Well, folks... I think I'm giving up...

[Mathurine]

I will be the first to agree with a strong correlation between prolonged sleep apnea and depression, especially where there is any family history of drepression or other mood disorders.
My husband lost a brother to suicide, (years ago) he had just been diagnosed with sleep apnea only weeks before. But all the years of the problems he had to go through got him before the treatment could even start to help. I always feel bad, wishing I had known them at that time, I would have rode his ass to get to the sleep doc just like I did with my hubby (took me 3 years to get him to the sleep study) cept not having heard him sleeping, I may never have known what was really wrong either.

Anyway, you are not alone suffering depression even though treatment, my husband has now been treated for just over a year, he still suffers greatly from mood disorders and even depression when his stress levels get too high.
He no longer works - he can only handle a couple hours of activity before getting tierd, and for him tierd can mean cranky and unreasonable. We decided it is better for him to stay home and get healthy then work a job that will end up killing him from stress. But we are luckey enough to be able to afford that at this point, not everyone is.
Even still, stress can come from many places, and he still falls ill from it on a monthly basis. I work hard to reduce any stress he may have to deal with, but alas I myself seem to also be a cause.
I wish i could put him into a stressfree bubble, at least until we figure all this out. but i digress, my point is:

I am looking hard at adrenal glad malfunctions as a cause of his ongoing stress and depression. I have read that if the adrenal glads and hormones are out of balance, they can cuase many problems (collectivly refferred to as Burn Out Syndrom) which require rebalancing of said hormones.
Now, where did I come up with this correlation, not from a doc, thats for sure. But given that apnea causes the adrenal glands to output enough adrenalin to wake you up (every three minutes or so for say 10 years) you might figure the thing might get burnt out from untreated apnea.

However the road to recovery from adrenal glad burn out is like two years of costisol therapy and a bunch of other viatmins, minerals etc. Problem is the testing for that is worse then the testing for apnea, might as well be witch craft. There are like 7 forms of adrenal gland hormones that could be out of balance, correcting hte problem requires accurate daignosis. The docs usually say, get more rest, excercise and loose some weight...

Anyway, I guess I've ranted enough, but to Liam, don't give up, and youre not alone, if he were on this board, my hubby would tell you he suffers the same way as you do. I guess I'm grateful he can sleep with his mask, even if it leaks, honks, whines and leaves terrible red marks on his face.

Mathurine

[dankazoo]

Here's another vote for Lexapro as an antidepressant. I started both Lexapro and CPAP at the same time. I am no longer the irritable sob I was previously. Maybe just a less irritable sob.

PS Linda-Isn't perverse what Shakespeare charged?

Dan

[LDuyer]

dankazoo,

Liked the perverse perverse joke.

Glad to hear the antidepressant helped. I've not had to resort to those things, but I know there are many people out there needing the help. Are there any side affect symptoms from this antidepressant? Have you used it for a long time?

....what's a "dankazoo"? Does this mean Dan has a kazoo? Can you kazoo?

Linda


....Irritability....is that like having irritable bowel movements? (grin)

[not2worry]

Well God must have sent me to this site tonight because I am at the same point as Liam. I was diagnosed with OSA in September and have been "compliant" every night since I received the equipment five months ago. I even comply when I need a nap.

It seems like my depression has come back because I get so frustrated with the whole situation. I use to go to bed at 10:00PM and get up no later than 8:00PM. Now I stay up until 1:00-2:00AM and I think it's just because I dread the mask. I take an ambien and a xanax just to get to sleep. Without it, the mask would have to go. I get about 4 hours of sleep with the mask on. I don't know if I am waking up naturally or if the drugs have worn off. I get up, go to the bathroom, back to bed and force myself to put the mask back on. I fall back to sleep for another hour or two. When I wake up the second time I just take the dang mask off and say screw it! I then fall back to sleep and my husband wakes me up because I am snoring.

