New CPAP User

[jipavl]

Hi all,

I'm a new CPAP user - started CPAP therapy a week ago. I was diagnosed with OSA in September and my AHI was about 45.
I have a Resmed Air Sense 10 and been experimenting with both full face and nasal masks.
I'm still working with the Resmed technician on setting the right pressure. Right now it is 4-14 auto, but she said she will set it to fixed this night.

Good things: I can sleep with the mask and my AHI is below 5. Best 1.5, worst 3.8.
Bad things: some skin irritation from the mask and mainly I don't feel whole much better.

It is disappointing that my condition has not improved so far, I really hoped to get my life back with the CPAP, but I guess I cannot do much else then to wait and see if my condition improves.

Kind Regards,
Jiri

[Julie]

If you have been using the machine with a min. setting of 4 (the machine's default low) you probably have a hard time inhaling at all, and are unlikely to be getting therapeutic levels of air. Changing the mode from Auto to plain Cpap will not help that problem, though depending on where she sets Cpap you could feel some benefit. Why is she changing it to Cpap?

[Pugsy]

Are you using the available software to monitor your therapy in detail?
https://sleep.tnet.com/equipment
Have you made sure that leaks aren't an issue?
How many hours of sleep are you getting?
Are you waking often during the night for any reason?
Do you take any medications of any kind ...if so what?

What is it that you

It is disappointing that my condition has not improved so far,

haven't seen improve that you wanted to see improve?

There's so much more to feeling better than just getting nice low AHI numbers.

One week on cpap....not nearly enough time to expect much improvement even if everything was perfect and it rarely is after just one week.
Heck, it took me over a month to quit waking up a gazillion times just to feel the mask on my face to make sure it was still there.

Where are you located? Helps us because different parts of the world go about doing things a bit differently.
Are you keeping this same machine or will you be getting a different machine?

[MrsRinPDX]

Welcome Jiri,

You are off to a good start.

Your skin irritation is a common complaint and usually can be solved by adjusting the straps on your mask. I don't wear an Air Sense 10, but there are plenty of users here who do. I am sure they will help out.

One week isn't much time for your body to recuperate from years of sleep apnea. Your AHI of 45 puts you in the severe sleep apnea category; it will take time to recover. Just remember to keep trying. Your life depends upon it. And don't worry, there are lots of folks here rooting for you.

[freetimecreations]

May take time to feel better. Second day I felt Excellent. Third day was okay. Each day is better I have bad habits I created while untreated and exhausted.

Where are your sores? With my sore I put adhesive part of a Band aid over it. Look at mask fitting guides.

Fill out user profile.

Read New User guide.

[jipavl]

Why is she changing it to Cpap?

Not really sure. She reviews the data every day and then adjusts the settings. Once she feel it is ok, I'll get the machine into my ownership.

[jipavl]

Are you using the available software to monitor your therapy in detail?
https://sleep.tnet.com/equipment
Have you made sure that leaks aren't an issue?
How many hours of sleep are you getting?
Are you waking often during the night for any reason?
Do you take any medications of any kind ...if so what?

Hi,
I'm also on antidepressants. I have been treated for depression for circa 5 years.

What is it that you

It is disappointing that my condition has not improved so far,

haven't seen improve that you wanted to see improve?

The extreme sleepiness and mental fog is still an issue. During weekend I slept 10-11 hours and easily could sleep more. Still tired.
I'm using the Sleepy Head software.

Kind Regards

[Okie bipap]

Have you tried using a mask liner? It may help with the skin irritation. Some people purchase them, and others, like myself, make their own out of an old, well-used tee shirt.

[Pugsy]

Anti depressants (both SSRI and SNRI kind) are notorious for both messing with sleep architecture (sleep stages) and sleep quality as well as simply making us feel like a drugged up zombie during the day.
https://www.google.com/search?q=SSRIs+a ... irefox-b-1
and here's just one study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548844/
and another
https://www.ncbi.nlm.nih.gov/pubmed/15892588

Whatever medication you are on...google it and all its side effects and read more than one hit that you will get when you google it.
Fatigue, drowsiness, drugged up zombie (my words), mental fog, insomnia (which means crappy sleep quality and with crappy sleep you feel crappy) etc...all notorious side effects.

So some of what you are feeling could very well be from the medications you are taking and the best sleep apnea therapy in the world isn't likely to fix it.
Of course discontinuing the medication is also likely to create a problem....so something to talk to your doctor about.
Often the depression symptoms that caused a person to be put on the medications in the first place were symptoms that were really OSA symptoms.

