CPAP: Day 0

[Outside Enemy]

I met with a DME today, and they set me up with a mask and machine. I am a complete noob regarding all of this, though I am hopeful that the therapy will prove useful. My sleep apnea was diagnosed right around the moderate/severe borderline.

I was set up with a Swift LT nasal pillow mask, and an S9 autoset machine. I wasn't expecting to go for the nasal pillow (I imagined that it would be quite uncomfortable), but, after trying out various masks, I went with the pillow. I'll may also get a full face mask as I have seasonal allergies which occasionally prevent me from breathing through my nose for a week or so at times.

Beyond all of the various medical concerns, I am hoping that therapy will address my chronic fatigue. I am tired all the time, regardless of how much I sleep. Being a graduate student, this has proven to be a serious issue throughout my academic career. Though I am extremely skeptical, I hope that this will begin to change with the therapy.

I'll be up until 1 or 2 in the morning grading final exams, but then I plan to begin my first night on CPAP. I'm off to get distilled water for the humidifier, and hope for the best.

Thanks all

[roster]

Though I am extremely skeptical,

Strange.

[elena88]

Hi and welcome!

I know how you feel, yore probably tired, and feeling a bit overwhelmed, but also exited that MAYBE this is the genie in the lamp you
have been looking for..

you wrote: " though I am hopeful that the therapy will prove useful."

YES! you just have to go thru pass thru the ring of fire, for some its easy, for some its very hard, but this will help you make your life and your health

the way you thought it should or could be.. You are on the right path, and there is a pretty huge learning curve.. but, things are about to change,
and in the end, it will be so incredibly worth it..

Be sure to read the "where newbies should start" too..

Good luck, and if you have any questions, just come here, someone will have an answer for you!

elena

[Janknitz]

Hey, I'm just here to say don't expect miracles the first night. Be realistic, set realistic and attainable goals for yourself.

You may be one of those people who take to CPAP like a duck to water, sleep great your first night, and feel like a million bucks tomorrow, but most people are NOT like that.

If you are like most people, you may need some time to adjust and feel comfortable with your mask and your pressures so that you can sleep all night. It takes patience and persistence, but it WILL pay off in less fatigue and a clearer mind--it just may take some time.

Sounds like you are starting off with the state of the art machine and a good mask. The LT is SO much more comfortable than a FF or nasal mask!!!!

I personally love the LT, but it can be challenging for a newbie. Take some time to play around with the mask to understand how it works and how to adjust it. Make sure it's put together correctly! Before putting it on your head, turn on the machine with the mask attached and touch the nasal pillows to the meaty part of your hand. Notice how the pillows kind of reach out and grab your hand? This is the seal you want against (not IN) your nostrils. You may have to experiment with the different pillows that came with the mask to find the ones that fit you best--if in doubt, go UP a size. Ideally, the whole mask should have a loose, comfortable fit and you shouldn't be able to feel or hear air coming out around your nostrils. Be sure you understand the difference in sound between nostril leaks and the exhaust port in front of the nose.

Good luck--hope it is a great night for you!

[Outside Enemy]

Though I am extremely skeptical,

Strange.

Is it so strange? Chronic fatigue has been the state of affairs for me for some time. Being tired all day every day is just how the day is for me. While I understand what the treatment is and the general theory regarding how it works, I don't know that I believe that it will change this state of overwhelming tiredness.

I certainly hope that I'm wrong. It's simply that it is quite difficult to imagine what it would be like to not be tired all the time.. though I know that there was a time when I didn't feel this way, I do not remember what it felt like.

In any case, I plan on full compliance, and I will check in with updates over the next few days to give my initial impressions. I've searched the board for several 'initial impression'-type posts, and I find them to be quite helpful. Good or bad, you'll hear from me tomorrow.

[roster]

Just remember, CPAP vs. apnea is the war that can't be won, the battle you never want to give up.

[carbonman]

I don't know that I believe that it will change this state of overwhelming tiredness.

Zen of the Mask - Recovery/Rebirth

Zen-direct experiential realizations toward obtaining an awakening.
The practice to discover, through daily, or in this case, nightly,
experiences that will lead one to ultimate enlightment.

All things are brought to each of us, for a reason.
Why OSA???

In OSA therapy, the mask, is everything.

recovery
a regaining of something lost or stolen

rebirth
regeneration of something destroyed: the regeneration of something that has died or has been destroyed

Hard exercise does not build strength and endurance.
Hard exercise tears the muscle down.
Proper nutrition and rest build strength and endurance.

