REM rebuild? Nasal Mask? Tracheostomy? Nasal surgery?

[lilasmom]

I have multiple questions and instead of posting multiple threads, I thought I'd combine them here.
I'm having nasal surgery in a few weeks, I'm having a septoplasty, turbinate reduction and a nasal oral suspension. I'm currently using a Airfit F10 full face mask, Medium size, but I'm claustrophobic and take it off during the night, if I don't medicate myself first for the anxiety. I can't continue to do that, it can become addictive. I tried a different medication and the effects of it were worse. Here are the issues I need help with-

1. I'm hoping to be able to use a nasal mask once I heal from surgery and stop taking the anxiety medications. I'll have to pay out of pocket for this mask and would like some recommendations on nasal masks and a great place to buy it.

2. I've been using my mask every night since 10/8! This is huge for me, I've started back on cpap a few times, only to quit after a week or two. This time I remembered why I quit every time. I'm tired every day with OSA and an AHI of 62, I've had it for at least 8 years so it's become my new normal. But when I start using my cpap again, I feel worse, not better. My exhaustion levels are unreal. I worry about driving safely, my mood becomes horrible, I'm very emotional, I'm a slug. I'm so exhausted I don't want to do anything, I get terrible headaches. I finally give in to these feelings and quit using my cpap and go back to just being tired all the time, but not exhausted. I've discussed this with my sleep therapist and she said I need to rebuild my Rem and it takes time. Has anyone experienced anything like this? How long does it take to kick in? I'm happy for everyone who "feels great", it keeps me motivated that I will one morning wake up and feel the same. Yesterday, I saw my neurologist and had a breakdown in his office. If this nasal surgery doesn't improve my breathing and cpap usage, I may look into a tracheostomy. Has anyone considered this? My father was hospitalized recently and his doctor suggested one for his sleep apnea. I thought his doctor was crazy, but now I'm not so sure. Sleep deprivation is a a lot worse than a hole in my throat at the moment.

3. I want to continue to use my cpap during my recovery from nasal surgery, I don't want to start all over in rebuilding my REM (if that's an actual thing). Is this possible? Any tips?

4. Has anyone had a septoplasty, turbinate reduction or a nasal aral suspension? I'd like to prepare beforehand as much as possible. What OTC items should I have on hand? What worked for you and didn't?

I hope I wasn't too negative, I don't want to be this way, but I've lost some of my gloss currently. I appreciate any help and advice anyone can offer. Thank you!

[49er]

Hi lilasmom,

I had a septoplasty/turbinate reduction in March, which I will get to in a minute. But as an FYI, even before the surgery, I found that I could wear the Sleep Weaver Elan Mask, listed in my profile. Perhaps you want to give that a shot?

Unfortunately, it didn't help my nasal breathing/pap therapy tolerance. But having said that, if you go back through the archives in this forum on septoplasty, you will find it helped alot of people.

Here are some actions to take that hopefully, will greatly increase your chances of a successful outcome. Have you asked your surgeon what he/she intends to do to avoid empty nose syndrome? You might want to google so you can prepare some questions to ask. I don't think I have that but unfortunately, my sinuses are very dry, which can be a complication of the surgery.

You might want to ask the surgeon what type of turbinate surgery he/she intends to perform. According to a book I have on ENS, the submucous resection with outfracture is supposed to be the most conservative. But see what what your doctor says about it.

Regarding using your machine after surgery, ask your surgeon if you use an F10 mask if that would be ok to use. Many want you to stay off of the machine for one to two weeks because they fear the mask will mess up the surgical area and they also have a concern about the pressures doing the same thing. They guy who did my surgery allowed me to use my machine since I used the FIt Life Full Face mask which didn't touch the nasal areas. But other surgeons I saw had a time table from 4 days to two weeks for staying off of the machine. So ask about that.

Not sure what your sleep therapist means about building REM.

Regarding having a trach, that is usually the last step when someone has tried just about everything else. How long have you been trying to make pap therapy work? Anyway, hopefully, the nasal surgery will give you the improvement you are seeking so take it one step at a time.

