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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
SedonaDreaming
 
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Old snoring apneic, new to APAP and not loving it

Postby SedonaDreaming on Wed Apr 19, 2017 12:27 pm

I am new to the forum and haven't really introduced myself yet.

All my life I have had trouble sleeping, never able to fall or stay asleep, except through sheer exhaustion after days of limited night-napping (what I call my miserable attempts to sleep at night). I perfected my intense snoring habit over recent years, developed a bit of extra weight and after many attempts to lose weight, being labeled pre-diabetic and after failure of anti-snoring devices up to and including the dental-fitted TAP3, I gave in and asked for a sleep study. Husband stated I don't breathe at times during sleep and that got me an in-house study, during which I slept a whopping 2 1/2 hours. Apparently, the data they gathered was enough.

Our family, in general, are very talented snorers. Brother wears CPAP. Everyone in my immediate family suffered from obesity, except for one sister.

I am using nasal pillows to keep as much off of my face as possible, but find that I just can't get my breathing to relax and find myself holding off inhaling through my nose at times so that I can momentarily catch my breath through my mouth. I think anxiety is my enemy here. I contemplated use of a mask, but not sure that's the right approach because I think if I can control my anxiety with the nasal pillows all will work out.

I have tried visualization, focusing on slowing my breathing and telling myself how easy the breath feels (doesn't work!), don't use the computer before bed and I use a foam neck pillow (Dr something-or-another brand) and it works great to keep my mouth closed and keep neck from drooping and closing airway..actually sort of comfy. Husband states I never was a mouth-breather, but I feel better with it.

I finally relented, after trying Unisom (doxylamine type), Benadryl, and melatonin to try to get me off to sleep after several nights of listening to my super-loud breathing in my ears so I could learn to tolerate the pressures and the windstorm in my ears, and contacted my sleep specialist who begrudgingly ordered Ambien 5 mg. I have taken it for two nights. First night...disaster...must have been breathing through my mouth and awoke several times to the Sahara desert. Last night...only a couple hours of sleep mixed with laying in bed with the mask on and begging the sleep gods for relief. I finally just got out of bed and sat up the rest of the night. This is my cyle...rinse and repeat.

From the sleep study, I was labeled as mild to moderate sleep apnea with mixed central and obstructive.

I downloaded SleepyHead and stored some info on an SD card.

I have the screen shots and can share that data, but have a couple of questions before I do so (because I didn't stumble on the concise answer through the search function):

1. Is it sufficient to post the Imgur link to the screenshot instead of posting a picture?
2. I use a Mac and cannot for the life of me figure out how to turn off the calendar feature in SleepyHead. Any ideas?

Glad to have this venue. I want to become compliant (hate that term!) and understand what my body is doing during sleep.

*I added my device info, but in case it doesn't show: I have a ResMed Airsense 10 for Her, ResMed nasal pillows, heated humidifier, pressure settings 5-15. I have been using the auto ramp feature because without it, I always felt like I couldn't exhale. With Autoramp, I don't have that suffocating feeling. My hope is to turn the ramp off as I get more used to this device.

Jen

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AliClick
 
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Joined: Tue Mar 28, 2017 11:19 am
Location: Baltimore MD
Gender: Male

Re: Old snoring apneic, new to APAP and not loving it

Postby AliClick on Wed Apr 19, 2017 12:44 pm

Welcome - sure you'll get some good advice. In answer to your questions, yes, posting the links should be fine. And regarding the calendar - it's not in preferences, it's actually in the interface. At the bottom center of the calendar, look for a small dot - click and drag it up, away goes the calendar.

_________________
Machine: DreamStation Auto CPAP Machine
Mask: Amara View Full Face CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Xtreme Comforts Slim Hypoallergenic Shredded Memory Foam Bamboo Pillow, great for stomach sleeper, very adjustable for mask

SedonaDreaming
 
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Re: Old snoring apneic, new to APAP and not loving it

Postby SedonaDreaming on Wed Apr 19, 2017 1:00 pm

Thanks, AliClick!

