Falling and staying asleep

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Matt00926
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Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 12:41 am

New BiPAP user of one week at fixed 19/4 pressure to treat hypoventilation. On average it's taking me several hours to fall asleep and then I keep waking up every hour or two. I have tried putting on the mask several hours before I plan to sleep but that doesn't seem to help.

I wake up "treated" with low AHI but the lack of proper sleep is making life very hard. I still wake up with headaches and feel like crap.

I am not able drugs that depress the central nervous system as I have kyphoscoliosis which causes respiratory insufficiency.

Anyone have any tips? I am going to stick with this and I don't mean to complain, I am just frustrated.
Machine: ResMed AirCurve 10 ST
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Pugsy
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Re: Falling and staying asleep

Post by Pugsy » Sun May 03, 2015 10:12 am

Is it the use of the cpap and mask that is preventing sleep? Meaning if you didn't use it you would go to sleep rather quickly?
Is it a matter of comfort or is it more just sort of hyper vigilant thing going on?

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chunkyfrog
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Re: Falling and staying asleep

Post by chunkyfrog » Sun May 03, 2015 10:22 am

I wonder if a mask liner would help.
http://www.padacheek.com/PAC_Maskliners.html
You could also cut a gasket out of an old, clean t-shirt.
Fabric on your face is quieter, softer, and drier than silicone.

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Matt00926
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Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 1:19 pm

I can pass out easily when I'm not wearing the BiPAP. The mask itself is uncomfortable because the IPAP pressure of 19 means I have to tighten both the upper and lower straps on the headgear or the mask ends up moving all around when the machine is turned on and then begins the leaking and "farting" noises. The tightening hurts the bridge of my nose and gives me headaches and I also wake up really sore.
Pugsy wrote:Is it the use of the cpap and mask that is preventing sleep? Meaning if you didn't use it you would go to sleep rather quickly?
Is it a matter of comfort or is it more just sort of hyper vigilant thing going on?
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 1:21 pm

I actually have a mask liner from there being delivered as we speak! I am excited to try it out. I am also going to try quitting caffeine to see if that will help in the long-term.
chunkyfrog wrote:I wonder if a mask liner would help.
http://www.padacheek.com/PAC_Maskliners.html
You could also cut a gasket out of an old, clean t-shirt.
Fabric on your face is quieter, softer, and drier than silicone.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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palerider
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Re: Falling and staying asleep

Post by palerider » Sun May 03, 2015 2:03 pm

Matt00926 wrote:New BiPAP user of one week at fixed 19/4 pressure to treat hypoventilation.
you've probably been told you can't use a nasal, or pillow mask, due to your pressures.... but I use the P10 and sometimes have higher pressures than your top end. it might be worth investigating.

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Last edited by palerider on Sun May 03, 2015 5:25 pm, edited 1 time in total.
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Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 2:29 pm

palerider wrote:
Matt00926 wrote:New BiPAP user of one week at fixed 19/4 pressure to treat hypoventilation.
you've probably been told you can't use a nasal, or pillow mask, due to your pressures.... but use the P10 and sometimes have higher pressures than your top end. it might be worth investigating.
I have yet to try the nasal pillow or mask using a bi-level machine. During my sleep study they did try a nasal mask for CPAP and I had to take it off after like 10 seconds.

I am going to wait and try my mask liner on the F10 full face first. If I still struggle I'm going to try a nasal pillow and a nasal mask, thank goodness for 30-days insurance.

I feel like getting the right mask is the hardest part.
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Pugsy
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Re: Falling and staying asleep

Post by Pugsy » Sun May 03, 2015 2:34 pm

Okay...now we have a starting point to try to work on.
Mask fit and comfort...not all masks are created equal and some are easier than others to manage with the pressure swings you are having to use.
If the mask liner doesn't help...let's visit other mask model options to see if a different mask would maybe work better and be less annoying.

Make use of that 30 day mask swapping time while you can.

You know my IPAP pressures routinely go past 20 cm almost every night. Now my EPAP is a little bit higher than yours so it isn't quite such a swing as you are having but I have good success using nasal pillows.

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Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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chunkyfrog
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Re: Falling and staying asleep

Post by chunkyfrog » Sun May 03, 2015 4:18 pm

I was conned out of my first DME's mask return, so I then used the resources of cpap.com
to try several likely models. Eventually, the right mask was finally invented!
What a blessing!

