Help! With wife's apnea

[thx1138]

I figured out my wife has sleep apnea too. She doesn't believe in it. We were going to do an overnight sleep study, but it would have cost $2000 even with the insurance. So between resisting modern medical science, and resisting spending money, she's not exactly with the program. However, I did get her to do a home sleep study for $150. And this came back with an AHI of 40, and a diagnosis of severe sleep apnea.

So now I am trying to get her to conform to a CPAP. I gave her my AirSense 10 Autoset, and I went back to my old S9. Set the pressure to 5 - 10 and humidity to 5. I looked on SleepyHead and it seemed like the graph was hitting the top, so the second night we tried 6 - 12 and also max humidity of 8. The first night the AHI got down to 1.5 and the second to 0.26. But each night she only tolerated the treatment for like 3 hours then took it off. Looking at the graph for night 2 (is there an easy way to upload?), pressure would run up to about 12 then gradually slide down over the course of an hour, then repeat.

Her complaint is that after 3 hours she wakes up. Her mouth feels like its glued shut, her mouth or throat muscles feel tense, like her breathing is fighting against something. Its upsetting to me also: I know she has severe apnea (also from watching her sleep), that CPAP is the best treatment, but she doesn't believe in sleep apnea, and seems to be consciously and unconsciously just fighting or resisting reality. At the same time I don't know what else I can try except maybe a heated hose. My sleep doctor said half his patients love him and the other half hate the CPAP machine and the treatment. Any ideas folks?

[Pugsy]

What mask is she using?

Did you turn on EPR? If you did...at what setting? If you didn't...turn it on at maybe 2 and see if she likes the feel of it.

I don't know if she would change her mind about believing in the diagnosis if she watched this video...but maybe.
https://www.youtube.com/watch?v=-gie2dh ... e=youtu.be

How to post images of the reports you see using SleepyHead and format examples can be found here
viewtopic/t158560/How-to-post-images-for-review.html

[djams]

Her complaint is that after 3 hours she wakes up. Her mouth feels like its glued shut, her mouth or throat muscles feel tense, like her breathing is fighting against something.

Good for you, trying to help her. Sounds to me like you're getting her off on the right foot, just need to make therapy more comfortable.

Painful dry mouth. I'm familiar with this and it's awful. Xylimelts were suggested to me, and boy did they help. Not a normal dry mouth lozenge. These have a dissolvable glue on one side. Stick one on the gum line before going to bed. It dissolves slowly overnight. Some members find them in local drugstores. I have to get them online. Not overly pricey - for the relief I got, worth every penny.

Breathing against the pressure was difficult for me when I started too. Pugsy mentioned EPR, and that was the ticket for me. What a relief it was.

[zonker]

Her complaint is that after 3 hours she wakes up. Her mouth feels like its glued shut, her mouth or throat muscles feel tense, like her breathing is fighting against something.

Good for you, trying to help her. Sounds to me like you're getting her off on the right foot, just need to make therapy more comfortable.

Painful dry mouth. I'm familiar with this and it's awful. Xylimelts were suggested to me, and boy did they help. Not a normal dry mouth lozenge. These have a dissolvable glue on one side. Stick one on the gum line before going to bed. It dissolves slowly overnight. Some members find them in local drugstores. I have to get them online. Not overly pricey - for the relief I got, worth every penny.

Breathing against the pressure was difficult for me when I started too. Pugsy mentioned EPR, and that was the ticket for me. What a relief it was.

thanks for bringing up xylimelts. i keep forgetting to explain them in full. that glue on one side part is what i fail to mention.

will try to remember it for next time.

[thx1138]

Really appreciate the support. I will get her some Xylimelts. Wife's mask is DreamWear Nasal CPAP Mask with Headgear.

EPR was on, at 2. Guess I'll try it at 3 tonight. How is EPR different from BiPAP? I'm gonna try EPR 2 on my old S9 for me now too.

Here's her first graph... I think at the end she just took the mask off so the graph there is not useful... Does it look like I got the pressure right, or any other things you see in there I could fiddle with?

