Depression, Suicide, Sleep Apnea and CPAP.

[y08hci0299]

So I've been going to periods of major depression and suicidal ideations for the past 8 years. In the past year I was finally diagnosed with sleep apnea and UARS which was a major contributing factor to my depression. I used a cpap last year for about 1-2 weeks, found it intolerable, hated it, and gave up on it. I exhausted all other options, (had UPPP and septoplasty, surgery was unsuccessful), had a sleep endoscopy, went for multiple sleep studies, all the top sleep doctors in my country refused to operate on me any further, and basically all told me to go back on cpap.

So now I have a dreamstation auto bipap sitting at home, with an airfit p10, a hybernite hose and a fisher & paykel heated humidifier. I have been using it for about 3-4 weeks, and have had no success and I am really frustrated. The longest I have slept with it is about 2h45min, and that's even if I can fall asleep with it at all. There's always something about it that keeps me awake or wakes me up. Sometimes the mask doesn't sit right even after adjusting or readjusting so there's a niggling discomfort. When I'm having a sore throat I can feel the wind from the cpap scratching against the back of my throat. Even with a chin strap my outh falls open and I wake up up with a dry mouth. My bipap is even causing me to have central apneas so I have to use it on single pressure because there's a delay in inspiration and expiration. This goddamn machine is pissing me off, it feels like I'm walking on a tightrope and everything has to be calibrated juuuust right or else evrything will fall apart. I feel like giving up but I don't have much of a choice. I'm just afraid that I will be one of those people who never adjusts to cpap even after months and years or trying again and again, every goddamn night.

[LSAT]

I won't reply to all your concerns, but I will tell you that with a negative attitude, you will never be successful with CPAP therapy.

[Julie]

Quite a few people have had success wearing a soft cervical collar that keeps their head up, airway open and jaws (if not lips) closed. It won't necessarily answer all your questions, but may help with some basics. You should also play with humidifier settings - some people don't use it at all depending on local climate, and others want it every night... all up to you. I would get checked for gastric reflux that wakes some people without they're realizing it's a problem ("silent GERD"), but once you do have things set up, you won't need to bother much with anything indefinitely.

And your 'central apnea' may in fact not be what you think... too often doctors see printouts but don't know how to interpret them well so assume what they see a few of at the start of the night (and then prior to waking) is Central Apnea, when in fact it's as likely to be "sleep wake junk" - clear airway events that only if they're seen throughout the night should be considered to be centrals, but otherwise should not and don't need to be bothered about. Software (such as free Sleepyhead most use here) can answer those questions, as well as help you tweak the best pressure settings.

[chunkyfrog]

Cpap CURED my depression!

[Thomas F.]

The situation you find yourself in is similar to mine. It took me a long time (many years) to resolve. Here is what works for me and I think it's worth a try for few weeks. What do you have to lose?

1. Wear a cervical neck collar to sleep. Does better job of keeping the mouth closed and only breath through nose. I use nasal mask.
2. Typically lower pressure works best for UARS. I run my machine on constant pressure of 5 with pressure relief 1. I can tell you with 100% certainty that UARS victims have a hyper vigilant brains. Find your ideal cpap pressure by starting at the bottom and work your way up from there. If I even increase my pressure to 6 instead of 5 my sleep is negatively impacted.
3. You may have to take trazadone for period of time to help you adjust to CPAP. I took 25mg and it did wonders for my sleep as I adjusted. Now I don't have to take anymore.

Hang in there and I hope you try these suggestions because it took me years to figure this out for myself.

[kteague]

Sorry to hear you're having such a bad experience with CPAP. You're in a good place to get tips and pointers to improve your experience. You're right, getting everything dialed in can be a real PITA. If you can manage to persevere and find workable solutions, you will have done yourself a great service. It will be helpful if you could read the threads at the top of the page that talk about getting started. The more key details you give us, the more targeted suggestions you will get. We can't predict your future as to your eventual ability to adjust to CPAP therapy. Many of us can encourage you that we had a hard time early on and that success was a hard fought battle, but achievable. I read on here that people with UARS are often prone to being those with high sensitivity to stimuli. That sensitivity can add a layer of challenge to the adjustment. You are still very new to this. It's hard to be patient when you're sleep deprived and utterly miserable. I guessing your state of mind will be improved once your sleep is improved. I remember when for months I would go to bed thinking, "Maybe this will be the night that I sleep." Over and over again is wasn't. But oh when it did happen - it was amazing! It was just a few hours but the sleep was deep and satisfying. It gave me a desire to persevere and get more of that wonderful stuff. Hope you'll soon have an experience that will motivate you to keep going. Don't be too hard on yourself. Sleep deprivation can unsettle even the most life-loving of people. There's a reason why it is a military tactic used to break people's mind and will - because it can do just that. I look forward to reading about your journey, about what things turn out to be helpful, and learning how much consistent long term effective treatment helps your outlook. You could very well be pleasantly surprised.

