New CPAP User Struggling in First Week

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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OboeVet
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Re: New CPAP User Struggling in First Week

Post by OboeVet » Mon Aug 25, 2014 9:18 pm

Snuggle Monkey:

I started CPAP/APAP almost a year ago. Started on nose hose but too much mouth breathing. Went to Medium Quatro thingy, then Large Quatro then Amara gel mask to a Fisher Paykel Simplus Large Full Face in about February or March. No more side-sleep leaks, no more raw infected nose bridge due to cranking down straps, and much easier cleaning (I drool ...). Also, the first month was not very pleasant because my auto-flex pressure settings were too low and too high: per the print-out I had MORE AHI's and Periodics when the pressure rose above 14 cm water pressure, and when I would "ramp" down due to face leaks waking me up it went down to 7 cm water pressure and I would wake up suffocating. The doc re-set my pressure to a narrower range of 10 cm to 14 cm and letting the auto-flex float between. Also, as someone mentioned, make sure your exhalation relief is set so you are not having to exhale through the incoming air at full pressure.

Between the pressure resetting and the 5th mask I can say my life is truly improved! I wear foam 30 db ear plugs (available at an industrial safety store) to block out the CPAP/APAP machine cycling as well as the two fans I run all night due to the room ambient heat compounded by my new TempraPedic mattress which stores heat. My urine output is less, so less bathroom trips. My nightmares are less frequent and when they do come are far less scary then with severe OSA. I sometimes even think I should go back to work .... NOT! But everyday is a wonderful new adventure thanks, in part, to my OSA treatment.

By the way, if I were a all night tummy sleeper (which I have never been), I would invest in a massage table-like head rest where your head is supported by the ring and the mask and hose go out through the bottom. However, it sounds like you move around a lot, which makes me ask "how's your mattress?" After 1 week of CPAP/APAP, I sort of woke up one night and realized I had been sleeping on my back for the first time in decades! It felt great. I probably spend 30% of my sleep on my back now, alternating between left side 50% and right side 20% [still recovering from shoulder surgery].

My two cents to you is DON'T GIVE UP AND DON'T GIVE IN! Keep being a gentle "pain" for your DME and sleep doctor pleading with them to help you. Try lots of mask and pressure combinations. Be cautious with sleeping pills, since my sources tell me they actually may make OSA worse, making your machine work harder than need be and maybe contributing to waking you up so much.

May your journey take you into new sleeping cycles and as your "little grey cells" become oxygenated all night long your entire life improves!

All the best,
Don D

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englandsf
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Re: New CPAP User Struggling in First Week

Post by englandsf » Tue Aug 26, 2014 5:21 am

Snuggle monkey - I started with FFM but worked hard on nasal rinsing so I can now use pillows. PM me if you want details of my very aggressive regime.

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SnuggleMonkey
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Re: New CPAP User Struggling in First Week

Post by SnuggleMonkey » Tue Aug 26, 2014 9:52 am

Thanks everyone!

I went to bed at 11pm and woke up at 3:30am and could not get back to sleep. I'm exhausted and I feel like I'm losing my mind. I called-in sick for work today and plan to call the technician who set up my CPAP machine. I really want to return it. I feel like I can't afford to be this exhausted and dis-oriented right now. I was diagnosed with a mild apnea and I wonder if I can exercise, lose some weight and eliminate the need for this machine.

I really don't know what's waking me up so much. I don't know if it's leaks, too much CO2, mask too tight. I don't notice any discomfort on my face. I'm hoping that the tech can read my SD card and tell me right away. We'll see what she has to say.

Thanks again!

SnuggleMonkey
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Re: New CPAP User Struggling in First Week

Post by SnuggleMonkey » Tue Aug 26, 2014 1:19 pm

Just got back from seeing the respiratory therapist. It turns out that she accidentally set my CPAP machine to 8-cm instead of 6-cm. Also, I discovered that if I tilt my head so that my chin is closer to my chest, the mask leaks a lot. I think that we've corrected both of these things, so I'll give it another go tonight.

