Opinions on partial night therapy

[Pugsy]

I see your point...the only thing I would want to try to answer would be the oxygen level thing.
If your desats aren't horrible and you want to try your idea of working up to more hours of use then that is of course your choice.
But if your desats were like mine...in the low 70s then I would work doubly hard on using the machine as much as possible.

[tedburnsIII]

No, I don't have an oxymeter. And I don't know what I want to do. I'm not sure what to do. I'm doing the only thing I can think of to do, which is slowly acclimating to the machine while also getting some restful sleep without it, to keep me from completely collapsing.

I mostly just wanted to make sure there aren't some health risks that I'm not aware of associated with on-again/off-again use of the machine.

Liam, tired.

I am not aware if you are using straight CPAP or APAP. Sounds as if you might be a candidate for Auto with a low minimum pressure, if you can get away with it and not have low sats.

Your choice is counter-productive to sleep with it half-on. You simply need to find a way to use it fully every night.

I think it imperative to monitor your data and also to get an oximeter. It's actually kind of fun to use and wake up and review the data, and know that your oxygen levels are adequate. If straight CPAP only, you might want to try dial-winging on a conservative basis with the oximeter to guide you and the data from the machine to monitor your AHI and CAI.

Finally, I see nothing wrong with sedating yourself to sleep until you acclimate to the machine and mask. Ambien works well for some people.

[Liam1965]

If your desats aren't horrible...

That's one nice thing from both of my sleep studies. Although I have 35-40 events per hour when on my back and not CPAP'd, my O2 sat never drops significantly. I'm not getting sufficient sleep, but I'm not particularly damaging my organs.

Which maybe also changes what's right for me from what might be right for a lot of other people.

Also, they tell me I have almost no apneic events when I'm sleeping on my side... In fact, they had to make me fall asleep on my back because it's not my normal mode of sleeping (although I won't say I never wake up and find I've rolled onto my back in the night, or else I'd just stick with side sleeping).

Liam, shutting down the computer, strapping on the mask, and going to sleep for half a night.

[tedburnsIII]

If your desats aren't horrible...

That's one nice thing from both of my sleep studies. Although I have 35-40 events per hour when on my back and not CPAP'd, my O2 sat never drops significantly. I'm not getting sufficient sleep, but I'm not particularly damaging my organs.

Which maybe also changes what's right for me from what might be right for a lot of other people.

Also, they tell me I have almost no apneic events when I'm sleeping on my side... In fact, they had to make me fall asleep on my back because it's not my normal mode of sleeping (although I won't say I never wake up and find I've rolled onto my back in the night, or else I'd just stick with side sleeping).

Liam, shutting down the computer, strapping on the mask, and going to sleep for half a night.

Yeah, try to sleep on your side.

I have similar, my AHI on my side was only 2.3 and on my back was 76.2, consisting of mainly hypnopneas. I've learned it has been referred to as possible 'Positional Sleep Apnea'. I intend to continue with the machine and after I lose more than 20 lbs. plan to go into another sleep test and obtain the results- take it from there. I find the notion of sleeping on my side all the time though difficult and unappealing and probably bad for my back.

It appears that a consistent pressure of 10.0 straight CPAP works well for me with adequate sats and fine AHI. This is 2cm less than the lab's and sleep doctor's optimal pressure (for which there is a clear definition in the literature) and there IS a difference in comfort level. As stated previously elsewhere, the optimal pressure may NOT be the 'best' pressure because it is based upon one being in the supine position all of the time.

IOW, perhaps you may be able to lower your pressure and get by just fine.

[zoocrewphoto]

I get the bad habit aspect of it, I do.

However, I was probably 1-2 nights away from giving up entirely due to the lack of restful sleep. I was literally unable to do much of my job and just kind of zombie-ing through life. So I look at this as a coping mechanism to keep me trying rather than giving up because the CPAP was not allowing me to rest at all.

Liam, who would really like for this to work.

I have been dealing with the results of this bad habit, so I can tell you that I wish I had not let myself do this in the beginning.

Also, keep in mind that most people have more events during REM sleep, and most people have more REM sleep during the last few hours of sleep. So, when you take the mask off, you are leaving yourself untreated during the worst part of the night.

Now, can we figure out how to help your treatment so that you do feel good after using cpap all night? Are you being disturbed by leaks? Pressure changes?