Sleepyhead B 1

Screen Shot 2019-04-14 at 10.48.44 AM.png (580.53 KiB) Viewed 814 times

[LSAT]

You could bump up max pressure...you can see the in a few cases the machine wanted to go higher, but couldn't. Also leaks. (could she be mouth breathing?)

[djams]

You could bump up max pressure...you can see the in a few cases the machine wanted to go higher, but couldn't. Also leaks. (could she be mouth breathing?)

With the extreme dry mouth I'd mouth breathing is a good bet.

I tape my mouth myself, but I know that isn't for everyone.

[djams]

Really appreciate the support. I will get her some Xylimelts. Wife's mask is DreamWear Nasal CPAP Mask with Headgear.

EPR was on, at 2. Guess I'll try it at 3 tonight. How is EPR different from BiPAP? I'm gonna try EPR 2 on my old S9 for me now too.

Here's her first graph... I think at the end she just took the mask off so the graph there is not useful... Does it look like I got the pressure right, or any other things you see in there I could fiddle with?

Screen Shot 2019-04-14 at 10.48.44 AM.png

Please see this to learn how to format the Sleepyhead charts for posting. You've broken *almost* every rule, but given your noble purpose, we'll let this one slide.

wiki/index.php/Sleepyhead:Organize

Had another thought, if you've got an oximeter, have your wife wear it for a few nights. Maybe you'll be able to show her some O2 desats during the time the mask is off.

[Okie bipap]

I agree that she needs a little more minimum pressure. Since there was only event, I would guess the pressure rise is being driven by flow restrictions. The dry mouth could be caused by mouth breathing. Even a couple of minutes of doing so can dry out the mouth. Being unable to use the machine for more than a couple hours a night when first starting is not that unusual. Encourage her to keep trying to keep it on longer. When I first learned my wife had sleep apnea, I special ordered a bright pink hose cover and strap pads for her. I decided I was going to do everything I could to make it easier for her to accept the fact that she needed to use that thing every night. She has now had it for almost two years and is doing quite well on it. Her AHI is always higher than mine, but she continues to have a few central apneas and I don't.

[bwexler]

I'll be watching this thread. I have finally started the conversation with my wife about her Sleep Apnea. She is in full denial and refuses to acknowledge her snoring, never much louder than a buzz saw.

[Okie bipap]

She is in full denial and refuses to acknowledge her snoring, never much louder than a buzz saw.

My wife was also in denial. I simply mentioned that she snored and would stop breathing during the night when we had our medical check up. Our PCP scheduled her for a sleep test, and her apnea is just as bad as mine. We ended up with identical machines which cuts down on the number of spare items we need to keep on hand.

[Julie]

Any particular reason you set her humidity to 5 considering where you live (vs Arizona)?

[thx1138]

Er, sorry about the screen shot, I'll aim to do it right next time.

So above is advice to bump both minimum, and maximum, pressure.
So I'll try going from 6 - 12 to 7 - 13.

Set humidity to 5 just cause, I dunno, dry mouth, try wetter air?

She's monitoring this thread, so appreciate the encouragement that she's not alone. Nor am I.

I wonder if a heated hose would help. It sounds like though she's going to mouth breathing. And the hose won't matter. So then all we could try is a full mask.

May or may not get another session in tonight. Then she's on a trip for a week and I'm pretty sure she's not bringing the machine.

I just feel like she doesn't know what she's missing, if she could only get situated with the CPAP.

I guess the only consolation is at least we're not spending a bunch on doctors.

[thx1138]

I made the adjustments recommended in this thread. My wife finally tried the CPAP for the last few nights. I have attached some recent and better screen shots. I would sure appreciate any analysis.

Went to a full mouth+nose mask. It seems to be helping. With only nasal pillow, she may have been switching to mouth breathing, drying out her mouth, and waking up. She says though she tried tightening the full mask, but it still seems loose and shifting around and thus waking her up. Though I don't see too many wakeups in the data.

[Jas_williams]

Based in the last graph more maximum pressure is needed 13 is not enough to clear all of the obstructive apnoea and the apap is at max pressure for a large amount of time