Although I've had insomnia for years (routinely waking between 2 and 4 am with difficulty getting back to sleep), it seems to be getting worse.

After using a CPAP for four months, last week I got a BiPAP auto SV. I thought this was going to be my ticket to less insomnia and more sleep. So far, it hasn't improved the quality of my sleep or the way I feel. I still frequently get up feeling like I've been run over by a bus. Run over by a bus translates as some combination of headache, all-over body aches/malaise, hypoglycemia, not wanting to think, talk, move, or do anything because I feel so awful.

So now I'm wondering if there is something else going on in addition to my complex sleep apnea . Although I'm not overweight, I know I'm still at risk for diabetes. My father has diabetes and OSA. There was a lot of diabetes in his family. (He is part Native American.) I am 54 years old and have had hypoglycemic issues for years. My 9-10-09 HA1c was 6.0. My 12-22-08 HA1c was 5.3. My doctor was concerned about the increase, but didn't say much about it.

I once worked for someone who had terrible insomnia and he eventually learned he had diabetes. After he began treatment, the insomnia improved/resolved. So I'm wondering . . . can diabetes (or pre-diabetes) cause insomnia?

wearysoul

Hi,

Do you know for sure that your CPAP treatment is effective? For example, what is your AHI when using the machine? Without knowing that, it might be that you are still having events or that your treatment isn't effective for some reason. Also, you leak numbers are important since many machines do not compute AHI in a reliable manner if you have high leak numbers.

-john-

I was very overweight and pre-diabetic. I have lost weight (58 lbs.) and my sugar numbers are now normal. When I started to lose weight my therapy worsened. I fought it over a year. Started HRT, changed masks numerous times and the latest thing I have discovered is my pressure range was now too high for me. I have lowered my range from 7 - 13 to 5.5-11 to see if this will help but so far no joy. Its almost like when I was fat my therapy was working but as soon as I lost weight it isn't and we can't seem to put a finger on what is causing the fractured sleep. So for me I would have to say no, it didn't matter for my therapy that I was pre-diabetic in fact just the opposite. When I became healthier and in the normal range for sugar numbers my sleep got worse. Go figure. I guess I will have to break down and get another sleep study which I would rather take a beating than do. Good Luck in finding the cause of your insomnia, I haven't figured mine out yet. I wake up every 2-3 hrs still after having a year of great therapy where I slept 6 hrs straight and then got 1 or 2 hrs. more. I miss it.

A person may have insomnia for lots of reasons, but as a direct 'result' of, or known symptom of diabetes, there's not a connection, though I'm sure lots of diabetics have insomnia if only due to undiagnosed OSA that often accompanies diabetes (and other potentially cardio problems).

Ditto what jweeks said. Don't ignore the elephant in the bedroom.

You need to have some data to make sure your therapy is under control before you start worrying about other causes of insomnia. Get that done in a hurry.

As soon as you are sure the therapy is effective, you need to start looking at the diabetes issue. The typical diabetic had diabetes six to ten years before he started treatment for diabetes. Don't wait that long.

Did you try using Google? There are lots of links to read when you put in "Diabetes and Insomnia".

Here are a few.

http://www.wrongdiagnosis.com/symptoms/ ... abetes.htm

http://insomnia.ygoy.com/2008/05/26/dia ... -insomnia/

http://sleepmeeting.blogspot.com/2009/0 ... -risk.html

If you're hypoglycemic and going low during the night, I would think that could also disrupt your sleep. Do you have a meter and check your glucose levels during the day and in the night when you have your sleep disturbances?

And, as has been said, untreated sleep apnea or inadequate therapy can affect either/both.


Den

If you think you are at high risk for diabetes due to the risk factors you mentioned, see your doctor and get tested. Symptoms of diabetes vary but fatigue is one of them. Fatigue can lead to insomnia along with all the other systemic inflammation that diabetes causes.

Get tested. It will at least put your mind at ease concerning that issue.

silver

I'm co-signing on the need to confirm your treatment is working its best for you. My early months of treatment were not therapeutic, and getting data was one key to turning it around, along with gaining a basic understanding of the ins and outs of this treatment. If you are still feeling bad, I'd first be suspect that the treatment needs tweaking.

That said, I also agree that there can be other contributors that get overlooked for too long under the assumption all symptoms come from OSA. For me, RLS and PLMD were the co-culprits of my poor sleep. The best CPAP treatment in the world won't help them. I feel that in a sense I was fortunate that my limb movement disorder was diagnosed before the OSA. I shudder to think of how many are out there wondering why their CPAP hasn't "cured" them of feeling crappy and have no idea that something else is going on. That something else could be any number of things.

About diabetes, I have a strong family history, yet all of my adult life I was hypoglycemic. The switch flipped sometime in my early fifties. I had some months of it being "borderline" then boom! A stint on Prednisone pushed me well over the line. I doubt my diabetes had much effect on my sleep - it wasn't high enough to cause frequent urination.

So, don't delay on pursuing answers. Feeling bad is a symptom of something - don't ignore it.

Kathy

Thanks, everyone, for the replies.

Yes, I'm aware that inadequate treatment for my sleep apnea may be the primary reason for my insomnia. I emailed my doc yesterday; she's open to tweaking my pressure but wants to see my data first. I've had some leak issues but I think I'm getting them under control. I'm going to collect two more nights of data and then mail the data card to my DME, who will download and email the data to my doc.

