rookie "early expereiences" -- Long!!

[osborsr1]

Folks – when I first joined this forum I promised to report back on my rookie experiences in adapting to the CPAP way …. apologies in advance for the length of this post …. I’ve been “on the hose” for all most three months now (rookie status??) and the experience has been quite interesting – well, to me at least, but probably will just draw a smile from the “pro’s” here …. one of the most important aspects of this forum is the sharing of information … in that spirit I add my $.02 worth ….

As background, here’s my situation – moderate OSA (AHI = 17.4) diagnosed in polysomnogram study with severe OSA in REM (60+) …. well, that was surprising to me as my only going in complaint to my PCP was (really bad) snoring and how that was impacting my wife’s sleeping (good thing we had a “flex room” for her to escape!!) …. honestly, I exhibited *none* of the other “classic” symptoms of OSA like headaches, daytime sleepiness, etc – none of those things other than snoring …. in the follow-on CPAP titration study the “optimum” CPAP pressure was determined to be 9 cm-H2O – not very high relative to some stories reviewed on this forum …. a trip to the local DME (a B&M outfit that I have been quite satisfied and have received excellent service) …. I was prescribed a Resmed M-Series Pro CFLEX (with SmartCard) model with humidifier …. the therapist recommended the Mirage Swift mask …. during the titration study, it was determined that I suffered from mouth leaks on CPAP, so a rather cheesy chin strap was also provided ….

OK, so off to home I went with all of my new “toys” …. OK, the only thing I can say good about the first two weeks is that they are over …. what a truly terrible experience learning to adjust to the equipment and the new, unusual noises …. I slept just awful …. in fact, when I reported back to the DME (every two weeks for a read-out of the card) the first time, they asked me if I was feeling better …. short answer – No!! …. the first two weeks did afford me the opportunity to experience what real sleep deprivation felt like and perhaps a small peek at what the real “OSA sufferers” have felt before getting treatment …. brain was foggy …. tired and sleepy a lot during the day …. as I said, my only outward symptom going in was bad snoring, none of the other things – now I was experiencing those “other things” … so was the cure worse than the disease?? ….

I must say, however, that I had little problem acclimating to the Swift mask …. for whatever reason, I adapted to it quickly and we’ve been friends ever since ….

I determined that much of my problem stemmed from mouth leaks and I had to fix that before I had any hope of getting CPAP therapy to work …. on the first visit back to the DME, I requested another chin strap and they came up with one similar to a Topaz model …. over the second two week period I spent each night fiddling with tension adjustments, etc …. my experience improved marginally, but my number of “bad nights” slowly gave way to more “better nights” …. of interest to note, my AHI went to 5-6 during the first two week period …. during the second two weeks (and subsequently), it dropped to 1-2 – mostly during the last week when I finally got all of the equipment working as a “system” …. during the third two week period I steadily improved the number of “good” over “bad” nights …. also, because of the detected “mouth leaks” I was prescribed a full-face mask (got a ComfortFull model) to try to see how that would work …. I never really got the f/f mask to work and I eventually fell back to exclusive use of the Swift – my new best friend ….

all during those first six weeks, I remained compliant getting six hours/night on the machine …. granted not all of those were spent in restful sleep, but I had the equipment on anyway …. as time wore on up to now, I became ever more comfortable with the therapy and my AHI remains at 1-2 with VS essentially zero …. now the Mrs and I are “happily together” again …. she still uses ear plugs for the exhaust noise from the Swift, but I don’t drive her out of the bedroom with raucous snoring any more – Victory!! …. I can now put on the mask and chin strap, hose-up and fall asleep within a few minutes …. I don’t bother with the pressure ramp feature any more as I adjust to the full pressure in about 15 secs …. I found the CFLEX function useful during the early days, but not necessary now …. now I feel like I did before starting therapy, but I bet I really am better off and just don’t know it (given the latest news on sleep deprivation and health) ….

lastly, I paid a visit to an ENT specialist …. after a reasonable examination, the doc suggested that I am an excellent candidate for UPPP surgery …. the doc was not that impressed with my original AHI and said that the UPPP procedure would fix the snoring (85% +/-) and the OSA (40-50%) …. he did say that since I didn’t have any other symptoms than snoring originally, the OSA was not a significant health issue …. my call on the surgery …. I hear the recovery is quite painful …. so, I have another option to ponder ….

for the casual reader of this forum’s posts, or for any newbie, I learned that one must exercise a lot of patience in adjusting to this therapy …. there are so many variables and everyone is unique in how they respond/adjust to the therapy and equipment …. getting comfortable with the mask is probably the biggest hurdle and certainly most personal …. it takes trial and error to get all of the pieces of the therapy to work as a system and provide the kind of rest needed …. I feel that my case is a rather mild one and it still took my two months to get really comfortable with it all …. I sleep almost “normally” now except for some of those minor annoyances – exhaust noise when air blows on close-up sheets, excess moisture when humidifier is set too high, etc – but nothing that I cannot cope with ….

hope this helps somebody else in adjusting to a new way living ….

cheers,

-Scott

[wirenut90]

Thanks for the update. I just started this torture on 3/8/07 and with the encouragement of this group am hanging in there. I am getting 2 to 3 hours of sleep at a time or I sleep through the night and wake up with the mask off and don't know how it ended up on the floor, but if I still have a hour to sleep I put it back on and KEEP TRYING. My wife says I am not snoring or gasping for breath in the past week so I guess it is helping plus I feel like I have a little more energy during the day so I am going to keep at it. Thank goodness for this forum as I know I am not the only Space Cowboy out there. Thanks again for the update. Don

[wirenut90]

I forgot to add Thank you Linda . I turned off the ramp and just started out full bore, balls to the wall at 12 and it seems to help.I am going to talk to my doc on Monday about a nasal mask and I'll let you know what happens. Thanks again, Don

[Snoredog]

lastly, I paid a visit to an ENT specialist …. after a reasonable examination, the doc suggested that I am an excellent candidate for UPPP surgery …. the doc was not that impressed with my original AHI and said that the UPPP procedure would fix the snoring (85% +/-) and the OSA (40-50%) …. he did say that since I didn’t have any other symptoms than snoring originally, the OSA was not a significant health issue …. my call on the surgery …. I hear the recovery is quite painful …. so, I have another option to ponder ….

What makes you an excellent candidate for a UPPP? because your insurance pays alot?

Because a UPPP hasn't been shown to cure anything much less OSA. What he forgot to tell you is OSA is caused by a large tongue falling into the back of the throat blocking the airway, making a BIGGER hole for the tongue to land into doesn't cure anything. Maybe if they remove your Uvula and carve off half your palate you will snore less, but you will also regurgitate food up in your nasal cavity, that is what the Uvula is for, to prevent that.

then from his estimate, the success rate is closer to 40% than it is 50%. Even then you have to analyze what they mean by "success". If it only reduces your AHI=60 by one half, that still leaves you a AHI=30 or in the SEVERE range, but that is still what they (the ENT) consider "success", all it has to do is reduce your AHI by 1 point and the ENT will consider the surgery a success.

Your so called ENT sounds to me like a money hungry quack, best thing you can do is find another one for a 2nd opinion. Ever notice that ENT's (even those incognito never come to sites like this to dispute the above?) that is because they know it is true.