CPAP Discontinuation
So CPAP or BiPAP hasn’t worked out? Whether it's because we couldn’t tolerate it, no symptomatic difference, etc There may be a few things that you can do to improve your sleep. I'll discuss briefly here some things to watch out, common bad habits, common issues and what we can do about it.
Nasal Passages:
Chronic congestion:
- Nani pot / squirt bottle with Sodium Bicarbonate solutions: are the best method to reduce the inflammation. If possible, ensure we have a humidified environment to ensure no further swelling.
- Nasal Gel Spray would also provide prolonged sinus relief.
- Menthol Crystals: melted in distilled water, can provide a vasoconstricting vapor that will assist your nasal passages from being congested.
Deviated Septum: This is a known cause that may lead to issues at night due to more interrupted sleep. Surgery can temporarily fix this and seldom permanently.
Polyps: Physical obstruction that will lead to better breathing when removed. CPAP is often prescribed until the polyp can be removed.
Broken Nose: If your nose has been broken once or a few times, there is likely scar tissue growth preventing proper air passage and naturally deviated septum due to the nature of the injury. This will need to be remedied through surgery and/or CPAP.
Screen Time
Being on the phone and computer at night leads to REM Latency during sleep which means the sleep architecture changes and affects the overall quality of the restorative sleep.
Insomnia:
Screen time: Reduce Screen time (2-3 hours before bed)
Nicotine: If you smoke, it is best to do it a minimum of 2 hours prior to sleep.
Caffeine: No caffeine past 6pm absolute latest
Sunglasses: This will mimic darkness and promote the natural release of Melatonin.
Meditation/ Relaxation: Relax & unwind the mind. Sometimes the simplest things can cause major improvements.
Keep a regular sleep cycle. Don’t oversleep. Deprive yourself of sleep on a bad night by waking up at the same time. Go to bed at the same time. By doing this you will assist your circadian clock to reset and make it easier to sleep.
If you cannot fall asleep, GET UP. Don’t lay there awake. Go do something else and come back with a refreshed mind and not as aggravated to fall asleep and accept it will be a shorter sleep. Don't sleep in.
Cryogenic sleeping environment: Stay cool at night. This seems to easy to be true but it makes a big difference in the quality of sleep as our bodies like cool temperatures.
CBTI: (Cognitive Behavioural Therapy) One company that I really liked with very positive feedback is MindBeacon. A CBTI therapy that is currently free for OHIP card holders. Why not try it?
Medication: Very last option will be medication due to dependency probability and worsening insomnia condition.
Alternatives to CPAP:
ExciteOSA- Tongue Stimulator
ExciteOSA This brand new technology works like a TENS machine but specifically for building up tongue muscles. This is supposed to help the tongue maintain tone during sleep reducing the events per hour and even snoring!
EPAP systems: Good for people not requiring full face masks on CPAP and no nasal issues.
Eg. Bongo Rx & OptiPillows
Positional Therapy: Ensure to sleep laterally as that can lead to lessening obstructive events.
Eg. Sleep Noodle for side sleeping
Bed Wedges: Have your torso at a 30-45 degree angle (Semi-fowler’s Position) to reduce the chances of full obstructions.
Restless Legs and Periodic Leg Movements (Before and/or during the night respectively). I am classifying them together but please note they are completely different.
Magnesium
Talk to your doctor to see if Magnesium supplements are safe for you. This can and does improve leg cramps and overall restlessness if Magnesium deficiency is at play.
Weighted Blanket
Much like a Thunder Jacket for dogs, our bodies like to be tightly held, at least the legs do. If you feel restlessness or if you have been diagnosed with PLM (Periodic Leg Movement) a weighted blanket can improve your sleep overall.
Psychological Stressors
Really think of situations currently that can be affecting the depth, adn quality of your sleep simply by stress simply overtaking your mind. There are many reasons to be stressed, but try not to affect your sleep. There are always paths to take to improve this, one that I have found has lots of positive feedback is MindBeacon. A CBTI therapy that is currently free for OHIP card holders.
Treat the Sleep Apnea Component with a CPAP Alternative.
Sleep Apnea / sleep breathing disorders can cause Restless Legs, leg cramps and Periodic Leg Movement.
Sincerely,
Rafael Mendonca, RRT CPSGT PFT Technologist Manager
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