1. < Sleep Health

What is more important: treating sleep apnea or insomnia?

Posted by jmgall @jmgall, May 7 1:31pm

I've had insomnia for years and was recently diagnosed with sleep apnea. My bipap severely affects my ability to sleep. Is it more important for brain health to treat the apnea or to sleep longer?

Interested in more discussions like this? Go to the Sleep Health Support Group.

jmgall | @jmgall | May 9 7:31am
In reply to @kudzu "I’ve also found cpap talk.com and apnea board.com very helpful. Can you describe the major issue..." + (show)
@kudzu

I’ve also found cpap talk.com and apnea board.com very helpful.
Can you describe the major issue making the machine so awful? For me, it seemed to be that we never could get the machine synced with my breathing. It was either trying to “drop out” from under me
before I was through inhaling or increasing the pressure before I was through exhaling.
Are the pressures too low or too high? My sleep dr recommended opening up the pressures on my apap from 10min to 20 max when I was having high numbers a couple of years back. It worked. Just because you have the max all the way up doesn’t mean it has to go there.
Just some ideas.

Jump to this post

I am not sure what wakes me up, I just do and can't get back to sleep unless I take it off. My insomnia is rather strong. I do find similar to you that the machine decides it's time to exhale before my natural breathing wants to exhale. It's like it starts to suck the air out of my lungs. What you call "dropping out before done exhaling". The inhale seems a bit too much as air can go into my mouth/stomach which is irritating and also affects my wakefulness. Some setting to increase the time length of inhalation was increased to max, which helped a lot, but it still does it unless I take a large, faster breath - which is, of course, not natural. The min and max numbers were also adjusted but I don't remember what they are. Will call (yet again lol).

REPLY
1 reply
jmgall | @jmgall | May 9 7:54am
In reply to @dalebout123 "The biggest problem is the sleep position I have had all my life -- like a..." + (show)
@dalebout123

The biggest problem is the sleep position I have had all my life -- like a starfish; on my face. I try to sleep in other positions, but even when I can get to sleep, I wake up back in the usual. So I stay half awake to prevent the mask being pushed off. The over the nose is working better as the head gear does a better job of holding it in place. Plus this has a vent for the extra air to escape through.

Are we discussing the same machine? Mine is called a CPAP. Yours is an Apap? I was told my doctor set the levels.

Anyway thank you for your suggestions and your response. I will look into all you have suggested.

Cheers,
Dana

Jump to this post

I'm a side sleeper so the mask isn't too much problem. I tried some different masks but find the full face with the memory foam to be the most comfortable. Airsense F20 I think. It doesn't fit quite right but it is the best of the ones I tried (pillows, etc). Many setting changes have been made and while a little better, it is still not working (meaning I don't get more than 2ish hours of sleep). Oddly enough, when I was in the lab doing the titration with bipap (not cpap or apap) I slept the longest (about 5 hours). I was super happy and thought that this was the answer as the cpap didn't work for me. But, alas, the home machine is nowhere near the lab machine even though they say it is the same. I don't believe it.

REPLY
2 replies
Phoenix | @kudzu | May 9 9:28am
In reply to @dalebout123 "The biggest problem is the sleep position I have had all my life -- like a..." + (show)
@dalebout123

The biggest problem is the sleep position I have had all my life -- like a starfish; on my face. I try to sleep in other positions, but even when I can get to sleep, I wake up back in the usual. So I stay half awake to prevent the mask being pushed off. The over the nose is working better as the head gear does a better job of holding it in place. Plus this has a vent for the extra air to escape through.

Are we discussing the same machine? Mine is called a CPAP. Yours is an Apap? I was told my doctor set the levels.

Anyway thank you for your suggestions and your response. I will look into all you have suggested.

Cheers,
Dana

Jump to this post

Yes, I think we’re discussing the same machine. They’re all cpaps; apap is just an alternate mode a cpap can be set to. ResMed is the most common brand I think.
I use a ResMed airsense 10; I briefly used ResMed Aircurve ST, the bilevel that for me was such a disaster.
Is that what you have?
Don’t know what to say about your sleep position; I’ve been told position can be a big part of it.
I know there are devices to keep back sleepers on their side, but face down I don’t know.

REPLY
1 reply
Phoenix | @kudzu | May 9 9:44am
In reply to @jmgall "I'm a side sleeper so the mask isn't too much problem. I tried some different masks..." + (show)
@jmgall

I'm a side sleeper so the mask isn't too much problem. I tried some different masks but find the full face with the memory foam to be the most comfortable. Airsense F20 I think. It doesn't fit quite right but it is the best of the ones I tried (pillows, etc). Many setting changes have been made and while a little better, it is still not working (meaning I don't get more than 2ish hours of sleep). Oddly enough, when I was in the lab doing the titration with bipap (not cpap or apap) I slept the longest (about 5 hours). I was super happy and thought that this was the answer as the cpap didn't work for me. But, alas, the home machine is nowhere near the lab machine even though they say it is the same. I don't believe it.

Jump to this post

I don’t believe the lab machine is the same as the home one either. Lab vs real world, as one dr said to me.
The problem is to figure out what works best at home.

