Sleep Apnea/CPAP Information Please

Good morning,

I hope everyone slept well. I'm new here and have just been diagnosed with sleep apnea and been given a CPAP machine. I'm on my second night with the machine.

I wanted to ask what people noticed after starting with the machine. How soon did you feel less tired? I appreciate that there could be other issues related to not sleeping well but wondered if it takes a while using CPAP for your body to adjust to the difference in sleep.

My first night was ok, woke as usual to pee and to readjust the mask. In the morning I noticed my nose was very bruised and sore at the top and decided I didn't have the mask high enough. I also spent a lot of the day still feeling like the mask was on my head and hair. I also felt very tired all day and yawned a lot. Also felt a bit anxious during the day, suddenly dizzy and heart skipping beats. I assume this was potentially the start of a panic attack which I talked myself out of. This sleep apnea thing does make you think more.

Night two, a bit better with the mask placement. Although it's annoying if your face suddenly itches in the night. Slept 10 hours and like to think that was better sleep than without the machine. Still some red marks on my nose but less sore, I guess my nose will toughen up. Still having a headache (day 4 now but could be stress).

Does anyone use special or different pillows? I'm a side sleeper.
Does anyone have any advice for new users about 'side effects'?

My machine is ResMed AirSense10, full mask.

Thank you in advance. Sleep well.
Rebecca

Hi, and welcome. Most people usually find some improvement within a few days to a few weeks. There are those that have to first experiment with various masks and pressure settings before noticing a lot of improvement, but everyone is different, though hopefully you'll feel at least somewhat better within a short time. Definite symptoms like having to pee more than once overnight or have wake-up headaches usually go away to an extent fairly quickly.

You may need a different mask altogether (and there are very many to choose from... see Cpap.com for ideas), or readjustment of the mask you have and/or a different size.

What are your pressure settings - it's quite possible they're on the low side and may need a slight raise, but download Sleepyhead (free) and we'll see what it says...

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

Bextastic wrote:My machine is ResMed AirSense10,

Exactly which model?

There are
AirSense 10 CPAP
AirSense 10 Elite
AirSense 10 AutoSet
AirSense 10 AutoSet for Her

model name is clearly shown on the face of the machine.

Review any mask fitting videos and tips you can find. People tend to over tighten things thinking that more tension is better for keeping a seal than less and sometimes it simply isn't true.
Noses shouldn't have to "toughen up" or get scars from abrasions or blisters or active bruising.

You might look at adding a mask liner though.
I suggest that you make your own to start with before spending money because you want to make sure that this mask is going to be your main mask.
Old T shirts make great DIY mask liners.
Instructions available on the forum but I don't have them handy at the moment.

Check with your mask supplier about mask swapping time frame. Don't be afraid to try a different mask within any mask swapping time frame you have available.

I actually think that the mask journey is the hardest part of this therapy. Even under the best of circumstances it just isn't normal to sleep with all this stuff on our face and heads.

Hi.

Thanks for the advice. It's the AirSense 10 Autoset (I hadn't realised there were so many). It was the one I was given on the NHS. I've got a review in 4 weeks where hopefully things will be more clear.

You've got a great machine. It's full data and works well with the SleepyHead software. You can use the software and the SD card in the machine to see what's going on now. No need to wait 4 weeks if you don't want to.

There's even so data on the machine itself.

Here's the manual that explains how to get to the data along with what some of the features are on your machine.

https://sleep.tnet.com/home/files/resme ... -guide.pdf
If the on screen data doesn't show up you just have to make a little change in a setting in the clinical setup menu.
Essentials needs to be changed from "usage" to "Plus".
All explained in the manual.

For the red spon on thenose, you can use a band aid over that night, or you can use a piece of mole skin on your nose. When I first started, I developed a sore on my nose. I used band aids on it while it was healing, and then used a piece of mole skin on my nose at night. The mole skin was the idea of the RT I was working with at that time. She said her husband had been doing that for a long time to keep his nose from getting sore. Since going to the mask I am currently using, I do not need to use it.

