Introducing myself

[CatButler]

Hello,

I have been following the board for about a month and have been treated for moderate to severe OSA for about 2 months. I apologize for not doing this sooner. Hopefully it will be useful to others just starting.

Background
I am a 46 year old male, about 5'10, 245lbs. I have moderate high blood pressure. When I work out regularly my neck size approaches 18". About 8 years ago my wife started to worry about my breathing during sleep. I was definitely tired at work and play. Soon after I started a low carb diet. Within days after starting she noticed a huge change for the better and I immediately started feeling better. At my lowest, I was down to about 175 lbs, and I was working out quite a bit. I kind of got irregular about the diet after 3 years and gained a bit back, but was happy maintaining at about 185. I over trained too much and developed some repetitive stress injuries in my hands that limited my ability to work out. After changing jobs, I lost access to my convenient gym, but I was getting so tired from my workout that I would fall asleep at work after coming back. Also the new job offered free snacks placed around the office and it was too easy to partake and get into bad habits. The last 2 years or so my sleep has been getting worse and my wife was getting worried again. At some point I started getting up to go to the bathroom in the middle of the night. That got me into a bunch of prostate/bladder testing that didn't show anything. It was getting difficult to drive long distances without getting sleepy. At my last physical I asked my GP about a sleep study and he agreed. I wish I could go back to low carb, but it is proving difficult with my family/job situation.

Sleep Study.
The sleep clinic was a fairly nice place with Sleep number beds like I have at home. I was signed up for a split study. Being in a foreign environment made it difficult to get to sleep. I had the 10pm slot and the next slot was in the room right next to me so once they got me ready, I could hear everything going on in the next room with the next patient. They really wanted me on my back, but I can't go to sleep that way. Eventually they set up the other patient. I shifted to my side and I got to sleep. I was woken up about 2 hours later and told I passed the test, so they put the mask on me for titration. I couldn't get comfortable and barely slept, but they got enough data and sent me home.

First 6 weeks of Treatment.
I was diagnosed with moderate to severe apnea and was given a F&P auto and a Resmed Quatro Full Face mask. I have great insurance which covered me fully once I reached the deductible. My initial pressure was 6 to 8 cm and I was given an appointment to come back in 6 weeks. The first night I was able to wear it most of the night and awoke feeling better than I had in quite a while. I had good luck for about 5 days, then started waking up about 2 hours after going to sleep with a really sweaty face. I turned down the humidity and things got better, but every once and a while I would have the same thing. All and all my quality of life was much better, but I was still a bit tired. About 1 night a week would be miserable because I was fighting a leaky mask. At the 6 week checkup, the AHI was somewhat better but not below 5, so he upped the pressure and I asked him about the leaks. He said if they persisted to buy a special CPAP pillow for side sleepers.

Next 2 weeks.
I went one night and just decided to get the pillow. I finally settled on a buckwheat hull pillow because it made sense that I could shape the pillow to my needs. It took about a week to get the pillow. First night on the new pressure went pretty well. Then I started waking up in the middle of the night feeling fairly refreshed, but I couldn't get back to sleep even after about 2 hours. Sometimes I would take about 500 mcg of melatonin and get back to sleep, but would oversleep. Other times, I would just get up, but soon end up exhausted. I think my body just wasn't used to getting some amount of good sleep and would wake up thinking it was refreshed, but still needed more sleep. Finally, I took the melatonin before bedtime and at least got back to sleep when I woke up. I did that a few days and dropped the melatonin and haven't had an issue since. I went back to the provider's office for a data download and they said it was better, but not good enough and up'ed the pressure some more. I asked about the mask and got a review about how to put it on. That brings me to where I am now.

The past week
After the combination of the pillow and the mask review, I think I have figured out how to adjust the mask properly so it's not too tight, it sits better on my nose, and doesn't leak if I move the slightest. I have noticed that I don't wake up sweating anymore, and I actually have had to turn up my humidity. Somewhere I read that if the ICON detects excessive leaks, it will increase the humidity to compensate. I wonder if solving the leak problem has improved that. I now sleep a bit longer before I wake up and can get back to sleep. I don't ever sleep through the whole night, but I don't think I have done that in 15 years. I am thinking of a few days of time release melatonin to see if I can improve that pattern a bit. Overall there have been no miracles yet, but I feel better, am not worried about driving as much, almost never get up to go to the bathroom in the middle of the night anymore. I have gained about 10 lbs in the 2 months or so I have been treated and my blood pressure has gotten slightly worse. I know I have a bit more to go. My hands feel a bit better to so I am hoping I can get back to the gym and still have enough energy to function during the day. I'm wondering if long term oxygen deprivation was starting to affect how I recovered from workouts. Hopefully that will start to work on the weight/blood pressure.

[Gerryk]

Welcome aboard!