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JDS74
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Re: Falling and staying asleep

Post by JDS74 » Sun May 03, 2015 5:09 pm

Based on the commentary, I get the idea that your machine is set to a fixed bi-level mode and doesn't use the auto function at all. It seems to be acting like a ventilator of sorts. Have you asked your doctor if raising the EPAP number up to 8 cm H2O or so will adversely effect your treatment? The huge difference in pressures breath-to-breath must be difficult to get used to. I know what it feels like to have my machine switch back and forth between 10 cm H2O and 25 cm H2O during the time I'm trying to go to sleep. Fortunately, I can tolerate that swing but a 21 cm H2O swing must be really difficult.

Do you have a copy of your sleep study / titration study so you can see what values were tried and how they worked in the lab? These studies have lots of useful information that may be helpful in dealing with your treatment.

On to masks, I use an Oracle 452 oral only mask and my pressures frequently get to the 22-25 range. With the use of a soft cervical collar, my leak rate hovers down near zero most of the time unless I'm getting close to the end of life on a mask.
I have a link to my experiences getting used to and living with this mask down in my signature block. Some people can adjust to one and other cannot but pressure is never an issue in terms of seal and leakage. If, after you read the post, you want to try one, they are available at a reasonable cost, less that $70 with free shipping so trying one isn't likely to break the bank.

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Matt00926
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Joined: Sat Apr 25, 2015 9:15 am

Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 5:43 pm

Pugsy wrote:Okay...now we have a starting point to try to work on.
Mask fit and comfort...not all masks are created equal and some are easier than others to manage with the pressure swings you are having to use.
If the mask liner doesn't help...let's visit other mask model options to see if a different mask would maybe work better and be less annoying.

Make use of that 30 day mask swapping time while you can.

You know my IPAP pressures routinely go past 20 cm almost every night. Now my EPAP is a little bit higher than yours so it isn't quite such a swing as you are having but I have good success using nasal pillows.
I am going to try the mask liner for two nights and if i still am having a hard time i am going to call and make a time to go in and try other masks. The whole "sleep disorder" business has been very frustrating, so far it just seems like assembly line medical care the more I actually read and learn myself.

I believe the large pressure support in my case is to help with respiratory insufficiency, from reading it seems like you want the EPAP to be as low as it can be provided that the level allows for adequate oxygenation. The high IPAP is to blow off CO2.

When I go in for a follow up I am going to ask to do a sleep test titration with an iVAPS machine.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 5:45 pm

chunkyfrog wrote:I was conned out of my first DME's mask return, so I then used the resources of cpap.com
to try several likely models. Eventually, the right mask was finally invented!
What a blessing!
I ordered my airfit f10 full face mask from there and I had a great experience. I paid for 48 hour shipping and it wasn't even that much more. I will probably go this route as my DME is in the middle of nowhere Brooklyn and I most likely would end up taking a cab anyway.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Falling and staying asleep

Post by Matt00926 » Sun May 03, 2015 5:52 pm

That is correct, based on my reading the auto pap mode is not optimal for me as i have restrictive lung disease. I have not asked what changing the EPAP setting would do, I am very new to all of this and TBH my sleep doctor did not go into any details.

I believe I need the large pressure support in order to address my respiratory insufficiency but I honestly could not go into detail about it.

I will upload a copy of my sleep report tomorrow when I have access to my scanner.

Appreciate the information about the mask and collar. My leak rates are surprisingly not even that bad according to Sleepy Head and the Leak alarm has never gone off. But the mask is sliding all over my face lol.


JDS74 wrote:Based on the commentary, I get the idea that your machine is set to a fixed bi-level mode and doesn't use the auto function at all. It seems to be acting like a ventilator of sorts. Have you asked your doctor if raising the EPAP number up to 8 cm H2O or so will adversely effect your treatment? The huge difference in pressures breath-to-breath must be difficult to get used to. I know what it feels like to have my machine switch back and forth between 10 cm H2O and 25 cm H2O during the time I'm trying to go to sleep. Fortunately, I can tolerate that swing but a 21 cm H2O swing must be really difficult.

Do you have a copy of your sleep study / titration study so you can see what values were tried and how they worked in the lab? These studies have lots of useful information that may be helpful in dealing with your treatment.

On to masks, I use an Oracle 452 oral only mask and my pressures frequently get to the 22-25 range. With the use of a soft cervical collar, my leak rate hovers down near zero most of the time unless I'm getting close to the end of life on a mask.
I have a link to my experiences getting used to and living with this mask down in my signature block. Some people can adjust to one and other cannot but pressure is never an issue in terms of seal and leakage. If, after you read the post, you want to try one, they are available at a reasonable cost, less that $70 with free shipping so trying one isn't likely to break the bank.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM