Two month anniversary and this isn't working at all for me

[johnthomasmacdonald]

I've used the machine religiously for at least 8 hours a night and haven't missed one night although last night i threw the mask away for a couple of hours in the middle of the night - hardly matters, my ahi was the same,21, with or without the mask and machine . I've gotten a couple of days in a row when i get my ahi below 5 but it never holds up. I've tried a bunch of different masks to no avail. Last failure was a respironics full comfort a couple of nights ago. i've got all the bells and whistles from pad a cheek. They do nothing to help. I've tried to keep absolutely everything the same, i take detailed notes before and after i try to sleep every night. I see the doctor next friday if she can't figure something out i don't know how much longer i can keep doing this - i'll have to try surgery and dental implants because the machine seems mostly useless for me . Everyone who knows me has commented that i seem much worse since i started this and i'm so tired and out of it that doing my job is near impossible, i barely know my name - i don't know how long i can keep this up.

[Posey]

Something is WRONG. I agree. (I am still waiting on my VPAP so am not the one to help you.) I do wonder if your titration was correct? My pulmonologist has to check my compliance at 1 mo to verify usage & efficiency and I hope I don't go 2 mo w/o a decrease in AHI. Let us know what your doc has to say.

[Lizistired]

John, I think you will have better luck here if you try to stick to one thread. It makes it easier for people to read through the history of your therapy and what has already been tried.

[danmc]

I struggled for ages when I started. Would wake up and rip the mask off. I just kept trying, same as quitting smoking. You can't lose if you never quit.

[sylvie]

I had a horrible number of months when I first started to. It was because I was titrated way too low and had a brick and had no idea that the pressure was way too low.

[The Sheikh]

John,

Just a shot, but is there a chance you are having a large number CENTRAL apneas? What did your sleep study say about it? Does your current machine show you the expanded breathing flow charts to see for yourself?

If you have centrals, a CPAP/BiPAP machine may not cut it and you may need an ASV machine instead.

Tom

[Sir NoddinOff]

Your story is all very problematic and troubling. IMO, there's some serious insomnia and/or sleep anxiety going on here. You need to talk to your sleep doc and get him/her to understand that something is not working out and your sleeping habits are on the skids. Once your airway is open with CPAP, you should be getting some relief, unless, like someone mentioned, lots of centrals are being triggered... again, time to see the doc. Maybe ASV or bilevel? Hard to say without tests. It's very difficult for the members of CPAPtalk to diagnose something this complicated without wiring you up, titrating you and seeing what's really going on. Sorry, if this sounds like 'ducking the issues' but I can't think of anything else to say.

[Kitatonic]

I noticed that you have the same Phillips machine that my husband had, with frequent wakenings, need for sleeping pill and a pressure that was too high (note the centrals). For him, changing to VPAP at a lower pressure greatly benefited him. We both have OSA, mine with severe hypoxia, but only his treatment has been problematic. He also, noticed that on the Phillips, his inspiration/expiration ratio was reversed (too short of expiration). This became completely normal with the VPAP as he could set the expiration relief at 4. Not sure this fits you at all, just a thought to consider with your doctor.

How would dental implants help? Since I have them, I asked DrPark, the ENT who does call in questions, and he replied that only if you are missing incisors/more the front teeth.

[americanfreedom]

i ve been on cpap for five years my mother has been on for two monthes had a lot of trouble with masks her no. was 59 ahi got her on a resmed but a fisher and paykel mask the mask works much better than phillips or resmed masks i also got her a heated hose which really helps with her sinuses and warms the air nicelygood luck and hang in there once you get things working good it makes a world of difference

[johnthomasmacdonald]

it actually got worse after this post, couldn't sleep at all the next night - with or without cpap. at low pressure i feel like i'm not getting enough air to breathe and at high pressure - the full face masks leak - and i can't exhale ( on both the full face and swift FX). Either way i feel like i'm being smothered to death. Last night i slept upright in a lounge chair and got my first decent sleep in weeks - I'll be doing it again tonight ( got a nice roaring fire going in the fireplace next to the leather lounge chair and a nice pile of books - I'm leaning towards starting stegner's angel of repose - always been meaning to read that) - I don't think i'll try cpap again until my order comes in from cpap.com ( went with the sponser over 1.800cpap, my previous supplier) ordered the omni 360 ( i think that's it ) and a new lg pillow for the swift fx. Also have an appointment next friday with sleep doctor and one on tues for a dental option.

