New to CPAP, 10 nights in

hogdaddy · Post by **hogdaddy** » Sun Mar 12, 2006 11:57 am

My first night on the machine (Respironics REMstar Auto C-flex with heated humidifier (6-20), Resmed mirage swift nasal pillows) was March 2, o6, so I have not been on it long. The first night, I slept for a solid four hours and woke up fairly energized . I could feel the difference. The second night was about the same, but I slept more. I am now on about my 10th night or so and when I wake in the morning I still feel tired. I typically go to bed in the 11-12pm range and wake at about 7:30 when my wife gets up. I usually take my pillows off at that time and roll around for another couple of hours after she gets up. I do not feel energized at 7:30 am and when I get up at 9:30 or 10:00am I really do not feel energized. After I am up for a bit and showered I do not feel tired. I feel like I am falling back into my old sleep patterns. Before I had the machine, I would always sleep very late. I guess I was compensating for not sleeping well by sleeping allot.

The funny thing is that I do not feel tired during the day, but at the same time I do not feel energized. I know that I have had some blowouts, but it is not all the time and I never have truly clear sinuses. I always have one nostril that is stuffy and it can fluctuate between the two nostrils with in a few minutes. I have even tried a sinus flush and that did not alleviate the stuffiness.

I have been experimenting with the settings on my machine as I learn more about it and the options it offers. My sleep study indicated that I needed a setting of 8 for the CPAP mode. Initially I ran it in the Auto mode set at 6-20 with c-flex enabled and the humidifier set at 2. The last few nights I have been operating with it in CPAP mode(8) with the c-flex enabled and the humidifier on at a setting of 3. I was just telling my wife that I was very thankful that I was not encountering many of the problems that I was reading about on this board, including uncomfortable masks or nasal sores, etc.. I feel that I have adjusted to the machine and mask quite well, bit it does seem that now I have my own unique set of problems. I suppose this is to be expected

My questions are:

1. What should I feel like in the morning after a good sleep?
2. Should I get the software and start analyzing the data on a regular basis? I was trying to avoid this.
3. The humidifier seems to have a very subtle effect. I thought it would be more like a room humidifier is that not the case?
4. Any suggestions on clearing my sinuses? I would love to breathe freely through my nose.
5. I have been exercising and losing weight for a couple of years now. When I started 2+ years age with a trainer I was 350lbs.+ . I don't know my exact starting point, because I was above the limits of most scales. I am now at about 322 and still motivated to get to 250. I an 6'6" tall ,so I can carry the weight well, but I was surprised that my setting was so low(8), considering my size. We have an older friend (I am 37), he is probably 57, but he is in good shape and is a triathlete and his setting is a 12, but he has a thick neck and he said that is where his problem comes from. Do y'all thing there could be a misdiagnosis with my setting and as I continue to lose weight will my settings go lower (that's why I bought the auto machine). Will I eventually be able to go without the machine after I lose enough weight. I sure hope so. I plan to lose enough weight to get off my blood pressure and cholesterol medicines as well. It appears that my acid reflux problem is already gone. I no longer have to take a pill daily (this happened before the machine, i know reflus and apnea are tied together quite often0. I await your responses and appreciate the time y'all put into answering these questions. I have really enjoyed this board and the information it provides. It has been very helpful over the last couple of weeks.

Thank you, Bobby "G"

Jim Eads · Post by **Jim Eads** » Sun Mar 12, 2006 12:18 pm

Bobby,

My first suggestion would be to let you APAP do its job. Try setting for a range of say 6 - 10 and see if that makes you feel differently. When you wake up, look at the machine to see at what pressure it is running. If it's always running 10, bump up the range.

And I would most certainly suggest you get the software and card reader. Otherwise, you're pretty much guessing in the dark, literally!

When i have trouble nose breathing, I use a nasal rinse. If that isn't completely satisfactory, I'll also use an spray decongestant but I don't like using that very often.

I haven't found new energy with CPAP. Instead I've gotten rid of feeling tired all the time and I can focus much better. Just because I'm not sleepy doesn't necessarily mean I feel like reroofing the house. )

Jim

Wulfman · Post by **Wulfman** » Sun Mar 12, 2006 12:27 pm

Hogdaddy,

Welcome to the forum.
Sounds like you've done some homework as you've got some pretty good equipment there.
I'll try to answer your questions and I'm sure others will join in and offer their opinions, too.

