If you’ve had a sleep study, but still can’t sleep, this article will offer you hope. We’ll take a look at some of the reasons why you’re still not sleeping well. And we’ll also address some things you can do to possibly improve your sleep.
Unfortunately, for some people, having a sleep study and being started on CPAP doesn’t restore good quality sleep. There are many reasons why this is so, and usually, these things can be remedied. There’s also the issue of insomnia, which is actually different than sleep apnea. However, in this article, we’re focusing specifically on sleep not improving with CPAP.
With that in mind, let’s take a look at some things.
You slept Better initially After Your Sleep Study, but now you Can’t Sleep
To begin with, think about things that have changed since your sleep study. How long ago was it? If it’s been a few years since your last sleep study, just the natural changes you go through as you age, such as weight gain, for instance, could make your sleep apnea worse.
Another thing to consider is the use of medications. Unfortunately, many medications can disturb your sleep and cause daytime sleepiness. So, if you were started on a new or different medication since your sleep study, talk to your Doctor about possible side effects.
In women, estrogen and progesterone help keep your airway open. However, after menopause, these hormones are gone, leading to an increase in sleep apnea.
Other physical disorders that can disturb your sleep, or cause a change in the way you breathe include:
- Heart Disease
- Certain lung diseases
- Some stomach and intestinal disorders
- Anxiety and/or other mood disorders
But what if you never did feel any better even right after your sleep study?
You Can’t Sleep any Better Immediately After your Sleep Study
Of all the reasons you can’t sleep, stress might be your biggest issue. Stress is quite common and can be the cause of more than just not sleeping well.
There could also be some, as of yet, undiagnosed underlying condition; such as Narcolepsy, for instance. Additionally, the use of alcohol and/or tobacco can cause sleep disruptions and drowsiness during the day as well.
Furthermore, did you tolerate your CPAP mask well during your sleep study, but now you’re struggling with it? It could be as simple as the wrong type of mask. Maybe they used a nasal mask on you during the study, and that particular night, you were able to breathe through your nose fine. Now, however, for some reason, you can’t breathe through your nose anymore. Perhaps CPAP is now drying your sinuses, causing mouth breathing.
Or maybe you just don’t have the mask fitted right and it’s leaking. This could cause frequent arousals. Also, if the leak is big enough, it would decrease the amount of pressure that actually reaches you. And that reduced pressure might no longer be enough to hold your airway open.
In fact, one of the more common problems people with nasal masks is mouth breathing. This can be a source of frequent waking. It can also cause less pressure to be delivered to you, thus making your CPAP less effective. Therefore, maybe you can’t sleep because of a mask and/or mouth breathing issue.
A mask issue can usually be remedied by properly adjusting your mask, or changing to a different one. But what about mouth breathing?
Causes of Mouth Breathing
We are naturally nose breathers. So for most of us, a nasal mask works quite well. However, there are a few things that can cause you to breathe through your mouth. Many people with nasal CPAP masks struggle with sinus congestion, dry nose, and throat.
Can you breathe through your nose while awake, but once you’re asleep your mouth pops open? The reason for that is usually because your airway is collapsing (see diagram). This causes you to open your mouth in order to pull in more air.
In that case, CPAP, which holds your airway open, should restore nose breathing in your sleep. However, the cause of mouth breathing could now be due to sinus congestion, caused by the drying effect of CPAP. This can cause short term mouth breathing. Therefore, if you can’t sleep, and use a nasal mask, mouth breathing might now be some of the cause.
Also, a surgical procedure that removes excess tissue in the back of your mouth lessens snoring and reduces apneas. However, studies have found that people who have had these procedures might still need CPAP. And they are also more likely be mouth breathers because of the lack of tissue support.
The question is, is mouth breathing anything to worry about? And if not, why not just use a full face mask and be done with it. Well, let’s see what happens to you physically when you breathe with your mouth.
Health Effects of Mouth Breathing
When you breathe through your mouth, the air isn’t warmed and moisturized like it is with nasal breathing. This causes dry mouth, which encourages bacteria growth, leading to cavities. Nasal breathing not only warms and moisturizes the air, it also acts as a filter, reducing dust and allergens.
Also, when you breathe through your nose, Nitric Oxide is produced in small quantities. This gas actually makes you absorb more oxygen, which is even more important while you’re sleeping. This is because your breathing becomes slower and shallower in your sleep.
Keep in mind that many people see their Dentist more than their Doctor. Therefore it’s usually the Dentist that notices mouth breathing issues. Especially important to consider is that mouth breathing in children can actually cause abnormal facial and dental development.
How to Reduce Mouth Breathing
Here are some things you can do to encourage nose breathing:
- Use a chin strap-These can be fairly effective if you’re not dealing with sinus congestion. Although, even then, they don’t always guarantee you won’t breathe through your mouth at times.
- Use a mouth guard
- Elevate your head
- Eliminate allergens
- Use decongestants to clear your sinuses.
- Excercise-Yoga and cardio workouts can improve your breathing
- Try sleeping on your side instead of your back
- Tape your mouth shut-I’m not kidding! Use surgical tape. However, this can be uncomfortable, especially at first.
Also, if you use a nasal CPAP mask, simply increasing humidification can help clear your sinuses, and therefore increase nasal breathing.
If you’ve had a sleep study, but you still can’t sleep, there are some things to look at as the cause. Most of these problems can be dealt with fairly easily. But be sure to consult your Doctor with any concerns you might have. You might just need a mask adjustment. But then again, another sleep study may be necessary.
Till next time…Blessings.