6 weeks in, no improvement whatsoever, losing all hope.

[y08hci0299]

Hi Kteague, just curious, how long did it take to to get used to cpap?

[TedVPAP]

Sounds like your issues go beyond that of sleep apnea, but to see what's going on what did your sleep study show? How about what your titration shows? Do you current treatment results match your titration results?

You can download a free software called sleepyhead it's free to use and is listed along with a tutorial in the section of posts above the user posts.

Then follow direction to post your results so people can see how your treatment looks. You may not have SA related sleep issues, or there may be adjustments the long term members can suggest. But they gotta see the data.

Maybe I missed it but I did not see responses to these questions?

[TASmart]

ted OP has Sleepy head and posted. ITs not as much a settings issue right now as a compliance issue - I can feel for them because I went through 40 years of on and off depression and sleep apnea. When you barely have the energy to poop, and have nothing left to be able to shower or brush your teeth, that's what it feels like.

Hang in there OP, I hope you can piece together a set of things that help you. It is so difficult I know.

[TedVPAP]

ted OP has Sleepy head and posted. ITs not as much a settings issue right now as a compliance issue - I can feel for them because I went through 40 years of on and off depression and sleep apnea. When you barely have the energy to poop, and have nothing left to be able to shower or brush your teeth, that's what it feels like.

Hang in there OP, I hope you can piece together a set of things that help you. It is so difficult I know.

But we still don't know what the sleep study results are, or what the titration pressure was.

Did the sleeping and suicidal issues start after CPAP treatment or before?

[robysue]

Hi Robysue, let's just put it this way, it's hard to put on the mask and use the machine every night when you're severely depressed.

You have to make a distinction between feeling lousy because of the depression and simply saying that CPAP therapy is not working for you and will never work for you.

I understand that depression makes everything much more difficult. And depression makes every small failure seem like a huge, personal failing. But you have to understand that it is possible to have OSA and depression as separate medical problems. Unfortunately depression and untreated OSA can work together in a nasty way: The untreated (or undertreated) OSA and its resulting sleep deprivation can worsen the depression and the depression can worsen your sleep in ways that make it harder to force yourself to do the things you need to do to adjust to CPAP therapy.

One thing that you've got to do is admit that treating the OSA is not going to be easy for you: There is nothing natural about sleeping with a six foot hose attached to your nose with air being blown down your throat. But if you are willing to put some time and patience into making CPAP work, then eventually the idea of sleeping with a CPAP won't seem so impossible. Once you are sleeping with the CPAP, then (and only then) will the untreated OSA no longer be able to aggravate your depression.

I even find it difficult to shower or to brush my teeth, it takes a lot out of me to muster up the energy to 'prepare' a night on cpap. especially when every attempt has been met with failure.

Right now you are not using the CPAP often enough or long enough for it to properly treat your OSA. In other words, if you did just throw the DreamStation into the closet and forget about it, your life would NOT improve at all in terms of the depression symptoms, including your sleep problems. So I want to talk about the depression for right now.

It's the depression that is making it difficult to shower, brush your teeth, and in general function on a day-to-day basis. How long have you been treated for depression? What are the psychiatrist and the psychotherapist doing to treat your depression? How often do you see them? And, most important, do you think any of the things they are telling you to do for the depression are making a difference? In an earlier post you mentioned that you had tried a number of different medications, but could not tolerate them or simply did not want to take them for fear of addiction. Have you and your mental health team talked about exactly what the medications were supposed to do, how to take them, and whether you are at high risk of addiction if you take something like xanax that actually did something positive for you?

And has your depression worsened in the last few weeks? If so, have you reported that fact to your psychiatrist and psychotherapist? If not, then why not?

And to answer your question, when I used the resmed airsense 10 auto, it was a 1 month trial from a local shop, I had to return it eventually, I did not realise that there would be such big differences between the machines, and the dreamstation bipap auto is actually a lot cheaper than resmed machines where I am from, so I conveniently thought, hey it's cheaper, philips is a good brand, lots of people use the machine, why not. It's only after months of tinkering that I realised that the differences were so stark, and that the little things actually made a big difference.