Hang in there.

49er

I have multiple questions and instead of posting multiple threads, I thought I'd combine them here.
I'm having nasal surgery in a few weeks, I'm having a septoplasty, turbinate reduction and a nasal oral suspension. I'm currently using a Airfit F10 full face mask, Medium size, but I'm claustrophobic and take it off during the night, if I don't medicate myself first for the anxiety. I can't continue to do that, it can become addictive. I tried a different medication and the effects of it were worse. Here are the issues I need help with-

1. I'm hoping to be able to use a nasal mask once I heal from surgery and stop taking the anxiety medications. I'll have to pay out of pocket for this mask and would like some recommendations on nasal masks and a great place to buy it.

2. I've been using my mask every night since 10/8! This is huge for me, I've started back on cpap a few times, only to quit after a week or two. This time I remembered why I quit every time. I'm tired every day with OSA and an AHI of 62, I've had it for at least 8 years so it's become my new normal. But when I start using my cpap again, I feel worse, not better. My exhaustion levels are unreal. I worry about driving safely, my mood becomes horrible, I'm very emotional, I'm a slug. I'm so exhausted I don't want to do anything, I get terrible headaches. I finally give in to these feelings and quit using my cpap and go back to just being tired all the time, but not exhausted. I've discussed this with my sleep therapist and she said I need to rebuild my Rem and it takes time. Has anyone experienced anything like this? How long does it take to kick in? I'm happy for everyone who "feels great", it keeps me motivated that I will one morning wake up and feel the same. Yesterday, I saw my neurologist and had a breakdown in his office. If this nasal surgery doesn't improve my breathing and cpap usage, I may look into a tracheostomy. Has anyone considered this? My father was hospitalized recently and his doctor suggested one for his sleep apnea. I thought his doctor was crazy, but now I'm not so sure. Sleep deprivation is a a lot worse than a hole in my throat at the moment.

3. I want to continue to use my cpap during my recovery from nasal surgery, I don't want to start all over in rebuilding my REM (if that's an actual thing). Is this possible? Any tips?

4. Has anyone had a septoplasty, turbinate reduction or a nasal aral suspension? I'd like to prepare beforehand as much as possible. What OTC items should I have on hand? What worked for you and didn't?

I hope I wasn't too negative, I don't want to be this way, but I've lost some of my gloss currently. I appreciate any help and advice anyone can offer. Thank you!

[jim22]

It took me many months to "get used to" CPAP, and even after 17 months, I think its still improving. Your situation sounds much worse than mine. I use a simple nasal pillow mask and reasonably low pressures. For a couple months, I would wake up often to move a bit, and I basically seem not to move much at all any more.

Surgery seems radical and unreversible. Any chance we can help you be more successful with the PAP therapy? Others here will recognize your equipment and maybe ask for sleepyhead data. Getting used to the mask takes time, assuming you have a reasonable fit.

Jim

[kteague]

I have to wonder if some of your claustrophobia and mask removal is related to the therapy not being optimized, and you are removing it due to a troublesome event. Are your surgeries with the intent to improve your sleep apnea treatment or is there something that medically needs fixed - like that suspension thing. It's new to me.

Are you on any meds that cause reduced REM? If not, I would focus on being sure treatment is optimized. Providing an environment conducive to safe and comfortable sleep is generally the best way to progressively get better sleep of all stages. If the brain doesn't begin to relearn how to get the necessary sleep it needs, then further investigation may be warranted. Sometimes medication side effect, other medical conditions, or other sleep disorders can complicate recovery. For me it was limb movements. But often getting CPAP treatment right takes care of things. If I were you I'd let folks here take a look at your data and see if they can offer any suggestions. BTW, do you have breathing trouble during the day as well as at night?

Tracheostomy is the last line of treatment. I would have to unequivocally know I'd pursued every other avenue first. I doubt you are there yet. Hope things turn around for you soon.