wait or adjust?

[tired and cranky]

Ok, so I've been through 3 nights with CPAP and I feel even more tired and irritable than before! My apnea was in the severe range so I was pretty tired before so how can I be even more tired? Funny thing is, I know I'm not snoring anymore. In other people's experiences, how do you know when to wait and give it time to work or when to make an adjustment? I NEED this to work!

[me2'sant]

I would give yourself a week to fully adjust but that is just my opinion.

[tired and cranky]

your opinion is worthwhile to me. Thanks!

[brazospearl]

It's probably going to take more than a week, but certainly more than 3 nights. How long were you untreated? If it's more than 3 days, you shouldn't expect to feel great in only 3 days. We'll do all we can to help you maximize your therapy. If you register and fill out your profile with your equipment (text, not pix) and let us know your settings we'll be able to give more specific information. Don't give up, you can make this work!

[rested gal]

What is the full name of the machine and mask you're using, and what pressure were you prescribed?

If your machine uses "EPR" or "C-Flex" for reduction of pressure each time you exhale, what EPR or C-Flex setting are you using (if any.)

I think it's probably not unusual at all for some (perhaps many) people to feel even more tired, sleepy, and worn out when they first start using CPAP, than they did before they started CPAP. After all, we're probably getting a lot of sleep disruptions just from the new-ness of trying to sleep in this crazy new way -- especially because of having a mask on one's face all night long.

A mask on the face, a hose to deal with, perhaps noises from leaks, perhaps mouth-breathing interfering with the therapy if not using a Full Face mask, difficulty in being able to sleep in one's favorite sleeping positions while wearing a mask... there can be many things causing arousals that might not be long enough wakeups for a person to even be aware of them.

For awhile, you may be trading off the dangerous sleep disruptions of apneas for a new kind of sleep disruptions -- equipment disruptions. Either way, sleep disruptions are sleep disruptions, and they mess with your sleep architecture (staying in each stage of sleep long enough to benefit from the stages.) There might even be more disruptions for quite a few nights while a person is getting used to all the equipment issues ... mainly the mask issues.

Finding a mask that is truly comfortable to sleep in is the main key to "doing" CPAP. Saying that a person has to get used to wearing a mask while sleeping is true, but if a particular mask is very uncomfortable there's not going to be any "getting used to" that mask. That's when a person needs to either find tweaks, fixes, or modifications to make an "almost ok" mask into a "hey, this is ok now" mask. Or, try a different mask or perhaps just a different size of the existing mask.

The first thing I'd want to know, if it were me, is what does the leak rate look like the next morning? Big leaks from either the mask, or from the mouth if not using a FF mask, can keep a person from getting the most effective therapy possible. Air gushing out into the bedroom is not going where it's needed to hold the airway open.

I would want a machine that can provide leak info. That's why brazospearl and I are asking what the name of your machine is -- some provide full data about leaks, AHI, etc., and some provide only "hours of use" info. Hours of use (compliance) info is useless when it comes to seeing how one's therapy is going.

I'd also want the software for my full data machine, in order to see detailed data about each of the most recent nights' therapy.

With those tools -- a full data machine and the software -- a person can see if there are obvious therapy problems that need to be addressed.

And of course this forum provides an invaluable tool. There's tons of information to dig into on this forum for how to make doing CPAP much more comfortable. Comfort is essential, imho, to speeding up the "getting used to it" phase at the beginning.

[Patrick A]

I have to agree with Rested Gal....She knows what she's talking about.
I had an appointment made for 30 days after my last sleep study. I would say give it 30 days, before I would make any changes to settings, let the doctor do them jmho.

[snuginarug]

I wanted to let you know you are not alone. I am on my third night also. I am just as tired as before, and also wondering how long it will be before I start feeling better. It takes some people longer than others to adjust and start reaping the benefits, and we just have to wait and see. I too am anxious to know whether I need adjustments in my therapy. The smart helpful people on this site have been a big help to me in figuring some things out, such as: I need a different pillow to accommodate the mask, I could benefit from a hose management system of some sort, and that I probably need a new mask. They have also told me I must be patient, which I am terrible at.

Hang in there!

[cjulia]

I am a registered user. Every time I try to post a new topic it says that the user name is already in use and to choose another one. Anyway, here is the equipment I've been using:
Resmed S9 Elite (with software)
Resmed 5i Humidifier
Swift FX Nasal Pillows

I appreciate the input very much.

[cjulia]

Forgot to mention that the pressure is set to 10 with a ramp up of 15 minutes. I also have the humidity set to 4.0

[jweeks]

I appreciate the input very much.

Hi,

Take a look at your AHI each morning. If it is above 10, then I'd suggest going back to your equipment provider or sleep doctor. The idea is that if it is really high, there may be something that isn't working right for you. If it is under 10, it might be you adjusting to the machine. In that case, I'd give it 10 days to 2 weeks. If it doesn't drop to under 5, then it is time to go back to your supplier or doctor.

Before I started on CPAP, I used to get up every 90 minutes or so to go to the bathroom. As a result, I was limber all the time. But once I started on the machine, I suddenly found my self in the same position for hours at a time. I wasn't used to that. I'd wake up stiff and sore. It took me a few weeks to get used to being asleep after not having slept hardly at all for the previous 18 months. It also can take a little while for your chest cavity and diaphragm to get used to your new breathing pattern. And if you are dreaming, it may take a little while for your brain to get back in that mode. I know that I was so into the dreams for a few weeks that I couldn't shut down my brain to get restful sleep. This is a lot of new stuff all at once, so it may take you a little time to get settled in.

