Failed with CPAP, trying Provent

It's been 4 months and I have failed with the CPAP machine. The doctor gave me the least restrictive machine (automatic, nasal pillows) and when i couldn't fall asleep with it he prescribed a short course of Lunesta. I was able to get to 2 hours (and even 3 hours once), with no apnea. But even with the Lunesta I would mostly find myself laying awake for an hour to an hour and a half, exhausted and unable to get to sleep, until finally turning the machine off. He prescribed Provent for me to try instead. Target carries it now and I will get it tonight. Any tips?

Good luck, most people here don't like them, find them hard to use. In the end they will cost you more then the machine.

Most of us chose not to fail and prefer the easy to use gold standard of a cpap machine with data.

Drugs are a temporary course of action. It may work better for you to try to habituate yourself to the device, in particular, to assume that you should be comfortable with the machine, and to solve problems that make you uncomfortable.

In particular, you need to identify what is happening differently now than without the gear. For example, do you feel the nasal pillows on your face? The headgear may be too tight (it should be loose, and you should not feel it). Do you get claustrophobic, or feel uncomfortable with your nostrils separated by the pillows? You may be more comfortable with a full-face mask (I am, even though I'm a nose-breather). Maybe you'll be more comfortable with a heated hose and high humidity. Maybe you prefer to sleep in a particular position, but feel that the mask is getting in the way, and you can't fall asleep in other positions. Do you feel the air hitting your face? You might do better by turning off your CPAP machine's "exhalation help" feature.

Your doctor should have also recommended that you wear the mask while awake for 30-45 minutes before bed, to get comfortable with the feeling. I've found this helps. Remember that when you lay down, the headgear gets tighter, so make sure that you only adjust the straps while prone.

Only you know how you sleep. It is possible to sleep extremely comfortably with CPAP, but it takes experimentation on your part. Doctors and forum members can offer suggestions, but it is your personal responsibility to identify how you normally sleep and fix any uncomfortable deviations. Drugs may help short-term, but experimentation with machine and mask settings is stable for life.

2IIAJ wrote:It's been 4 months and I have failed with the CPAP machine. The doctor gave me the least restrictive machine (automatic, nasal pillows) and when i couldn't fall asleep with it he prescribed a short course of Lunesta. I was able to get to 2 hours (and even 3 hours once), with no apnea. But even with the Lunesta I would mostly find myself laying awake for an hour to an hour and a half, exhausted and unable to get to sleep, until finally turning the machine off. He prescribed Provent for me to try instead. Target carries it now and I will get it tonight. Any tips?

It's a psychological problem. You haven't really made a commitment to CPAP and good sleep hygiene.

I should add that I have tried Provent. Worthless for me. CPAP is da stuff!

Sheffey wrote:

2IIAJ wrote:It's been 4 months and I have failed with the CPAP machine. The doctor gave me the least restrictive machine (automatic, nasal pillows) and when i couldn't fall asleep with it he prescribed a short course of Lunesta. I was able to get to 2 hours (and even 3 hours once), with no apnea. But even with the Lunesta I would mostly find myself laying awake for an hour to an hour and a half, exhausted and unable to get to sleep, until finally turning the machine off. He prescribed Provent for me to try instead. Target carries it now and I will get it tonight. Any tips?

It's a psychological problem. You haven't really made a commitment to CPAP and good sleep hygiene.

Hmm, someone who has been trying for 4 months hasn't made a commitment to pap therapy?

2IIAJ, provent therapy is certainly worth a shot if you can afford it. You might want to do a search of the archives for Provent therapy as there have been threads on it.

If you decided to give pap therapy another try, you might want to post the specific difficulties you are having so members can better target their advice to your situation. Many of us realize that contrary to popular belief that not everyone adapts right away in spite of their best efforts.

Best of luck.

49er

Can you tell us what machine you have and what the settings were?

Many doctors and DMEs set the auto machines wide open which makes them uncomfortable and not very successful. It could be that you need very different settings that would work much better for you.

Provent seems to be hit or miss. I haven't been able to try them as I breathe through my mouth, and that won't work with provent.

