Adventures behind the mask
I was diagnosed with Obstructive Sleep Apnea in the summer of 2012. My headache doctor at the time was searching for untreated comorbidities that might explain why I was not responding to any of the typical preventives. After my husband ratted me out by telling her that I snored “like a foghorn”, she referred me for a sleep study. When the results came back positive, I was not surprised. In fact, I was relieved that there might finally be an explanation for the many headaches and migraine attacks I was getting.
It did improve my health though. Because I slept better, my body was able to maintain a consistent sleeping routine. That eliminated a strong migraine and cluster headache trigger. Before using a CPAP, I would wake up at 3:00 am a few times each week because of a cluster headache attack. The cluster attack, in turn, would trigger a migraine just about the time I got it aborted. I was sleep deprived and in a lot of pain most of the time. Sleeping with a CPAP put a stop to all of those early morning attacks. I still got attacks more than half the time. They just moved to later in the day. Because I was awake and well-rested, I could start treatment earlier and abort the attacks sooner. This allowed me to have more headache-free time each day.
“I don’t know how you can stand that thing on your face all night. How in the world do you ever sleep?”
This is the most common question I get asked about sleep apnea and using a CPAP. Looking at the mask, it appears cumbersome. When your throat closes up and cuts off your airway up to 100 times a night, you don’t sleep very well. Being able to breath is essential for survival. The body naturally goes in a “red alert” panic mode when you can’t catch a breath. How can our bodies do anything else? Without oxygen, there is no life. It’s not just about waking up feeling refreshed. It’s about staying oxygenated all night long.
Finally being able to breathe means that mask becomes a subconscious signal of relief. After a few good nights of oxygen-rich sleep, I began to crave sleep. In the early weeks, I took a lot of naps because I was making up a “sleep debt” from all the years of poor quality sleep. Over time, my sleep routine normalized into a 7-8 hours of restful sleep. The better I slept, the fewer migraine attacks, the better I felt. I sleep better now than I ever have. I don’t snore or grind my teeth anymore. And best of all, I rarely wake up with a migraine or cluster attack. Those incessant 3:00 am wake-up calls are still burned deeply into my memory. Whenever I am tempted to skip the mask, I remember those days and strap on the mask anyway.
So, is migraine the worst thing that can happen if OSA is left untreated?
Unfortunately not. Untreated OSA dramatically increases the risk of depression, anxiety, obesity, high blood pressure, high cholesterol, heart attack, and stroke. Hmm…that list sounds eerily familiar. Oh, wait! Those conditions are often comorbid with migraine. Are you starting to understand how important it is to get good quality sleep?
Tips for better CPAP compliance
If you are diagnosed with OSA, it can take some time to get comfortable using the mask. You may be tempted to give up, but stick with it. Most people find that after about 6 weeks of consistent use the mask becomes a natural part of their sleep routine. If you are having trouble sleeping with the mask, talk to your doctor or medical supply provider. They can help you explore strategies to make the transition easier.
- Try several masks before taking one home. Ask for the machine to be turned on so you will know how it feels. If there are any air leaks or problems with the fit of the mask, these problems are best addressed before you use it at home. Think about your current sleep routine. If you often go to sleep with a migraine, read in bed, etc. you might consider getting a mask without any gear on the forehead. If you are a mouth breather, you might need a full face mask that covers both your nose and mouth.
- Make sure there is always plenty of water in the humidifier. Dry air can irritate your sinuses, causing you to wake up with sinus pain. Never use tap water. Instead, use distilled water to prevent hard water deposits from building up inside the reservoir.
- Clean your mask and tubing daily. Warm water and mild soap is quite effective. This will prevent bacteria from growing that could cause a sinus infection.
- Don’t be alarmed if, in the early days, you remove the mask in your sleep. This is common and usually isn’t a long-term problem if you stick with it.
- Newer models submit sleep data electronically to your doctor. You can also view your reports online through a secure portal. If you have this feature, use it to track your progress. If you have an older model, you might consider asking your doctor about getting a newer machine.