My CPAP Journey

[caffeinatedcfo]

I thought I would share some highlights of my journey for newbies (haha I'm still a newbie).

My wife has been telling me for a couple of years that I had sleep apnea and snore terribly. I am a stubborn male and didn't take action. In my defense I generally felt that I slept well, and had plenty of energy for exercise etc. However, about a year ago I started developing some minor neurological issues (similar to Raynaud's) and some significant daytime fatigue. I also started waking several times during the night - every night. These symptoms progressed and after a full cardiac work-up, circulation tests, EMGs, and multiple blood tests my primary care doctor finally suggested I submit to a sleep study. On paper I seemed to be in good health.

Here is my original sleep study.




At first I was mad, anxious, determined to beat this "severe" OSA. I am a belly sleeper - they didn't test me in the prone position I told my wife. Well, a couple more terrible night's sleep changed my attitude and I asked for a consult with my sleep doctor. He reviewed all modern treatment options, including the risks and (not so great) success rates associated with surgery. I finally felt more comfortable after talking with him about CPAP and agreed to begin treatment while awaiting my titration study (scheduled for 4/21).

Week one was mostly getting leaks under control ... I took pretty easily to using a ffm. With the support of this forum I was able to determine my mask size was too big and this helped me get control over my leaks.

Week two has been slowly adjusting my minimum pressure upwards since based on my data I believe I will fall somewhere in the 12-14 range. I still need the lower pressure initially to maintain relaxed breathing while settling in for the night. I am up to 8 now and my AHI has been below 1 for the past three nights.

Although my AHI is low, I wonder if it is because I have not been sleeping well the past few nights. I'm still having some other sleep disturbances and am trying to figure them out. I have some mild carpal tunnel that seems to be waking me sometimes. I'm also waking many times feeling the need to change positions. Maybe this is my body trying to get used to side sleeping.

I will update with future highlights.

[caffeinatedcfo]

If anyone sees an issue that could explain 5-6 conscious awakenings (other than the short break to itch my nose when I de-masked), please comment.

[ArmandXP]

I wish my numbers looked that good!!!! I never got any docs from my sleep study. I've been using the sleepyhead software and I can't get below a 7 on the AHI. But, I'll keep trying....

[Pugsy]

Maybe those 2 OAs at around that 2:50 time frame right before the break in therapy line where you turned the machine off...was that the itchy nose or the unknown cause for wake up?
Maybe if the OAs were real they may have caused an awakening????
It's a guess...we don't have any way to know for sure but it would be possible.

The other awakenings....only thing I might think of is that maybe the pressure changes in APAP mode are maybe slightly disruptive to your overall sleep. Some people are sensitive to the least little change in pressure and find that the changes cause their sleep to be disrupted. So those people seem to do better in straight cpap mode or a very tight APAP range.
Some people can sleep through hurricane force winds changes.

You know it's normal to have a few remembered awakenings...which usually means that we had more that we don't remember.
If you feel that the awakenings (remembered or not) might be impacting how you feel then you might want to do a little detective work to see if you can figure out something that might be contributing to the awakenings and maybe causing you to feel less than optimal.

Remember, there are other factors that affect the quality of our sleep besides the sleep apnea events.
Meds, pain, general health, bed comfort, itchy nose , or whatever. There's a big list.
Myself...I can sleep through pressure changes from 8 to 20 and never know it till I see the report but I have pain issues that cause me to wake up more than I want.

[Drowsy Dancer]

I'm surprised they described a sleep onset latency of 3.2 minutes as "normal."

[morrigan]

Have you tried wearing a wrist brace to bed for the carpal tunnel? I do that when my hands are acting up. I wouldn't suggest wearing it all day, but if you wear it while you are sleeping, it will keep you from bending your wrist.

I also have some exercises I do that stretch out the tendons. Please PM me if you are interested.

[johnthomasmacdonald]

my main advice to anyone starting this out who was having problems is to mainly work at getting comfortable with the devise. Learn how to sleep with the mask on and the air blowing- don't worry so much about fine tuning the therapy to minimize your ahi.

[cosmo]

7 hours of sleep and AHI of .71 is pretty good for a newbie using a full face mask.

[caffeinatedcfo]

The other awakenings....only thing I might think of is that maybe the pressure changes in APAP mode are maybe slightly disruptive to your overall sleep. Some people are sensitive to the least little change in pressure and find that the changes cause their sleep to be disrupted. So those people seem to do better in straight cpap mode or a very tight APAP range.
Some people can sleep through hurricane force winds changes.

Remember, there are other factors that affect the quality of our sleep besides the sleep apnea events.
Meds, pain, general health, bed comfort, itchy nose , or whatever. There's a big list.
Myself...I can sleep through pressure changes from 8 to 20 and never know it till I see the report but I have pain issues that cause me to wake up more than I want.