Truth be told, most people can't feel the difference between the two algorithms. But you're not most people, you are you. And you happen to be in the small minority of people who can feel a difference and have that difference matter.

For what it's worth: I started out on a Resmed S9 AutoSet and the dang "Easy Breath" algorithm that you prefer drove me nuts and the PR BiPAP with Rise Time = 3 works quite well for me. Different people who are sensitive enough to feel a difference can have very different reactions to the algorithms.

If the PR Machine can be exchanged for another Resmed, that's one option you should consider. Or depending on where you live, you might be able to pick up a gently used Resmed S9 AutoSet for not much money.

I'm really grateful for all your suggestions and your questions and I am pouring over them and I'll answer them one by one. My sleep doctors(yes plural) have been pretty useless, most of them have no idea how to operate a cpap, and I'm not going to pay $100 consultation to have them tell me to be patient with cpap and to just keep going.

I've had a lot of experience dealing with doctors and techs that don't listen. But there are ways of getting the doctor to focus on YOUR issues rather than just providing you with stock answers.

That said, at this point when talking to a sleep doc or a tech (or even people on a forum like this), the usage numbers are the critical problem that stands out from the data. And the stock answer to someone who uses the machine for an average of 1-2 hours every other night and then says, "CPAP is not making me sleep any better" will be, "You need to use the machine more. As in every night, all night long."

See the thing is, a sleep doc doesn't have any real idea as to why you are not using the machine more. S/he only knows that in the last 116 days of owning a CPAP, you've used it on only 35 days, and on most of those days, you've used it for less than 2 hours and on many of those days, you've used it for less than 1 hour. Which means you haven't really gotten to the point where you are sleeping with the machine. It looks to me like this: On many of the nights when you try to use the CPAP, you put the mask on when you first go to bed at night (or when you can't sleep), but if you are still awake after 15-20 minutes, you take it off and then presumably go to sleep without the mask on. Unless you can articulate why you feel compelled to take the mask off on those nights, there's not much a sleep doc or a tech or even a person like me can say other than "Keep trying. Put the mask on every night and try harder to not take it off."

I have worked with sleep techs, the ones I've worked with so far have been woefully incompetent, they don't even know what sleepyhead is, they don't even know what UARS is, and they just give simplistic advice like mask not working out? Try a new mask. Pressure not comfortable? Try a new pressure.

Keep in mind: Sleepyhead is a beta-version piece of software written by a CPAP patient. It is NOT officially sanctioned by any CPAP manufacturer, nor has it been independently verified to "work" by some organization like the FDA. That's why sleep docs and sleep techs don't know about SleepyHead and why many of them don't trust it even if you tell them about it. That said, I'm a big fan of SleepyHead and I've compared my data in SleepyHead to what it looks like in Encore (the official PR software) and ResScan (the official Resmed software.) But I also know that a professional who works in sleep medicine is going to have lots of valid reasons for not knowing about SleepyHead or not trusting it.

UARS is a whole different kettle of fish. The problem with UARS is that it is not yet a diagnosis that is routinely accepted by all sleep professionals. Moreover here in the US many insurance companies will not pay for a CPAP machine for a patient with a UARS diagnosis. I also believe that neither Medicaid nor Medicare will cover CPAP for UARS. So unless the insurance situation changes, US UARS patients often have real problems obtaining equipment if they need to pay for it with insurance dollars.

My psychiatrist basically just wants to keep throwing different pills at the problem, sort of like throw shit at the wall and hope something sticks. My psychologist is the only one who has been really helping put through this process, but she's a psychologist, not a sleep specialist, she provides a listening ear, but she can;t exactly help me along because she knows nothing about sleep medicine/cpap usage etc.

How long have you been frustrated with your psychiatrist? And if you are not happy with him/her, then why not try to find a different one?

The psychologist may be able to help you more than you realize---if s/he is willing (and capable) of doing cognitive behavior therapy. Because the sleep science end of things is not actually where the problem is when it comes to learning how to sleep with a six foot hose attached to your nose. It's a behavioral thing. There are things that you can do to make it easier to learn how to sleep with the CPAP and there are things that you can do that make it harder to learn how to sleep with the CPAP. And right now, you are doing a lot of things that make it harder to learn how to sleep with the CPAP.

so i really the support i'm getting on these forums is the only support that I'm getting. Not that I haven't tried reaching out, just that the asisstance I have received from these professionals is inadequate. I mean you gave me more information and insight into cpap usage in your 2 replies to me on this forum compared to all the sleep techs and sleep doctors I have seen in the last year combined.

It's good to know that you're reaching out to the forum to get help rather than to get permission to just give up. As long as you are willing to work at it, folks on this forum will be willing to help you.

I'm feeling physically lousy because of my poor sleep, but i think the mental/emotional aspect of feeling lousy really comes the frustration not being able to get used to cpap.

I have had a few sources of discomfort so far
1)The feeling of the chinstrap against my face, I've woken up once because the chin strap was too tight and it caused me pain, sometimes it's just the feeling of fabric against my skin.
2)The feeling of the mask, the pillows on the inside of the nose which sometimes causes irritation, the feeling of mask resting against the top of my lip which causes heat and moisture buildup,
3)The pressure. The bipap is uncomfortable for me, but if I use the cpap function, too high a pressure eliminates my events, but causes me anxiety and requires more effort, lower pressures are a lot more confortable but I end up having more vents.

GOOD. You've give us some concrete issues to work with. The more you can articulate what is wrong, the easier it is to suggest things that might actually work for you.

Let's look at them one at a time:

)The feeling of the chinstrap against my face, I've woken up once because the chin strap was too tight and it caused me pain, sometimes it's just the feeling of fabric against my skin.

My advice is: Ditch the chin strap. At least for now. Yes, you might mouth breath. But until you are using the machine more, large leaks from mouth breathing are just not very important. If it turns out that you have enough large leaks to worry about after you are using the machine every night, all night long, then you'll have plenty of time to revisit whether you need the chin strap.

2)The feeling of the mask, the pillows on the inside of the nose which sometimes causes irritation, the feeling of mask resting against the top of my lip which causes heat and moisture buildup

Nose irritation from nasal pillows is a very common problem. Things to try:

• Make sure you don't insert the pillow tips too far into your nostrils. Only the tippy-tips of the cones go inside the nose, but you would be surprised at how many sleep techs seem to think you need to jam the whole thing into your nose.
• Lansinoh nipple (breast) cream. Yep, the stuff that is sold to nursing mothers to soothe dry, cracked sore and tender nipples is used by CPAPers to soothe sore and tender nostrils. Look for it in the baby aisle of your local grocery store, drug store, or big box store like Target or Walmart. It's kind of expensive, but you only need a tiny amount so a tub will last you for a very, very, very long time.
• Loosen the head straps. If the head straps are too tight, that can pull the pillows into your nostrils. Now, as I recall, you are using the P10, which does not have headgear that looks adjustable. Turns out that the wider you spread those two strap pieces, the "looser" the mask fits at the nose. So experiment with pulling those two pieces of the strap as far apart as you can get them. Also helps if you don't regularly wash the backstrap in hot water since that will make it shrink back to its original size.
• Try different pillow sizes. Try going UP a pillow size. It sounds contradictory, but the larger pillow will be more resistant to slipping too far into the nostrils.
• Try a Padacheek pillow cozy. These are high quality fabric wraps designed to go around the pillow without blocking the vents. They help keep the plastic/silicone part of the mask from touching your upper lip. They also provide a bit of insulation which can help with the moisture build up.
• Try alternate temperature and humidity settings. Since you are complaining of heat build up, turn the heated hose down or off if you are using a heated hose. Try turning the humidifier down as well. Not everyone needs to have the humidity and heat set as high as possible. Some people do best with very little (or no) additional humidification. Others need a lot.

3)The pressure. The bipap is uncomfortable for me, but if I use the cpap function, too high a pressure eliminates my events, but causes me anxiety and requires more effort, lower pressures are a lot more confortable but I end up having more vents.

I think you need to work on baby steps here. For the time being you need to tolerate more events being scored as long as the lower pressure allows you to use the machine more. Work up to the necessary pressure with some time.

To make this clearer, we need to start at the beginning: Did you have titration study done? Or were you just given an Resmed AirSense 10 AutoSet and told it would find the right pressure?