She also printed out a report from my first week of data from the SD card and it looks like my AHI's have gone down from 13 to 5. The leak report looked reasonable too.

Hopefully this pressure adjustment will help. Fingers crossed!

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coolbranch
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Re: New CPAP User Struggling in First Week

Post by coolbranch » Tue Aug 26, 2014 1:47 pm

I can relate. It took me 90 days to get the pressure range set for me. I also went through a few masks before I found what worked for me. I felt 10x worse than before I started CPAP. I developed bags under the eyes and I felt terrible. With Sleepyhead software I was able to find the right settings for my machine, and now I fell great.

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englandsf
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Re: New CPAP User Struggling in First Week

Post by englandsf » Tue Aug 26, 2014 1:48 pm

There is so little technique applied to mask selection - yet it's issue #1 for new users. Take the time to try as many as you can until one works.

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Lady Mechanic

Re: New CPAP User Struggling in First Week

Post by Lady Mechanic » Tue Aug 26, 2014 2:02 pm

Good luck snuggle! Sounds as if a simple mistake left you very frustrated! I'm new to the CPAP world myself. Just diagnosis 30 days ago with osa (mild) my ahi is 6 but my o2 drops to 84% and I have hercules snoring lol. My first FL is in the morning so we shall see how I an doing. I'm using the nasal mask at this time. Good luck with your adjustment!

SnuggleMonkey
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Re: New CPAP User Struggling in First Week

Post by SnuggleMonkey » Wed Aug 27, 2014 2:06 pm

Thanks everyone!

Yeah, I'm wondering if I should try some different masks overnight. I've only tried them on at the office and given them a quick thumbs-up or thumbs-down based on my initial feeling with them.

Anyway, I feel better today than I did yesterday but I'm not 100% myself again, yet. Lowering the pressure on the CPAP and adjusting the mask seemed to help. Although, I may have tightened the mask too much - I can see marks on my face! Will try to back it off a little tonight.

SnuggleMonkey
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Re: New CPAP User Struggling in First Week

Post by SnuggleMonkey » Sat Aug 30, 2014 10:37 am

Now I'm about to round the corner on my second week with a CPAP machine, heading into week 3. The pressure adjustment seems like it may have helped. I did sleep better for 2 nights in a row at the new pressure setting. But I'm still a bear at work.

I had to give a presentation at work on Friday, and I didn't want to risk being too tired, so I slept without any CPAP on Thursday night and felt great on Friday morning! I went back to using the CPAP last night and I think that I've identified a problem.

I think that I'm re-breathing the air that I exhale into the mask. I'm familiar with the symptoms of breathing excessive CO2 and my ears are ringing this morning. That's a sign. Plus I stayed awake in bed while trying to just relax and breathe and I noticed that I was inhaling the warm air that I had just exhaled. I'm trying to determine how this can be fixed.

Would it be...

1.) Raising the pressure back up so that the fresh air circulates in and out of the mask more quickly?

2.) Getting a different mask that circulates the air better?

3.) Something else?

I'll search the forum today to see other mentions of re-breathing.

For anyone who uses a Nasal Pillow, how do you keep your mouth closed all night? When I briefly tried one for a couple of minutes at the doctor's office, I was finding that my ears would pop a lot when I opened and closed my mouth. I was thinking that this might be a good mask for breathing in through my nose and out through my mouth but not if my ears will pop all night. Any thoughts?

Thanks again!

