Newbie from Malaysia

[flattyre]

Greetings from Malaysia!

I came across this forum in my research on Sleep Apnea after being diagnosed with it late Jan. It's wonderful knowing of such a forum to share experiences and for newbies like me to seek assistance. Thanks guys! (& gals )

Just to share, i just received by APAP 2 nights ago and have been diligently trying to use it every night. Have to admit, not much success yet. It seems every time i start to doze off, i feel that i can't breathe and can't fall asleep. In the end, i resort to taking the mask off. I'll get up like in 3-4 hours time and put the mask on again, and its fine. Can't understand why. Any pointers? I have the Intellipap Auto, and it is on delay for 30 minutes, but the period might have ended before i doze off. Perhaps i should lengthen the ramp up period?

[dtsm]

Salam dan selamat datang di forum

When I first started, could not fall asleep the first few nights with the mask on. What is recommended is to keep the mask on for up to 30+ minutes each night. I did that but no good. So I would fall asleep without the mask, and then about hour later get up, put mask up and go back to sleep. I did this for about 7-10 days, eventually got 'used' to the mask.

If you can get 4-5 hours each night in the beginning, that's a good start, especially since REM cycle is usually early morning hours. Don't worry, don't give up, some folks [like us] require more time to get used to the feeling of the mask, the noise of the machine and mask, etc. etc.


PS - what pressure are you on? You might not need ramp up....

[robysue]

flattyre,

Welcome to the forum. Your English, by the way, is excellent.

You write:

It seems every time i start to doze off, i feel that i can't breathe and can't fall asleep. In the end, i resort to taking the mask off. I'll get up like in 3-4 hours time and put the mask on again, and its fine. Can't understand why. Any pointers? I have the Intellipap Auto, and it is on delay for 30 minutes, but the period might have ended before i doze off. Perhaps i should lengthen the ramp up period?

The "delay" feature is often referred to here as a "ramp" It could be that if the ramp starts at 4 (which is pretty common) and your pressure setting is something like 10 (also pretty common) that the ramp's relatively low pressure is what is causing you to feel like you can't breathe just as you are dozing off. Do you use the ramp later on when you put the mask back on in 3-4 hours and everything is fine? If not, then that's more evidence that the ramp is the problem.

So---first thing to try is: Turn the delay feature off and see if starting at full pressure is any easier. If that doesn't work, see if you can increase the starting ramp pressure up to something much closer to your final setting.

Second---if you are using the ramp both at the beginning of the night AND 3--4 hours later when you can put the mask back on and every thing is fine, try to figure out what's different. Is it just that you are now really, super, super sleepy and no longer care? If so, then the you need to try to work on helping your mind start to associate CPAP and putting the mask on with going to sleep. It might not be easy. [It sure was NOT easy for me. You might want to search for my posts if you are interested.] But you do need to work on helping your mind make that connection.

Things that might help you:

• Try to get as much of the CPAP "stuff" done ahead of time---things like cleaning the mask, putting the machine back together, putting water in the humidifier, pre-fitting the mask if needed, and even washing your face if that tends to wake you up. You want to try to have nothing that needs to be done with the CPAP right at bedtime that will make you MORE alert if at all possible.
  
  Try to pay attention to your overall sleep hygiene. You are already doing one thing right: Getting up and doing something outside of the bedroom for several hours is a MUCH BETTER IDEA than lying in bed trying and failing to get to sleep with the hose on your nose. Lying in bed NOT sleeping is teaching your mind and body the wrong association. It's frustrating to get out of bed, but sometimes it's necessary. You can find other good sleep hygiene tips at http://www.sleepeducation.com/Hygiene.aspx
  
  Try to get up at the same time every day---regardless of how late you wind up going to be and how little you slept. This will help encourage your body to go to sleep with the mask on at your desired bedtime the next night.
  
  Try not to nap during the daytime.
  
