dormeo]

For insomnia, some people benefit from CBTi, which stands for cognitive bahavioral therapy for insomnia.

[ECM5]

Thanks, I am familiar with CBTi and it is definitely worth a try. It's harder to find a provider who specializes in it unfortunately, and long wait for appointments.  I do have an app

[Deborah K.]

I was taking Trazodone before pap use and continue to take it now.  It works well for me.  I sleep better now that I use a pap machine, waking up less often, etc., but I have experimented and I still need the Trazodone for good sleep.

[ECM5]

How much do you take?  That is one of the ones they are putting in a new pill combo with the atomoxetine.  I think I have taken either 50 or 100 a couple times and it did not do much but there was also once it really knocked me out and next day sedation so I didn't want to take again.