Wake up after 3 or 4 hours with CPAP and can't go back to sleep


I have been on CPAP for only a few weeks, and I am still getting used to it.

I have noticed over the last few nights that I tend to go to sleep fairly quickly now (while it was a struggle when I started CPAP) but only stay asleep for 3 or 4 hours. I therefore wake up at 1am or 2am, quite refreshed and feeling well. However, I struggle to go back to sleep with the mask and machine on, so I go back to sleep without CPAP, and wake up more tired.

Is this usual?

I am assuming 3 or 4 hours is matching a sleep cycle?

It’s possible that matches a sleep cycle for you. As for the only getting 3-4 hours of sleep with CPAP, that’s probably going to increase your chances to fail CPAP therapy. It sounds much like the pattern I’ve read on the other forum I’m involved in for apnea. My guess is your CPAP pressure is set too low and you’re probably feeling air starved. So the natural reaction is take the restriction (blame the mask so off it comes).

Before changing anything on your machine, working on sleep hygiene might help.
In this particular case, sleep hygiene relates to what you actually do under the circumstances you mention.
So, when you wake up in the middle of the night and can’t get back to sleep within 15-20 minutes,
then: take off the mask, turn off the machine, get up and out of bed and go to another room. Read something light (nothing about violence or politics or anything that is stimulating). Eventually (hopefully soon) you will become sleepy again (not the same as tired). When that happens, go back to bed, mask up, etc.
Rinse and repeat as necessary if the 15 minutes pass without going back to sleep.

What this will do is to help train your brain to the (new to you) habit of “I’m in bed and therefore I’m going to sleep.” Prior to developing this new habit, your brain was OK with being in bed and not being asleep. For example reading or watching TV, listening to music, etc. Got to stop all those things and make a new habit. For now , until you get this new habit ingrained, bed is for sleeping and nothing else. All other activities are somewhere else.

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Very good tips there on sleep hygiene.