Sleep aides, masks fitment, and chasing a good night sleep

[crayonbone1]

Hi everyone and thank you in advance. I was diagnosed with copd and sleep apnea and congestive heart failure few years ago and didn't have insurance. Well fortunately now I do have insurance and had sleep study done. I'm using a dreamstation auto bi pap and the pressures are pretty high. I'm a mouth breather. My mask is a mirage Quatro. I don't know what the pressures mean but the ipap max is 25. evap min is 16. Ps min is 5. Ps max is 8. So the first area I need help with is mask fitment. The first couple nights were good. I slept most of the night with one or 2 potty breaks. Then I started having all kinds of issues with my mask leaking. I'd sleep a few hours and get woke up by the noise and sensation of it and this happened several times a night. Kept adjusting the straps tighter to the point that the one one the back of my neck made it hurt in the morning. It got to the point that when it would happen I'd just take it off and sleep without it.
Which brings me to my next question. After I got out of the hospital when I got diagnosed with all this is starting taking 2 Tylenol pm to sleep and eventually added 2 benadryl to the mix. This was well before my sleep study. Well the place I got my machine from said I should really quit taking them. I continued taking them until I could see my Dr. He prescribed 150 mg of trazodone. Well I just took the first dose last night and now I sit here this morning writing this having just experienced probably the worst nights sleep I've ever had. I think I got about 4 hours sleep. Machine said 3.7 therapy hours with mask fitment of 69%. Obviously mask fitment was an issue but the trazodone didn't help me sleep. But it did give me some pretty bad dreams, a pounding headache, and dry mouth far worse than I've ever had.

So that's pretty much it. I'm close to ready to Chuck the machine because I think I actually slept better with out it just taking the Tylenol and benadryl. And before someone asks, yes I was my face right before bed and my cushion gets cleaned daily. Also after the first month I went to the store I boughtc my machine from and talked to them. They said it was due to cushion being a month old. So I bought a new cushion and had 3 good night's. Any help anyone can offer will be greatly appreciated.

[LSAT]

If you are using the Quattro, the cushion should last a lot longer than a month. I have 2 that I alternate with and each one is close to a year old. Watch some of these videos....

https://video.search.yahoo.com/search/v ... k&fr=yfp-t

[Malinalli73]

LSAT is right, a month old cushion shouldn't make a difference, they usually last longer.
My guess is that they didn't measure you right and you're wearing the wrong mask size.

[raisedfist]

I would ask your doctor about sleep aids because sometimes ones that are respiratory depressants can cause issues in persons with lung/heart disease when they sleep. I think Ambien is safe to use in that regard. I did experience very intense dreams when I tried it out but no other real side effects.

In regards to mask fitting, I find keeping a clean shaven face, and wiping both my face and mask before bed helps a lot. I use the F&P Simplus sometimes and I adjust one strap at a time until the fit seems reasonable while laying down and the machine is on.

Since you have COPD you would have a hard time getting air out, which is why your EPAP pressure is rather high. I am wondering if you can try a nasal pillow mask. At therapeutic pressures some people don't actually need to breathe through their mouth when they sleep. I like the nasal pillows because leaks are usually much more manageable.

[avi123]

Which brings me to my next question. After I got out of the hospital when I got diagnosed with all this is starting taking 2 Tylenol pm to sleep and eventually added 2 benadryl to the mix. This was well before my sleep study. Well the place I got my machine from said I should really quit taking them. I continued taking them until I could see my Dr. He prescribed 150 mg of trazodone. Well I just took the first dose last night and now I sit here this morning writing this having just experienced probably the worst nights sleep I've ever had. I think I got about 4 hours sleep. Machine said 3.7 therapy hours with mask fitment of 69%. Obviously mask fitment was an issue but the trazodone didn't help me sleep. But it did give me some pretty bad dreams, a pounding headache, and dry mouth far worse than I've ever had.

The Trazodone is more against depression than for sleep. I would ask the Doc to let me try taking Zolpidem instead (omitting the Tylenols). Taking a 10 mg Zolpidem tablet before sleep should help you. You need to take it before 8 hours of wake up time.

See this info on it:

[palerider]

which is why your EPAP pressure is rather high.

wrong.

people with COPD do have trouble exhaling, so they need as much help as possible, rapid inhalation and extended exhalation period with lower epap to help avoid auto-peep.

unfortunately, the respironics doesn't offer customize ability to best address that problem.

[D.H.]

If a new medication is making things worse, call the prescribing doctor and discuss the possibility of discontinuing or switching to a different medication. Don't discontinue the medication on your own, though.

Also, you tried tightening the mask, which might be part of the problem. Most CPAP masks make their seal by inflating like a balloon. Making it too tight can defeat the seal. Try loosening and tightening the upper and lower straps to minimize leakage.

A big mistake among newbies and even long-term users is to make the straps too tight.

[Lucyhere]

I would ask the Doc to let me try taking Zolpidem instead (omitting the Tylenols).

Avi... you have mentioned Zolpidem many times. I'm glad it works for you, however, there are many doctors who disagree with taking Zolpidem every nite, especially for people over 65. Google Zolpidem in older adults. My sleep doctor as well as my GP suggest taking 50mg of Trazodone and/or 0.5mg of Alprazolam. They think that combination is safer (if it's necessary to take anything at all).

[Lucyhere]

Which brings me to my next question. After I got out of the hospital when I got diagnosed with all this is starting taking 2 Tylenol pm to sleep and eventually added 2 benadryl to the mix. This was well before my sleep study. Well the place I got my machine from said I should really quit taking them. I continued taking them until I could see my Dr. He prescribed 150 mg of trazodone. Well I just took the first dose last night and now I sit here this morning writing this having just experienced probably the worst nights sleep I've ever had.

I agree that taking Tylenol PM and Benadryl every nite isn't a good idea, for various reasons. However, if you abruptly stopped taking them last night, you might be having withdrawals, which could be why you had trouble sleeping. I'm surprised your doctor didn't mention that.

Also, 150mg of Trazodone is a high starting dose. In higher doses Trazodone is used for depression. I'm surprised your doctor suggested starting with such a high dose. Consider breaking the 150mg of Traz in half and see if that makes a difference. (First see if that med can be cut in half.) Of course, ask your doctor and see what he thinks before you do anything.

[avi123]

...

[Lucyhere]

My Medicare prescription insurance pays for 30 tablets of 10 mg Zolpidem (for a full month supply for 12 months) which tablets I split in half. So instead of 10 mg tablets I take 5 mg. I plan to get off taking Zolpidem, completely. At the moment I am not sure what causes me to be sleepy in the next morning till 11 A.M. May be you can tell. Here are my ResScan graphs from last night. :

Avi... I don't feel comfortable discussing what "I" think about your graphs. Some people do feel comfortable and I hope they will chime in.

It's good that you cut the 10mg Zolpidem in half. As to why doctors think it's not good for those 65 and older, I'm not entirely sure. You can Google. I seem to remember my doc saying that it causes people to feel groggy in the morning, which I think is what you mentioned. And, feeling groggy equates to possible falling/balance problems. I'm glad you are doing physical therapy (exercising). It does help with balance problems.

I, too, have Tinnitus, which I totally ignore. I have it only when I think about it, so I don't. On occasion it's very loud (at night) and I 'listen' to it. After about two minutes of doing that, I don't hear it and fall asleep.