Okay… let’s be realistic.
The challenge is not just the apnea itself, is it?
It’s the masks that don’t quite fit… the machines that beep at the very minute you finally dozed-off… the mornings you wake up groggy despite doing everything right. And let’s not even get started on the frustration of trying to explain to someone why you're not just ‘tired’.
So yes, sleep apnea therapy can be stressful.
And if you’re anything like me, or the hundreds of other apnea peeps I’ve spoken with, there are moments when it makes you people-scatteringly angry.
That’s okay… you’re human. Sleep deprivation is, after all, a form of torture.
So, this week let’s take a look at what we can do to reduce our stress levels… and those homicidal tendencies.
The Vicious Circle
Firstly, let’s address the elephant in the room… stress makes apnea worse.
When you’re stressed, your body produces cortisol… a stress hormone that can interfere with your sleep quality. And, surprise surprise, poor sleep makes you more stressed. It’s tempting to look around expecting to spot some hidden cameras.
As with the old saying ‘A journey of a thousand miles starts with a single step’, we first need to recognise what this cycle is doing to us before we can give it a metaphorical kick in the nuts.
You’re not just stressed because of random life stuff. Sleep apnea is in addition to all that. Those without sleep apnea have problems too. We just have to factor in yet another issue to overcome.
And to get us onto a level playing field with those who don’t stop breathing during sleep, we really need to get those zeds in.
Friend or Foe?
If you use CPAP (or its APAP and BiPAP cousins), you already know it’s a love-hate relationship.
Sure, it’s extending your life, but some nights it feels like it’s trying to ruin it, too.
Mask leaks, dry mouth, pressure settings that feel like you’re in a wind tunnel... it’s enough to make anyone lose their cool.
Here’s what you can do when CPAP feels like the enemy:
Tame the Mask Monster
- Fit is everything: If your mask isn’t comfortable, talk to your provider about trying a different style. Don’t settle for ‘good enough’. You are worth more than that.
- Use mask liners or cushions: These can reduce irritation and help with leaks. At Cracking Sleep, we make the Stag’s Head strap cover, which has now helped thousands of PAP users get a better night’s sleep. As for mask liners… jeeze, we have been trying to develop one for more than a year without success. They are all hit or miss… you just need to look at the reviews to see that. The answer to that one is trial and error. What works for you may not work for the next guy. But that’s okay. You are the most important person on the planet, so look after yourself first.
- Clean it regularly: A clean mask feels better and smells better… win-win. Silicone masks need washed every day. If you have a fabric or memory foam one, it still needs wiped-down with wet-wipes every day to help remove some of the sweaty build-up it absorbs during the (hopefully) 8-hours you wore it last night.
Adjust Settings… With Help
- If your pressure feels wrong, don’t just suffer through it. Reach out to your sleep specialist or equipment provider. Sometimes, small tweaks make a big difference. Time can make a difference too. Maybe you needed a pressure of 20 when you first started… but, with a year of experience later, should that 20 maybe be a 12?
Maybe You Need a Break?
- Pretty much every sleep specialist says any insomnia sufferer should get out of bed instead of just laying there for hours hoping sleep will come. That is good advice for anyone staring into the dark getting more and more frustrated when, for whatever reason, this wind-tunnel strapped to your face is more than a bit distracting. It’s okay to step away for a bit if you’re feeling overwhelmed… just make sure you come back to it. Consistency is key.
Managing the Emotional Toll
And, while we are on the subject of emotions, sleep apnea can mess with your mood even when therapy is going well. Add stress or frustration to the mix and it’s a perfect storm.
Here are some strategies to help you keep your cool:
Give Yourself Permission to Feel
- It’s okay to feel angry, sad or fed up. Suppressing those emotions only makes them bubble up later. Let yourself have a good rant (or cry) if you need to.
Talk to Someone Who Gets It
- Whether it’s a support group, a friend with sleep apnea, or an online community, connecting with people who understand can be a huge relief. Sometimes, just hearing ‘me too’ is enough to lighten the load.
Practice Gratitude… Yes, Seriously
- At the risk of sounding cheesy, focusing on what’s going well can help shift your mindset. Maybe it’s a night with fewer mask leaks or a morning where you feel just a little more rested. Celebrate those wins. You earned them!