Right now I am more tired than before I started the CPAP. I have tried so many masks and still haven't found one that works. I was prescribed a full face mask, but can't find one to fit so I have a nsal mask plus a chin strap. On top of that I grind my teeth so I have to wear an upper tooth guard. It has gotten to the point when I just get anxious thinking about going to bed.

This morning my husband woke me up because I took the mask off and was snoring. I explained the frustration I was having with this whole OSA thing. He asked me if I was losing any weight. I just burst out crying. I'm 5'9 and weight 150 pounds. I'm 55 years old. I don't consider myself obese.

I told my husband tonight that I was to a point of just sleeping in another bedroom without the CPAP equipment so he could sleep and not be disturbed with my snoring.

Liam, understand how you feel. I never heard of sleep apnea and it was the last thing I thought I would have to deal with in my life. It's to the point of where I feel like "I got to do this for the rest of my life?"

The other question I have regarding CPAP, is can you become dependent on it? By this I mean, with the air flowing constantly at a constant pressure, can you lungs actually become weaker because the machine is delivering air to you consistantly?

Well, I am going to try to get an appointment with my doctor and discuss all of this with him. I don't know if I am depressed because I am tired, or tired because I am depressed. My husband keeps telling me there are worse things in life that could happen to me, and I agree, until it's time to go to bed!

[JK]

Liam:

I'm a bit behind the curve with this post, but your question about a dental appliance got my attention. I used 2 different types for over 6 years and got some relief from OSA. The first one was a fixed position mouth piece and was really difficult to get use to. It lasted a year.

The second was hinged so I could talk, drink and wiggle my jaws a little. When I'd relax--as in fall asleep-the hinges forced my lower jaw to drop slightly and move forward. It was real easy to like this appliance and it worked quite well. The cost was about the same for either type--$600 mas o menos.

However, during an antelope hunting expedition with my son and a friend I lost the hinged appliance and am now reduced to acquiring a CPAP. If you really, really, really don't think you can work with the CPAP I encourage you get a referral to a GOOD dentist and try an appliance, especially if your OSA is mild to moderate. Don't know if the appliance would be of much help with severe OSA, but it's sure worth a try.

Hang in there--PLEASE.

[vcbamom]

It is good to know that I am not the only one with problems using the cpap.
it worked great at first, and then my baby boy ( who was extremely active and loved to throw his head back while sitting in my lap) broke my nose.
I did not realize that it was broke, it was very painful, but I lived.
I did not relate that incident to not tolerating the cpap machine. I could wear it for a while, but more and more frequently woke up in the morning with the mask on the floor.
I went to see my dr. to see if he would adjust the pressure or something, and he said I probably could not tolerate the mask anymore and suggested using medication to help me rest better.
I told him no, because I have a baby and my husband works nights. No way can I be doped up and not be able to take care of him.
I changed dr.'s and the new dr looked into my nostrils and asked me, "when did you get this deviated septum?"
It took a while, but I remembered the incident with Alex. This dr. put me in for another sleep test and guess what? The pressure on my cpap had to be adjusted from an 8 to a 12.
That work well for a while and now for the last several months I again wake up with the cpap somewhere other than my face. I havn't used it at all for a couple of months now and I am so slowing down with my thinking. I am having trouble getting to work on time.
I have to wake up two hours before time to leave the house, because it takes me an hour to wake up enough to get functioning.
then of course I have a family,which means many interuptions. Sometimes I do not get to sleep until late. (Like tonight I am up posting this message lol)
My work schedule varies everyday, some days 7am - 4pm to 11am - 8pm and 2pm - 11pm. And sometimes work as many as 8 days straight.
I just cannot handle this, but I don't want to lose my job, or have to find the energy to search for another one right now.
I did not want to use a physical handicap as an excuse because I want to go into management on day, and I don't want that to be an obstacle.
Tonight I have learned that sleep apnea is covered under the American's with disabilities Act. And if severe enough to interfere with your work performance you can get on disability benefits.
I plan to get back to my dr and see if something can be done to help me use the cpap again.
In the mean time I think I should approach my manager and see if under the disability act my schedule can somehow be adjusted so that I can more regularly get some rest.
Has anyone here had to use the Disability Act at work? And has anyone ever not been able to use the cpap machine, after using it successfully for several months?

