Still Trying to be compliant after 3 yrs Is APAP an option?

[Ms. L]

Ms. L,

I'm glad to hear your husband is getting less aerophagia on the BiPAP. That's also been true for me. I'm running my PR S1 BiPAP Auto in straight BiPAP mode though with fixed IPAP=8 and EPAP=6 though and have set the ramp to 30 minutes with starting pressures of IPAP=7 and EPA=5.

One thing you might have your husband experiment with if he's still having occasional trouble with the aerophagia is Bi-Flex versus the Rise Time setting. (I think both options are still there in Bi-Auto mode, which is what it sounds like your husband is using.) I found that I was much more comfortable with Bi-Flex turned OFF and with Rise Time set to 3. My problem was that I could feel the slight increase in pressure back up to full EPAP during the second part of my exhale on every single breath and it really tickled the back of my throat in a most uncomfortable way. And that sometimes lead to my unintentionally swallowing air.

So check to see whether your husband needs the Bi-Flex turned on. Since his EPAP is already down at 6, he may not need any additional pressure relief at the start of his exhale and turning Bi-Flex off might help the residual aerophagia issues.

I'd report the morning headaches and their association with the days where the IPAP is over 10 to the sleep doctor's office if I were you. Sounds like a strange correlation. And it might be worth limiting the top IPAP for a trial period to see (1) if the morning headaches disappear and (2) there's no increase in AHI overall.

Thanks RobySue

I will let him know. For right now, you were right, he is in Auto mode. The doctor wanted him to auto-titrate for a bit, then send the info in. So we won't be changing anything on the machine just yet. We (I mean "he") has an appointment next month, so we will see how it goes.

[Ms. L]

4) Have you ever slept with the CPAP on enough nights over a long enough time to start to feel a difference in how you feel and function during the daytime? I don't expereince day time sleepiness.

[/quote]

I'll rephrase the question based on my own (negative) experience then. When you've used CPAP for a week straight, do you find yourself suddenly having problems functioning in the daytime? In other words, is it HARDER to function in the daytime when you are using CPAP than when you are NOT using CPAP?

I know that sounds counter-intuitive. But in the earliest and darkest days of my CPAP treatment, my daytime functioning plummeted. I had virtually no daytime OSA symptoms pre-CPAP, but developed a whole slew of them in the first two weeks of therapy. It is part of what led to the first set of official changes in my prescribed treatment. I did post about it here back in early October.

Robysue,
This sounds exactly like my husband's case. No daytime OSA problems pre-cpap, but definitely after starting cpap. Just like the OP, he wouldn't use it for month's at a time. After he started trying to use it, I had to call the doctor and leave a message with the nurse that he was ready to throw it out the window. Definitely with all the aerophagia, and other issues, something clearly wasn't right. So with all of this, this started changing my husband's prescribed treatment as well. It's interesting to see that there seem to be a lot of common issues here.

I don't know if the doctor was going to prescribe an auto bipap or a non auto bipap, but the second he mentioned the word bipap, I asked if it would be an auto. And that's what we got. Thanks to a lot of great advice here on the site, I knew to speak up about that.

I will say that I can sympathize with those who have Apria. When we initially went to get the cpap machine, we were going with Apria and didn't know any better. They were going to give us a basic machine that didn't record any info which isn't what the doc wanted. That whole first appointmnet was a big mess. Thankfully, the doctor's office, had another provider in mind and got the machine that they wanted us to have.

Not that we stayed for the rest of the appointment with Apria, but it did appear they had several different masks set up (and open)for people to try on. I can't believe that some couldn't be tried on. That is just ridiculous. Yes, yes I can. Especially after searching posts for Apria.

[Bert_Mathews]

It seems that with my lack of complaince has come many health issues besides the obvious "Sleep Apnea". - - - - My 2 yr old granddaughter spent the night and woke up in the middle of the night cause she was scared of the bear! - - - - - Thanks Debbie

Warning! - - WARNING!! - - W A R N I N G !!!

DO NOT Take your Granddaughter ANYWHERE while -YOU- are driving!