1. From your description, what you're feeling at this point is about "normal". It can take up to several months to regain an energy level. Don't despair, hang in there.....it WILL get better.

2. Absolutely!!! It's hard for me to imagine anyone doing this therapy without monitoring their progress. After all, this is YOUR therapy.....take control of it.

3. The heated humidifier has several settings. You may have to tweak it to get the best results for YOU. Some of us use the unheated (passover) mode and some use the heated option.....it's entirely up to you.

4. Possibly a saline solution? Others here may have other suggesitons. I use a Vicks nasal inhaler (stick) and give each nostril a couple of shots each night before putting my mask on.

5 Your pressure setting has virtually nothing to do with your body or neck size.....it's whatever pressure will do the best job to keep your airway open when you sleep. I believe my sleep doc made that mistake in prescribing me with a pressure of 18......I'm doing just fine with a pressure of 10 (which I set myself).
Chances are, even with weight loss, you may be using this therapy for the rest of your life. My advice is to "embrace it". After 10 months on CPAP, I can't hardly sleep without being "on the hose".

Hope this answered some of your questions. If you have more, please feel free to ask.

Best wishes,

Den

Aswab · Post by **Aswab** » Sun Mar 12, 2006 2:13 pm

First, I am not a long timer I have just finished 6 weeks on the xPAP so YMVV.

1. Without the software, which I don't have (current machine doesn't support it), you (and I) can not monitor the treatment. I was pretty sure, and subsequent experience has supported it, that I was having real problems with mouth leaks so I wasn't getting the full benefit of the therapy. Chinstraps did not seem to be doing the trick so I finally decided to try taping and it is working for me. I am already feeling better after 5 days of taping. Taping doesn't seem to be for everyone so that isn't a recommendation, I'm just sharing what seems to be working for me. YMVV

4. See the ENT! Get a referral and learn what it is you are dealing with. I learned I have a deviated septum and turbinate constriction. I also have large tonsils and will likely have an endoscopy to see what the rest of the structures are like. I may have turbinate reduction and a septoplasty (I haven't made up my mind yet) but I know what the issue is now. I don't contemplate UPPP. Flonase, Astelin and nasal irrigation has helped my sinus congestion enough to make the pillows work. I am not super conscientious so I find that if I skip a few days one passage (can be either one) closes up after 4-6 hours. I return to the nasal irrigation and the Flonase/Astelin combination and it works. I hope to get by with just irrigation soon.

Hang in there, it will get better. It is getting better for me now. I still feel tired. My weight is around yours as well. There is no way that xPAP can make us, who weigh that much, feel worlds better. It can only offer enough marginal improvements to hopefully help us with weight reduction. xPAP can save our lives though! A large part of the energy issue has to be related to the excess weight. This is just reality.

David

Wulfman · Post by **Wulfman** » Sun Mar 12, 2006 2:46 pm

Aswab,

The picture of your machine at the bottom of your post indicates that you have a REMstar Pro 2, however you stated that your current machine doesn't support the software. If you indeed have the Pro 2, it DOES support the Encore Pro software.

Den

roztom · Post by **roztom** » Sun Mar 12, 2006 2:51 pm

All I can add is that I am a Newbie 4 weeks and I am embracing AND enjoying my therapy.

It has NOT been easy and it has been challenging. Like many here this therapy is NOT "plug and play."

The more you embrace it and roll your sleeves up and get involved the better you can make it work for you.

As those before me suggested - Get the card reader and software. It is NOT a big deal. You do not need to be a computer wiz to do it - you just need the desire to become proactive and gain the knowledge of what your body needs to help you feel better.

The first step to feeling better is to be SURE you are getting the best therapy.

One night in a sleep lab is not necessarily going to give you enough data to be properly titrated. As many here will indicate after monitoring their therapy they have modified it and greatly improved it.

IT's YOUR body - why not make things the best they can be.

Best,

Tom

chdurie2 · Post by **chdurie2** » Sun Mar 12, 2006 2:54 pm

hogdaddy:

i am not a veteran so i cannot advise with the experience that many of these people here have. but i do know a few things.