REPLY
Phoenix | @kudzu | May 9 11:00am
In reply to @dalebout123 "The biggest problem is the sleep position I have had all my life -- like a..." + (show)
@dalebout123

The biggest problem is the sleep position I have had all my life -- like a starfish; on my face. I try to sleep in other positions, but even when I can get to sleep, I wake up back in the usual. So I stay half awake to prevent the mask being pushed off. The over the nose is working better as the head gear does a better job of holding it in place. Plus this has a vent for the extra air to escape through.

Are we discussing the same machine? Mine is called a CPAP. Yours is an Apap? I was told my doctor set the levels.

Anyway thank you for your suggestions and your response. I will look into all you have suggested.

Cheers,
Dana

Jump to this post

PS: yes, your dr does set the levels based on the sleep study results, but I found that doesn’t always work in the real world.

REPLY
dalebout123 | @dalebout123 | May 10 10:34am
In reply to @kudzu "Yes, I think we’re discussing the same machine. They’re all cpaps; apap is just an alternate..." + (show)
@kudzu

Yes, I think we’re discussing the same machine. They’re all cpaps; apap is just an alternate mode a cpap can be set to. ResMed is the most common brand I think.
I use a ResMed airsense 10; I briefly used ResMed Aircurve ST, the bilevel that for me was such a disaster.
Is that what you have?
Don’t know what to say about your sleep position; I’ve been told position can be a big part of it.
I know there are devices to keep back sleepers on their side, but face down I don’t know.

Jump to this post

I have ResMed, Airsense 11. The nose cone seems to be a good fit for me as the head gear holds it in place. But some nights I look at the device and say, "Nah! I just want to sleep". As I have written in other posts I am a very good sleeper. Never had the insomnia the others talk about. Sometime I wake in the middle of the night with "monkey brain", but that is cured with doing a crossword puzzle and I am off to sleep.

I just finished a bout with bronchitis and a cold. Are we supposed to use the CPAP when we are in this condition? I did, but could tolerate the machine for shorter times.

Thanks for your response

REPLY
1 reply
ann728 | @ann728 | May 10 11:44am
In reply to @jmgall "I am not sure what wakes me up, I just do and can't get back to..." + (show)
@jmgall

I am not sure what wakes me up, I just do and can't get back to sleep unless I take it off. My insomnia is rather strong. I do find similar to you that the machine decides it's time to exhale before my natural breathing wants to exhale. It's like it starts to suck the air out of my lungs. What you call "dropping out before done exhaling". The inhale seems a bit too much as air can go into my mouth/stomach which is irritating and also affects my wakefulness. Some setting to increase the time length of inhalation was increased to max, which helped a lot, but it still does it unless I take a large, faster breath - which is, of course, not natural. The min and max numbers were also adjusted but I don't remember what they are. Will call (yet again lol).

Jump to this post

I suggest you take these important issues to the clinician/ technician who programmed your device. It is their professional responsibility to meet your needs.

REPLY
ann728 | @ann728 | May 10 11:46am
In reply to @jmgall "I'm a side sleeper so the mask isn't too much problem. I tried some different masks..." + (show)
@jmgall

I'm a side sleeper so the mask isn't too much problem. I tried some different masks but find the full face with the memory foam to be the most comfortable. Airsense F20 I think. It doesn't fit quite right but it is the best of the ones I tried (pillows, etc). Many setting changes have been made and while a little better, it is still not working (meaning I don't get more than 2ish hours of sleep). Oddly enough, when I was in the lab doing the titration with bipap (not cpap or apap) I slept the longest (about 5 hours). I was super happy and thought that this was the answer as the cpap didn't work for me. But, alas, the home machine is nowhere near the lab machine even though they say it is the same. I don't believe it.

Jump to this post

I encourage you to continue to return to the clinician/ technician who programmed your device. We need to ask for assistance when needed.

REPLY
1 reply
jmgall | @jmgall | May 10 12:34pm
In reply to @ann728 "I encourage you to continue to return to the clinician/ technician who programmed your device. We..." + (show)
@ann728

I encourage you to continue to return to the clinician/ technician who programmed your device. We need to ask for assistance when needed.

Jump to this post

I think she is tired of me lol. I have had so many adjustments to both the original cpap and also to the bipap she switched me to. Been working on it over 60 days with some comfort improvement but no sleep improvement at all. Technician says there are no other adjustment she can make so I am supposed to talk to the neurologist to see what he thinks. Will likely look to other options as I don't think ignoring my apnea is a good idea for long term brain health even though it is considered mild. That was my original question to see if anyone knew if it was better to treat apnea vs treating insomnia. If I use my bipap, I sleep okay for 2 hours but then poorly for the rest of the night. Since quality sleep is sooo important (that's what they say), then am I getting more benefit from the bipap or from just trying to sleep?

REPLY
1 reply
ann728 | @ann728 | May 10 1:20pm

I hope your neurologist is able to answer your questions. I slipped into a pattern of only around 3 hours of sleep for 3-4 nights and fell into a depression. This was new for me. I didn’t have dangerous thoughts just down-way down. Fortunately. I got in to see a social worker quickly and she helped me to see that my depression was from sleep deprivation. I am managing that better and the depression has lifted. I can see that sleep drives so much…physical and emotional energy.
Take care…keep looking for help.

REPLY
View MoreView Less
Please sign in or register to post a reply.