Wake up after 2-3 hours on CPAP and cannot fall back to sleep

I have been using my CPAP machine since late March. I have gone thorough the a period of taking off the mask and turning off the machine during the night but not recalling why later in the morning. Now I wake up after 2 -3 hours and cannot fall back to sleep. I tried taking the mask off and putting it back on for a good fit but that does not help. Since I am very tired at the point I end up taking the mask off and going to sleep without it. This ends up causing my number of 4 hour + days of use going down which can have an affect with insurance. Any suggestions will be welcomed.


@schwerz You might find a solution in taking a step back and trying to desensitize yourself to the mask. When a person begins wearing PAP, a process called desensitization is beneficial. The concept is that it may help to practice wearing just the PAP mask for short periods of time while you’re awake, for example, while watching TV.

Then try wearing the mask and hose with the air pressure on-- still during the daytime, while you’re awake.

Once you become accustomed to how that feels, shift to using the PAP device every time you sleep — at night and during naps.

Inconsistently wearing the PAP device may delay getting used to it. Stick with it for several weeks or more to see if the mask and pressure settings you have will work for you.

This below is something you can do as well- extremely effective…try this, please. It is a go-to method for a positive approach to wearing PAP and putting it on in the beginning of the night. Understanding that the pressure is filling the back of your throat as an invisible split…or even a balloon… helps to ease tension about putting the mask on. Let’s try this “chill out” exercise right now!

I had to go through several masks before I got the right one. Also I had the 3rd in hospital sleep lab. The pressure had to be adjusted differently. Also they found out that I have both Obstructive and Central Sleep Apnea. Just keep using it. I put mine one when I go to bed, even if I am reading. That will help with your hours for insurance purposes. Just don’t give up!

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I have had the same problem with mine. I would take it off during the night and not recall doing that. Now I sleep with it but only for about four to six hours. I struggle to get a good night’s sleep with the mask on. Without it I have no problems sleeping eight to ten hours. I wish I could give you some advice after using my CPAP for over two years, but I am sorry to report that I have no such advice.

I have a similar problem caused by other conditions. First the problems…I have BPH which wakes me after 2 1/2-3 hours every night and has been for ever. I also have a biphasic sleep pattern which is extremely hard to break. Since I am 70 and chronically ill I have to rest a lot in the afternoon and I fall asleep unwittingly without the mask on. It appears I also have narcolepsy which gives me no warning and suddenly I am asleep when taking those afternoon rests.

I have had a terrible time finding a sleep MD – None would listen to these issues and my pressure was 4-18 on a Dreamstation CPAP machine. Mask fit was awful and after I lost weight the high pressure was breaking the mask seal (full face) which caused my AHI to climb to levels as high as 15, mostly due to hypoapneas. The respiratory therapist evaluated my mask fit and pressure and told me in a instant my pressure was too high and they seldom go higher than a range of 4-14 whereas one MD started talking surgery which is very risky for me and not necessary as my primary care MD had to call in a change to 4-14 which solved the problem. None of the 3 sleep MDs I tried would do this. Finally I think I have one I can work with (after 2 years) but the anxiety over months of poor fit, too high pressure and MDs who don’t listen have made these problems worse. Right now I am only averaging 3:15.

Any suggestions on how to get this mess sorted out and return to the regular 4 hours a night which I had early on and felt fantastic when I did get 4 hours. Now nasal pillows for mask work great for me. I just need to get more mask time. 3 hours helps but 4 is much better.

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@rsgibson WELCOME and thanks for sharing ! :grinning:

I have the same issue with my cpap machine. I’m more tired when I use it than when I don’t, when I use the machine, being a truck driver I have to pull over and take a nap just to get rested. I’ve tried every conceivable method until just recently I was in an accident where I ended up losing my job and my medical card for driving. The police investigators tried to blame the accident on me because I used a cpap machine. After all was said and done, I was not charged in the accident but lost my medical card for 5 years by the federal government and lost my job also driving a truck. I explained to my doctor the cpap machine was not helping me at all. It’s nothing more than a money racket between doctors and government to keep us down even more. I stopped using my machine and haven’t felt this rested since I stared using it.

As a former 11 year regional truck driver myself, I can relate. Glad nobody got hurt in that accident BTW. My apnea was at that time undiagnosed.

When I hear of apnea patients that can only go a few hours with mask on, I think of a few reasons, and it’s not just blame the patient.

Here’s my list:
wrong mask - size of the cushion or type = full face, nasal, pillows

wrong xPAP machine - lots can get by with standard CPAP, some are better suited for BPAP, others like me need high level ASV, ST, ST-A, or even real ventilators like a ResMed Stellar or Astral or Respironics Trilogy

maybe you’re in need of looking at your sleep data with a free program like OSCAR from techy people on Apnea Board, this OSCAR will give you the data charts to help you see if your pressure settings are not set right, BTW I believe most will find their CPAP settings need to be tuned better than what Dr. Duck is willing to help with. Most doctors have blinders on. They see AHI under 5, pat you on the back and say good job see ya. If they don’t see an AHI under 5, most will be very puzzled and clueless.

I bypass the clueless, I looked at OSCAR data, adjust my ASV for best therapy results. That’s what every apnea patient should do IMO. The first few months of therapy are basically a long titration.

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Great tips! Thank you for sharing!

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