1) as someone else said, ask your doc if you have a deviated septum. that alone can make your nose congested, with or without cpap. i have one, and i have found that cpap and saline both seem to help and hurt it. if so, you may want to consider the deviated septum operation.

2) go easy on the chemical nose inhalants. you can burn your nose out with cpap, flonase and the non-prescription nose inhalants. even ayr saline gel burned my nose after a few nights. i find saline solution the best, although when the stuffiness won't go away at night with cpap, i use the ayr saline gel.

3) i don't know that weight loss will eliminate your apnea. i have been up and down the scale over the years and my apnea has remained the same. ( i have never been obese--most was 20-30 pounds overweight, and i have enjoyed years of thinness. i think maybe heaviness and apnea is one of those myths that will die hard--they used to say that women didn't have apnea.

when i first went for sleep diagnosis, the docs said i couldn't have apnea because i was thin. then i went to a better doc and replayed that, and he said i could have apnea, that you don't lose or gain weight in your throat. after examining me and seeing my floppy throat tissue and hearing my tonsil history, he said i very well could have apnea. so i think heaviness may be a link in that it makes sense that if you have apnea and are heavy, breathing will be more difficult, just as if you don't have apnea and are heavy, breathing will be tougher. but i think docs are more willing now to check out thin people for apnea because they realize there is not the causal connection they once thought.

i think it depends on the configuration of your particular attributes.

good luck. you came to the right place. people here have been very helpful to me, and i've been around here about 10 days also.

caroline

ozij · Post by **ozij** » Sun Mar 12, 2006 3:13 pm

I agree with what the others wrote, but I noticed you write that

I usually take my pillows off at that time and roll around for another couple of hours after she gets up

Don't do that - by dozing without your mask you're giving yourself two hours of lowered oxygen, and that might contribute to you not feeling so fresh.

O.

rested gal · Post by **rested gal** » Sun Mar 12, 2006 4:49 pm

hogdaddy wrote: 1. What should I feel like in the morning after a good sleep?

One of the best descriptions I've read about degrees of feeling better with cpap treatment was written in a post by by Perry at viewtopic.php?t=6234

I agree with ozij that we really, really need to use the mask and machine for every sleeping moment. Deliberately removing a mask (or not putting it back on) in order to grab a few hours sleep without a mask on is taking a step backwards.

Any time we sleep or nap without CPAP treatment going, what we're really getting is a few hours of suffocation. Not good sleep.
_____________________________________________
Excerpt from Perry's post:

"What is feeling good?" Here are how I define the recovery and treatment process as I experienced it.

"Walking Dead" is where most of us start at. That is how a person with severe OSA problems feels before PAP. You seem to sleep very well - but am always tired, cannot think hardly at all, and can barely function well enough to eat, bathe, do a basic job (with not a good performance), and usually come home to die in front of the TV and sleep (you can sleep at the drop of a hat). Life is no fun at all, and you can be extremely frustrated because you know that something is wrong and you used to be able to do better. Your personal relationships sink to all time lows. You are probably so far out of it that your "other" in life may seek others for intellectual level or intimate companionship so that they can have a life at all (The best time to tell your “other” that you love them or care for them is before someone else tells them – I suggest that you do so daily – starting right now: even if you are not in the “walking dead” zone).

"Basic Treatment" is the next step. In my case this happened first on CPAP, then on AutoCPAP that was set-up totally wrong for me. All the sudden you feel much better. You start to notice that there is more to life than you have been experiencing lately. You now find the energy to do things in the morning you really should have been doing all along like flossing teeth, or some house cleaning. But you still cannot think clearly like you used to, while your job and personal relationships improve a little, you still come home from work exhausted, and retire to the TV or recreational reading because you don't have the mental energy to do anything else.

It is amazing how well you feel compared to before - but you still don't have the energy that you remember (or that you see other people with). Naps are still needed if you are to function at all throughout the day. Often it takes a couple of months – but there comes a point where you know that you are not where you should be.

I will note that most sleep Dr’s are satisfied once a person progresses from Walking Dead to Basic Treatment. They consider you a success, and are not likely to provide much support past this point. My personal experience is that I was better off dealing with a family Dr to move beyond this point as I was dealing with other health issues.