It takes time to get used to your equipment as you have seen. It also takes time for your body to begin to sleep through the night. I personally do not think anyone sleep through the night without waking up to some degree. Many people wake up to go to the washroomm at night or just wake up enough to move or adjust themselves at night.

It took me a while until I was sleeping through the night and then when I did, I didn't notice it for a while. I kind of woke up one day and said wow I didn't wake up last night. Then I woke up and remembered a dream that I had which I had not had in ages.


Just keep at it and before you know it sleeping with the cpap will be a habbit as will sleeping most of the night.

[CatButler]

Welcome aboard!


It took me a while until I was sleeping through the night and then when I did, I didn't notice it for a while. I kind of woke up one day and said wow I didn't wake up last night. Then I woke up and remembered a dream that I had which I had not had in ages.


Just keep at it and before you know it sleeping with the cpap will be a habbit as will sleeping most of the night.

Actually, I forgot to mention I had a dream the other night. I think it's been quite a few years.

[Gerryk]

It was a weird feeling for me when I woke up after dreaming and remembered it. Kind of exciting but weird.

[chunkyfrog]

My dreams pretty much 'went away'.
They were unpleasant, so I don't miss them.

[jweeks]

They really wanted me on my back, but I can't go to sleep that way. Eventually they set up the other patient. I shifted to my side and I got to sleep. I was woken up about 2 hours later and told I passed the test, so they put the mask on me for titration. I couldn't get comfortable and barely slept, but they got enough data and sent me home.

Hi,

The reason they want you on your back is because that is usually where your OSA is the worst. This is great for setting your machine for the worst case scenario. At the same time, many people have much fewer OSA issues on their side, and can get away with a much lower pressure. If you do well on your side, then feel free to sleep that way.

It isn't unusual to have issues sleeping during a sleep study. Many sleep doctors offer patients a sleeping pill of some kind to ensure that they will get to sleep. If you have a follow-up study you might want to ask about that option.

After the combination of the pillow and the mask review, I think I have figured out how to adjust the mask properly so it's not too tight, it sits better on my nose, and doesn't leak if I move the slightest. I have noticed that I don't wake up sweating anymore, and I actually have had to turn up my humidity.

You are doing a great job a problem solving. You probably don't realize it right now, but it is much harder to figure out and solve issues when your brain is foggy from OSA. In 6 months to a year, you will look back on this and wonder why you had any issues at all--your brain will be so much clearer once you get some good sleep behind you.

I now sleep a bit longer before I wake up and can get back to sleep. I don't ever sleep through the whole night, but I don't think I have done that in 15 years.

Since you had issues with OSA and haven't slept well for years, your body has developed adaptations and coping strategies. Now that you can sleep again, your body has to unlearn these tricks, and essentially learn how to sleep all over again. That might take some time. Don't get frustrated if you wake up and have a hard time getting back to sleep. That happens to a lot of people. Some get over it in a few weeks, but my issues drug out for 6 to 9 months. Now, I only wake up during the night (long enough to remember it, at least) only about once every 6 to 8 weeks.

The theory that I have is that your body used to get maybe only an hour or two of useful sleep before you started CPAP. Now that you can actually sleep, after about 2 hours in bed, your brain thinks that it is done for the night, so it wakes you up ready to go to work. This internal time clock is one of the things that you are going to have to unlearn, and it will happen as you get more nights of sleep using the machine.

Good luck!

-john-

[zoocrewphoto]

The theory that I have is that your body used to get maybe only an hour or two of useful sleep before you started CPAP. Now that you can actually sleep, after about 2 hours in bed, your brain thinks that it is done for the night, so it wakes you up ready to go to work. This internal time clock is one of the things that you are going to have to unlearn, and it will happen as you get more nights of sleep using the machine.

-john-

Interesting theory! I just started 9 days ago. The very first night, I slept about 3 hours, woke up, took off the machine, and went back to bed. I vaguely remember doing it, then seeing the clock, realizing it was only 5am, and I must go back to bed. I woke up a couple hours later, went to the bathroom, put the machine back on, and slept pretty good again. I think your theory makes sense. I vaguely feel like I got up and took the mask up because I thought it was time to get up.

Now, I have had ups and downs since, mostly due to dry mouth, and a leak at the top of my nose that blows toward my eyes. Last night, I stuffed a kleenex in there, and I slept great after that. Tonight, I will stick a cotton ball in there and see if I sleep longer. So far, I have had a few short nights with the machine of 4-6 hours, sometimes split with me putting it back on later. But most nights, I have used it most of the night, even if I woke up a lot. I tell people are work that my personal rechargeable battery and I are getting to know each other. We haven't quite come to the perfect agreement yet.

I have noticed that I yawn less. And sometimes I feel somewhat energetic. I also feel more cheerful, even when I am not energetic.

About dreams. I have been less aware of dreaming. I used to remember dreaming just about every day, even if I couldn't remember the actual dream. I have barely been able to remember that I had a dream a few nights since. I am definitely sleeping differently than before.