I agree--it's a very inefficient way of doing business, at least for me, but the best I can do right now. I don't even have basic data because the auto SV I now have, though it is top-of-the-line, does not have the LED feature that gives a daily readout of leaks, AHI, AI, HI. I haven't invested in a card reader or software because I'm a Mac user, and at the moment I can't afford to buy the card reader, the software AND a PC (or the software required to equip a Mac to function as a PC). I'm working on it.

So while the wheels of the medical establishment are grinding, I've been wondering, as you suggested, Kathy, if there might be something else going on besides the sleep apnea. Thanks, Den, for the Google links. I've done a few searches but couldn't find much that supported my question. Some articles suggest that insomnia can cause diabetes rather than that diabetes can cause insomnia. I posed my question because I wondered if any of you had learned or experienced anything different. I am definitely concerned about my risk for diabetes and will stay on top of it.

I am putting most of my energy right now into maximizing my ASV therapy. Once I get some data, I will start another thread to ask the ASV-knowledgeable for opinions on my ASV settings.

wearysoul

I recommended this to 2 diabetic friends who had insomnia and it worked: protein & fat snack 30 mins before bedtime, something like an oz. of meat or cheese, an egg. Both found had several benefits: greatly reduced the insomnia, reduced nightime wakeups, lowered their morning blood sugars. To see if it reduced her insomnia & wakeups, my mom (who has great glucose control) tried this snack and it works for her.

I third the suggestions to make sure your therapy is optimal.

wearysoul wrote: .......
I am putting most of my energy right now into maximizing my ASV therapy. Once I get some data, I will start another thread to ask the ASV-knowledgeable for opinions on my ASV settings.

wearysoul

Excellent.

One more comment on insomnia. A narrow definition of insomnia is inability to fall asleep within a reasonable amount of time upon first going to bed. You seem to be experiencing what is call premature awakenings.

When a person has apneas, it is common for their body to produce excess cortisol and adrenalin. This can cause premature awakenings and inability to go back to sleep.

So maybe you sleep a few hours, have apneas, produce excess adrenalin, are awakened by the adrenalin, and cannot go back to sleep because of the adrenalin. This is not uncommon among apnea patients.

I'm type 2 and on insulin and other medicines for it. I sleep like a log. Usually always have but would wake up with night sweats before insulin and the APAP therapy. So no, I don't think diabetes causes insomnia.

I seem to be having problems similar to yours. I am diabetic, too. I started off my cpap therapy on September 2, 2009 with very good results. I had no energy during the day time and I was getting up 4-5 times a night for trips to the bathroom prior to beginning cpap therapy. I immediately regained enough energy in the daytime to start exercising when I started using my cpap machine. I was now getting up just once to use the bathroom, about 90 minutes after going to bed but then I slept until morning. After the first month, things started going bad with my cpap therapy and it seems to coincide with the weight loss I have been experiencing. I started getting up for 2, 3, and four bathroom trips after that first month. Last week, I started waking up almost every 90 minutes. Three days ago, I was waking almost every hour to go to the bathroom and last night I woke up after one hour, took a trip to the bathrooom, slept for another hour and woke up for good because I could not get back to sleep. It's very timely that I have ended up here reading your posting about similar results associated with weight loss. I am calling for an appointment with my doctor. I hope she can clear this up and get me back on the right track. This whole cpap therapy experience has been so very, very frustrating for me. I am having troubles with finding the right mask, having troubles with my DME and understand their lack of involvement in helping me adjust to my equipment, and having trouble pinning down who's responsibility it is to read the dadgum data card in the machine. No one has read it, yet. I have been assuming it tells the story of what is going on with me and my sleep but I don't know who is suppose to read it.

If you get any answers pertaining to the weight loss and fractured sleep please post what the Dr. says as I am very interested to see it. I'm very discouraged too but I will hang in there. Good luck finding answers.

PurpleSwan3033 wrote:I seem to be having problems similar to yours. I am diabetic, too. I started off my cpap therapy on September 2, 2009 with very good results. I had no energy during the day time and I was getting up 4-5 times a night for trips to the bathroom prior to beginning cpap therapy. I immediately regained enough energy in the daytime to start exercising when I started using my cpap machine. I was now getting up just once to use the bathroom, about 90 minutes after going to bed but then I slept until morning. After the first month, things started going bad with my cpap therapy and it seems to coincide with the weight loss I have been experiencing. I started getting up for 2, 3, and four bathroom trips after that first month. Last week, I started waking up almost every 90 minutes. Three days ago, I was waking almost every hour to go to the bathroom and last night I woke up after one hour, took a trip to the bathrooom, slept for another hour and woke up for good because I could not get back to sleep. It's very timely that I have ended up here reading your posting about similar results associated with weight loss. I am calling for an appointment with my doctor. I hope she can clear this up and get me back on the right track. This whole cpap therapy experience has been so very, very frustrating for me. I am having troubles with finding the right mask, having troubles with my DME and understand their lack of involvement in helping me adjust to my equipment, and having trouble pinning down who's responsibility it is to read the dadgum data card in the machine. No one has read it, yet. I have been assuming it tells the story of what is going on with me and my sleep but I don't know who is suppose to read it.

Whose therapy is it? Is it the doctor's?......the DME's? No......it's YOUR therapy.
If you've read anything on this forum, you should have come to the conclusion that at some point (many times, sooner than later), the patient gets cut loose by the doctors or DMEs and have to fend for themselves. For them it's all about MONEY. They don't give a darn about how successful you are with it or how you're doing.
Your nightly data summary is in your LCD screen......the software will tell you much more. I'd suggest getting the software and card reader and taking control of YOUR therapy.


Den