"Advanced Treatment" may follow. Here your feel so tremendously great compared to before. Life starts to be good again; you can see that there is a future (especially in the morning when you get up). Your sleep seems to be under control, you have the opportunity to do things in your job and personal life that you could not even imagine before. Mentally you can start to think of several different things early in a day. But you still feel run down in the afternoon (this must be normal you figure) and look forward to bed each night.

"Mental Zest" is where you want to be, what happens when treatment is really working well for you. All the sudden your mind and life is free again. You typically wake up feeling great, can do multi-tasking of different mental task (which really helps your job and personal life), and have energy all day. Can stay up much of a night if needed - with energy and mental involvement - without major effects on the next day. You can see how to make life great once you solve those problems that accumulated when you weren’t feeling so well (and some of those problems can be major issues to solve). You finally realize that this is what normal life should be. You may recognize at this stage that this is how you felt when you were a teenager. As long as you have a positive attitude about yourself and life - you are ready again to take on the word…

It took me years to get to the Mental Zest stage. I would like to claim that I can stay there. Pollen season knocks me back to the Advanced Treatment, and excessive work hours can easily knock me back to the Basic Treatment Stage (simple exhaustion). Proper diet, nutrition, and exercise are also required to keep you at the Mental Zest stage.

May each of you have a safe and quick journey to “Mental Zest.”

Perry

Goofproof · Post by **Goofproof** » Sun Mar 12, 2006 6:32 pm

ozij wrote:I agree with what the others wrote, but I noticed you write that

I usually take my pillows off at that time and roll around for another couple of hours after she gets up

Don't do that - by dozing without your mask you're giving yourself two hours of lowered oxygen, and that might contribute to you not feeling so fresh.

O.

And you are missing out for two more hours of repair. You are also sending the body the message that you aren't 100% committed to helping your health. The first thing you have to do to treat your problems is to convence your self you are going to do it, then you can.

Wulfman · Post by **Wulfman** » Sun Mar 12, 2006 7:21 pm

Hey, guys........lighten up on Hogdaddy (Bobby) a little bit......

I can relate to what he's going through......"transition" and "tolerance".
I did pretty much the same thing when I started. After a few weeks of shorter nights (about 5 hrs) under the mask, I started putting it back on after the potty break and before the alarm clock went off. For awhile, after the alarm clock went off, I'd try to get just a few more Z's.....but if I put the mask back on, I'd be "zonked" for several more hours (and be late for work)......SO, I'd leave my mask off for just a short time (about 30 to 45 min.) because I KNEW I could wake up without oversleeping.
I gradually built up my tolerance (my bladder, too) and longevity that way. I figured whatever amount of time I was getting on the machine was more than I had had for many years.

Ok, now you can beat up on me.......but it worked for me. Maybe it'll work for Bobby.

Best wishes,

Den

Goofproof · Post by **Goofproof** » Sun Mar 12, 2006 9:06 pm

Wulfman wrote:Hey, guys........lighten up on Hogdaddy (Bobby) a little bit......

I can relate to what he's going through......"transition" and "tolerance".
I did pretty much the same thing when I started. After a few weeks of shorter nights (about 5 hrs) under the mask, I started putting it back on after the potty break and before the alarm clock went off. For awhile, after the alarm clock went off, I'd try to get just a few more Z's.....but if I put the mask back on, I'd be "zonked" for several more hours (and be late for work)......SO, I'd leave my mask off for just a short time (about 30 to 45 min.) because I KNEW I could wake up without oversleeping.
I gradually built up my tolerance (my bladder, too) and longevity that way. I figured whatever amount of time I was getting on the machine was more than I had had for many years.

Ok, now you can beat up on me.......but it worked for me. Maybe it'll work for Bobby.

Best wishes,

Den

Ok! Beat up on Den. I started 14 cm, no ramp, FF Mask, 8 hours a night, no breaks.

Failure is Not A Option!!! No! I am not a Marine, Just a tired mechanic with a failing body. So I had to do what works quick! Jim

Its me forgot to log in · Post by **Its me forgot to log in** » Sun Mar 12, 2006 10:11 pm

Thank you all for your input. I really do appreciate it. I do not know what others experienced before being diagnosed, but I never experienced any of the "Walking Dead" symptoms. I was not overly tired during the day, I had no problem staying up at night and since 1997, I have built quite a successful real estate business.