Silently, alone in the dark of the night, from deep in the abyss of my brain,it seeps out.
Quietly it flows throughout my body and I am recovered and
reborn.
HGH-human growth hormone. Secreted from the pituitary gland during REM sleep.

From the 5th morning, after 5 of the most horrific nights of my life,
I felt the first stirrings of the recovery/rebirth. I had just lived through the first
5 nights of cpap therapy.....and survived.
It wasn't much. Just a slight easing of the pain in my legs as I walked up the stairs at my work.
It was enough to convince me to keep trying.

Last Saturday, ~2 miles from the summit of Vail pass, my rebirth was complete.
My mind, firmly in control. My body, begging to stop this madness.
Mind dictating to body, you're fine.
Today is our day.
Today we are reborn.
Today, through cpap, we are recovered.
In retrospect, the strongest ride of my life.

So, 1yr after starting cpap,
at the tender age of 58,
I am reborn.
What was stolen from me for years, has been found.
What was dying, has been rebuilt.

With every night of cpap, the horizon continues to stretch farther away.
The boundaries of my limits continue to expand.


Yin/Yang of life-
MY choice to embrace or reject, the mask, and in so doing,
chose quality of life.

I have chosen quality of life.

[cotech50]

Improvement may be dramatic or you will see small improvements over time. Bottom line if you find a mask or masks that will work and you start getting periods of better sleep you will improve. After 6 mos I have more energy and can do more but I still get tired in the late afternoon and still head to bed around 9pm. This may be it for me but it is far better than where I came from. Good luck and keep a positive attitude, this a major lifestyle change and will probably be long term not short term.

[roster]

Don't forget, CPAP will not make everyone an inspirational poet.

[fisamo]

Though I am extremely skeptical,

Strange.

Is it so strange? Chronic fatigue has been the state of affairs for me for some time. Being tired all day every day is just how the day is for me. While I understand what the treatment is and the general theory regarding how it works, I don't know that I believe that it will change this state of overwhelming tiredness.

I certainly hope that I'm wrong. It's simply that it is quite difficult to imagine what it would be like to not be tired all the time.. though I know that there was a time when I didn't feel this way, I do not remember what it felt like.

Look at it this way. If you have a machine, it means you've done a sleep study or two - you should have been told an AHI, which stands for apnea/hypopnea index, or "events per hour". Mine was 18, which is moderate. Average it out and round up to 20, and I was having an 'unable to breathe' event every 3 minutes. When that happens, your body naturally rouses (to some extent) to clear the obstruction, catch a few breaths, and you generally don't even realize your sleep was interrupted. My point is, your quality of sleep has been poor. It probably declined gradually over a fairly long while, so you never really noticed anything until it got really bad...

I'm in your boat, only a day ahead of you. In theory, if your pressure is right and you've figured out all of the other art of setting up your therapy (humidity level, hose management, mask type, and mask fit are just a few of the variables), you'll find that treatment will dramatically reduce your number of events. (I make this statement based on my second sleep study, where with my pressure (7 cm H2O), my AHI dropped to 0.2--anything under 5 is considered 'treated'.) Based on my treatment last night, my AHI dropped to 6.2 (from 18 untreated), which means I have more tweaks to make. I had noticeable leakage, which definitely interrupted my sleep (especially with my wife smacking me to adjust my mask! ). I have felt noticeably better today (some could be placebo effect, I have to admit), but definitely not where I want to be.

In any case, I plan on full compliance, and I will check in with updates over the next few days to give my initial impressions. I've searched the board for several 'initial impression'-type posts, and I find them to be quite helpful. Good or bad, you'll hear from me tomorrow.

Great plan! The key thing here is to not give up. Post your experiences, thoughts, ideas for improvement - this board has a great group of supporters, because they've all been there. Also, take a good look at the data your machine provides. When you get up tomorrow AM, after you take off your mask and 'turn off' your machine, hold the Info and Settings buttons down for 3 sec to get at the 'detailed info' display to get your AHI, leak rate, and event count. You can monitor those over the first few days for an overview of how your initial therapy goes; with the ResScan software, you can get much more detailed information. (I have not yet installed it, but there are plenty of people here who have used it extensively.)

Welcome aboard. Feels funny to say that, since I've only started my therapy yesterday, but you will find a lot of help here. If you haven't checked out the Wiki and New Users icons at the top of the page, there's a wealth of great information there. Rest well! err.. when you're done grading.

