I want to try a recap of what I remember of your cpap therapy:
- You tend to insomnia, and on both sleep studies slept very little
- Your first Rx was for a pressure of 9; that pressure gave you aerophagia and nightmares of being force fed like a goose.
- A trial on a Resmed auto resulted in a recommendation to run the APAP pressure at 6 to 8 IIRC.
- You then had a new sleep study, and based on 17 minutes of sleep were Rxed a BIPAP at IPAP 8 EPAP 6
The things that bother you:
- Aerophagia if the pressure is 9
- EPR starting too soon on the Resmed
- Biflex bringing air in too soon on the Respironics -- solved by a rise time of 3
- Air tickling in the back of your throat
Furthermore:
All options tried till now have resulted in worse sleep quality than you had before cpap.
Fact: When you sleep at home, there is indication of residual snoring, on both machines.
There are a number of ways of understanding this information:
I. xPAP therapy is not helping you at this point because you have not yet arrived at the proper pressure to keep your airway clear - hence the residual snores.
II. Your extreme sensitivity at the back of your throat is making xPAP therapy a cause of added arousals, instead of a cause of improved sleep.
III: Your hypopneas with arousal seen in the sleep study are a result of GERD - which has recently been identified as a cause of insomnia, arousals, irritation of the nasal mucosa and back of throat. People with a weaked lower esophagal sphincter will have more acid reflux -- and more aerophagia.
Of course, all of the above may be true.
I would do the following:
1. Have the issue of GERD thoroughly investigated.
2. Make a concerted, conscious effort to get the back of my throat used to the blowing air. I would do that by using the machine during the day when I'm awake and busy concetrating on something I like doing. This would serve me as a way of experiencing the fact that "air in my throat is something I
can tolerate".
Being highly sensitive can be very difficult -- and sometimes, just knowing we are highly sensitive is a big help in going through life. Sometimes that's not enough, though. Sometimes the next step is finding the ability to tell ourselves "I'm highly sensitive, but I want to try to develop the capacity to ignore this or that irritant". It's not easy, and growing up where our sensitivities are mis-perceived or ignored often makes them clamor for our attention insistently. Learning to overcome some of them means developing the paradoxical capacity of being highly tuned to yourselves, listening to that clamoring voice giving it the attention it needs, accepting it, and yet learning to distract ourselves from it, without making that sensitive part feel betrayed and bereft. Very difficult.
3. I would search for a combination of IPAP and EPAP that would keep me from snoring
consistentlyAnd now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery
Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023