Good thoughts. I did start taking Claratin-D last Thursday (the 24-hr version). I'll try skipping it today and just take a benedril at bedtime. I had trouble again last night and it seemed related to leaks. I can not seem to get my liner clean enough to regain it's tackiness. I switched back to non-AB hand soap yesterday and the liner is only 4 days used.

my main advice to anyone starting this out who was having problems is to mainly work at getting comfortable with the devise. Learn how to sleep with the mask on and the air blowing- don't worry so much about fine tuning the therapy to minimize your ahi.

Thanks - the mask and breathing are ok; except i can't stop the mask from leaking at pressures over 10 without cranking the straps super tight.

Have you tried wearing a wrist brace to bed for the carpal tunnel? I do that when my hands are acting up. I wouldn't suggest wearing it all day, but if you wear it while you are sleeping, it will keep you from bending your wrist.

I also have some exercises I do that stretch out the tendons. Please PM me if you are interested.

I did and it did nothing - I still woke up with tingling fingers and pain. I'll PM you.

7 hours of sleep and AHI of .71 is pretty good for a newbie using a full face mask.

I agree except I didn't sleep close to 7 hrs - more like 4 combined (2 + 1 + 1). The rest of the time I just laid there with mask on.

[SleepWellCPAP]

Hello Caffeinatedcfo,

The download you have posted looks exceptional. Nothing from that would indicate from an airflow perspective why you are experiencing disruptions to your sleep episode.

One of the things I came acrossed during my research, was that in order for a rest period to feel recuperative, we go through four to five sleep cycles. We drop from awake to stage 1 to 2 then 3 for a while, back to 2, then REM. We exit REM to stage 2 and repeat the cycle without hitting 1. Stages 1 and 2 are light sleep, according to published literature, if you wake someone in these stages they may say they weren't sleeping at all. I'm wondering if the 5 to 6 disruptions you're having are occurring during the stage 2 breaks.

The main question I suppose would be, are you feeling rested?

Hope that helps, please keep posting, it sounds like your doing well. Based on the download you are doing great.

Jim

[caffeinatedcfo]

Thanks Jim. No I have not felt rested since last Friday. Last night I was more aware and believe it's one of two culprits:

a) My mask cushion is shot (after 4 days use) - I've noticed it isn't as tacky as it was when I got the mask. I wash it with unscented, non-AB hand soap and hot water every morning. By the middle of the night it is very smooth. Basically, when my pressure goes above 10 I have to crank the straps tight to prevent leaks. This in turn is definately causing some discomfort in my neck. I called Lincare and they are giving me another cushion today for free.

b) I started taking Claritin-D for allergies last week (24-hr). A potential side effect is insomnia. However, I don't have trouble falling asleep. I just seem to have trouble staying asleep.

I'll have an idea tomorrow if the new cushion has a positive effect. If not, Lincare said they would get me back in to re-fit a different mask at no charge since I'm still a new patient.

[LSAT]

Thanks Jim. No I have not felt rested since last Friday. Last night I was more aware and believe it's one of two culprits:

a) My mask cushion is shot (after 4 days use) - I've noticed it isn't as tacky as it was when I got the mask. I wash it with unscented, non-AB hand soap and hot water every morning. By the middle of the night it is very smooth. Basically, when my pressure goes above 10 I have to crank the straps tight to prevent leaks. This in turn is definately causing some discomfort in my neck. I called Lincare and they are giving me another cushion today for free.

b) I started taking Claritin-D for allergies last week (24-hr). A potential side effect is insomnia. However, I don't have trouble falling asleep. I just seem to have trouble staying asleep.

I'll have an idea tomorrow if the new cushion has a positive effect. If not, Lincare said they would get me back in to re-fit a different mask at no charge since I'm still a new patient.

Your cushion should not be 'shot' after 4 days...these cushions last months. I change mine every 3-4 months, but I have used a cushion for over 6 months. I use the same mask at 13-14 pressure without 'cranking it down'.

[caffeinatedcfo]

Thanks LSAT. I'm wondering if i did something wrong caring for it. The DME gave a me new cushion today. Hopefully this one lasts.

What do you clean yours with? I've been using soapy hot water with unscented, non-anti-bacterial handsoap. I let it air dry.

[LSAT]

Thanks LSAT. I'm wondering if i did something wrong caring for it. The DME gave a me new cushion today. Hopefully this one lasts.

What do you clean yours with? I've been using soapy hot water with unscented, non-anti-bacterial handsoap. I let it air dry.

I wipe it daily with a CPAP wipe...I wash it once every 7-10 days with hot water and liquid hand soap....every 60 days I boil it.

[caffeinatedcfo]

Yep, the new cushion did the trick last night. I slipped and used baby wipes on the previous one a couple times last weekend and must've messed it up.