Expectations and my story

[Buddhist Sage]

How should I expect to feel with CPAP therapy?

I've been on CPAP therapy for a year and a half. And the vast majority of that year and a half I've felt confused and mediocre. I just woke up about 3 weeks ago, and realized that I needed to pay more attention to what was going on. I'm tired of walking around and having a hard time putting words together, or feeling stressed out because I didn't sleep well. I'm done with this quality of life. I feel mediocre on most days of the week. I might feel great once a month if I'm lucky.

So, I decided to take this energy and turn it into something positive: I have mild sleep apnea, and this has been confirmed by two different sleep centers. Both centers concluded that it takes a pressure of 9 to eliminate all obstructions when I'm laying on my back.

I was placed on the resmed S9 with a nasal mask. I'll spare you any stories about my adjustment with CPAP. Point is, it helps me fall asleep, and stay asleep BUT I still have cognitive deficits! So, I began to look at my story differently to find out what is going wrong.

Like I said, in the beginning, I was placed on CPAP with pressure at 9, with a nasal mask. Right into therapy I noticed that I would wake up with mouth leaks, because my jaw would drop. I was given a chin strap to remedy the situation. I didn't last long on the chin strap since it was causing wrinkles on my face. So I asked for a full face mask, and I settled for the Mirage Quattro. And then I forgot about the situation for almost a year now.

Unfortunately as I'm realizing now, this did not solve the jaw problem! Once my facial muscles relax my jaw drops! And this had me thinking: I never breath through my mouth. It's to uncomfortable. Even when I'm congested I breath through my nose, I just add more pressure. When I wake up and my mouth is open with the full face mask, there is NO pressure going through my mouth to my throat! THIS IS GETTING IN THE WAY OF THERAPY!

I just got off the phone with the DME, and they're sending me an ESON nasal mask with a chin strap. I remember my nasal mask days where I could actually feel that the pressure was keeping my throat open. I really hope this solves the problem. If not I'm seriously going to consider other means to solve this. I'm not going to live my life with these cognitive deficits. I want to go to medical school, and I need my brain to work in top top shape!

Point is I want to get to the point where this thing doesn’t steepen my learning curve and cause cognitive problems. I sincerely want to experience the promised land, and I will do anything that is practical and reasonable to get there!















Like I said earlier,

[Julie]

Your local pharmacy should have an inexpensive soft cervical collar (a lot smaller and lighter than what you'd use for whiplash) and it's helped a lot of people with your problem... could be worth a try.

[zoocrewphoto]

Which S9 do you have? If you have data, you can find out if your therapy is actually working or not.

Also, if you are wearing a full face mask, as long as both your nose and mouth are contained in the mask, it doesn't matter if your mouth is open or closed. The pressure will be fine (assuming the pressure is correct for you).

Hopefully, you will have a machine with full data. Last year, I let my mom use my S9 autoset for two partial nights. Her older machine was a brick, and she never had much improvement despite using her machine every night. The first partial night, I set my machine to straight 10, her prescription. Her ahi was 3.4 which sounded good. But when I looked at the graph, I saw a cluster of events - 8 apneas of 30 seconds or longer in only 10 minutes. And one of them was 62 seconds long. That is much worse than a higher ahi of shorter events spread out over a night.

She went to my sleep doctor, got a new auto machine with a range of pressures and full data. And she feels much better. It seems like most doctors don't really check data even if it is available. So, odds are, nobody has actually confirmed that your setting of 9 is working for you. Sometimes, the data from the sleep study isn't representative of real sleep at home.

If you don't have a machine with full data, I would suggest asking your doctor for a recording oximeter to wear overnight, or even better, a rental of a full data machine.

[Sheriff Buford]

I agree with Zoocrew... you can open your mouth with a full face mask and not lose therapy. What are your numbers... especially your leak rates? I'm more incline to let my body do what it wants... in your case... open your mouth at night... if you can tolerate a full face mask. Early on, I would kill for the opportunity to wear a nasal-pillow mask because it's less intrusive and I have a deviated septum. But... (always a but ) after getting used to my mask, I don't worry about the nasal-pillow mask and have accepted my therapy and mask for what it is. In fact, next to my service revolver, my mask has become my "best friend". Tell that to my wife... .
What I'm saying is that if you are happy with the full face mask and it is comfortable, it allows you to open your mouth and not lose therapy. I wouldn't worry about it and concentrate more on my numbers. I would make sure the leak rates are low and maybe tweaking the pressure a little to see how my therapy responds to the changes. I would also experiment with seeing if straight cpap therapy would work better than autopap therapy.

Best wishes, Sheriff

[Buddhist Sage]

I have both the S9 Elite and the S9 AutoSet. I took a look at the data last night and came to the conclusion that my autopap therapy isn't good for me. My pressure keeps climbing up to 14 and around that pressure I have numerous CA's, anywhere from 4-7. So autopap complicates things for me. But on a lower pressure I'll have significantly less or no CA's, but 4-5 OA's.

Personnally I disagree with the comments about the fullfacemask. When I started off with a nasal mask I could really feel that the pressure fully occupied my throat. I really felt that my throat cavity was being kept open. But when I switched over to the FF mask, this sensation went away, and my numbers went up. On the nasal mask my AHI on most nights was .3-.4 or even lower. On the FF mask with a chin strap my numbers are.7AHI or .8AHI with CA's kept to a minimun (2.AHI)

Also I wake up sometimes when my jaw drops, and I get to feel what it's like. It feels like my mouth is a dead end for pressure. I dont feel the pressure reaching my throat! I have a small jaw and it makes things crowded. As my sleep doc said "You have a small jaw and a crowded throat".
After work I'll upload a photo for all to see.