  Let your sleep doctor's office know that you are having a really tough time falling asleep at the beginning of the night with the mask on. Ask if you can speak to a nurse, physician's assistant, or the doctor about this problem. The doctor may (or may not) suggest prescribing sleep medication. You will need to decide whether you want to take sleeping pills. Some people find they help. If you do decide to opt for sleeping pills and your doctor is ok with that, then also discuss how long you will be taking them and how you will be weaned off of them. You do not want to wind up with rebound insomnia in a few weeks or months and then find you're right back where you are now as far as learning how to sleep with the mask.

Best of luck,
robysue

[flattyre]

Hi dtsm, My guess is that you're also a Malaysian?

Thanks for the advise. I was thinking of doing such. Just putting it on as much as i can, so as to get my body used to the idea. Didn't think it would be an issue as i didn't have any problems during the sleep test in the hospital with the CPAP on. Somehow, at home it's different. Hopefully with time, will be able to use it through the nite. My wife is already saying that i might have wasted my money on this as i'm not using it fully. (Insurance doesn't cover the CPAP device in Malaysia )

BTW, my pressure for CPAP was diagnosed at 7. The APAP is able to do from 3 to 20. During delay, the screen shows it at 5-6. Almost at the prescribed level already.

[flattyre]

Hi robysue,

Thanks for the tips and the compliment. I sure do plan to go through your previous posts and others, but my guess it's going to be a while to cover the entire forum. Years worth of info for me to be digging in!

On the delay, like you mentioned, yes it starts at 4. But my prescribed level is 7. Not sure how much difference the few digits make.

On the later half, when i wake up in the wee mornings and put on the mask, the device has the auto-on feature, so i just put the mask on and it starts pumping. Have no idea whether the delay kicks in or not. Could be "i'm just too darn tired" !!. Will need to experiment more i guess as most people have been advising.

Will also try without the delay on and see how it works.

Will keep you posted. Thanks for the advise.

[dtsm]

Hi dtsm, My guess is that you're also a Malaysian?
BTW, my pressure for CPAP was diagnosed at 7. The APAP is able to do from 3 to 20. During delay, the screen shows it at 5-6. Almost at the prescribed level already.

Saya cina tetapi perjalanan ke Malaysia sangat sering

I would re-set the apap to 7-12 for now. One reason for your current difficult in falling asleep with the mask on is because at low pressure settings, eg 3,4,5, it feels very hard to breathe [yes, the few digits do make a difference in feeling!]. That might be the cause of your problem. Ramp time is optional - i used it when I first started but now my machine starts at regular pressure immediately [i'm on apap, 10.5 to 13].

Cpap equipment and supplies are ridiculously expensive in Asia. My colleague and his brother both recently started on cpap, and I was able to buy here stateside and ship to them. In the future, use on-line suppliers and have them ship supplies to you.

Keep at it....it's worth the effort!

[robysue]

On the later half, when i wake up in the wee mornings and put on the mask, the device has the auto-on feature, so i just put the mask on and it starts pumping. Have no idea whether the delay kicks in or not. Could be "i'm just too darn tired" !!. Will need to experiment more i guess as most people have been advising.

With the auto-on feature, it's most liklely NOT using the ramp/delay feature when you put the mask on in the middle of the night. 7cm is not that high of a setting---you might do just fine starting the night out without the ramp in the first place. Try that.

Good luck!

[Marietjie]

Flattyre/Dtsm - you guys had me very curious . . .

Salam dan selamat datang di forum

Greetings and welcome to the forum

Saya cina tetapi perjalanan ke Malaysia sangat sering

I am Chinese, but a trip to Malaysia very often
WELCOME, to the forum, flattyre

[dtsm]

Flattyre/Dtsm - you guys had me very curious . . .

Salam dan selamat datang di forum

Greetings and welcome to the forum

Saya cina tetapi perjalanan ke Malaysia sangat sering

I am Chinese, but a trip to Malaysia very often
WELCOME, to the forum, flattyre

Sorry about that, just a cultural thing. I posted once for a friend in Indonesia - to see if anyone there to help him out, and no one ever responded. Glad some one in Malaysia found this great community. One day he'll be able to help a fellow countryman.

[Marietjie]

One day he'll be able to help a fellow countryman.