[y08hci0299]

Sorry to hear you're having such a bad experience with CPAP. You're in a good place to get tips and pointers to improve your experience. You're right, getting everything dialed in can be a real PITA. If you can manage to persevere and find workable solutions, you will have done yourself a great service. It will be helpful if you could read the threads at the top of the page that talk about getting started. The more key details you give us, the more targeted suggestions you will get. We can't predict your future as to your eventual ability to adjust to CPAP therapy. Many of us can encourage you that we had a hard time early on and that success was a hard fought battle, but achievable. I read on here that people with UARS are often prone to being those with high sensitivity to stimuli. That sensitivity can add a layer of challenge to the adjustment. You are still very new to this. It's hard to be patient when you're sleep deprived and utterly miserable. I guessing your state of mind will be improved once your sleep is improved. I remember when for months I would go to bed thinking, "Maybe this will be the night that I sleep." Over and over again is wasn't. But oh when it did happen - it was amazing! It was just a few hours but the sleep was deep and satisfying. It gave me a desire to persevere and get more of that wonderful stuff. Hope you'll soon have an experience that will motivate you to keep going. Don't be too hard on yourself. Sleep deprivation can unsettle even the most life-loving of people. There's a reason why it is a military tactic used to break people's mind and will - because it can do just that. I look forward to reading about your journey, about what things turn out to be helpful, and learning how much consistent long term effective treatment helps your outlook. You could very well be pleasantly surprised.

Thank you. It just feels as if everytime I put the mask on and turn the machine on it feels like I'm entering a ticket for the lottery, if I can actually get good sleep then yay me, but so far it hasn't happened yet(it seems as though the chances are slim to none. Everytime it doesn't happen I get more and more dejected, and more and more desperate.

[Julie]

But are you interested in improving things? Did you consider any of the suggestions made here by others?

[ajack]

use it while you watch tv, your brain will get use to it and you won't notice its there. don't get frustrated, when you wake up read a book using incandescent non blue spectrum light, till you get sleepy again. no computer, iphone etc. sleep hygiene is very important once the apnea is being treated, you aren't as exhausted and passing out into a semi comatosed state of suffocation. you are also getting use to cpap therapy. it can be a rough few months.

why did they prescribe a bpap over a cpap? a bipap/bilevel has to be set up for you with a night of titration and fine adjustment from someone who knows how to drive one. it really does need a sleep specialist to go over your charts and settings. it sounds like the timing of the bpap is out, it should work in uniform as you breathe, not feel to come in too early or late. In the end you may need to adjust your own trigger settings. if you can't get someone competent to work with you.

[Bill44133]

use it while you watch tv, your brain will get use to it and you won't notice its there. don't get frustrated, when you wake up read a book using incandescent non blue spectrum light, till you get sleepy again. no computer, iphone etc. sleep hygiene is very important once the apnea is being treated, you aren't as exhausted and passing out into a semi comatosed state of suffocation. you are also getting use to cpap therapy. it can be a rough few months.
.

+100% You are going to have train your brain that it is OK to have the mask on.

This therapy solved my problem with depression.

I wish you well..

[TedVPAP]

So I've been going to periods of major depression and suicidal ideations for the past 8 years. In the past year I was finally diagnosed with sleep apnea and UARS which was a major contributing factor to my depression. I used a cpap last year for about 1-2 weeks, found it intolerable, hated it, and gave up on it. I exhausted all other options, (had UPPP and septoplasty, surgery was unsuccessful), had a sleep endoscopy, went for multiple sleep studies, all the top sleep doctors in my country refused to operate on me any further, and basically all told me to go back on cpap.

So now I have a dreamstation auto bipap sitting at home, with an airfit p10, a hybernite hose and a fisher & paykel heated humidifier. I have been using it for about 3-4 weeks, and have had no success and I am really frustrated. The longest I have slept with it is about 2h45min, and that's even if I can fall asleep with it at all. There's always something about it that keeps me awake or wakes me up. Sometimes the mask doesn't sit right even after adjusting or readjusting so there's a niggling discomfort. When I'm having a sore throat I can feel the wind from the cpap scratching against the back of my throat. Even with a chin strap my outh falls open and I wake up up with a dry mouth. My bipap is even causing me to have central apneas so I have to use it on single pressure because there's a delay in inspiration and expiration. This goddamn machine is pissing me off, it feels like I'm walking on a tightrope and everything has to be calibrated juuuust right or else evrything will fall apart. I feel like giving up but I don't have much of a choice. I'm just afraid that I will be one of those people who never adjusts to cpap even after months and years or trying again and again, every goddamn night.