[lazer]

How would dental implants help? Since I have them, I asked DrPark, the ENT who does call in questions, and he replied that only if you are missing incisors/more the front teeth.

Not to go off-topic but I wonder if I should be wearing my "uppers" at night? And I would consider dental implants but they are so expensive or so I presume.

/Carry on, sorry for the interruption..

[jtmarten]

it actually got worse after this post, couldn't sleep at all the next night - with or without cpap. at low pressure i feel like i'm not getting enough air to breathe and at high pressure - the full face masks leak - and i can't exhale ( on both the full face and swift FX). Either way i feel like i'm being smothered to death. Last night i slept upright in a lounge chair and got my first decent sleep in weeks - I'll be doing it again tonight ( got a nice roaring fire going in the fireplace next to the leather lounge chair and a nice pile of books - I'm leaning towards starting stegner's angel of repose - always been meaning to read that) - I don't think i'll try cpap again until my order comes in from cpap.com ( went with the sponser over 1.800cpap, my previous supplier) ordered the omni 360 ( i think that's it ) and a new lg pillow for the swift fx. Also have an appointment next friday with sleep doctor and one on tues for a dental option.

Are you data logging? If the PR doesn't, I'd recommend getting a machine that does. My Dr prescribed 7cm based on my sleep study, but my AHI was still in the mid-teens, low 20's (vs 70ahi during my study with 90% of the total being centrals). Increased my pressure to 10cm in auto mode on the S9, now my ahi is single digit. If you have centrals, you really need a data logging machine.
I just went from a ComfortGel nasal mask to the Opus 360 this week (received it Mon). The decrease in felt airflow is a huge change compared to the ComfortGel. My breathing always felt 'labored' after taking off the ComfortGel. With the Opus, breathing feels about the same as without the cpap. But, I find I'm sleeping much better, at least I feel better, more rested in the mornings. Its nice not having to fully wake up several times a night to unwrap the hose from around my neck.

[Sloop]

at low pressure i feel like i'm not getting enough air to breathe and at high pressure - the full face masks leak - and i can't exhale ( on both the full face and swift FX).

Also, from reading your other thread, you seem to be experimenting. If so, why don't you try this for one night. Turn your machine to basic CPAP and use your normal high setting BUT put the A-Flex to maximum (3?). I can tell you this -- with my machine set to 12 and C-Flex set to 3. I feel NO pressure at all on exhale -- everything is very comfortable.

[johnthomasmacdonald]

dear sloop, thanks for the advise - i'll give in a shot tonight - Used machine for the first time in almost a week last night ( my new pillows for the fx and an omni 360 finally arrived by mail yesterday) - used the omni last night and i had a pretty good sleep - slept 8.5 hours and only woke up 3 or 4 times, ahi was fairly high 8.7 ( my untreated ahi is 21) but the machine recorded 9% large leaks ( i don't think it was the pillow but rather my mouth opened even though it was duct taped and I had the respironics deluxe chin-strap on - on waking the tape was all wet and loose ) - i'll try your advise tonight ( i used the machine as cpap last night but i've never fooled around with the a-flex settings so it is whatever the default is). I also got measured for my dental appliance yesterday, i'll get that in about 3 weeks - hopefully some combination will get this under control - but thanks again for your advise

[johnthomasmacdonald]

right now i don't have a dme. I was diagnosed using a home test which showed an ahi of 21 and a low O2 saturation of 88% since my insurance company refused to pay for an overnight sleep test which was $7500 at the sleep center that is actually in their network and THEIR sleep doctor estimated my odds of apnea based on their predictive model at 98%) - insurance is horizon blue-cross/blue-shield but they have a limit on my policy of $1000 a year for "diagnostic tests" which i had already used up on a colonoscopy this year. I'm seeing a different sleep doctor this friday and am willing to pay out of pocket for a titration study if I can get the price range down to around $2000.