Thank you for all your advice and suggestions. The machine is good, very quiet and easy to use. Because it was prescribed to me I have limited access to the controls (I can see only how long I used it for and whether the mask leaked but I can't access other information and the humidifier part isn't attached. I expect the doctor will determine if I need that at a later stage. I'll look into the sleepyhead and nose pad stuff. Thanks again, it's a brave new world.

Of course you can access all the controls - that bs from doctors and techs is just ... that. You need your clinician manual however, and should be able to find it on apneaboard.com (with a bit of scrolling or help from others here). We all do our own tweaks and you should be able to control your own therapy. No such thing as 'locked'.

I posted a link to the manual for the AirSense 10 machines in my post above.

It explains how to get to all those settings plus it has some really useful information in it that the typical user manual doesn't cover.

At some point, most of us take control of our therapy. If you just started, and are not comfortable making changes at this time, that is understandable. I did not start making changes until I had been on the machine almost six months. Most insurance companies have a compliance period where you need to prove you are using the mask. A lot of companies use the same guidelines as Medicare. You must show you have the used the mask for 21 out of 30 days. This has to be verified by your doctor and must be completed within the first 90 days of using the machine. Once the compliance period is over, you may only need to see the doctor once a year or less to have him verify you are still using the machine and it is treating your SA properly. Some insurance companies require the annual certification in order for them to pay for your supplies.

Hi Bextastic,

You don't say which part of the UK you're from, and it can make a difference. There are roughly 150 Foundation Trust Hospitals, most with a sleep medicine department (and as part of lung function medicine or non-cardiac chest medicine), and while they are all supposed to follow NICE guidelines, there can be - and are - variations.

You've already encountered one of them - you've been given a fully auto-adjusting machine, made by ResMed. Here in Gloucestershire, where I live, the standard procedure is to give people a fixed-pressure machine - a Dreamstation - made by a company called Philips Respironics.

Another difference - most UK patients are now given a humidifier - either one that clips on, or as part of the machine. From what you say, you haven't been given one - but that may change later.

A third difference: they've got you started - with the message that they'll see you again in four weeks. The idea is that the machine will record how you're doing hour by hour on the fitted SD card, and at the review your doctor or specialist nurse or sleep physiologist will read the card on their computer, and if needed, make some adjustments.

In some parts of the UK, this intial 'sample period' is one week - in a few places, two weeks. Like I said, local practice varies.

A fourth thing that - from what you say - is clearly different where you are is: mask fitting. Here in Gloucestershire, half of the first treatment session (after diagnosis) is patients being given a range of masks to try on - usually four or five different makes and models, and with the machine running - to find out which is the best fit for you.

From what you say, that hasn't happened to you - yet. And it may be part of the review process. If it isn't, you must speak up about any mask fitting issues you have, so that they can offer you alternatives. Masks are part of the prescription, and as an NHS patient you shouldn't have to be buying one (although in the present political climate, it may come to that).

One more thing I'll say for now. There is a lot of great advice available here from some extremely knowledgable people - and some of it will be about you individually adjusting your machine pressures.

Patients taking this aspect of their treatment into their own hands makes a lot of sense in a medical system where each visit to the system is yet another bill, to be part-paid-for - either by a 'co-pay' or a 'deductible' - even if the patient has what we in the UK would call private insurance.

And it makes even more sense when some of the forum advisors here are way more knowledgable - and helpful - than some of the US medical staff and technicians.

In your case, however, you aren't going to be billed for any of it. I would suggest you let the hospital staff do their thing at this up-coming review, and see how that goes.

If that works out with regard to pressure adjustment, fine. And if it doesn't, then you can do what I do, and people here on the forum do - use the shareware software to see what you need, gain entry into the 'clinician's area' of the machine's controls, and make your own adjustments.

BTW, the staff at my sleep medicine department know that I do this - and aren't bothered. I talk to them at my annual review and explain my reasoning - and as long as they get that I'm not being stupid or dangerous, they're ok with that. My numbers are within their treatment targets.

But, I suggest, you're not there yet. Let's get you through your four-week review, and then see what needs doing.