A bit confused about what to do

[orion260]

Hi everyone,

I was diagnosed with very mild sleep apnea in March and have been doing CPAP treatment since April (the pressure setting on my machine is a 6). I haven't really noticed any difference in my sleep quality since, and told my doctor so when we had our follow-up appointment in late May. He replied that since my apnea is so mild, and since I haven't noticed a difference, he doesn't recommend me continuing with the treatment, and that it'll really only be useful to me if I have a bed partner and I snore (I don't snore).

I figured I should give it a bit more time to confirm that the treatment hasn't helped me (I had changed masks just before I had my follow-up so I wanted to make sure that didn't affect my results) and now it's a month later and my sleep quality is basically the same, i. e. I wake up a lot at night and it takes me a long time before I start to feel awake the next day. I don't think the mask has been an issue -- I'm pretty used to it now -- so I'm leaning more now towards thinking the doctor was right and that my apnea's too mild to respond to treatment. Also, I gotta say, wearing the mask every night hasn't been great for the acne I get around my nose so it would be nice if I didn't have to keep using it, purely on a vanity level.

What do you guys think? I know I've read here several times that it can take months to notice a difference in sleep quality because your brain needs to get used to an apnea-free sleep, but so far my experience has been what it is and my doctor was very definite in advising me that it wouldn't do anything. Should I discontinue CPAP?

Thanks in advance.

[Pugsy]

So exactly what sleep quality problems were you having that led you to a sleep study in the first place that haven't improved with cpap use?
Have you used available software to see if anything stands out that might explain not feeling improvements?
Just how "mild" was your OSA AHI numbers from your sleep study?
What were the oxygen numbers like?
Do you take any medications of any kind for any reason, if so, what?

[orion260]

Thanks for the reply. I don't know the numbers on any of those unfortunately. They didn't give me any numbers after my two sleep studies -- should I request them? I haven't used any software either as I don't really know how to.

In terms of my sleep quality problems... the reason my GP sent me to the first sleep study was actually due to a whole bunch of seemingly unrelated issues with my digestion and my heart. I'd already seen a lot of specialists for those so my doctor decided to try something new and see if they had any relation to my sleep quality. I told him that I haven't really had a refreshing sleep since I was like, 10 or something, and that sealed the deal. So yes, my issues would be long-lasting drowsiness in the mornings through much of the afternoon (I only really wake up properly in the evenings), difficulty falling asleep at night (it takes me a long time to fall asleep even when I practice good sleep hygiene before going to bed), and frequent waking up in the middle of the night (I probably wake up on average 3 times in the night).

I don't take any medications, no.

[Jlfinkels]

I was in the same boat as you. Digestive and heart issues that they found no real cause. Needed a nap every afternoon, couldn’t fall asleep, etc. I did a sleep study, but they did tell me the numbers when I asked for them. My events were between 10-15 an hour (mostly hypopneas) which the ENT called mild apnea.

After 6 weeks on the machine and a few adjustments to the settings like adding a heated hose, changing pressure from 4-20 to 8-18, upping EPR from 2 to 3, and turning off ramp, my events are down to about 1 an hour and I sleep well. Still takes me 5 minutes to an hour to fall asleep, but once asleep I only wake briefly during a “mouth or mask fart” (air escaping), then fall right back to sleep. Thanks go to Pugsy and others on this forum for their help. I would never be where I am in my CPAP journey without their support. I no longer need a nap and have enough energy to exercise again. Almost no remaining digestive or heart issues either.

The biggest challenge for me was finding a mask that worked. I went through 5 masks before settling and am working towards making some minor corrections to make it even a better experience. It takes time to manage the nuances of CPAP and get adjusted to a new way of sleeping.

Hang in there, it does get better. If you are not doing it yet download OSCAR and use it to report on the detailed data loaded onto the SD card in your machine (assuming it has one and is not encrypted). Don’t obsess over the numbers as it is all about sleep quality. The data will lead you to what works for you.

[orion260]

Oh, that's really interesting Jlfinkels! Sounds like we had much the same symptoms going into CPAP. I'll ask my doctor about my numbers then and download OSCAR. I want to give this thing a bit more of a try before I give up on it. Honestly, the most annoying thing about it at this point is the pimples I've been getting in my nose area. I didn't have this problem when I was using a pillows mask but didn't find the pillows stayed in so I switched to the mask that goes fully around your nose (a Wisp). I wonder if I should try those masks that are pillowless but go beneath your nose. I like to really bury the side of my face into the bed pillow at night when I sleep though so I worry a mask like that won't be stable enough. We'll see I guess.

May I ask why you switched to a heated hose? The company I bought my CPAP equipment from gave me one but I figured it was only necessary in cold weather. Are there other advantages to it?

[Deborah K.]

The advantage of a heated hose to me is that the air blowing up my nose is warmer, which feels better to me.

[readingteacher]

The hose is heated primarily to keep condensation from forming in the hose and the mask. It prevents "rainout" moisture in your mask, and prevents mustiness in the hose. The cooler your sleeping room is, the more important it is.

[Jlfinkels]

Oh, that's really interesting Jlfinkels! Sounds like we had much the same symptoms going into CPAP. I'll ask my doctor about my numbers then and download OSCAR. I want to give this thing a bit more of a try before I give up on it. Honestly, the most annoying thing about it at this point is the pimples I've been getting in my nose area. I didn't have this problem when I was using a pillows mask but didn't find the pillows stayed in so I switched to the mask that goes fully around your nose (a Wisp). I wonder if I should try those masks that are pillowless but go beneath your nose. I like to really bury the side of my face into the bed pillow at night when I sleep though so I worry a mask like that won't be stable enough. We'll see I guess.

May I ask why you switched to a heated hose? The company I bought my CPAP equipment from gave me one but I figured it was only necessary in cold weather. Are there other advantages to it?

Honestly I switched to the heated hose as I had rainout with the unheated slimline with higher humidity settings and a few knowledgeable folks recommended the heated one. I find the heated humid air is very comfortable.

I’m still doing battle with masks. I started with the P10 nasal pillows but because I was mouth breathing slept like crap as the air kept escaping through my mouth while asleep. I switched to an F30i and liked it once I figured out how to get it properly fit on my face, but ended up shaving my beard to get a good seal. For now I’m sticking with the F30i and growing my beard back to see if the leaks were just my bad newbie fitting the mask or caused by the beard. I hope to use the nasal pillows for better comfort as I work on training myself to nose breathe while asleep, but to me as my AHI is under control with pillows or FFM I can focus on sleep quality. I’m not too concerned about the leaks as I sleep through most of them, but I do get an occasional elbow for waking up the boss.

BTW, the F30i is a mix of a full face and nose cushion. The cushion is similar to the N30/N30i, but put on top of a half-face mask that covers your mouth from the bottom lip to bottom of your nose where the nose cushion is built into the silicon. Something to consider.