Here are the Imgur links to my data images:

http://imgur.com/9sT7To1
http://imgur.com/CwPniON
http://imgur.com/e6v6l4J
http://imgur.com/C8M295w
http://imgur.com/E42kcA4
http://imgur.com/chtBFZZ

I really don't know how to interpret some of this stuff and not sure it's all meaningful. If anyone has any sage advice from these graphs, my ears are open!

Jen

rohdej
 
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Re: Old snoring apneic, new to APAP and not loving it

Postby rohdej on Wed Apr 19, 2017 3:32 pm

Looking at this, http://imgur.com/9sT7To1 it looks like your pressure minimum pressure starts about 4 cm. Your anxiety when putting on your mask is probably fresh air starvation and not anxiety at all. Below 6 cm My P10 pillow mask will not flush all of my exhaled air out the mask. I need a minimum of 7 cm and 7 cm looks like a good starting point for you too from the one graph I have seen. Most of the night it looked to bounce from 8-10 cm. If you do nothing else, make sure you turn off your ramp to minimise the time it will take to get up to treatment level.

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palerider
 
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Location: Dallas(ish).
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Re: Old snoring apneic, new to APAP and not loving it

Postby palerider on Wed Apr 19, 2017 6:25 pm

SedonaDreaming wrote:Thanks, AliClick!

Here are the Imgur links to my data images:

please do them like this, next time:

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

it tells us a lot more, and you only need one screenshot per day.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Vpap Auto

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robysue
 
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Re: Old snoring apneic, new to APAP and not loving it

Postby robysue on Thu Apr 20, 2017 8:19 pm

SedonaDreaming,

The most useful image you posted is this one: http://i.imgur.com/9sT7To1.png

The upshot of this data is that your machine prevented all but a handful of events from taking place: Only 8 apnea events were scored in the 4:12 that you used the machine. The 95% leak rate indicates that you don't have any serious problems with leaking going on. It would be nice to see the leak graph; you can do that by resizing the graphs and turning the unneeded ones off.

See the thread at viewtopic/t103468/Need-help-with-screen-shots.html for details on which graphs to include and how do select/unselect the graphs in SleepyHead.

You also write:
SedonaDreaming wrote:I am using nasal pillows to keep as much off of my face as possible, but find that I just can't get my breathing to relax and find myself holding off inhaling through my nose at times so that I can momentarily catch my breath through my mouth. I think anxiety is my enemy here. I contemplated use of a mask, but not sure that's the right approach because I think if I can control my anxiety with the nasal pillows all will work out.
I'm trying to understand precisely what you are talking about when you say that you hold off inhaling until you can "momentarily catch my breath through my mouth."

Is the problem that too much air is coming in through the pillows, so you hold off the inhalation until you decide to breathe through your mouth?

Or is the problem that too little air is coming in through the pillows for you to get a good, satisfying inhalation, and so you hold off the inhalation until you breathe in a nice deep inhalation through your mouth?

Because the standard suggestions for how to fix your problem, and hence reduce the anxiety, really depend on which of those two scenarios is closer to describing what you feel is going on.

I have tried visualization, focusing on slowing my breathing and telling myself how easy the breath feels (doesn't work!),
Sounds to me like you're working too hard on focusing on your breathing. And the more you focus on slowing the breathing and telling yourself "how easy the breath feels", the more your brain (and your nose and lungs) start screaming at you, "IT'S NOT WORKING!"

