Am I doing myself a disservice? Any Guidance appreciated

[trike-mike]

Hmm.... there may be something to the facial relaxation as well. I really wish I had a data logging device so I could detect that.

Your other bit about the microarousal thing might be closer to it. Maybe as I get more used to this that will start to go away. This could be a good reason for my initial question to, at this point, to stick to ONE mask for a while to get deeper into this. Perhaps the multi-mask approach got me this far and something to go back to. Later.

[SleepyT]

Mike,
So sorry for your troubles at the beginning of your journey....but I can tell already that you will be one of the ones giving advice before long. You have flung yourself into this and you won't stop until you figure it out! You are well on your way! Congrats! As far as masks go...Carbonman could explain about 'de lure of de mask'... It's normal to want to try them all out! How else will you find your perfect one? And preferences change....I hated the nasal pillows at first...but now I love them. You just need time to test drive them....time to get used to CPAP...lots of changes at the start....but you will settle into it soon. Good luck!

[The Guest]

Sorry to hear about the trouble you are having. But your attitude is great and I am confident you will reach a point where you feel you are successful with PAP therapy. Don't know if this is very helpful but I think that the disservice you received was in the diagnosis of your sleep apnea. A home sleep study almost never records EEG, so there is no way to determine if you were awake or asleep. Sure you might have had 41 desats an hour but that would be reasonable when awake if you are moving around a lot, which it sounds like you probably were. But your AHI while asleep might not be so high. So your sleep apnea might not be as bad as you think. But you do have sleep apnea or using the machine would not help your headaches. Also, it is very difficult to get an accurate reading from your APAP in just three nights. My respironics rep suggests a 3-4 week trial. Then you can be prescribed a PAP device with a set, accurate pressure. If that is not an option then, as other members suggested, you probably would benefit from an AutoPAP device so that you receive optimal therapy. You should not be switching masks that often. Very likely your mask removal corresponds with the 4-5 REM cycles when sleep apnea is at its worse. Because your apnea gets worse your brain wants to compensate by taking the mask off to get as much oxygen as possible. In my experience it sounds to me as if your pressure is too low.

[trike-mike]

SleepyT and The Guest.... Thank you so much for your words of encouragement and thank you to all for the encouragement and advice. I have been suspicious of the "sleep study" I got as I was with the "calibration". Be that as it may, I am glad I posted as to whether I was doing a disservice to myself re: the masks but also what has, as I mentioned before, become the all important question: Getting the dang pressure right.

What I have done so far that I have immediate control over is to stick with just one mask for the time being. Somewhat the opposite to SleepyT, I loathed the first nasal mask and could only somewhat tolerate the full face mask but rather liked the nasal pillows when I tried them. I may have helped myself get to this point with the many switcheroos so I could get used to the hose but the only tolerable full face is now rather pleasant to me. The Mirage Quattro is proving to be the best all rounder since it will suit whether I am having sinus issues or not.

The other thing I did, and the reason I haven't reported anything back yet, is to send a message through the Kaiser message portal to my RCP. They ostensibly have 48 hours to respond to messages via that vehicle so I wanted to wait until I had something to report.

What I have to report is that I have no response with the 48 hours officially now expired. Time to escalate AND request an office visit at the same time. More and more, from the wonderful advice here, I am convinced that it isn't the mask that is giving me the problem given that I am now quite content with the Quattro when I disliked it at first. T.G., your thoughts on the removal tend to strike home in that, on some occasions, I am actually somewhat awake enough to consciously realize that I am yanking the mask off BECAUSE I am not feeling like I am getting enough oxygen. This is coupled with my previously cited observation that, when I had the APAP home and I was sitting up reading or something to get groggy enough to sleep quickly, I felt BEST when the pressure was 6cm H2O or higher. This was when I was AWAKE so, to my tiny mind, seems to me that if I DO have an apnea in the night, even HIGHER pressure would be needed.

One other thing with the whole mask thing. I am getting to like the rather rigid but still quite comfortable Quattro for a reason utterly unrelated to CPAP. You know those times when just a TINY change in head/neck angle would be the PERFECT change to an already OH so comfortable sleeping position but you can't because it stuffs your nose into the pillow? Well... NOW, I can DO it because the mask keeps my nose unencumbered and the narrow band of high mounted vents are essentially ALWAYS clear unless one is almost face down. Very cool.

[trike-mike]

Another update....

Friday the RCP finally called me back after RE-sending the email after the 48 hrs expired. He has told me to come in on Wednesday to get the pressure changed on my machine. The conversation went something like this:

"Hi, I was reading your email and it seems you are thinking your pressure is too low"

"Yes, I recall when I had the APAP home, while I was awake and would look at the display, I FELT most comfortable when the display said it was producing 6 cm H2O and above and the machine said my average, after two fairly good nights of sleeping to be 6.8. I am also yanking the mask off after about 2 hours all the time and, when conscious when I do it, I am aware of feeling like I am NOT getting enough oxygen"

"Ok, I don't have any open appointments but bring your machine in on Wednesday. We'll up it to 6 or 7."

"Ummmm.... Now that I am more used to CPAP, might it be beneficial to at least bring home the APAP again for a few nights to see what it might report?"

"I don't think so.... We'll just put it up to 6 or 7... probably 7."

"........ Ok...... We'll chat more on that when I get there"

"Ok... see you on wednesday. Bring your machine so I can change it."

Click.

Is anyone else who may be reading this having a "what the...." moment here? I like Kaiser for a lot of reasons but this and other elements sometimes make me seem less enthused. It is coming up time for annual health plan enrollment time. I do have the choice of Kaiser or (I think) Aetna.

Any thoughts on any of this?