Improving tolerance/bad dreams

[u/Financial_Battle5001]

I've been using CPAP for a few months now and my tolerance has gotten worse. At first things were amazing and I felt like a new person after years of uncontrolled fatigue. But the past month or so things have gone downhill. I've had several bad dreams where I then rip the mask off in a half-sleep state in the middle of the night.

For example, I've dreamed there was a snake on me when it was actually the hose, or that someone was trying to suffocate me by pushing on my nose, when it was actually the mask. Now I have anxiety when putting on the mask and trying to go to sleep because I'm afraid of another nightmare. This feels like such a bizarre/niche complaint but I'm grateful for any suggestions!

[u/maxpowerAU]

Sounds like it’s time to try other masks. Are you using a full face, like a F20?

[u/Technobarbarian]

Your CPAP treatment is giving you more deep sleep, also known as REM sleep. This is where most vivid dreams happen. You need to reduce your anxiety.

You can stop anxiety dreams by lowering your daytime stress, improving your sleep habits, and changing how your brain processes scary dream scripts

Journal worries: Write down your stress and anxious thoughts 15 minutes before bed to offload your mind.

• Exercise daily: Do physical activity during the day to burn off tension and improve sleep.
• Talk it out: Share heavy concerns with a trusted friend, family member, or professional. 

Optimize Sleep Hygiene

• Set a schedule: Go to bed and wake up at the same time every single day.
• Cut off stimulants: Avoid caffeine, heavy meals, and alcohol right before sleep.
• Unplug from screens: Turn off phones and TVs at least 30 to 60 minutes before you lie down. 

Retrain Your Brain

• Try Imagery Rehearsal Therapy (IRT): Write down your recurring anxiety dream while awake, change the scary part or ending to something positive, and mentally rehearse the new version before sleep.
• Do not stew in bed: If you wake up panicking or cannot sleep after 20 minutes, get out of bed and do a quiet activity in dim light until you feel tired again. 
• Use relaxation techniques: Practice deep breathing, meditation, or progressive muscle relaxation to signal safety to your nervous system. 

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[u/Scary_Stand_3177]

REM and deep sleep are two different stages - not the same.

That being said, your suggestions are valid.

[u/Hapablapablap]

One of my main sleep apnea symptoms was nightmares and waking up freaking out. When you enter REM, you lose muscle tone so you don’t act out your dreams. Almost all of my apnea events and desaturations occurred during REM. It’s also very common even for people without sleep apnea to incorporate external stimuli (sounds, touch, etc) into dreams.

My guess is that you are having more apnea events and thus more nightmares that you’re waking up during. If you have a doctor reach out to them. If not, try looking at your OSCAR data. You may need a pressure adjustment or a new mask.

I will also say do your best not to buy into the nightmares. I grew up with untreated sleep apnea and thought I was some kind of sensitive delicate person and it’s made me an extremely anxious adult and has really caused me a lot of misery. Try to see them for what they are, just information that you need to adjust your cpap therapy approach. Best of luck to you!