It took me a few months before I finally had good therapy. If your mouth is dry then you are mouth breathing. Unless you are using a mask that allows mouth breathing, the mouth breathing is defeating your treatment. I use the Ultimate Chin Strap to control my tendency to mouth breath. Other people tape their lips. Download SleepyHead and read your SD card so you can learn what about your therapy is wrong.

[y08hci0299]

use it while you watch tv, your brain will get use to it and you won't notice its there. don't get frustrated, when you wake up read a book using incandescent non blue spectrum light, till you get sleepy again. no computer, iphone etc. sleep hygiene is very important once the apnea is being treated, you aren't as exhausted and passing out into a semi comatosed state of suffocation. you are also getting use to cpap therapy. it can be a rough few months.

why did they prescribe a bpap over a cpap? a bipap/bilevel has to be set up for you with a night of titration and fine adjustment from someone who knows how to drive one. it really does need a sleep specialist to go over your charts and settings. it sounds like the timing of the bpap is out, it should work in uniform as you breathe, not feel to come in too early or late. In the end you may need to adjust your own trigger settings. if you can't get someone competent to work with you.

I actually rented an apap from a local respiratory technician before committing to buying one, I was having problems adjusting to higher pressures, so he suggested I use a bipap so i could have a higher inspiratory pressure and a lower expiratory pressure. I eventually bought a bipap from amazon.com as in my country the local suppliers charge literally a few thousand extra for the device. Also, I realised that the respiratory technicians in my country just didn't really know their stuff or outright gave me wrong information so I felt it was pointless to work with them, they barely even knew how the machines worked. I have also tried tinkering with the settings, rise time and bi-flex I think the call it? Yeah, didn't really work. For some reason the resmed airsense 10 that I tried before adapted to my breathing patterns seamlessly, not sure why the dreamstation struggles to do so.

[ajack]

as I understand it (fellow aussie? )

ok, so there is no real medical reason. the machine can be adjusted to your needs and very few people need an ASV, which is even harder to get use to than a bpap.
do you have the clinical manual? available here http://www.apneaboard.com/adjust-cpap-p ... tup-manual and is also a good site to join. they have the clinical manual Philips-Respironics DreamStation Auto BiPAP

download sleepyhead and post a chart.

do a factory reset because out of the box setup is ok and you won't have to go through every setting for now.
you can manually titrate,
( different brand same principal https://www.resmed.com/us/dam/documents ... lo_eng.pdf )

or set auto and let that do it. I guess you want auto.

I would set something like. if it's how I think the auto would work with adjustable min/max epap and adjustable min/max pressure support.
no ramp
min epap 6 max epap 10.... max ipap 13 to get it out of the way
min PS:1 max PS:1.1 (I think it's going to work like an auto cpap, 7-11 with a pressure relief of 1...but that's fine for now. the max pressure 11 for a week or two will get you use to it.

this will not get an AHI of 0.0000001 but that's not the aim at this stage, it's just to get you using the machine with minimum frustration.

if anyone has any corrections to my post, I would welcome it

[zoocrewphoto]

Thank you. It just feels as if everytime I put the mask on and turn the machine on it feels like I'm entering a ticket for the lottery, if I can actually get good sleep then yay me, but so far it hasn't happened yet(it seems as though the chances are slim to none. Everytime it doesn't happen I get more and more dejected, and more and more desperate.

A lot of times, doctors assume they have set the iseal settings, and then don't really followup. That leads to failure for a LOT of people. The good news is that you are here now, and with more information and graphs from your machine, we can help you improve the comfort level (ability to sleep with it) as well as improve your therapy with more ideal settings. Once that happens, you should actually start to feel better. And many people have found that depression, anxiety, fatigue, etc, improve a LOT.

[DeeCPAP]

Thank you. It just feels as if everytime I put the mask on and turn the machine on it feels like I'm entering a ticket for the lottery, if I can actually get good sleep then yay me, but so far it hasn't happened yet(it seems as though the chances are slim to none. Everytime it doesn't happen I get more and more dejected, and more and more desperate.

A lot of times, doctors assume they have set the iseal settings, and then don't really followup. That leads to failure for a LOT of people. The good news is that you are here now, and with more information and graphs from your machine, we can help you improve the comfort level (ability to sleep with it) as well as improve your therapy with more ideal settings. Once that happens, you should actually start to feel better. And many people have found that depression, anxiety, fatigue, etc, improve a LOT.

You're right. That's exactly what happened to me. That's why the helpers here are a godsend. My brother, who doesn't need cpap treatment told me CPAPs are a bogus treatment. He knows quite a few "college educated" people who get cpap treatment and it only one feels a lot better after using it. I do think docs aren't doing a good job with the settings. Maybe it's the software docs use. My doc saw my data (his tech showed him) and wanted to know where I got the software. I think *their* software is very limited because they only see TWO DAYS worth of data. To me, that's a crime because the machines cost at last $1000 and they're not being used properly!