CPAP therapy can only fix bad sleep when that bad sleep is caused by sleep apnea. It can't fix bad sleep that is caused by something else no matter how much we might want or expect it to.

Talk to your doctor about your medications and consider altering dose or time of dose or even getting off the medication to see if it helps with those unwanted symptoms you are having.
Just a couple of weeks ago I read here on the forum where someone mentioned that going off anti depressants greatly improved their daytime unwanted symptoms of just what you are complaining about. The did it under a doctor's care though...don't go off your meds cold turkey without being under a doctor's care.
And depending on which meds and your diagnosis...going off meds may not be an option and sometimes it helps just to know that what we are experiencing is related to the meds so it makes it a bit easier to swallow.

In the meantime do what you can to maximize the sleep apnea therapy and the mask issues etc...to give yourself the greatest chance of feeling better.
Use available software so you understand what is happening and can monitor leaks, etc.

[jipavl]

Anti depressants (both SSRI and SNRI kind) are notorious for both messing with sleep architecture (sleep stages) and sleep quality as well as simply making us feel like a drugged up zombie during the day.
.

I was complaining to my shrink about sleepiness for a few years already. He changed my prescription several times to no avail. It was always SSRI based medication. After several years of getting nowhere this way I decided to pursue other options and finally got the OSA diagnosis.

I'll sure talk to my doc again about this.

Thank you,
Jiri

[jipavl]

Have you tried using a mask liner? It may help with the skin irritation. Some people purchase them, and others, like myself, make their own out of an old, well-used tee shirt.

Was looking into this, but have not really tried anything yet. You use just a plain cotton shirt?

[freetimecreations]

Antidepressant/medication have side effects. Zombie is onet. Hope you can reduce with Dr. approval
There are members to help with sleep apnea therapy.

[MrsRinPDX]

Jiri,
Pugsy is an excellent resource and is well respected by all here. However, read her reply carefully. I would strongly caution you NOT to go off antidepressants until after you've given CPAP therapy a thorough try. Here's why.

I am speaking from experience. I have dealt with anxiety and depression for close to 20 years. Abruptly ending antidepressants can not only make your symptoms WORSE, it made me suicidal. Your AHI is 45. You definitely have a sleep apnea problem. Let's fix that.

Like you, I have severe obstructive sleep apnea. My final study AHI (it was reviewed later by another technician) was 71. I take antidepressants and my depression is well controlled with medications. I know exactly what you are complaining about when it comes to mental clarity, and memory loss, and tiredness. You will see an improvement but it will happen in baby steps. A week is hardly any time at all.

Do talk to your depression doctor. Mine was very interested in my sleep apnea journey, and our long term goal is to reduce the antidepressants if that proves prudent down the road. First things first.

[Pugsy]

Yes, please read my reply carefully.
I am NOT advocating doing anything about the medications until you have talked all of it over with your doctor and whatever you decide is with the support of your doctor...what you and your doctor are comfortable with doing or not doing.
It is assumed that this usually takes time and while waiting for all that sort of stuff (appointments etc) we still use cpap and optimize it the best we can.

While your meds may or may not be a factor in your unwanted symptoms...they might be a big part or a little part and for that reason talk all of this over with your doctor or doctors.
Even if they are a factor there's nothing preventing sleep apnea itself from also being a factor.
It's very rare in life that we have only one problem and eliminating one problem fixes everything in our lives that is wrong.
Most of the time we have several things going on at one time and we have to fix or try to fix (after we identify the problem which isn't so easy either) each problem separately to end up with desired results.

Finally there are people who have nice low AHIs...no meds at all to blame anything on...and they get 7 to 8 hours of good solid sleep and have really good sleep hygiene...and yet they still feel like crap for some reason or other. It happens.
But CPAP therapy itself...can only fix problems directly related to sleep apnea and if a person is unlucky enough to have more than the sleep apnea problem...we can't expect cpap to fix the other problem or problems. Just doesn't work that way and unfortunately a lot of people have unrealistic expectations as to what the machine is supposed to do or can do.
Doesn't mean we don't continue to try to optimize therapy though...we always do that but with a big dose of reality while doing it.

[jipavl]

Thanks for the replies so far. I definitely intend to continue both CPAP therapy and my anti depressants while waiting to talk to my psychiatrists.
I red many of those "how long it takes to improve" topics to know that it can take time to feel better. Just hope it will happen sometime.