The summary data you posted shows that you've pretty much been running at CPAP pressures of 10cm and above or BiPAP pressures with the IPAP set at 13 cm or above. Why?

You also say you are not using the ramp, but if pressure is keeping you from getting to sleep, then the new smart ramp is a feature that could very well be important for getting you to the point where you can put the mask on without thinking about it. (And yes, that's the eventual goal in adapting to CPAP therapy---to be able to put the mask on and go to sleep without giving the mask and machine any more thought than you do to your bed pillows, blanket, pjs, etc.)

So some questions:
1) Do you know if you are comfortable breathing against 8 cm of pressure? What about 6 cm? What about 4 cm? In other words, at what pressure setting does your anxiety and the "extra effort" kick in making it hard to tolerate the machine?

2) When the pressure is bothering you, is the problem that you feel like you cannot fully exhale? Or is it something else?

3) Do you ever feel like you are getting a stomach ache from the pressure?

It's really hit or miss, the sensations are the same every night, but some nights I'm ok with it,

That summary data says you are NEVER "ok" with it. You've only used the thing for more than 3 hours ONCE in the last 116 days. You've only used it more than 2 hours ten times in the last 116 days.

Be honest: How many times have you actually fallen asleep with the mask on your nose? As in really fallen asleep, not just sort of dozed?

some nights I just get so agitated I pull everything off.

This is believable. However, on the vast majority of nights, you haven't even tried putting the hose on. To be fair, however, you HAVE tried to use the machine 5 of the last 7 nights. And that is a major step forward.

So lets get back to those "sensations" you mentioned earlier. What are the three most irritating sensations that seem to pop up every time you put the mask on your nose? Try to be specific. You need to focus on those three sensations first. If you can eliminate or minimize them, it will be easier for you to keep going.

Yes, and I have tried using it while awake, the discomfort becomes too much to bear after awhile.

How long can you keep the mask on before the discomfort becomes to much to bear? 10 minutes? 30 minutes? an hour? Once you know that, you have a major piece of the puzzle figured out. If the discomfort becomes unbearable in 15 minutes, then you know that you will have to train yourself to fall soundly asleep within 15 minutes of putting the mask on at night. That may sound impossible, but it can be done.

Again, let me talk about my own adjustment problems for a bit: Prior to starting CPAP I had a very long latency to sleep every night. As in I would lie in bed next to my husband for an hour or so before drifting off to sleep. This never bothered me because I did a lot of very pleasant daydreaming while waiting for sleep to come. But that long latency to sleep just didn't work with CPAP: I started to become miserable (mainly due to aerophagia) after 10-15 minutes of turning the machine on, and once the stomach ache started all kinds of other littler "irritants" from the CPAP conspired with the aerophagia to make me become more and more and more awake the longer I laid there in bed trying to get to sleep. This went on for months. Until I started doing CBT for insomina (CBT-I), where a huge part of my CBT-I focused on getting my latency to sleep down to the 10-15 minute period I could manage to use the CPAP without getting too horribly uncomfortable.

Even today, after almost 7 years of PAPing, I still need to fall asleep pretty quickly after putting my mask on or I run a high risk of having a miserable night of tossing and turning with aerophagia raising its ugly, uncomfortable stomachache. But because of the CBT-I I did back in 2011, I've been able to keep my latency to sleep short enough to allow me to fall asleep comfortably on CPAP, and once I'm asleep, it doesn't bother me any more. I do still have middle of the night wakes, but with using the ramp and the CBT-I I can also get back to sleep before I become uncomfortable from the CPAP.

I've also tried sleeping pills, all they did was make me sleepier, but they did nothing to actually help me sleep, and I would wake up even more tired in the morning.

Sleeping pills have one purpose and only one purpose: They are suppose to make it easier to fall asleep at the beginning of the night.

Sleeping pills will not improve the quality of your sleep, and with untreated OSA they may very well make the quality of the sleep worse since some of them can increase the tendency of the airway to collapse during sleep.

And sleeping pills will not keep you asleep: If you have frequent middle of the night wakes where you have significant problems getting back to sleep, taking a sleeping pill at the beginning of the night usually won't fix the problem of waking up, although it may make it easier to get back to sleep after you wake up.

