New to cpap- how long will it take to sleep??

[Rjcisme]

Im 43 yr old male, athletic, and not overweight. (5'8" , 170lb)
I was diagnosed last fall after several years of wife's complaints. I finally got 2nd opinion recently and DR confirmed CPAP was best option. My score was in mid to high twenties as moderate.
I was fitted for machine and started using Tuesday. After 3 nights, I've never felt worse in the morning. Completely foggy with big circles around eyes. The first night I took off mask at 4am, 2nd night at 6, and today at 8. I wake up continuously throughout night and am not very comfortable.

Equipment: Resmed S9 series, H5i
Mask: Resmed Quattro Fx

I expected this to be an adjustment but thought the sleep would be better. Is this normal? If so, how long does it take before I'll get a good nights sleep?

It's scary thinking I may have to wear this for the rest of my life. Especially if I can't sleep.
Any other suggestions and feedback are appreciated.
Thanks

[Tino2You]

you may want to load the SleepyHead software and extract your data from your S9 SDCard. That data will "show" you how you are sleeping. Maybe your mask is leaking, or your AHI is worse on your prescribed pressure. No way to tell without data.

Finally, there is an adjustment period to just sleep with all this crap going on. Take your time, it will come.

Patience grasshopper

Cheers,
-tino

[Sheriff Buford]

Please go to your profile and fill out your equipment. People are different and respond to therapy different. Some people are successful sooner and some later. I would think you will see improvement on a daily basis. The trick is to keep going. You will adjust. Work all your issues here. Best of luck!

Sheriff

[Tino2You]

ok, I just re-read my post. I hope you have an s9 Elite or AutoSet. They are the two full data machines. If you have an s9 Escape, I am sorry but you have a 'brick' that cannot report leak and flow data. To find which machine look at the top, above the power button will be Escape, Elite or AutoSet
-tino

[Rjcisme]

It is an Elite.

This is all a little overwhelming: how to use, adjust, cleaning,etc.

[themonk]

I am 6 weeks in and still sleep horribly, much worse than before PAP. My docs only advice at my 6 week follow up was to see a counselor trained in sleep disorders and to keep the mask on as long as I can each night. He also suggested I see an ENT surgeon with sleep training. I have an appt next week so we'll see what he says.

The short of it is that PAP works - it effectively treats apnea for the majority of people. However, it can cause serious sleep issues which can actually make overall life worse. That seems to be where I am. It is kind of damned if you do, damned if you don't. That is the interesting thing about this therapy. At the macro level, you are fine. It is treating your apnea and serious health issues will likely be averted. The bad news is you don't live at the macro level, you live at the micro level. If you aren't sleeping, your day to day life will absolutely suck. Mine was very fine before PAP honestly. I had no health issues, didn't snore, was active, etc. I now feel like crap all the time.

I think despite best intentions, this therapy isn't for everyone. You are clearly too early into the process to know for sure, but don't be embarrassed about looking into alternatives. There are several that are proven to be effective for some - from oral appliances to surgery. PAP is the first line because it works for most people and is the quick and easy solution for docs to prescribe. That doesn't mean it is the best for you.

[Tino2You]

I know this seems to be very daunting. if you look at my profile, you'll see that I am sort of new to this too. Got my machine in May. I am one of the people that took to the treatment quickly and have been seeing results. BUT --- unfortunately, that is not the norm. Most people will see slow rewards. One of the best things you can posses is a positive attitude. Buy into the treatment, knowing that you may feel worse before you feel better. Be a fanatic about using the machine and mask. The more hours you keep it on, the better your general health will become.

Links to the SleepyHead software I referred to earlier can be found on Pugsy's profile viewtopic/t80379/memberlist.php?mode=vi ... le&u=40932

It is free. One of the members here created it and for that we are all thankful. Using that you can definitively see how your are sleeping. In my case, I had to control leaks so that my S0 pressure could do battle with my collapsing throat tissues ;=)

Finally, when you feel frustrated and overwhelmed, come on in here and vent. We've all been there, done that, and have the tee shirts to prove it.

Welcome to the club
-tino

[TalonNYC]

It's true, sometimes the therapy doesn't work, but it's also true that it's a bit early to say. For me, I felt worse for about two weeks, then very quickly (within the next few weeks) felt better and better.