PS: What graduate degree/discipline are you working on?

[Julie]

This may be silly, but has anyone actually explained the dynamics of OSA and Cpap to you? Do you understand what happens when you get apneas at night and therefore feel awful all day afterward? And how Cpap, a plainly mechanical aid that allows you to breathe normally at night can make a huge difference? It's always easy to assume that people know the basics, but if they're never told, they won't know, and may feel they should so don't ask. Do explore all the links from the lightbulb at the top of the forum and you may get a better understanding of what's going on and why it therefore works (in theory 100% of the time, in reality depends on how well you get set up and how well you follow through). Of course there will be small glitches along the way as with anything else, good days and bad ones, but on average you should start to feel a lot better within a relatively short time. If not, then come here with what's happening and we'll all be glad to help out.

[cobra4x4]

You will probably find you won't need a full face mask, If you get congested from allergies you'll probably find after 5-10 minutes on cpap that your congestion goes away, mostly due to the pressure thats being forced in but also because the air your breathing in while on cpap is being filtered.

[DreamOn]

Welcome, Outside Enemy! You have a top-of-the-line machine that's capable of reporting full data such as leak rates, AHI and apneas, so you'll be able to monitor your progress.

This therapy can change your life, but sometimes there are adjustments that need to be made along the way to optimize therapy. Others here have faced the same challenges, so be sure to ask any questions that may arise.

I look forward to hearing how things go for you, and I hope that you're pleasantly surprised with your results. Sleep well!

[roster]

You will probably find you won't need a full face mask, If you get congested from allergies you'll probably find after 5-10 minutes on cpap that your congestion goes away, mostly due to the pressure thats being forced in but also because the air your breathing in while on cpap is being filtered.

Not.

[Outside Enemy]

... and I have returned.

I should say, I do understand the basic concepts involved with sleep apnea and CPAP treatment. That being said, there is possible comorbidity involved in my chronic fatigue that that even if the therapy works flawlessly, my ever-tiredness may not be cured.

So far as my first night... it didn't go so well, but it was a learning opportunity:

-Getting to sleep was somewhat difficult. It isn't the mask/headgear as such, but rather the constant worry that it isn't sitting correctly, or that my next movement will dislodge it (possibly in ways I would not notice until I checked the machine readout the next morning).

-I can't remember the last time I was so conscious of my breathing. Breathing through my nose is much easier with the machine, and I've found it to be a natural tendency to take deep steady breaths when using it.

-I woke up quite early, and decided to just get up for the day as I didn't think that I would be able to get back to sleep with the mask. Part of the reason for this is that my nose was hurting from the nasal pillow mask... more on that in the next point.

-When I went to bed, I got the machine ready, through on the mask, and resolved to try it. After a short time, I noticed that the mast was much less comfortable than it was when I was trying it on with the DME. Even as I tried to fall asleep, I was resolving to call the DME on Monday to look into straight nasal masks. I didn't bother changing the mask sitting save to tighten straps a bit. In the morning, my nose was very uncomfortable... the top of my nostrils and the skin around the ridge had been scrunched up all night. After messing with the mask in the morning, I realize two things: 1. To me, it is intuitive that you would want to line up the pillows in the axial direction of the nostril... this, however, is a mistake. It goes against the design of the mask, and with the straps it causes the whole thing to pull up on the nose quite a bit. 2. The mask was WAY TOO TIGHT. You think 'air-tight seal' and the idea comes to mine to jam those pillows in and tighten those straps to keep it in there. Playing with the mask this morning... they maintain a seal even with very little pressure beyond being gently seated on the nostrils. My brief experiments this morning seemed to indicate that the mask could be much more loosely strapped on and irritate my nose much less.

-My nose/throat has been a little raw today... I'm going to try increasing the humidity to 4.0.

-The little clip that allows the mask hose to clip to the top of the head was quite useful for me, given how I have everything set up.

-To be honest, I didn't feel much better today than before. I suppose I was a little faster on the gas in the morning, and I've been able to grind through grading exams without the debilitating urge to sleep, but the change was subtle if present at all. We'll see if things improve over time.

-Sleeping on my side, I had an AHI of about 28 during my sleep study (almost entirely hypopnea) and about a million RERA events, many of which resulted in significant arousal. In the morning, the S9 measured my AHI at 2.2.

-My recommended titration pressure is 7 cm H2O. When I woke up and poked the machine, it was at 10.5.

Hopefully, tonight will be better than last night. We shall see.