Also, feeling more tired in the morning is a pretty common side effect of sleeping pills, particularly ones with a long half-life. The usual way of handling this problem is to try a smaller dose of the sleeping medication AND make sure that you allow enough time in bed for the pill to fully wear off.

Finally, I have a few questions about your usual sleep habits. And by "usual sleep habits" I mean on days when you aren't trying to use the CPAP as well as thinking back to what your sleep looked like before you started trying to use the CPAP.

1) How long do you think it takes you to fall asleep after you go to bed on a typical night?

2) When is bedtime? How irregular is your bedtime?

3) When do you typically get up in the morning? Does it strongly depend on when you went to bed? Do you sleep much later on weekends than weekdays?

4) How many times do you typically wake up during the night? How long does it take you to get back to sleep after you wake up in the middle of the night?

5) How much sleep do you think you need to feel rested in the morning? How much actual sleep (NOT time in bed) do you think you get in a typical night?

[ajack]

Hi Robysue, let's just put it this way, it's hard to put on the mask and use the machine every night when you're severely depressed.
.

ask your doctor about valdoxan, it's a more sleep oriented one and uses a different pathway than the usual ssri type, that can actually impair sleep and REM. It works on the depression and the circadian rhythm, have a google about it. once the apnea is treated a lot find the depression clears. It can be just a symptom of apnea.

[zilch]

I use the airfit p10 along with a chin strap to keep my mouth closed.

I'm sorry you're having such a hard time. I started the same time as you with CPAP and have had an easier time, but I was also fortunate enough to find the right mask.

Have you tried other masks besides the P10? I know many people on this board rave about it, but I tried it and found the pillows to be very uncomfortable. I wear the Dreamwear with nasal cushion (not pillows) and find it to be far more comfortable.

If you'd prefer to use pillows, I also tried the Swift Fx and prefer it over the P10.

Masks are very personal and you may need to try more until you find one you like.

I wish you the best of luck and hope you keep trying to use Cpap every night.


Sent from my iPhone using Tapatalk

[kteague]

Hi Kteague, just curious, how long did it take to to get used to cpap?

Well, I don't know that the answer is direct. I was 5 months into a miserable CPAP experience when I found this site and got some solid advice about tweaking my settings, and I began right away getting better sleep in between the frequent wakeups. Those bits of decent sleep were enough to give me hope that I was still capable of sleep. Even though my CPAP treatment was pretty routine I was still having limb movement troubles, so my sleep was still quite broken. We have to address any other contributors to find good sleep. I just kept giving myself the best opportunity for good sleep, trusting that my body and brain would relearn how to do that which used to come natural. Even now I don't sleep through the night, and I'm ok with that as the several blocks of sleep are soooo good. I am grateful for any good sleep I can get, knowing that tomorrow I'l get another chance at it. One thing CPAP use did for me was resolve the many potty trips during the night. Sometimes it would be every 15-20 minutes for hours I'd wake up urgently needing to pee. It was on here that I learned that apnea events were causing the potty runs. Just eliminating those wakeups from my night was a huge improvement.

This may be just gobblygook but I think anyone needing to improve their sleep could possibly benefit by making some changes to their sleep environment. Something that makes the brain not associate the sleep situation with the previous bad sleep. One thing that helped me was a comfy mattress pad and nice sheets on a well made bed. There was something about getting into that bed that made me say "ahhhhh" and relax and feel sleepy. Maybe it was just a placebo, but hey, whatever works.

[nicholasjh1]

2 things:
1. I use putting on the mask really early to help getting used to it. I wear it about an hour while I'm watching TV.
2. Alternate antidepressants: Buproprion/Wellbutrin - It's not an SSRI - It's an Dopamine and Nor-Epinepherine reuptake inhibitor - it increases awareness and feeling rewarded throughout the day. It also reduces apettite so it helps with weight loss too. Just another thing you could try if Traditional (SSRI's) anti-depressants don't seem to work.... It's also really good for ADHD

[Soothest Sleep]

This may be just gobblygook but I think anyone needing to improve their sleep could possibly benefit by making some changes to their sleep environment. Something that makes the brain not associate the sleep situation with the previous bad sleep. One thing that helped me was a comfy mattress pad and nice sheets on a well made bed. There was something about getting into that bed that made me say "ahhhhh" and relax and feel sleepy.