Tools You Can Use Tonight
Now… let’s get into the nitty-gritty of stress management.
These aren’t one-size-fits-all solutions, but they’re a good starting point. Try a few and see what works for you.
Deep Breathing
- This is a classic for a reason. Slow, deep, breaths can calm your nervous system in minutes. Try inhaling for 4 counts, holding for 4, and exhaling for 6. Exhaling for longer than you inhale has been proven to reduce the heart-rate.
Progressive Muscle Relaxation
- Lie down (CPAP-free for this one) and focus on tensing and relaxing each muscle group, starting at your toes and working your way up. It’s oddly satisfying.
Mindfulness or Meditation
- More and more people are recognising the benefits of meditation. Even for as little as 5 or 10 minutes. The guided meditations provided by apps like Headspace or Calm seem to work well for some. Similarly, you may find your phone or health tracker (like watch or ring) comes with a meditation app built-in.
Journal It Out
- Many people, CPAP users included, find just getting frustrations out and onto a page can make all the difference. It can be therapeutic and keeping track of your therapy experience might help you identify patterns or triggers.
Move Your Body
- Whether it’s yoga, a brisk walk, or dancing around your living room, physical activity is a proven stress-buster. If you have a dog, maybe take it for an extra walk today.
- If you live near a park or woodlands, getting into nature can also help bring those stress-levels down.
What to Do When You’re Really Upset
I get it.
Sometimes, stress boils over into full-blown anger.
It happens.
Most of us have been in situations where pressing the big red button seemed like the best option.
But… it wasn’t.
The key is to handle it in a way that doesn’t make things worse. Let’s be honest, yelling at your CPAP machine isn’t going to make it treat you any better.
Step Away from the Edge
- Just like when you are staring into the dark waiting for the CPAP distraction to subside just enough to nod-off… if frustration or anger brings you to a mid-mask meltdown… take a break. Walk away for five minutes, drink some water or do a short breathing exercise.
Use ‘I’ Statements
- When talking to a partner or healthcare provider about your frustrations, focus on how you feel rather than placing blame. For example, ‘I’m really struggling with this mask’ is more productive than ‘You gave me the wrong mask, you incompetent dipstick!’.
Use the Force
- Anger can be a powerful motivator. Use it to advocate for yourself… whether that’s pushing for a different treatment option or insisting on better customer service.
- You are in charge of your future.
Building a Sleep Apnea-Friendly Routine
Sometimes, stress stems from feeling out of control. A solid routine can help you feel more grounded and make your therapy feel less overwhelming.
Here’s a sample evening routine:
- 30 minutes before bed: Turn off screens (yes, even your phone). Dim the lights and start winding down. The screens part isn’t anything to do with blue-light but everything to do with how screens are designed to be engaging. Engaging screens are the enemy of sleep.
- 15 minutes before bed: Do a short relaxation exercise… whatever works for you.
- Bedtime: Put on your mask and focus on the benefits it’s bringing you. If it’s not comfortable, adjust it before frustration sets in.
- If you need to get up: Think consciously about relaxing again when you get back to bed. You are in control.
You Are Not Alone
Millions of people are navigating sleep apnea, and no one has it all figured out.
The important thing is that you are trying… whether that’s sticking with your CPAP, exploring alternative treatments or just reading this article to find some encouragement.
Bad nights happen.
Stressful moments happen.
But you have got this.
And if you need a little extra support… ask for it. That could be to a friend, a doctor, or even a fellow apnea warrior in a Facebook group like the Cracking Sleep Apnea group (other groups are available).
If you feel like some personal contact, feel free to email me at alan@crackingsleep.net. I’m a CPAP user too. I may not have the answer, but I do have a desire to help you find it.
Cheers,
Alan
P.S. I have taken to creating various bits on sleep and sleep apnea. If you would enjoy hearing more and find out where else you can find stuff like this, you can get my weekly Triple Whammy email, which has 3 short topics each week. Some written or recorded by me and others I’ve found out there in the strange world we live in.
If this is you, sign up here and you will get the very next one.