-john-

[torontoCPAPguy]

You are tripping over your feet expecting the 'magic bullet' to mysteriously appear and I hate to say it, but it is very very rare for this to happen. I have been working dilligently at this for several MONTHS now and while the CPAP machine made a difference from the very first day it took me time to get used to it and get a better night of sleep. It will come but for most of us it is slow. You need to start grabbing your data daily including blood pulse oximetry data (mainly blood oxygen saturation data) as well. I use the data from my S9 and match it with my blood oxygen saturation reading (SaO2). Read, absorb, discuss, read, absorb, discuss and as you do the numbers will begin to make sense to you and you will be able to either discuss things intelligently with your doctor(s) or make minor changes to things like your pressure yourself. As you experiment you will find things improving hopefully. In order to discuss with you your data we need to see the data - there are many more experienced heads on here than mine and we are all here to share and help one another. And it generally works if you stick with it. You MUST stick with it. Your major hurdles will be getting a pressure range that works best for YOU (I use APAP and it works great for me - no ramping from day 1 but I have my EPR set to 3 all the time which means that when I exhale the machine senses it and reduces the pressure being presented by 3 cmH2O); mask comfort and fit... I went from nasal pillows to nasal mask to full face mask and with each I played with different sizes and models. I have come to rest at the Mirage Quattro full face mask having gone through many others including the Swift LT, the Mirage Activa nose mask and so on. I find that my leakage is minimal with the Quattro but having said that... unfortunately this may not be the same for you. I still intend to play with a bunch of masks that I have here already; both nasal pillows and nose masks. I find that I am a pillow smoosher and when I smoosh my face into the pillow the nasal pillows are toast - they turn into air power washers and blow holes in my eyeballs. The nose masks leak like a sieve. Only the Quattro full face mask has taken the beating and kept on ticking... no leaks generally. And it has a forehead brace so I don't have blisters on my nose in the AM. Now that my numbers are way way down, my blood oxygen sat is of concern and I still do not get a great night of sleep. My seperate recording blood oximeter (a Contec 50E) shows that my SaO2 goes down to the low 70% range some nights... and I am told that my autonomic nervous system is hollering at my body to wake up and breathe deeply - as if I was suffocating or drowning. Hence, a disturbed night of sleep but I cannot tell without another sleep study using an EKG to tell my levels of sleep. In conversation, reading past threads and in discussion with my rehab MD I get the distinct impression that an infusion of pure O2 into the air feed might bring my SaO2 at night up into the mid 90's and stabalize my sleep patterns after a while. I intend to try it. You must keep in mind that although CPAP has been around a while it is still relatively new and folks like my own GP have little knowledge when it comes to CPAP and sleep asides from writing an Rx for a pill to make me sleep. Doesn't do much for my quality of sleep nor my blood oxygen at night. SaO2 is critical for the health and performance of your liver, which processes the drugs, hormones and enzymes that your body is being fed or generating. Affect one for better or worse and your drug interactions change too. Sounds complicated and it is... and thus the reason that it takes time to find your own personal 'magic bullet' and a great night of sleep. I have had a few and I can tell you that it is worth the effort... I have not felt that good since I was a kid!

So, my simple advice is to get educated as best you can and as intensively as you can.... be your own advocate and be firm but polite with your MD's.... know what you need ultimately and seek it out. You will eventually notice the difference and hopefully will eventually find that magic bullet that gives you a great night of sleep and better health. Good luck. You CAN do it.

[torontoCPAPguy]

I appreciate the input very much.

Before I started on CPAP, I used to get up every 90 minutes or so to go to the bathroom. As a result, I was limber all the time. But once I started on the machine, I suddenly found my self in the same position for hours at a time. I wasn't used to that. I'd wake up stiff and sore. It took me a few weeks to get used to being asleep after not having slept hardly at all for the previous 18 months. It also can take a little while for your chest cavity and diaphragm to get used to your new breathing pattern.
-john-

John is, of course, spot on. I can remember waking up in so much pain that I was almost in tears. My chest was aching so badly that I thought I was having a heart attack and fortunately held off dialling 911 for a minute as I arose because as soon as I flexed things I realized that it wasn't a heart attack at all but 'muscular' or 'skeletal' in nature. For weeks I would arise from the pain and go the the washroom just to do something... after a while my body got used to sleeping in one position and the pain subsided. Now it is a rare occurence. But if I do awaken because I have been still for a long time I am able to move around and smoosh into my pillow now without fear of a major leak in my mask, etc. And I have installed hose management so that I don't get tangled up in the air line. Remember... this all is going to take time to get used to and implement. Keep reading and learning. You WILL get there.

[cjulia]

Thanks folks! I'll start paying more attention to the data. I haven't checked it yet because I wasn't sure how but it's a simple as reading the directions. I'll give it some time before I get discouraged. Thanks, again!

[cjulia]

how the heck do I read the data? do I have to remove the sd card?

[Sheriff Buford]

I Just past 30 days. I was miserable for about two weeks. Then one day in the third week, I slept all night, and woke up refreshed. I haven't felt that good from a one night's sleep for years. I still have good and bad nights, but I know the end result will be that every morning will be like that one morning.

It's like fishing... if you never catching any fish you quit going. But you go that one time and get into a "mess-of-em', and you'll never stop going. My problem is that I never got into a mess-of-em'.

Sheriff