Waking Up Repeatedly on #CPAP? Tips from Your Sleep Doc!

Recently, I was seeing an executive in his late 50s for a routine CPAP follow-up. He was using CPAP for 7 hours and 32 minutes every night. His sleep apnea was well-controlled with only one per hour of shallow respirations as seen in the following compliance report. But he was waking up repeatedly at night and feeling tired during daytime.

The reasons were obvious:

1. He was working only 40 hours per week, and yet was not exercising at all because of his knee pain. We talked about a daily exercise of 20-30 minutes doing water aerobics or a stationary bike. This should reduce his awakenings and should improve his deep sleep percentages.

2. He was worried about his parents who were recently placed in a nursing home. We talked about writing a journal every night in the living room outlining problems and solutions. Once he closes the journal, he will stop thinking about it.

3. He was getting frustrated at night when he could not fall back asleep. I taught him progressive muscle relaxation to use when he wakes up at night.

4. He was staying in bed for 9 hours from 9 pm and 6 am. Most Americans need 7 hours of sleep on an average. The reason for his sleep difficulty is obvious; if you need 7 hours of sleep and spend 9 hours in bed, your brain will be awake for 2 hours no matter what. Because of this reason we talked about sleep consolidation. He will go to bed at 10 pm and see how he slept. 

5. He would switch to decaf coffee even in the morning. Caffeine has a duration of action of 24 hours. A cup of coffee in the morning may cause repeated awakenings at night in a sensitive individual.

6. He will not consume alcohol after 7 pm. Alcohol may put you to sleep, but it will rob you of your deep sleep and it will cause frequent awakenings.

7. Make sure your mask is comfortable, your humidifier is working, and that your CPAP is working properly.

You can try these interventions to minimize your awakenings and get more REM sleep. This will improve your energy level next day.

Best Wishes.