CPAP not total answer

[Mark from UK]

have been diagnosed with a severe sleep disorder three years ago been, put on a CPAP machine. The machine while of great help has not been a total success, the problem is getting back to sleep after I awake at night 3 or 4 hours later,

Getting back to sleep with the machine on is hard and so I have been leaving it off. Also when it is warm the mask bothers me. I also get a red mark around my face where the mask goes which can be irritating but goes away with the help of creams

Has anyone experienced this

Also after pressing my GP for a proper investigation I have been diagnosed with large inferior turbinates and a congested nose the pharygngeal wall collapsing on nagative valsalvas. Now what does this mean

I have been trawling through the web trying to find answers and as far as I can find it says no where that the CPAP machine is recommended as treatment instead some sort of rebuilding/strengthening surgery is suggested.

Can you give me some advice

PLEASE

[NightHawkeye]

Welcome, Mark. Can you provide a little more information please. Usually, people are prescribed CPAP for Obstructive Sleep Apnea (OSA). Was that true in your case?

If you have OSA, then nasal surgery can help your OSA treatment, but won't cure the OSA. A few folks here have written of their experiences with nasal surgery. You could do a search to find those. One in particular which I remember was from Snork1.

What kind of machine do you have? One thing which helps many of us here is using a machine which collects overnight event data. That helps us understand how effective our therapy is and which adjustments to therapy are successful.

What kind of mask are you using?

Again, welcome, Mark.

Regards,
Bill

[Bearded_One]

The $50 words describe nasal problems. The turbinates and other nasal problems have nothing to do with sleep apnea. The sleep apnea obstructions happen in the throat, not in the nasal passages. If you have nasal obstructions, correcting them will probably help with being able to use CPAP.

I assume that "severe sleep disorder" means severe obstructive sleep apnea.

CPAP is the gold standard for treating sleep apnea, if you haven't been able to find that out, you are looking in the wrong places. google for cpap+gold+standard

Surgery is totally worthless for severe sleep apnea.

[Guest]

Such fast answer thank you

Originally I was diagnosed with sleep apenea after a sleep study, some professor who is one of the leading doctors in the field decided it was due to how I was built and the throat mussels being the main culprit

However I never had any x rays done or anything like that

I was unhappy with the diagnoses as my sleep problem started with a nose problem and after years of winging at my Doctor he sent me to a specialist who used a camera and came up with

a large inferior turbinates and a congested nose the pharygngeal wall collapsing on nagative valsalvas.

I have a full face mask

[Mark_from_UK]

Sorry did not add name above post

I have registered now!

[NightHawkeye]

... my sleep problem started with a nose problem and after years of winging at my Doctor he sent me to a specialist ...

Sounds reasonable. Nasal problems aggravate OSA. You could have had OSA before the nasal problems, but the effects weren't noticeable to you then. That'd be my guess, anyway.

I won't try to second guess your physician, but before you undergo surgery you might want to ask the surgeon whether he expects the surgery to change the OSA, or the need for its treatment. If so, in what respects? Typically, reports here from folks who have had various surgeries expecting improvement in OSA are disappointing.

I have to wonder whether your current poor CPAP treatment is because your pressure setting is not quite where it needs to be. Often, judging from reports here, the sleep lab titrations, while close, provide accurate pressure settings only for the night the titration was performed. Sleep in one's familiar home environment results in pressure needs somewhat different. Any chance you've attempted to adjust your pressure settings hoping for better treatment? Any chance you've used an APAP for a short time to check your pressure needs at home? If so, was it recently? Any chance you've checked for mask leakage? Air leakage can easily prevent effective therapy. Full-face masks are quite prone to leaking air. Best way to know for sure is with a machine which records overnight data.

Just a few starters to check for. Hope this helps you sort through things a little.

Regards,
Bill

[Snoredog]

CPAP therapy will never be successful if you have chronic nasal congestion, if the ENT says you have enlarged turbinates, that is what you have.

http://www.somnoplasty.com/PatientTrack ... rbfaq.html

http://www.obstructednose.com/nasal_obstruction.html

I had that surgery over 25 years ago, never regretted it for one minute.

[michaelho]

This is my problem as well. I go to sleep and then wake up anywhere between 1-3 hours later and have real trouble getting back to sleep with mask on. It may due to a feeling of heated air, or noise or combination. Sometimes after 45mins I just throw the mask away, then get back to sleep. Of course it's not good sleep, though. I then wake up an hour or 2 later and try to sleep again with the mask. I constantly wake up 6-12 times a night. Anyone else have this problem?

[roster]

This is my problem as well. I go to sleep and then wake up anywhere between 1-3 hours later and have real trouble getting back to sleep with mask on. It may due to a feeling of heated air, or noise or combination. Sometimes after 45mins I just throw the mask away, then get back to sleep. Of course it's not good sleep, though. I then wake up an hour or 2 later and try to sleep again with the mask. I constantly wake up 6-12 times a night. Anyone else have this problem?

I struggled with nearly the identical problem for two years. Every time I went to the sleep doc he said I needed to take a sedative or a sleeping pill. Most of the ones he prescribed helped me sleep more to some extent but every one of them made me feel much worse the next day.

I began to question the pressure of 10 cm and the doc kept saying he was sure his lab had the correct pressure. Finally I intimidated his assistant into writing me a prescription and letter of medical necessity for an apap. I got the Encore Pro software and found out the damn doc did have the pressure very wrong.

I did get a new sleep doc who sent me to an ENT. In November of last year, I had all six turbinates reduced and a double deviated septum corrected. I am glad I had the surgery and it should have been done many years ago. But they do have much better surgical techniques today.

There is more to the story, but at this point I would encourage you to get a system that you can use to titrate your own pressure at home and also seriously consider the nasal surgery. Those are the first two steps you should take in my sole little opinion.

Good luck.

[Mark_from_UK]

Just to say many thanks for all these that answered, you have all been very helpful