+1 on that!

One of the tricks I've added to help me through depressive times is to make my bed in the morning as my mother used to prepare it for me at night when I was small--turn the corner of the sheets down, plump the pillows, have a good book waiting on the coverlet for a few minutes of reading before going to sleep--having these things waiting for me at the end of the day makes me feel cared for and appreciated.

Some encouragement for y08hci0299:
Poor sleep and depression feed off each other, not in a good way; so keep working on strategies for both your depression and apnea treatments. Every second you put into your own self-care is worth it. Give yourself credit for every effort you exert. Keep a journal to record each change you initiate and the results you experience. Be kind with yourself, set do-able goals, and practise resilience when you hit a bump in the road. Give yourself a cheer when you see a positive change, no matter how small.

Wishing you a peaceful night,
Jean

[CPAPPED-ADAPT]

Hi Robysue, let's just put it this way, it's hard to put on the mask and use the machine every night when you're severely depressed. I even find it difficult to shower or to brush my teeth, it takes a lot out of me to muster up the energy to 'prepare' a night on cpap. especially when every attempt has been met with failure. And to answer your question, when I used the resmed airsense 10 auto, it was a 1 month trial from a local shop, I had to return it eventually, I did not realise that there would be such big differences between the machines, and the dreamstation bipap auto is actually a lot cheaper than resmed machines where I am from, so I conveniently thought, hey it's cheaper, philips is a good brand, lots of people use the machine, why not. It's only after months of tinkering that I realised that the differences were so stark, and that the little things actually made a big difference. I'm really grateful for all your suggestions and your questions and I am pouring over them and I'll answer them one by one. My sleep doctors(yes plural) have been pretty useless, most of them have no idea how to operate a cpap, and I'm not going to pay $100 consultation to have them tell me to be patient with cpap and to just keep going. I have worked with sleep techs, the ones I've worked with so far have been woefully incompetent, they don't even know what sleepyhead is, they don't even know what UARS is, and they just give simplistic advice like mask not working out? Try a new mask. Pressure not comfortable? Try a new pressure. There have been times where they barely even knew how to operate the machines they were selling. My psychiatrist basically just wants to keep throwing different pills at the problem, sort of like throw shit at the wall and hope something sticks. My psychologist is the only one who has been really helping put through this process, but she's a psychologist, not a sleep specialist, she provides a listening ear, but she can;t exactly help me along because she knows nothing about sleep medicine/cpap usage etc. so i really the support i'm getting on these forums is the only support that I'm getting. Not that I haven't tried reaching out, just that the asisstance I have received from these professionals is inadequate. I mean you gave me more information and insight into cpap usage in your 2 replies to me on this forum compared to all the sleep techs and sleep doctors I have seen in the last year combined. I'm feeling physically lousy because of my poor sleep, but i think the mental/emotional aspect of feeling lousy really comes the frustration not being able to get used to cpap.

I have had a few sources of discomfort so far
1)The feeling of the chinstrap against my face, I've woken up once because the chin strap was too tight and it caused me pain, sometimes it's just the feeling of fabric against my skin.
2)The feeling of the mask, the pillows on the inside of the nose which sometimes causes irritation, the feeling of mask resting against the top of my lip which causes heat and moisture buildup,
3)The pressure. The bipap is uncomfortable for me, but if I use the cpap function, too high a pressure eliminates my events, but causes me anxiety and requires more effort, lower pressures are a lot more confortable but I end up having more vents.

It's really hit or miss, the sensations are the same every night, but some nights I'm ok with it, some nights I just get so agitated I pull everything off. Yes, and I have tried using it while awake, the discomfort becomes too much to bear after awhile. I've also tried sleeping pills, all they did was make me sleepier, but they did nothing to actually help me sleep, and I would wake up even more tired in the morning.

Have you tried a different mask? If it's the sensation on the inside of the nose only that bothers you, perhaps a Dreamwear nasal mask would help. I switched from a nasal pillow to a Respironics Dreamwear mask early on, and it got me over the hump. I can tolerate a FFM as well now, but I seem to get the best results with the Dreamwear.