Seriously, a lot of newbies find that as soon as they put the mask on, they're far more conscious of their breathing than they've ever been before. And they start focusing on their breathing thinking that somehow focusing on the breathing will make it easier to go to fall asleep. Maybe that works for some people, but it certainly did NOT work for me. When I first started out, I found that the more I focused on my breathing, the harder it was for me to actually fall asleep with the mask on my nose. It finally dawned on me that the best thing I could do was to find a way to distract my consciousness from focusing on my breathing. In my case, the solution turned out to be using my iPod to play a four-hour long playlist of Gregorian chants on a loop. I put the iPod in an iHome and I kept the volume rather low. But the music was just (barely) loud enough for my mind to focus on it instead of my breathing. That helped me out tremendously in learning how to not panic with a sense of "too much air" being stuffed down my throat.

I finally relented, after trying Unisom (doxylamine type), Benadryl, and melatonin to try to get me off to sleep after several nights of listening to my super-loud breathing in my ears so I could learn to tolerate the pressures and the windstorm in my ears, and contacted my sleep specialist who begrudgingly ordered Ambien 5 mg. (emphasis added)
The italicized, boldfaced comment supports my hypothesis that you are too conscious of your own breathing and you need to work on NOT focusing so much on trying to "slow it down."

As for the Ambien: In retrospect, the biggest mistake I made in my own CPAP adjustment was in rejecting the idea of using Ambien for a few weeks while I was going through a very difficult adjustment period. The Ambien may very well help you get over the hump so to speak.


I have taken it for two nights. First night...disaster...must have been breathing through my mouth and awoke several times to the Sahara desert. Last night...only a couple hours of sleep mixed with laying in bed with the mask on and begging the sleep gods for relief. I finally just got out of bed and sat up the rest of the night. This is my cyle...rinse and repeat.
This sounds counterintuitive, but ....

You may want to get out of bed sooner rather than later when you start to get frustrated with your inability to get to sleep with the CPAP. One thing that I had to do for several months was hold myself to the following "rules":

  • Get out of bed if I wasn't asleep in what felt like about 20-30 minutes. And leave the room and do something (anything) that was at least a little bit fun and also relaxing. Listening to music. Reading. Working a crossword. Taking a shower. You get the idea.
  • Only go back to bed once I started feeling sleepy, not just tired. I learned that if I was sleepy enough, my body usually was able to get to sleep with the dang mask on my nose.
  • Force myself to get up at my normal wake up time regardless of how little sleep I got.
Was it fun? No.

Was it hard? Yes.

Was it worth it? In the long run, yes it was worth it. Eventually my body finally learned to get to sleep in a reasonable fashion and stay asleep for at least a full sleep cycle between wakes.

I have the screen shots and can share that data, but have a couple of questions before I do so (because I didn't stumble on the concise answer through the search function):

1. Is it sufficient to post the Imgur link to the screenshot instead of posting a picture?
Acceptable yes, but Imgur makes it easy to copy and paste the bbcode to properly embed the image in the post. Select "Large thumbnail" for the size.

2. I use a Mac and cannot for the life of me figure out how to turn off the calendar feature in SleepyHead. Any ideas?

Here's how to minimize the calendar in SleepyHead. Look carefully at the calendar. There is a little "up" triangle by the date. I've circled it in this screenshot from my mac:

Image

If you click on that triangle, the triangle will switch to a "down" triangle, and the calendar will disappear, although the date bar will stay visible. When you want the calendar to come back, click on the "down" triangle, and it will change to an "up" triangle and the calendar will come back.

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Machine: DreamStation BiPAP Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Additional Comments: PR System DreamStation and Humidifier. Max IPAP = 9, Min EPAP=4, Rise time setting = 3, minPS = 3, maxPS=5

Diamondminek
 
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Re: Old snoring apneic, new to APAP and not loving it

Postby Diamondminek on Sat Apr 22, 2017 10:46 am

When I first started, I had to stop doing my relaxing breathing exercises and switch to different exercises, like loving kindness mindfulness and progressive muscle relaxation - plenty of examples on you tube. Once I had got used to the machine and had the settings right I was able to bring the breathing ones back in. Your brain sorts your breathing for you - if you start thinking about it, it goes wonky even at the best of times.


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