[Woody]

I am lucky I never had trouble wearing my full face mask and never sleep
without it. But I was talking to someone I met in my local town who's son
decided he didn't need to put his mask back on for a short nap and he never
woke up.

[tedburnsIII]

I am lucky I never had trouble wearing my full face mask and never sleep
without it. But I was talking to someone I met in my local town who's son
decided he didn't need to put his mask back on for a short nap and he never
woke up.

WADR, that guy would probably have died anyway, even without the nap. I don't believe that failure to wear CPAP one time for a short nap
would be the sole cause for the death. He probably would've died anyway, even with it on.

I don't believe that we need to overly dramatize and 'shock' OP into compliance.

[Liam1965]

I don't believe that we need to overly dramatize and 'shock' OP into compliance.

It's OK, I recognize hyperbole when I see it.

Liam, who was so disappointed his team didn't make it into the Hyper Bole this year...

[tedburnsIII]

I don't believe that we need to overly dramatize and 'shock' OP into compliance.

It's OK, I recognize hyperbole when I see it.

Liam, who was so disappointed his team didn't make it into the Hyper Bole this year...

[zoocrewphoto]

I am lucky I never had trouble wearing my full face mask and never sleep
without it. But I was talking to someone I met in my local town who's son
decided he didn't need to put his mask back on for a short nap and he never
woke up.

WADR, that guy would probably have died anyway, even without the nap. I don't believe that failure to wear CPAP one time for a short nap
would be the sole cause for the death. He probably would've died anyway, even with it on.

I don't believe that we need to overly dramatize and 'shock' OP into compliance.

Sleep apnea is a death of a thousand cuts. One night without won't cause much damage. A few thousand nights may not. But over time, it gets worse and worse. My sleep apnea was diagnosed as severe (79+) three years ago. I know I went undiagnosed for at least 10 years. I possibly had symptoms (without obvious snoring) 20 years ago. So, who knows how long I went slowly causing long term damage?

I was 37 when my doctor (unaware of the sleep apnea) started warning me that my high blood pressure was putting me at a higher risk of stroke. Her warnings got more dire as my blood pressure did not improve much with medication. At 38, I awoke to severe vertigo (later doctors figured it must be caused by a viral ear infection). I went to the ER as the room was spinning so fast that I could not walk or even keep down a sip of water. With my eyes closed, I felt like I was in an earthquake. There I was, 38, looking much younger than that, and the doctors were checking me for stroke. I couldn't believe it. A few days later, the vertigo returned, and I was at a different ER, again, being checked for stroke. That really scared me. About 6 months later, I learned that high blood pressure (and stroke) is often caused by sleep apnea. So, I finally confessed to my doctor, got tested, and got treated.

Will one night without kill me? Probably not. But if I make it a habit, my risk increases. The more I go without treatment, the worse my odds will get. I would rather not do that. So, I do my best to use my machine every time.

[Morbius]

And I'm really getting sick of the back handed "help" in here. I swear, 10 years ago this group was nothing but supportive, now it seems like the first response to anyone new is to initially be suspicious of their motives and their knowledge and everything else, and only after they pass all of your f***ing tests will you grudgingly bestow your wisdom upon them.

Hey, I hear ya, kid.

And even when one passes on some "wisdom", ya gotta pull teeth to get a MF thank you.

Morbius, not surprised at all, but feigning same cause he needs to put in his mandatory 3.5 posts per day.

[Liam1965]

And even when one passes on some "wisdom", ya gotta pull teeth to get a MF thank you.

For those who have offered honest help and guidance, I thank you.

So I'm not sure if that was aimed at me or not, but I *DID* offer thanks to the people who honestly thought they were trying to help. Just frustrated at the ones who would rather lecture me on everything I'm doing wrong or on not being a 100% subject matter expert on something I'm just newly starting, or those who would rather spend all of their time Chicken LIttle-ing about how the sky is going to fall and my organs are going to fail if I miss a couple of hours of CPAP every night.

The first post I saw when I came back to this site a few weeks back was a newbie asking a question about having trouble tolerating the CPAP, and he/she got jumped on and verbally pummeled, and when I commented on that, one of the responses was "You have to realize, in the last few years, we've had a sharp increase in the number of trolls who show up, post a question and then disappear."

And my thoughts were A) trolls are usually more obvious than that, generally a troll will do something like pop in and post a link to an article of dubious sourcing claiming that apnea isn't real, or that it really just signifies a deficit of vitamin Q or something, not come in and post a very real and legitimate sounding question, and B) if every newbie who shows up gets similarly jumped on, it's no wonder a lot of them disappear and don't come back. If you punch everyone who knocks on your door in the face, you don't then get to say "See how unfriendly my neighborhood is? Almost no one comes to my door, and the ones who do never come back!"

Just my two cents. You know how frustrating this is, you've all been through it or something like it. You also know how tired and short your fuse gets when you're first starting out and not sleeping well, and yet several prominent people seem to expect perfect behavior and perfect knowledge out of people who are new to things, daunted by the process, and probably extremely sleep deprived. It just frustrates me to see people ask a simple question and get lectures and condescension instead of help.

Look, if I'm here for a couple of months and you determine that I've done something worth of condescension, you can give it to me. But you really can't make that determination in a couple of days on one thread, and so anyone who has posted with such in their tone really needs to look at whether they're really here because they want to be helpful or just because they want to be the big fish in a fairly small pond, and want to urinate on every new thing quickly in order to mark its relative place in the hierarchy.

Liam, feeling tired and, er, pissy this morning...

[palerider]

[quote="Liam1965"Liam, feeling tired and, er, pissy this morning...[/quote]

why don't you download sleepyhead, (get the windows 32 broken GL version for simplicity sake,) (link in my sig) install it, run it, import your data into it, and post a chart.

three very nice pages from krelvin here to guide you through posting:

https://sleep.tnet.com/resources/sleepyhead/shorganize

and let's move on to actually having something to work with, eh?

[Liam1965]

I downloaded the 64 bit version last night, both executables have an error in them and come up as "not valid Windows executables". So then I downloaded the 32 bit and they seemed to run OK.

But the next problem is that my computer no longer has a SIM card reader in it, so getting the data is going to be tough. I need to order one from Amazon...

Oh, and I asked my doctor for a recommendation on an oximeter, and she suggested that it wouldn't tell me any useful information, at least not until we first look at the data on the CPAP machine. So she's setting up an appointment to review that data...

Liam, feeling like he's a character in the SIMs, with his SIMplus mask and the SIM card reader. Or perhaps he's just some sort of simian.

[SteveGold]

Liam, I think I can relate to your experience.

When I started CPAP I felt "better and worse." I found this almost impossible to describe to my doctor. But I'll try again now. There was no question that CPAP made me feel groggy and rested, and I started to feel emotions again for the first time in 10 years. But it came with unrelenting brain fog that made it impossible to function. I found I did better on 5 hours CPAP and 2 hours off than a full night on therapy. I also took the occasional night off completely and then went back on. After the "split" nights I had a much clearer head and more energy than with a full night of CPAP or no therapy.

If you'll pardon my French, CPAP and no therapy made me feel "differently shitty." My thinking is that the CPAP was helping but also disturbing my sleep: better in some ways, but worse in others that had a qualitative effect on my mind the next day. So I did 5 hours on the hose, woke up when my body had had enough, and rolled over for 2 more hours of "real sleep." For me, this was necessary to get used to the therapy. I was in hell until I figured out that I needed to take breaks to "reset."

Eventually I started sleeping through the night without feeling the need to take off the mask. I still take breaks sometimes when I get in a rut.

The other posters cautioning you against sleeping without therapy have a good point. But I think they're mistaken when they say that you need to force yourself to sleep all night with CPAP until you get used to it. That *will* enforce a habit - the habit of fighting the therapy and associating CPAP with disturbed sleep. And at least in my case the only way I was able to inch toward compliance was giving myself the breaks I needed. To the extent you can manage it you should associate CPAP with positive experiences and good sleep. If partial therapy moves you toward that goal, and is more tolerable than a full-time therapy at this point, then it's worthwhile.

For additional context, after two years of very inconsistent therapy - feeling great one day and wretched the next with no difference in any of my stats - I ended up on a BiLevel and have been sleeping better than I have since high school. But even before then I was able to get more comfortable with straight CPAP as I describe above.

All that said, obviously the goal is full-time therapy and there are real dangers in sleeping without it that should be top of mind at every step. And the underlying causes of your experience may very well be different from mine and must be identified to get you on track. Hope this helps.