How is this for a first post?

[Liam1965]

Well, I'm really glad others are getting some benefit out of my rant here... It is good to know I'm not alone in having trouble tolerating this stuff.

It's also really good to see all the great people on here encouraging each other to stick with it and try different things.

I guess we just all need to keep helping each other out, supporting each other, and maybe we'll all get through this.

Or else we'll end up on a hillside singing about buying the world a coke.

(Man, could I pull an older references out?)

Liam, who was going to reference "kumbaya", but wasn't sure how to spell it.

[Grant I]

I, too am new to the forum, and picked up Liam's thread tonight (a wee bit of insomnia..)

My sleep study was in March 2003 (the night we invaded ???) and I got my Remstar Plus in May 2003. Having suffered ridiculous tiredness for 5 years (started during chemo for non-Hodgkins lymphoma and never went away) it took that long for me to finally demand to see a sleep doc. I had long been banished to the spare bedroom because of the landing zone sound effects I generated. My sleep study clocked me at 90 (yes ninety) episodes PER HOUR! My initial pressure was 11, and I used the 'net to learn all I could about the equipment before my doc wrote the script. When I demanded C-flex and a humidifier, he joked about me "starting off with the Mercedes..." but ordered it anyway.

Dealing with the home health care folks that provide DME for my insurer has been so-so. The first RT that came out with my machine and a couple masks set me up with an Ultra mirage--not even checking to see if I was a mouth-breather (which I am). Needless to say, it was 4-5 months and 4 different masks before I was set with a workable mask (Mirage S2 full face).

I'm one of those who took to CPAP like a duck to water--first night, all night, and about 99.9% compliance since. Even with that compliance for almost 2 years, it took close to 6 months to start to feel GOOD. The funny thing was that during my sleep study, I awoke after 90 minutes, was told I "passed" (failed??) and had OSA, then they titrated me up to 11. When I awoke 5 hours later (of course the lab kicks you out at 5AM) I felt WONDERFUL--the "NEW MAN" and lasted the entire day without falling asleep at my desk or needing any naps. Of course, the next day, I was right back to my tired self--stayed there for 2 more months until I finally got my machine (thanks, Blue Cross). Boy, was I upset that after my first night at home with my own machine when I DIDN'T wake up the next morning feeling GREAT!! That prompted my search for the right mask.

Where am I today? Usually no trouble falling asleep--good for 5-6 hours before I wake up. When I start having multiple days of tiredness (my sentinel sign is falling asleep at my desk after lunch) I know I need to "play" with the hardware. Sometimes its readjusting the straps, cleaning the face pillow (I'm not big on cleaning...) or playing with the pressure (yes, I know how to adjust it--thanks, Internet!).

So, Liam--HANG IN THERE! You've been given tons of good advice, tricks to try. Don't throw in the towel (or your hose away )

After I get through some more posts, I'll probably be back with some questions of my own that I need help with.

Grant I (CPAP means my troop gets the closest campsite, because I have to "plug in" at night)

[Liam1965]

I'm one of those who took to CPAP like a duck to water--first night, all night, and about 99.9% compliance since.

I envy you. I'm one of those who took to CPAP like a duck to hydrochloric acid.

Don't throw in the towel (or your hose away )

If I throw my hose away, my wife will leave me.

After I get through some more posts, I'll probably be back with some questions of my own that I need help with.

Great! Welcome! I and others will try to help if we can. (I've never been the sort to let the fact that I'm not good at something keep me from expounding at great lengths about how OTHERS might make it work for them. )

Liam who, having finally gotten everything reset after the power outage all day yesterday, is going to head back to Dr. Mengele's device and try to sleep.