[user from Singapore]

Zoocrewphoto,

I did not sleep properly until I got a nasal pillow mask. I would strongly recommend trying.
I think that the problem I had with the full face mask was too many leaks.

[zoocrewphoto]

I have little air flow through my nose, so I am a mouth breather most of the time and all night. I can't even exhale through my nose with the machine on, and that is with a clear nose. I only breathe through my nose for short times, maybe a couple minutes at a time at most, and only if I am sitting or standing still.

It's not a big deal for me. I did have some better luck with the leaks last night, so I will see tonight if I have it figured out.

[JohnBFisher]

... I am a 46 year old male, about 5'10, 245lbs. I have moderate high blood pressure. ...

Sounds like a good number of us. I started having serious problems in my mid-thirties. But I am almost certain I had obstructive sleep apnea since my early teens. As I went through puberty, I started to snore. And my sister complained that I snored 'Just like Granddad!". Ouch! Based on his snoring, I almost certainly had obstructive sleep apnea - even when UNDER ideal weight.

So, you might not see the sleep apnea stop .. but you should see the high blood pressure come under control with medication and exercise.

... At some point I started getting up to go to the bathroom in the middle of the night. That got me into a bunch of prostate/bladder testing that didn't show anything. ...

Sigh! Once the prostate/bladder tests show "normal", Urologists should (a) screen for diabetes, and (b) screen for sleep apnea. Neither are difficult. Both can be easily controlled. But "It's not my job!" is all too often the norm.

... Being in a foreign environment made it difficult to get to sleep. ...

Yeah, it's more of a sleepless test than a sleep test. And the sleep techs can sometimes come out with the oddest statements .. well meaning, mind you. I have REAL problems with sleep onset central sleep apneas. I tend to stop breathing for more than a minute at a time as I fall asleep. As you might guess, it tends to make it very difficult to fall asleep. After many, many, many of those sleep onset apneas .. I had one sleep tech come in and say "You've got to get to sleep so we can check your sleep!". To which I replied, "Don't you get it? I can NOT get to sleep when I stop breathing as I fall asleep!!"

Fortunately, you fit into their nice "normal" patient category, so while an ordeal, it was not too much of an ordeal.

... I was diagnosed with moderate to severe apnea and was given a F&P auto and a Resmed Quatro Full Face mask. ...

Some of us can go home, fall asleep and have no problems. A very few of us. But the rest of us have to claw our way toward better sleep. You are with the vast majority of us. All too often people just give up. In fact, the estimates are that only 50% of the patients with sleep apnea actually stick with xPAP therapy. That's a horrible statistic. It would be like saying only 50% of the diabetics who need insulin take it.

... I think my body just wasn't used to getting some amount of good sleep and would wake up thinking it was refreshed, but still needed more sleep. ...

It's REAL normal for it to take a while before your body adjusts to this thing called "sleep". I had much the same problem. It took me months before I could sleep the night through without awakening and feeling completely rested .. without really getting enough sleep. But your body will adjust.

... I think I have figured out how to adjust the mask properly so it's not too tight ...

It's a bit of an art .. perhaps even a black art. I still fight leaks on some nights. And I've been doing this for 22 or 23 years at this point. Of course, with that much time using an xPAP device, I tend to just fix the leak and move on .. It's just "one of those things" in my mind.

... I have noticed that I don't wake up sweating anymore ...

Sweating may also indicate untreated apneas (due to the leaks). Again, if you are not doing it anymore, it's a good sign.

... I don't ever sleep through the whole night, but I don't think I have done that in 15 years. ...

As I noted, it takes time. Besides, as you age you will naturally tend to awaken at night. Most of us NEVER sleep the night through. Until the industrial revolution this was considered normal. But since then we have this myth that you should sleep a good eight hours and be done with it. Sleep used to take longer and include a normal period when people would awaken during the night .. It was often referred to as first and second sleep.

... Overall there have been no miracles yet, but I feel better, am not worried about driving as much, almost never get up to go to the bathroom in the middle of the night anymore. ...

All great signs of progress.

... I have gained about 10 lbs in the 2 months or so I have been treated and my blood pressure has gotten slightly worse. I know I have a bit more to go. ...

It's not unusual to have weight change (up or down) after starting xPAP therapy. Give it time. The increase in energy will soon kick in and you will find that you are able to loose weight without as much work. Why? Your overall activity level will increase.

... My hands feel a bit better to so I am hoping I can get back to the gym and still have enough energy to function during the day. I'm wondering if long term oxygen deprivation was starting to affect how I recovered from workouts. Hopefully that will start to work on the weight/blood pressure. ...

The long term oxygen deprivation was met each and every day when you were awake. While it's *really* hard on the body (and lots of bad things, such as diabetes, high blood pressure, cardiac problems and strokes) can and do occur, once you are on xPAP therapy you have the chance to regain your normal activity and work off some of the excess weight. But it normally takes time.