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.

[joepublic23]

I struggled with insomnia for years, but I leaned good sleep hygiene techniques that helped a lot. It had been years since I would have multi night episodes of being unable to fall asleep.

I have long known that I snore, but I never really sought treatment for it, as I don't believe that my body can physically fall asleep with a CPAP machine or dental device. I finally got the sleep study done after I learned about Inspire as that was the first treatment that sounded remotely viable to me.

After 2 months I managed to fall asleep with the CPAP once, and I had to drug myself with benadryl to do that. I am seeing the Doctor later this month to hopefully get a more powerful sedative to force my body to fall asleep with the mask on. I am hoping that might get me on the right track to actually use the CPAP. If that doesn't work I will probably throw in the towel on the CPAP.

[ECM5]

I have since found quite a lot of info that sleep apnea can cause insomnia especially in women (so in other words insomnia can be a symptom of sleep apnea).  Dr Krakow has a video on it that’s  pretty good & also has one on pharmacotherapy failure and sleep apnea 

https://youtu.be/izgtCxsLVd0

https://youtu.be/vdm1kTFJCK4

[Deborah K.]

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.

I take 150mg of Trazodone.

[CorruptAlligator]

I have done CBTi and two most important things are wake up consistently at the desired time (which is important than sleeping at the same time), and use bed only for sleeping activities, and if possible, do not use bedroom for anything else, but sleep.

It seems most important is reinforcing the habit of the waking up time, not sleeping time. For example, let's say you went to bed a little late on Sat, you should still wake up at the same time to keep yourself in the habit of waking up at the same time.

The thing about if you can't fall asleep within 15-20 min, get up, that you find online. I wouldn't pay much attention to that. I would try to get back to sleep if it takes longer.

And to answer the OP's question, yes, CPAP has contributed in me getting better quality sleep, but I think the cervical collar and side sleeping knowledge has a lot of weight as well.