[friedanjohn]

DO NOT GIVE UP. Liam. My oldest brother (55 at the time) was scheduled for a sleep study. We noticed he was sleepy...he'd fall asleep while he was talking to you. A day before he went in to get tested, he fell asleep and never woke up. CPAP would have saved his life!

I hated the stupid mask, too, when I started in November. But I kept thinking about my brother. My apnea is not as bad as he was, but why take a chance? I use the machine when I can for as long as I can. Some nights, I rip it off. Sometimes, I'm too stuffy and rip it off. Gradually, though, over the past 2-1/2 months, I've been able to keep it on longer. As I sleep better, I get sleepier before I go to bed. I take Lexapro for my depression and Trazadone to sleep...sometimes a little Cyclobenzaprine (Flexeril) for my Fibromyalgia. Little by little, I'm able to take less of the sleep aids - but if I need it, I take it. I use the nasal pillow, and run the hose on the side I don't sleep on much. It attaches with a little velcro strap to the mask strap, and stays out of the way. This helps with the leaks and gives me a couple of comfortable positions to sleep in.

What's really cool is that I have so much more energy during the day! My work is *improving!* I'm more cheerful, easier on myself and expectations. I don't fall asleep when I drive. Did you know that 87% of accidents that occur when you fall asleep at the wheel are FATAL? It's been worth the time and money! Ask your wife!! I know my sister-in-law was devastated to lose her husband of 30 years at the age of 55!!! Good luck! Please don't give up.

[Janelle]

So, Liam, you've never given us a report on your night with the Swift????????


I think if more of the people who couldn't stand the mask on their face,no matter what kind would try the Swift, which has NOTHING on the face except the headband strap from the barrel of the nasal pillows, there might be more compliance right from the start.

I think, too that many just make up their minds to "hate" the "thing" they have to wear. They don't see it for what it is, a virtual life saver. They just think of it as one more "treatment" for a condition. But it is much more.

CPAP is not addictive in the strict sense of the word. You can quit using it any time you want. your lungs do not become weaker. Actually, in many cases they become stronger because they are finally getting enough air to work effeciently. Of course if you quit using it you could die. Plain and simple.

Liam, have you ever said what kind of machine you are using? I think this, too is a very big part of early compliance. Most people simply can't tolerate the straight CPAPs. And many problems with later pressure adjustments could be easily rectified if they had started out with an APAP either with or without CFlex. Those who are titrated at high pressures don't need these throughout the night, only when they have an "event" and even then it might not need to be so high.

I still sleep about 2-4 hours and then wake up. Sometimes I can go back to sleep and sometimes I can't. 2:30 seems to be my big wake up, stay up an hour or so and then I can sleep until regular time to get up. In my case that is 5:45.

I'm going to tell you folks something my first RTsaid, about the only logical thing she said, for that matter. You might only get 2-3 hours of sleep to start off with, but they will be better quality of sleep than you had before. What she didn't tell me that I found out on my own, is if you are going to only wear it part of the night, the early morning hours are the most important. This is when most of the events happen. Coincidentally, this is also when the ER has the most heart attack victims.

If you don't want to use CPAP therapy to stay alive, it is your choice.

[Liam1965]

OK, since you asked...

I hadn't reported on it yet because until last night, I hadn't tried it. I hadn't PLANNED on trying it until tonight.

From a COMFORT standpoint, the Swift was really nice. Didn't have to be too tight, etc. But I had one of the same issues I have with every mask I've tried (can't stop focusing on my breath long enough to fall asleep), and the worst one I've had with every NASAL mask I've tried (after a while, I start gasping for air by mouth, because I don't feel like I'm getting enough).

I think perhaps that CFLEX, like heat/humidity, is one of those features which I hate in a full face mask, but perhaps will help in a nasal cushion affair. I'll try that tonight. (The problem is that it takes me a while to fall into the symptoms, and switching the CFLEX settings is a pain in the butt, by the time I thought maybe it'd help, I was too far frustrated for it to do me any good).