There are a few reasons this may be happening to you:

1 - You've never had to try to sleep with something strapped to your face and blowing air at you all night. Perfectly normal issue for most folks, and takes some getting used to. If this is the case, it *will* get better as you continue.
2 - You've got the wrong mask for your face/breathing/sleepstyle. There are dozens and dozens of masks, and nearly none of us on this forum got the right one the first time. Talk to your doctor and DME (the folks who get you your masks, machine, etc.) about trying different kinds of masks. I was prescribed a nasal mask, but it was horrific for me. Once I switched to a full face mask, things got a lot easier in terms of staying asleep, keeping it on, etc. Many folks are the exact opposite, hating the full face and loving nasal masks.
3 - CPAP isn't right for you. It's only a minority of folks who try CPAP therapy who end up here, but it does indeed happen. There are other choices to explore if CPAP just isn't the right choice. Maybe you need auto-adjusting PAP therapy, or surgery, or something else. Circle back with your doctor and discuss options.

I'd suggest going through options 1 and 2 before heading to 3, just in case it's one of the easier-to-fix issues, but that's just me =)

[Pugsy]

I wake up continuously throughout night and am not very comfortable.

Until you can sleep better without the wake ups feeling better likely isn't going to happen. Frequent wake ups for any reason be it apnea events or whatever keeps the body from going through the needed sleep cycles for restorative sleep.

What is not comfortable? Just having all this stuff on your face in general and the newness to it all? Or something specific like discomfort with the mask or leaks or whatever? Attempting to fix a problem involves trying to figure out what the problem is at first. If your mask is uncomfortable, painful or leaky then no amount of time is going to fix that. Try a different mask or try things to make this mask better. If it is just general hyper sensitivity to having the alien mask stuck on your face then time will help but you may need extra help. Talk to your doctor.
So what is causing the wake ups? Do you know?

[kteague]

Yes, an adjustment phase is to be expected. Problem comes when someone's therapy is the problem, and they keep waiting to get used to it. I had a couple things working against me early on. For one, I have limb movements that continued to disrupt my sleep, and they worsened after starting CPAP and not understanding their interactions, I thought the CPAP was all to blame for my misery. But my CPAP treatment sure had enough of the blame. I was the poster child for what not to do with the ramp feature. I got the machine with the ramp starting at 4. Didn't realize it could (should) be changed. Being desperately sleepy, I fell asleep immediately but in minutes I jerked back awake feeling like I was suffocating. Obeying the doctor's and DME's instructions, when I woke up every few minutes, I hit the ramp again to go back to sleep - always immediately. Little did I know I was sentencing myself to a night of having apneas with only a pressure of 4, so I was doing worse instead of better. Coming to this board and being given the suggestion to decrease my ramp time and increase my ramp pressure was the beginning of my real adjustment. Gave me enough energy back to begin to work more on other contributors. I'm really glad it worked for me in the end. A battle worthy of the fight. I was not even considering the popular surgeries back then because 3 friends had their soft palate reduced and uvulas removed and it was a rough experience for all of them. none were cured of their apnea, and one was left with trouble swallowing and "spitting" out his nose. Not to say it never works, but I just hadn't seen it work.

Another problem some have is trying to use a nasal mask or nasal pillows mask with nose problems so bad they can't even breathe through it during the day. A deviated septum to the point of being blocked, or turbinates so large they block the airways, can add challenges to CPAP treatment that either need resolved or use a full face mask. Those whose airway is so narrow not even CPAP can splint it open enough for comfortable breathing have a unique challenge too, and the surgery for that is serious business but I've heard it can be life changing. Getting this treatment right can be a challenge. First time around I quit after a few months. Found this place when I was ready to start again, and bit by bit the challenges have been met.

[robysue]

I expected this to be an adjustment but thought the sleep would be better. Is this normal? If so, how long does it take before I'll get a good nights sleep?

It's scary thinking I may have to wear this for the rest of my life. Especially if I can't sleep.
Any other suggestions and feedback are appreciated.
Thanks

You are only three days in. Very few people feel better that soon---regardless of what some docs and RTs claim about how quickly PAP will make a difference. And some of us face a pretty steep learning curve in teaching our bodies how to sleep well with the mask.

That said: If it feels like insomnia is setting in, it is important to NOT ignore it. That's a lesson I had to learn the hard way. It took me several months of cognitive behavior therapy for insomnia to rein in the insomnia monster that moved into my bedroom with the start of CPAP. If I could do one thing different about the first six months of therapy, I would have started the CBT at the end of Month 1 rather than waiting until the end of Month 3.