Hello and welcome. I certainly understand not being a quick adapter to this treatment. My adjustment was complicated by jumpy legs, but even so, at about 5 months I decided to quit using CPAP because I was worse instead of better. But I couldn't stay off it long because I really needed it. With some help from members here I was able to optimize my treatment and begin reaping its benefits. I don't know what your attempts looked like or how much of that 4 months was spent in diligent effort. My personal tendency is to have a perception that doesn't always match reality. If that happens to be your inclination, I suggest you look at your machine and/or your data and see exactly how many hours you have actually used the machine. If you see that your therapy was effective when used and you honestly feel you have done everything possible to adjust, then it's understandable you are seeking other possible solutions. Nothing wrong with that. I couldn't help you on the Provent because the thought of anything blocking my nostrils like that just doesn't set well with my personal quirks. Good luck with getting your sleep apnea effectively treated - that's what matters. What we don't know is the severity of your apnea and if it is significantly positional. Do you have a copy of your sleep report to check out those things? Maybe there's some things you can do to mitigate the problems if your situation is amenable to those measures. Without hard facts it's anybody's guess. Again, best wishes.

My first night with the Provent wasn't great. It made me feel the way it feels when breathing with a terrible cold. But it did help me figure out the issue I've been having with the CPAP. It's the exhalation, I feel like I can't breathe. I know I can intellectually, but it doesn't help.

Thanks to all who took time to respond. I did an at home sleep study. The score was 17, 32 in REM sleep. I use the resmed auto set with nasal pillows. It starts at 3 with a ramp,of 20 minutes . I managed to use it for more than 3 hours a handful of times. I used it every night since the beginning of January, an average of 1.4 hours.

Anyone try hypnosis?

If exhalation is your problem, there may be a way to address that and make using CPAP easier for you. Most machines have a feature allowing exhalation relief. I'm not familiar with your machine but hopefully someone else can weigh in. Here's my thought - use your data to get an idea what fixed pressure might work best for you, and switch to cpap mode (instead of auto) with exhalation relief and see if you find it any more tolerable. For people with higher pressure needs, sometimes a bilevel is needed for comfort. Maybe you can make CPAP work for you yet.

What pressure were you using on the S9 AutoSet?
and were you using the EPR exhale relief? and if so, at what setting?

Thanks Pugsy. It's been so long since I used an auto I forgot if one could have exhalation relief in auto mode. Thanks again!

I got used to my unit quickly. What I did was read with it, watch TV, mess with the settings, etc… I was going to use it in the office. I’m an accountant with a home office….I could have easily done that. I’d take off my mask for eating. Trying the equipment all the time when awake and messing with the settings got me to get used to the mask and the machine. Now I know what good air feels like. Another thing, if the mask is not YOUR mask (or pillow) you are likely to fail. Having the right gear for YOU means everything. Wearing the gear and unit all the time while awake helps a great deal. My opinion….that’s all. Good luck!

Pugsy wrote:What pressure were you using on the S9 AutoSet?
and were you using the EPR exhale relief? and if so, at what setting?

Yes, the EPR on my AutoSet is really helpful, I have it maxed out, at 3. Without it, I might not be able to use the machine. If the max EPR isn't enough, there are other machines that can give you more exhilation relief, but that remains to be seen whether you need to go there or not.

2IIAJ wrote:My first night with the Provent wasn't great. It made me feel the way it feels when breathing with a terrible cold. But it did help me figure out the issue I've been having with the CPAP. It's the exhalation, I feel like I can't breathe. I know I can intellectually, but it doesn't help.

Thanks to all who took time to respond. I did an at home sleep study. The score was 17, 32 in REM sleep. I use the resmed auto set with nasal pillows. It starts at 3 with a ramp,of 20 minutes . I managed to use it for more than 3 hours a handful of times. I used it every night since the beginning of January, an average of 1.4 hours.

Anyone try hypnosis?

I'm new to CPAP myself - just one month in. I will tell you that after finding a mask I could wear - nasal pillows, I experienced trouble breathing one night - felt like I couldn't catch my breath - the great folks here pointed out that I had it set to ramp at 4 for 45 minutes - and I no longer needed that ramp time, so found it very hard to catch my breath. I see you're saying you have trouble exhaling - does your machine let you set it to have any relief on exhale? I have mine set to 3 and while I sometimes feel more resistance when I exhale, for the most part I have acclimated - you are right - it is more of a intellectual thing than anything else. Maybe go through your settings again, to see if it's set up for you optimally, then try building up more time with the mask. It seems to be a very varied thing, how long people take to acclimate - some can have the mask on all night, some have to build up to it, but if you can tolerate it for almost an 1.5, then maybe it's a matter of sticking with that and seeing if you can improve it? I do definitely feel much better without my ramp time - which I very much needed in the beginning. Good luck to you, I hope you find a way to have it work for you, it really is the best thing to help.