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Pugsy
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Re: New CPAP User Struggling in First Week

Post by Pugsy » Sat Aug 30, 2014 10:56 am

SnuggleMonkey wrote:For anyone who uses a Nasal Pillow, how do you keep your mouth closed all night? When I briefly tried one for a couple of minutes at the doctor's office, I was finding that my ears would pop a lot when I opened and closed my mouth. I was thinking that this might be a good mask for breathing in through my nose and out through my mouth but not if my ears will pop all night. Any thoughts?
I keep my mouth closed all night. It's difficult to inhale through the nose and only exhale through the mouth without a torrent of air rushing out the mouth which is annoying at the least and at the worst it allows loss of valuable air pressure that should be staying in the airway to hold it open. The ear thing when/if it occurs (rarely now) I just do what I would do in an airplane to equalize the pressure. Usually swallowing does the trick for me. We are supposed to keep the mouth closed when using a nasal interface mask so that therapy pressure isn't lost out the mouth. If you can't keep your mouth closed then you either have to use a full face mask or figure out some way to keep the mouth closed like with a chin strap.
My ears don't pop all night and in fact it's rare that I have to do anything to equalize the pressure.

Are you using EPR? I forget. If you are then your pressure is dropping further on exhale so even less air is vented. If you are using EPR you might try reducing it or turning it off so that more air moves through the mask. If you can turn down the temperature (if using a heated hose) that might be more comfortable for you. If you aren't using EPR or if you are and wish to continue using it then a little more pressure might offer more comfort as long as it doesn't create leak issues.

Using a relatively low pressure (and the 6 cm is relatively low since the machine won't go below 4 cm) can feel rather stifling for some people. Often people say they just feel more comfortable with a little more pressure even though it technically might not be needed for treating the apnea events. It's just more comfortable so they sleep better and sleeping better usually means we feel better in general.

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SnuggleMonkey
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Re: New CPAP User Struggling in First Week

Post by SnuggleMonkey » Sat Aug 30, 2014 11:45 am

Thanks Pugsy,

I do have EPR enabled, I think. I will experiment with those settings to see what feels comfortable.

My machine was accidentally set to 8cm and I felt like it was a problem for me. After changing it to 6cm, I thought there was an improvement. I'll try some different tweaks.

There are many variables to this and we all have different faces so I'm sure that one size doesn't fit all. I have a very prominent nose and a mid-sized mouth. The full-face mask feels comfortable in covering my face. I have it tight enough to prevent leaks and it's not leaving a mark on my face any more!

I found some posts about CO2 and got some advice on other masks that have helped other folks, so I'll look into that if my tweaks to the machine don't work.

Cheers!

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Re: New CPAP User Struggling in First Week

Post by SleepyToo2 » Sat Aug 30, 2014 12:13 pm

SnuggleMonkey wrote:For anyone who uses a Nasal Pillow, how do you keep your mouth closed all night? When I briefly tried one for a couple of minutes at the doctor's office, I was finding that my ears would pop a lot when I opened and closed my mouth. I was thinking that this might be a good mask for breathing in through my nose and out through my mouth but not if my ears will pop all night. Any thoughts?

Thanks again!
I find that sometimes when I am sitting up in bed with the pillows on my ears do go a little funny - as though the air is going out through them. However, when I lie down the feeling goes away. Avoiding opening your mouth is the key - I use a chin strap. Over time, the leak average is gradually falling. I think it is partly subconscious - your brain realizes that you are getting enough air through your nose, so there is no need to open the mouth. I have just started using the P10 pillow mask, and changed up to the large pillows. When I take the time to make sure that there are no leaks when I lie down, it seems to stay in place much better than any other mask I have tried. I was not aware I was opening my mouth, but SleepyHead told a different story!