Dtsm, well I hope he has better success than me regarding telling people about the dangers of
sleeping without a hose and mask! I visited my doctor the other day and mentioned to him that
I am on cpap therapy. Oh, he says - I also have sleep apnea but don't like that mask thing.
And a friend of his has severe sleep apnea - he also can't tolerate a mask. Both of them
never tried any other kind of mask.

[flattyre]

With the auto-on feature, it's most liklely NOT using the ramp/delay feature when you put the mask on in the middle of the night. 7cm is not that high of a setting---you might do just fine starting the night out without the ramp in the first place. Try that.

Good luck!

Hi robysue,

Tried that last night. But i think i found out what causes it. The mask! Tried adjusting, playing with it while watching tv, way before trying to sleep. Found out that if i adjusted it correctly, or to a position that was better suited, i would be breathing normally.

So guess what!!? I could sleep nicely last night with the mask on!! Hahaha. Am so happy Could breathe nicely with the mask on when i slept. Woohoo...

Next steps: Deepen understanding of all these numbers and how to get the data out of my smartlink module

Thanks for the tips and advise.

[flattyre]

Saya cina tetapi perjalanan ke Malaysia sangat sering

I am Chinese, but a trip to Malaysia very often

Hi dtsm & Marietjie,

Nice to meet fellow countrymen / women with experience in this. I suppose you guys would know that OSA is not well known here, to the extent that even the insurance doesn't cover it.

And yes, it's DOUBLE the price vs the States. Thank god, I had also purchased it on-line and had my mother who was on business trip to the states to carry it home. She had to leave behind some of her shoppings to accomodate my APAP & stuffs

Am also on the lookout for people with OSA in Malaysia, so at least we could have some support from each other. I couldn't find any in Malaysia, and luckily found this forum and you guys! Perhaps the next time you guys are back we could meet up and compare notes?

Thanks for the tips and advise. Have a good weekend!

[flattyre]

Update:
I increased the lower limit to 5.5 (from 4) and it makes wearing the nasal mask a breeze. Thanks for the advise of increasing it.

Based on the average pressure, i'm ranging from about 6 to 9, hence i suppose 4 was just not helping at all. Guess need to just tinker with the setting more to find an optimal pressure for me.

Perhaps should consider getting some nasal pillows instead. Its just the idea of stuffing it up my nose seems weird

[dtsm]

Based on the average pressure, i'm ranging from about 6 to 9..... Guess need to just tinker with the setting more to find an optimal pressure for me.

Once you learn how to use the software, check for leaks. That is one of the key/important factors in getting good therapy and insuring 'optimal' pressure. If you leak too much, pressure will increase to compensate and lots of fluctuations. No rush but once you get settled in, your 95th percentile pressure setting should remain fairly constant.

[DreamDiver]

Update:
I increased the lower limit to 5.5 (from 4) and it makes wearing the nasal mask a breeze. Thanks for the advise of increasing it.

Based on the average pressure, i'm ranging from about 6 to 9, hence i suppose 4 was just not helping at all. Guess need to just tinker with the setting more to find an optimal pressure for me.

Perhaps should consider getting some nasal pillows instead. Its just the idea of stuffing it up my nose seems weird

flattyre,

Welcome to the forum!
If you're using your smart-code to check out your numbers on the Devilbiss site, take a look at your 95th and 90th percentile pressure for the last 30 days. A good place to put your minimum pressure might be somewhere between the 90th and 95th percentile. Here's an example report:
https://www.cpap.com/SmartCode-Report-A ... s-Used.pdf

Here's a link about smart codes:
https://www.cpap.com/viewDefinition.php?PropertyID=93

You can generate a report of your own from the form on this page on cpap.com:
https://www.cpap.com/productpage/2696
Just type in the smart-code from your LCD readout on the top of the machine.

Also, check your "high leak flow time" for the last day. (We also call this "large leak rate" on the forum.) If your large leaks are more than a few percent, your mask may not be properly seated during certain parts of the night, allow pressure to escape, or you may be mouth-leaking. There are lots of tips on the forum on how to deal with large leaks and mouth leaks.

I absolutely agree with Robysue that if your pressure is as 7, you probably don't need any ramp.

I hope this will be helpful.
Welcome and good luck!