Sleep Deprivation and Reaction Time Comparisons, they performed worse and were more vulnerable than those who had a blood alcohol level of .05, considered by many to be alcohol impaired. http://sleep.lovetoknow.com/Sleep_Depri ... ction_Time

It's Your Health and like others have stated ONLY YOU can make it work. . . "There is NO MAGIC PILLS"
It also EFFECTS Others around you and you Love!
Bert

[atruvirgo]

Sooooooooooo I am on day 8 Woohoo! Aerophaigia is a little less and so is the ear pain. I am only getting 4-5 hours per night on the machine. THis seems to be the time during the night that I awaken enough to feel like I can't keep it on any longer. I am wondering if anyone can help me understand why it is always around 4-5 hours. I am also experiencing alot of eye inflammation and headaches all day. I noticed by neck hurts where my strap lies but it is not tight. In an effort to do this I will keep seeking your expertise here on the TALK!!!

Thanks to all of you
Debbie

[cflame1]

First guess with the eye inflamation... is that your mask is leaking into your eyes.

[atruvirgo]

First guess with the eye inflamation... is that your mask is leaking into your eyes.

I think I actually have concluded that it is the exhaust that is getting in my eyes. Just not sure how to prevent it. I feel so dry in my nose and eyes in the morning.

[cflame1]

just a guess... either try a different mask... or

https://www.cpap.com/productpage/eyeeco ... -mask.html

[Bill B]

As silly as it may sound, I cut the end off an old sock and sleeved the exhaust port. That diffused the air enough to not blow in my face and eyes

[robysue]

Sooooooooooo I am on day 8 Woohoo! Aerophaigia is a little less and so is the ear pain. I am only getting 4-5 hours per night on the machine. THis seems to be the time during the night that I awaken enough to feel like I can't keep it on any longer. I am wondering if anyone can help me understand why it is always around 4-5 hours.

First, congrats on getting UP to 4--5 hours per night on the machine. Remember---the longest journeys start with a single step, and you've got the first several steps taken.

As to why you are hitting a plateau at 4--5 hours and feeling like you have to take the mask off at that time every night, it might help to write down what happened (to the best of your memory) each MORNING after you wake up while things are still relatively fresh in your memory---write it down in the MORNING so that keeping track of this information doesn't interfere any more than necessary with your sleep. Don't worry much about the writing the time you took the mask off; the important thing to write down is anything specific you can remember about how you felt at the time you took the mask off---if you were consciously awake when you did it. Just a short note: "Took mask off because I felt like I couldn't breathe" or "Took mask off because my neck was in severe pain because of back strap" is plenty of detail. The purpose of tracking this for several days (or a week or so) is to start to look for patterns. If there are one or two reasons that crop up a lot on your list, then that's where you can start attacking the problem. If no one or two specific reasons start to emerge, it may be that you simply need more time wih the machine.

In the meantime, don't beat yourself up for taking the mask off at night. The important thing is that you ARE putting it on and you ARE wearing for 4--5 hours each night. Keep up the good work and build on it.

I am also experiencing alot of eye inflammation and headaches all day. I noticed by neck hurts where my strap lies but it is not tight. In an effort to do this I will keep seeking your expertise here on the TALK!!!

Others have given you ideas on how to try to eliminate the exhaust flow from the mask blowing in the eyes. If you eliminate that as a possibility and you still feel that air is getting into your eyes, report the problem to your sleep doctor. Though it doesn't seem to be a common problem (or at least that's what the sleep doctors seem to say), air can get into the eyes via the tear ducts---if you are particularly sensitive to the pressure and your pressure is higher than it needs to be.

The headaches could easily be stress related---worried about eye inflammation and the neck pain? And simply dealing with the eye inflammation and the neck pain all day? Easily could trigger some nasty tension headaches.

The neck pain could be caused by sleeping with your head in a funny position in an (unconscious) attempt to minimize leaks and minimize the exhaust flow bouncing off the bedcovers and back into your eyes---particularly if you are an "active" sleeper when you don't use the mask. And the pain could be where the straps lie across the neck just because that happens to be where the stress of the funny position is being felt. Do you think you've had to adjust your sleeping position?