So call the sleep doc's office NOW and report the problem. It's early enough where they're likely to say, "Just keep trying." But it will establish a baseline in your medical records in their office that you are struggling. They may also offer to prescribe a short term prescription for Ambien or some other sleeping pill. Some folks are willing to take them and some aren't. But if you have no objections to sleep medication, many folks do find them useful for getting over the initial hump of adjusting to CPAP.

And it will help both you and your doc if you can try to pin down exactly what the issues are and document just how bad the problem is. A simple sleep log can go a long way in helping both you and the doc to measure the size of the problem and help you detect subtle, but important changes that indicate the PAP is doing some good and that the insomnia is beginning to wane. My advice about sleep logs, along with a whole host of other information about CPAP-induced insomnia can be found in the "Taming the CPAP Induced Insomnia Monster" link in my signature.

And do look at the data:

• If the AHI is still high (above 5), you may need a pressure adjustment in order for the machine to do its job and for you to eventually get some sleep
• If the leak data looks bad, you may need to change masks or add a chinstrap before you will be able to sleep with the machine.
• If both the AHI data and the leak data look good, you may find that will provide you with some motivation to keep on trying.

[chunkyfrog]

I am one of the few to feel a change the very first night. --No morning headache! --and no nightmares!
I had forgotten what waking up with no head pain was like; it had been going on for YEARS.
I still had a struggle adjusting. My pressure was 14cm. the dang thing nearly blew me across the room.
Even with EPR of 3, I had to fight to exhale at first. I had two of the worst-fitting masks (for me) for the first 4 months.
The techs didn't know (or care) about fitting these things.
Nose sores, leaks in my eyes, LOUD mask farts all night long, sore and shifting teeth, multiple wake-ups were only a few of my problems.
But NO HEADACHES! I guess I was lucky for those headaches and nightmares--they motivated me to make it work.

[Rjcisme]

thanks for all the feedback so far...this is great.

I think I'm going to wait a few more days to see if it gets any better. If not put a call in to my Dr office for feedback. I'm hoping the issue is just getting used to a mask strapped to my face all night. The lining on the mask is very soft and it seems like it starts to leak if I move to the side and adjust my head.
I am falling asleep and stay asleep for a period of time but guess that I wake up at least 4-6 times a night. The air pressure is not bothering me at all (set to 11).

If it is the mask..what suggestions do you have to try others? It seems like you really should get 3-4 at a time and try a different one for a few days. (I doubt the DR will do that)

[Pugsy]

If it is the mask..what suggestions do you have to try others? It seems like you really should get 3-4 at a time and try a different one for a few days. (I doubt the DR will do that)

Mask preference is highly individual. We are all different and have different problems and different needs. What I might love you might hate when you try it. I would hate, hate, hate to try to use your Quattro FX for reasons that are too numerous to go into. Others love it.

You are using a full face mask. Those typically will have more leak and comfort issues (just simple physics because of larger surface area to contact skin) but lots of people use them with great success. They do sometimes take some work or adjustments or mask liners to eliminate issues.
Do you have nasal issues that stop you from breathing through you nose only? Any consideration for trying a less intrusive mask like the one I use? Nasal pillow masks are by far the lightest and least intrusive and so much easier to maintain a good seal but you have to be able to breathe easily through your nose to use them.

Get the SleepyHead software (links in my signature line) and let's make sure that there isn't anything screaming "fix me" on your reports that might be causing some of your wake ups. It could just be the normal adjustment the brain has to make with learning to accept that the alien mask on your face is really a good guy but it is a good idea to check the reports just to make sure that maybe something else is contributing to the problem...like a big leak or something.

[archangle]

I think despite best intentions, this therapy isn't for everyone.

Only for those who don't want to die a slow, painful death.

You are clearly too early into the process to know for sure, but don't be embarrassed about looking into alternatives. There are several that are proven to be effective for some - from oral appliances to surgery. PAP is the first line because it works for most people and is the quick and easy solution for docs to prescribe. That doesn't mean it is the best for you.

The alternatives have cure rates similar to sacrificing a goat to your favorite supernatural being.

Sometimes it does take a lot of trial and error to figure out how to make CPAP work. Figure out what in particular is bothering you and fix it.