So, the long and the short of it is that I like it better than most anything ELSE I've tried... but until I can get over this problem of focusing on the breathing, and then on the "I can't fall asleep", I'm not sure it's gonna do it.

Liam, who may not be the long of it, but damn well isn't going to admit to being the short.

[Liam1965]

Liam, have you ever said what kind of machine you are using? I think this, too is a very big part of early compliance. Most people simply can't tolerate the straight CPAPs. And many problems with later pressure adjustments could be easily rectified if they had started out with an APAP either with or without CFlex. Those who are titrated at high pressures don't need these throughout the night, only when they have an "event" and even then it might not need to be so high.

I'm on a Remstar Pro-2, set to a pressure of 9. I have a heated humidifier, which sometimes I turn on and sometimes I turn off. I have CFLEX which I also play with a bit. And as discussed, most recently, I have the ResMed Swift mask and the ResMed Ultra Mirage FF mask.

Other ones I've demoed overnight include the ResMed Activa Nasal and the Respironics (dis-)Comfort Lite.

I've also tried on, and determined I couldn't get a good or comfortable fit, the Nasal Aire II (I forget who makes this), the Respironics ComfortGel, and one or two others.

The only two I've not tried that I have any hope for at all are the Breeze (but I don't expect it to be any better than the Swift) and the Oracle (which *MIGHT* solve some of the problems I've got, but not enough to actually buy one to find out).

The reason I don't think AutoPAP will be my cure all is that even with the RAMP function on my CPAP, I can't get to sleep. So it's not the AMOUNT of pressure, it's the fixation on my breathing and the question of "Will this be the day that I can sleep with this thing on my face" that perversely forces the answer to "NO".

The worst of it all, and people have touched on it, is that I'm SO short on sleep at this point that even logical and reasonable arguments no longer feel logical or reasonable. I feel so muddled that making decisions just doesn't seem to work.

Add to that the fact that I've now gotten myself into the "focus on my sleep and wonder if I'll ever get there" phase of insomnia I hit every so often, then even trying to sleep WITHOUT the CPAP for a few nights until I get back enough cognition to be able to make intelligent decisions isn't working, because I'm still not getting enough.

And therein lies my frustration.

Liam, who keeps writing these volumes about himself in the narcissistic belief that anyone really wants to read them.

[Janelle]

Liam, did you see my post about putting the piece of net in the barrel of the Swift. I swear, you will hear absolutely nothing!!! Go down to the store, buy a bag of pistachios (they are good for you anyway, if a bit expensive), and cut a piece about 2" long and 3/4 of an inch wide, just enough to fit in the barrel. Amazing what a difference this will make.

Personally, I think you'd get better sleep on an AutoPap instead of the straight CPAP you are using, but since you are kind of stuck with it....Any chance of the DME letting you try the RemStar Auto with CFlex during this rental period?

YOu'll have to muddle through the weekend without me. I'm off to sunny Florida to judge a dog show there.

[Liam1965]

Liam, did you see my post about putting the piece of net in the barrel of the Swift. I swear, you will hear absolutely nothing!!! Go down to the store, buy a bag of pistachios (they are good for you anyway, if a bit expensive), and cut a piece about 2" long and 3/4 of an inch wide, just enough to fit in the barrel. Amazing what a difference this will make.

Actually, sound is not a problem I've noticed. Maybe they've modified the design slightly or something, but I didn't notice any particular noise from it. But as I was using it, I was thinking about that exact suggestion and figured one of these days I'll pick some of that netting stuff up and check just to be sure. Thanks!

YOu'll have to muddle through the weekend without me. I'm off to sunny Florida to judge a dog show there.

Your life is so hard, I don't know how you muddle through.

Liam, who is singing for his wife, and thus, can't think of a good one-liner. Just imagine this is melodic, and you'll get the effect.