We are all very lucky to have someone with the acumen of robysue (among others) helping out here. Hang in there, you started on a good path by coming here.

[kteague]

This may be just gobblygook but I think anyone needing to improve their sleep could possibly benefit by making some changes to their sleep environment. Something that makes the brain not associate the sleep situation with the previous bad sleep. One thing that helped me was a comfy mattress pad and nice sheets on a well made bed. There was something about getting into that bed that made me say "ahhhhh" and relax and feel sleepy. Maybe it was just a placebo, but hey, whatever works.

Had to chuckle when I re-read this today and tried to remember what sheets I was referring to. Then I remembered the video of my legs jumping that's linked to in my profile. Those are the sheets I was using in 2004/2005 when trying to address my poor sleep, and those are the same sheets I slept on last night. I'm sure they weren't expensive but they sure have lasted!

[nickdanger1]

I'm sorry you're having such a difficult time. I encourage you to share your concerns regarding CPAP with your psychotherapist - I assume you have discussed your suicidal thoughts with your therapist.

It can be really hard to find the right mask and the right tension on that mask that works for you. When I had my titration study, my technician tightened the straps so tightly that it gave me a tension headache and hurt my face. Until I came to this site, I assumed that was the right way to do it and found that the mask was so uncomfortable that I despaired of ever getting it right. Some things you said made me think that maybe your mask is adjusted too tightly. You talked about the pillows being "inside your nose" - they should lightly rest on your nostrils with the very tips barely intruding into the outer nostrils (yes, they may lie against your top lip - if you want to use nasal pillows that may be something you need to get used to). If you overtighten the mask, it has the counterintuitive effect of increasing the leaks because the pillows are so compressed that they can't inflate (they only inflate a very little bit) - that slight inflation creates the seal.

This treatment sucks (well actually it blows...), but after a few months I found I was getting good sleep. Now I am so conditioned to using the machine that I have a hard time falling asleep without it.

I know it feels that CPAP isn't worth it. I can only say that it has improved my health and given me my life back.

One thing that may increase your comfort sleeping with the mask on is to wear the mask (not connected to the machine) while winding down in the evening - while you're reading, watching TV, browsing the web, or whatever your calming ritual is for the evening. Yes, I felt like Chthulu while wearing the mask and the short hose while reading before bed, but it did help me become more comfortable with the mask.

Take care and find what works for you.

Nick Danger

[EdNerd]

Just talking off the top of my head here, because I'm not a doctor of any kind and have never played one in children's theater! I'm just throwing out some thoughts that might

Sometimes anxiety can grow out of our belief that there are better options. There *must* be a way to live like this and NOT feel uncomfortable! But that might not be completely true.

People learn to tolerate and live in situations that others would find intolerable. The difference is that the first group has no other options, and they settle that up front. People sleep outdoors, live in abandoned cars, eat from garbage cans, suffer through physical and emotional abuse, and so forth because they have settled that this is what it will take to stay alive.

I heard a man who developed trouble swallowing t the point of not being able to eat and was given two options: have his throat operated on until he couldn't speak and other complications, or learn to shove a rubber hose down his throat and pour in his food. He went with the hose because it was the only option that gave him a near-normal life.

That was my approach to CPAP. I hated the mask! But the alternative of not breathing well was not an option. Yes, using CPAP has caused some other difficulties. But I'm alive, breathing well, good O2, and working out the other kinks. (Now - if I could just learn to go to bed on time to get more than 5 hours of sleep!!)

I've seen anxiety and depression very up close and personal, so I'm not trying to minimize what you feel or the struggles you face. And without a decent support team, it's definitely an uphill battle. The fact that you have NOT given in to the suicide voices tells me you DO have what it takes to make it!

There's just this one other little part - when the rant and whine and cry is over, it still just has to be done. And it might not ever get much better than this. Staying alive, breathing well, and being a functionable person in your sphere of influence - is this worth it to you?

Ed

[Lucyhere]

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Just read this thread. What excellent suggestions by so many caring and knowledgeable people! I hope the OP comes back and reads them.

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