First some background. I am a 33 year old male, with no major health issues other than sleep apnea. I don’t smoke, rarely drink and exercise 5-6 days a week. I had my first sleep test (in-home) in January of 2019 after complaining to my primary care physician that I was exhausted most of the time. The results showed I had an RDI of 15.9 which was a complete shock. I asked the doctor I was referred to if he thought it was a mistake and he assured me the tests were “pretty” accurate (w/e that means…). The end result was a prescription for CPAP and a “good luck”.
After a few weeks I picked up my CPAP machine (Resmed AirSense 10 autoset) and mask (Airfit N20 nasal) and the fun began. From the start, I knew I was going to have issues with CPAP. I’m a notoriously finicky sleeper and have trouble getting to sleep unless conditions are near perfect. I started trying to use the machine right away but was unable to fall asleep with it. I would put the mask on for a little while, maybe an hour and then take it off so I could actually go to sleep. I eventually stopped using the machine altogether after I got pretty sick with a respiratory infection. I didn’t exactly keep up with cleaning the machine so that might have been the cause.
I didn’t use the machine for multiple months. My timeline for some of these past events is kind of fuzzy as I didn’t keep records. I started trying to use the CPAP machine again sometime around April or May of 2019. I struggled with the same issue as when I first tried. I would go to bed with the mask on but was unable to fall asleep with it on. I tried to use the machine for what I think was the better part of 2 months (??). In that time period, there might have been 1 or 2 nights where I slept for 4 hours with the mask on. Eventually I gave up and started looking into other options. I ended up getting a mouth guard which seemed to help some with how I feel during the day and has solved my TMJ issues for the most part. The mouth guard may not be fully treating my apnea but it is worth using for the latter reason alone.
While I was looking into other options, the nurse I was seeing kept encouraging me to try CPAP as it’s the “gold standard” of treatment. I ended up getting a few different masks to see if that would help. I hated one of the masks and the other (Resmed Airfit P10 nasal pillows) is okay. It kind of hurts my nostrils after awhile. Anyways, I was prescribed some Ambien (sleeping pills) which helped me to fall asleep with the mask on most nights that I took them. This allowed me to get at least some data which was nice. That being said, when I got into the clinical menu and started looking at my events, 99% of them were central. And, furthermore, the events per hour were higher than my in home sleep test. Perplexed, I spoke with the lady I got the new mask from who talked to the nurse. To sum things up, they were concerned that possibly the CPAP was causing central apneas and that I should get an in-lab sleep test to get a more definitive diagnosis.
I ended up waiting a long 6 months to get my in-lab test. Honestly, the intervening period where I did not have to try to use the CPAP machine was kind of nice. I’m not sure anybody can relate to this but it was like being laid off from a job you hate. Anyways, I got the results of my in-lab test about a month ago, the results of which are shown below. I can provide more screenshots of the results if anybody wants them. All I have is the summary though, I don’t have the full study.
- sleep_test_031420.png (51.09 KiB) Viewed 14046 times
At this point, I’m not really sure what to do. I’m going to be starting work again on Monday and I honestly don’t know if I can continue trying to get used to CPAP and work at the same time. That might sound crazy but I end up losing sleep while trying to use the CPAP which makes things even worse. Not only am I getting no perceivable benefit from the treatment; it’s making it even harder to function during the day. I cringe at the idea of having to make myself more tired to try and get used to using this machine that I hate. I’m already so tired some days that I just want to crawl up into a ball and cry. The fact that I feel like I have to choose between working and treating my medical condition is pretty crappy. It makes me feel like it is hopeless and I am screwed.
A large portion of myself wants to just say screw it and give up on using the CPAP. I’ve never seen any actual benefits from it and I’ve been this tired for years. I could probably just put up with it until I kick the bucket. Most of my family doesn’t really seem to think what I have is serious anyways. Only my fiance thinks I should treat it because she says she wants me around for as long as possible.
To those that have actually read all of this and been through a similar ordeal:
Did any of you consider just giving up on treatment? If so, what made you persevere? Was it worth it? Do you feel better now?
Should I actually be concerned about the health effects of my condition? At this point, I really just don’t want to be tired anymore. The health effects are a secondary concern.
My current CPAP settings:
Machine: Resmed airsense 10 autoset
Mask: Airfit N20 Nasal
Ramp- ON, 30 mins starting at pressure of 4
Pressure relief is ON
Mode: Autoset
Min pressure=6
Max pressure=10
Avg usage last 6 nights- 4.6hrs (yeah Ambien!)
Avg pressure- 7.3
AHI=12.8
AI=12.5
Central AI=12.3
I am working on getting OSCAR and an SD card reader so I can look at some of my data.
I apologize again for the incredibly long post. Any encouragement/advice anybody wants to give would be greatly appreciated.
. I will try to watch them later.