restlessness and muscle pains after a few hours sleep

[MaddMike]

Hello, I'm wondering if anyone else seems to get this. It is very difficult to deal with and I have been searching for the answer for years. I don't know if it is related to poor sleep or what, but with my data I can see restlessness now before I awake.

I have no issues when going to sleep. I am tired and drowsy and I can generally relax. I usually take half or 1/4 ambien to doze off. Taking the SR ambien that is supposed to last 8 hours does not keep me asleep.

I wake up after 3-4 hours of sleep and my muscles hurt and I am tired like I want to throw a temper tantrum. I cannot get back to sleep unless I take something that ruins my day. More Ambien doesn't cut through the discomfort. Lunesta screws with my Apnea and I wake up feeling terrible. Pain pills, no way... I can take Tramadol, but it doesn't help with this.

I just want to sleep through the night, any thoughts or ideas?

Mike

[DariaVader]

getting my apnea under control is what got my muscle aches and cramps under control. I can now sleep through the night without waking due to pain, or any other reason (nocturia...) almost every night! What is your current AHI?

[MaddMike]

I had been around 15-18 AHI unknowingly for a couple years because I never knew how to look at it and "assumed" that I was treated. I bought my own new machine recently (from S8 cpap auto to S9 Vpap auto) and Got it dialed in pretty good. I was <5 for a few days, but things are going the wrong way again. If I wake in the night and look at my sleep quality, the AHI will be around 3....If I am able to go back to sleep, I will wake up feeling tired and the AHI will be much higher than in the night, today it was 7.7 when I got up.

I am not an expert with the graphs, but I can see my breathing rhythm breaking up later in the night once this pain sets in. I have a bit of RLS, and may have to start taking those meds again, but I don't understand why I can sleep wonderfully for a few hours before this happens.

It seems like the good sleep early in the night is totally negated by the poor sleep in the second half...

[DariaVader]

some observations I have made about my own treatment:
1. AHI might be higher when I slept better. Deeper sleep gets more events than shallow sleep or wakefulness
2. AHI is definitely affected by pain and will be higher when I hurt even when sleep was not deep
3. Poor sleep and high AHI even for 1 hr will bring desats and the headaches and foggy noggin that go along with desats

[retired_guy]

Mike, I suspect something a bit different:

Before cpap, you were fighting to get quality sleep. So you unknowingly tensed up at night, and finally woke up with discomfort.

Now, you have started your cpap therapy, but you're still tensing up. I suspect you might not be as comfortable with your mask, or your sleep position as you need to be. It has to get to a point where "the mask and you are one." "The mask and you are one." Before you go to sleep tonight, say "The mask and I are one" two hundred and three times.

Or, as an option: raise the head of your bed to change your sleep dynamic. Investigate other masks if you are the slightest bit uncomfortable with the one you're using. Shake things up a bit. Sleep in your jammies? Go to a t-shirt and shorts instead. The idea is to change your sleeping dynamic so that your cute little body can quit getting all worked up at night.

And forget the drugs.......

[Jim Bronson]

And forget the drugs.......

I couldn't agree more. If you've been taking Ambien for a while, you've almost certainly built up a tolerance. In other words, you may think it's working but it isn't. I was on it for several years, and I had a psychological addiction to it. I needed that pill to get to sleep. I slowly tapered off it using a program that DocWills posted, and I'll never take it again even once. Moreover, I'm not convinced that prescription sleeping pills and ant-anxiety meds (benzos) are safe over the long term. Do yourself a big favor and get off the pills.

[MaddMike]

Apparently i have failed to convey the seriousness of this pain and restlessness. i have been on cpap for 7 years and am quite fine with the mask. Perhaps i do have a tolerance for ambien now but that is not the issue... It was given initially because as was pointed out, i got better sleep and my body decided to wake up thinking it was rested. This is much different and it has been advancing for many years. Been blown off by enough doctors to just give up. Right now im standing and i cannot stop moving my toes.
Anyhow... Anyone else have any ideas? Im about to ask for mirapex for rls, bit its so difficult with multiple diagnoses as i also have an autoimmune thyroid condition that normal doctors have no idea how to treat...

[retired_guy]

Well Mike, I do believe you have some serious issues. I'm sorry you feel I was not being serious as to giving you some advice. It seems clear you are looking for a drug solution, and I'm not someone that can go there with you. So, good luck.

[MaddMike]

More assumptions. You should think more about the things you say. I would rather not take any drugs EVER, actually... I take very few as of late because every doctor i saw wanted to push pills instead of properly diagnose me. First they start with antidepressants and start piling them on from there.

i am trying to inderstand why it hurts me to sleep, and trying to get insight from others who have the same issue. I have long known that apneas and poor sleep will aggravate my symptoms, however i haven't got all the knowledge to know exactly how it relates as far as cause or effect.

there are several possible things that could cause this, i have a fair bit of knowledge of how the human body works, i just dont understand why i can go comfortably to sleep at bedtime and wake up 3 hours later in pain, especially since it looks to me like that is when i get my best sleep.... I can totally understand why i would feel this way after a bunch of apnea and low 02, but that doesnt happen till later. I get back to sleep at some point but have more apneas and never hit rem and then feel even worse when its finally time to get up.

[TyroneShoes]

I have no issues falling asleep most nights. I have the soreness on occasion, but not the restlessness. I think it is mostly connected to how well you are physically supported while you sleep; a soft mattress will surely mean I will be too sore to stay asleep after 3-4 hours.

But that is not the only thing; sometimes I get a few nights in a row of this, even in the same bed, same sleep positions, but most of the time I do not have the problem, as long as the bed is firm enough. The soft bed at my PSG test confirmed this once again, something I have known for 30 years.

Often aspirin or just tylenol will help with this. But sometimes I have to get up, take the aspirin, and sit up in a desk chair or put a bunch of pillows on my desk and sleep for a couple hours laying over the desk, in the chair. By then I can usually go back to the real bed. But it does not happen that often. Unfortunately, I can't seem to connect why this happens to anything.

And it is possible that none of your symptoms, or mine, have anything at all to do with OSA or xPAP therapy.

I am on record here indicating how dangerous I consider Ambien/Lunesta to be. Diazepam has recently been connected to Alzheimer's, so I won't take anything that will fall in either category. OTC just makes me zonked for the entire next day.

If you have to get up for a while and then go back, that is not really all that problematic (if you have enough hours to get the sleep you need). Biphasic sleep is pretty common, and was the norm before the industrial revolution, electric lights, and 8-hour work shifts. We've had biphasic sleep as the norm for millions of years, and single-phase sleep as the norm for only about 240 years. Many animals sleep like this as well. Bottom line, if life pushes you towards biphasic sleep, roll with it. I think the Mexicans with their siesta were also on to something.