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SteveMP170
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Re: New CPAP User Struggling in First Week

Post by SteveMP170 » Sat Aug 30, 2014 12:43 pm

I understand what you're saying! I am not a doctor but I started two years ago. After I had my sleep study I was talking to the sleep therapy company representative and mentioned that I tend to sleep with my mouth open (who knows if I did or not?!) She thought she was doing me a favor and gave me a full face mask. This was the worst thing she could have done. For 9 months I could get no relief. The full face mask was so claustrophobic it was keeping me from sleeping well. My doctor was not happy at all; he said she should have given me the mask I used on my sleep study and made the change for me. What a difference! I now average 7-8 hours of sleep nightly compared to the 5 hours before the sleep study. Take my advice---try the nasal mask (I use Res Med Mirage FX.) Hope this helps you. Happy sleeping! Steve
SnuggleMonkey wrote:Hi All,

I've been seeing a sleep specialist or pulmonologist for about 6 years but I was only recently diagnosed with a mild sleep apnea. They told me I had an average of 13 blockages an hour, which seems very high to me but they tell me that this is mild. I guess there are others who have over 100 blockages per hour and I can't imagine that!

I just got my CPAP machine about 6 days ago. I've used it for 5 out of the past 6 nights and I feel like I'm sleeping FAR worse than I ever did before using this machine. I promised myself that I would give it a minimum of 3 weeks to see if I can get used to it but a friend of mine said it took him longer than that. How was it for y'all? Did it take longer than 3 week for you too?

I'm using the ResMed S9 with Humidifier attachment and a ResMed Mirage Quattro full face mask with a 6ft hose.

I think that I'm waking up multiple times during the night and I can't really sleep on my stomach any more. I use the "Sleep as Android" app and it's detecting tons of movement throughout the night, so I have no doubt that I'm shifting around a lot.

I'm used to sleeping with an eye-mask and headphones on my head, so the CPAP mask is just one more thing covering my head. I'm pretty sensitive to noise and vibration so I do my best to shield this out. I live in an apartment near a pretty noisy road and my neighbors tend to jar me awake with a slamming door or foot stomp on occasion.

In any case, my Dr. said that the CPAP machine would "change my life" but so far, it's seems far worse than before. I'm wondering how long it will take before I see an improvement. It's impacting my performance and attitude at work, so that concerns me a lot.

I've read a few posts already and I'll keep reading more. Thanks for supporting each other!
Steve

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Re: New CPAP User Struggling in First Week

Post by library lady » Sun Aug 31, 2014 11:43 am

SnuggleMonkey wrote: I think that I'm waking up much more frequently than I was before. Unfortunately, I live in an apartment building shared with college students who have just returned to school, so that's another variable that could be impacting my sleep.

I took a sleeping pill last night and I only remember waking up two or three times during the night (instead of 6 or 7 times previously.)

According to my "Sleep as Android" app, I have averaged about 7 hrs and 18 minutes of sleep over the past 2 weeks. This seems about right to me. I did stay in bed for almost 10 hours on Saturday, though. The first few nights, I was definitely fiddling with the mask. I hate it when my nose itches and I have to undo the mask to scratch it. The seal seems pretty good but the eye-shade mask could be letting air in.

I usually shift to sleeping on my side in the middle of the night, anyway. I don't feel like I *have* to fall asleep on my stomach but that's what I'm used to. We'll take it one night at a time!

Thanks!
[/quote]


Snuggle Monkey, I see that you figured out the nose itch problem, but if you have that problem again, you might try doing what I do. Anytime I get up in the night and need to use the loo, or to scratch my nose, I just pull the connector off my mask so I don't have to take it off. I keep q-tips handy by the bed for scratching my nose through the connector port.

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Re: New CPAP User Struggling in First Week

Post by Lady Mechanic » Sun Aug 31, 2014 12:53 pm

I an a mouth breather but my chin is small therefore not allowing a good seal. So I use a chin strap to keep my mouth closed at nite or you will get the ear popping. I also have put in plugs to help with the adjustment of going from the auto setting to 7 this week. I think I like the auto better. I never knew what the machine was doing by the time I hit dreamland. You might ask your Dr about the auto titration. Since you seem to having a Lil bit of an issue. That gives you about 20 minutes to go to sleep & you'll never know or use the ramp feature on your machine.

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