Thank you!

[zoocrewphoto]

I have both the S9 Elite and the S9 AutoSet. I took a look at the data last night and came to the conclusion that my autopap therapy isn't good for me. My pressure keeps climbing up to 14 and around that pressure I have numerous CA's, anywhere from 4-7. So autopap complicates things for me. But on a lower pressure I'll have significantly less or no CA's, but 4-5 OA's.

Personnally I disagree with the comments about the fullfacemask. When I started off with a nasal mask I could really feel that the pressure fully occupied my throat. I really felt that my throat cavity was being kept open. But when I switched over to the FF mask, this sensation went away, and my numbers went up. On the nasal mask my AHI on most nights was .3-.4 or even lower. On the FF mask with a chin strap my numbers are.7AHI or .8AHI with CA's kept to a minimun (2.AHI)

Also I wake up sometimes when my jaw drops, and I get to feel what it's like. It feels like my mouth is a dead end for pressure. I dont feel the pressure reaching my throat! I have a small jaw and it makes things crowded. As my sleep doc said "You have a small jaw and a crowded throat".
After work I'll upload a photo for all to see.

Thank you!

Please post some of the graphs. It is hard to tell if you are talking about an ahi of 4-7 to or 4-7 events all night.

Also, you aren't supposed to feel a ton of pressure in your throat. It should feel natural. I use a full face mask with my mouth open all night, and I sometimes have to check that it is on because I don't feel it. We aren't supposed to feel like air is being forced down our throats. We are simply supposed to be able to breathe naturally without our airway closing. I think your expectations are leading you to believe it isn't working when it is.

[Buddhist Sage]

Sure, I'll post some graphs tonight. But to clear up what I said, I had really low AHI with a nasal mask. Normally around 0.3AHI and under. And with a FFMask it's usually around 0.7AHI.

And for the section on Central Apneas, I meant 4-7 events per night.

But I'll post some screen shots. Thank you all for you help and support. I really appreciate it!

[zoocrewphoto]

Sure, I'll post some graphs tonight. But to clear up what I said, I had really low AHI with a nasal mask. Normally around 0.3AHI and under. And with a FFMask it's usually around 0.7AHI.

And for the section on Central Apneas, I meant 4-7 events per night.

But I'll post some screen shots. Thank you all for you help and support. I really appreciate it!

Your numbers are awesome. Why are you worried about them? Our goal is less than 5 per hour. You are doing way better than that.

Unless you are having trouble sleeping or feel bad, don't worry about. Most people would love to have your numbers.

[Buddhist Sage]

Thank you, I just freak out cause I feel confused, and I have a hard time putting words together sometimes. It drives me nuts!
How can I post a photo here of my RESCAN reading of last night?

[BlackSpinner]

Thank you, I just freak out cause I feel confused, and I have a hard time putting words together sometimes. It drives me nuts!
How can I post a photo here of my RESCAN reading of last night?

You have to upload it to a photo site like flickr or photobucket or your personal website and then link to that.

[Goofproof]

This is best day in my college life that I want to share my previous days life this is about last year when in our college hockey match is held and different colleges students are take part and we are all very excited and have lots of practice when the match is going to start we are very excited but confused to see the opposite team because they are looking very sharp minded so in short time the match is start and we enter in play ground so when we play match we forget all confusions and we just enjoy and play it with our constrictions. So at the end of match when the prize is announced so we are shocked we get first award. I don’t forget that time. Anyway now we all friends going to celebrate the charismas day in los angles anyone like to join us.

I think we have a new spammer with link!

[Buddhist Sage]

I have great numbers but, I still feel stressed out and confused. Last night I had breakthrough though. I made sure I washed my mask well in hot distilled water with mild soap. I brushed the silicone with a tooth brush, risned it in cold tap water, and lastly rinsed it in hot distilled water. The mask was super clean!

I switched back to my AutoSet and put the settings at 13.2-14.6 cmH20 no EPR. Put on both my fullface mask and chin strap, and I was shocked what happened. My AHI dropped from 0.8AHI to 0.1AHI. But in reality it is 0.0AHI. The rescan software showed that I had 1 obstructed apnea at 12:30am, but I was wide wake so that's an error. Then absolutely no apneas for the rest of the night.

My obstructions were due to not having enough pressure, but auto therpay solved that. And my centrals were due to jaw dropping and leaks!

I'll keep this up and see if I get the same consistent results.

By the way, what is the acceptable leak range? My leak max was 2.6m/l. I don't want my autoset pumping out more pressure in response to leaks, even though it is awesome that the machine does that!
"Yes, under 5AHI, but I'm striving for that zero!"

[bwexler]

On your Resmed anything under 24 L is acceptable, your night was near perfect. About the only way to make it better would be to wake up with a pot of gold at the foot of your bed.

Be happy!

[chunkyfrog]

Or Hugh Jackman in the kitchen, making waffles.

[DoriC]

I think you're overthinking this, I know because that's what I've been doing for 5years as I try to make my husband's therapy "perfect"! All I've done is cause myself tremendous anxiety. It's only lately that I've "let go" and given myself some peace and try to enjoy my husband's improved quality of life. Please don't strive for 0 AHI, it rarely happens even to the pros and is just a number. Just strive for restful, undisturbed sleep with minimal leaks and AHI <5, and you'll begin to see the benefits. And don't go overboard on the cleaning, it's not necessary and some folks say they have less leaks without excessive cleaning. Be happy!