I did not feel that I had APNEA, because I did not think I had many of the symptoms. I knew that I slept poorly and woke often, but I thought that was just me, because I always tossed and turned allot. Christmas eve of 05 and the subsequent nights brought me to the realization that I needed to get tested.

I had a mild bronchitis, but it caused me to have a bit of difficulty in breathing. I felt that I was waking up gasping for air and could not sleep for more than a few minutes without the gasping sensation waking me. By 4:00am I was starting to get a bit panicky. I had been up essentially all night, watching my wife and the dogs sleep and I felt so alone. I finally had to wake my wife to calm me down. I was having a bit of an anxiety attack. My mind just kept racing and I was thinking "what is wrong with me, why is it that everyone can sleep but me, what if I can never sleep normally again". It is amazing hoe your mind can run away with things. For the next few nights things got worse and I was very tired and anxious. My father in law suggested that I see his ENT and I did, but it took a bit of time with the holidays. I actually got to the point that I was crying in front of my wife when I talked about my sleep problems. I had become so sleep deprived and emotionally drained. I have since learned that the anxiety is a classic result of sleep deprivation. I even cried in the ENT's office as I was explaining my experience, it was that bad.

That's what finally drove me to get tested. I just said to myself that there has to be an underlying sleep problem that the bronchitis exacerbated and sure enough that is what pushed me over the edge and finally made me take my health seriously. I am glad it happened now and I will be able to stave of diabetes. I am working hard to lose the weight (swam 110 laps at the YMCA today) and will do it, no matter how long it takes. No fad diets or surgery for me...I am doing it the old fashioned way...more exercise, less eating, no drinking and a much healthier diet. I still eat allot, now it's just very healthy and natural. It is amazing how good an apple tastes.

Linda3032 · Post by **Linda3032** » Sun Mar 12, 2006 10:36 pm

BRAVO. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Goofproof · Post by **Goofproof** » Mon Mar 13, 2006 10:18 am

Its me forgot to log in wrote:Thank you all for your input. I really do appreciate it. I do not know what others experienced before being diagnosed, but I never experienced any of the "Walking Dead" symptoms. I was not overly tired during the day, I had no problem staying up at night and since 1997, I have built quite a successful real estate business.

I did not feel that I had APNEA, because I did not think I had many of the symptoms. I knew that I slept poorly and woke often, but I thought that was just me, because I always tossed and turned allot. Christmas eve of 05 and the subsequent nights brought me to the realization that I needed to get tested.

I had a mild bronchitis, but it caused me to have a bit of difficulty in breathing. I felt that I was waking up gasping for air and could not sleep for more than a few minutes without the gasping sensation waking me. By 4:00am I was starting to get a bit panicky. I had been up essentially all night, watching my wife and the dogs sleep and I felt so alone. I finally had to wake my wife to calm me down. I was having a bit of an anxiety attack. My mind just kept racing and I was thinking "what is wrong with me, why is it that everyone can sleep but me, what if I can never sleep normally again". It is amazing hoe your mind can run away with things. For the next few nights things got worse and I was very tired and anxious. My father in law suggested that I see his ENT and I did, but it took a bit of time with the holidays. I actually got to the point that I was crying in front of my wife when I talked about my sleep problems. I had become so sleep deprived and emotionally drained. I have since learned that the anxiety is a classic result of sleep deprivation. I even cried in the ENT's office as I was explaining my experience, it was that bad.

That's what finally drove me to get tested. I just said to myself that there has to be an underlying sleep problem that the bronchitis exacerbated and sure enough that is what pushed me over the edge and finally made me take my health seriously. I am glad it happened now and I will be able to stave of diabetes. I am working hard to lose the weight (swam 110 laps at the YMCA today) and will do it, no matter how long it takes. No fad diets or surgery for me...I am doing it the old fashioned way...more exercise, less eating, no drinking and a much healthier diet. I still eat allot, now it's just very healthy and natural. It is amazing how good an apple tastes.

I never had any symptoms either except for falling asleep 20 times a morning driving home from work. I have one of those Smart Cars, it knew the way home, but if it got lost it would go to the right shoulder and wake me up and ask directions.

Also I would wake up every couple of hours for the potty break and another glass of water. I felt good. Then I had the Heart Attack, End of Story.. Jim

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New to CPAP, 10 nights in

New to CPAP, 10 nights in

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