Feeling hopeless after septum surgery

[Jak3099]

Hi everyone,

I was diagnosed with sleep apnea ~2 years ago. I would wake up sweaty, people told me I was gasping for air, etc. I've tried CPAP with both nasal pillows and a full face mask. Neither mask seemed to help, and the full face mask kept waking me up with air leaks. If I wasn't tired from the apnea, it was from a mask leaking air. I would use the CPAP on and off for a few weeks, and finally gave up in despair.

On top of the sleep apnea, I have OCD and depression and am on 40 mg Prozac and 1 mg Ativan. I had surgery for my deviated septum 2 months ago, but I still feel tired. I've tried Claritin/Zyrtec before bed, probiotics, Respir-All (herbal supplement), and taking the Prozac/Ativan at different times of the day. My ENT said if my sleep doesn't improve over the next 6 weeks, then I should do another sleep study. It looks like I can't avoid the CPAP.

Is it just a matter of finding the right pressure setting/mask? Also, I'd really appreciate any feedback on septum surgery outcomes and effects of Prozac/Ativan. I'm doing the following in the meantime:
- Start using the CPAP again
- Stopping the Claritin or Zyrtec (due to dry eyes)
- Stopping the Ativan
- Improving my sleep hygiene by going to bed/waking up at the same times everyday, even if I feel tired.

I don't know how much longer I can stand being tired all the time

[kteague]

Maybe this time around things will fall into place better for you. If nothing else, fixing your septum may enable you to use a smaller style mask. Can you breathe through your nose or do you mouth breathe? Getting a comfortable mask is a major part of the battle. There are so many masks out there, surely you'll find something at least tolerable and hopefully even comfortable. Some on here who have had surgery for a deviated septum have reported it did make their CPAP use easier. I think going back to CPAP and working through any issues is going to be beneficial to you. Especially with you dealing with OCD and depression, giving your body and brain the proper rest and oxygen it needs is so important. Please talk with your doctor about any med changes. I'd recommend not doing too many changes at one time or it may be harder to determine to which to credit improvement or blame for issues. Good luck as you go forward.

[STL Mark]

Sorry to hear things are a bit overwhelming right now. I believe some people here have found Anti anxiety scripts helpful in the transition to using cpap. Personally I've found CBT based mental health therapy helpful when I reach a point in my life where I become focused on negative things.

It may make you feel more in control if you make yourself aware of the various medical equipment providers (DME) accepted by your insurance company that are in the area. Stop by and talk to them about how they handle their clients. Pay attention to which ones have Respiratory Therapist that work with the clients. find out what their policies are on mask exchanges, and if you can test masks at their office. It is amazing the variety of DME policies and procedures in place for dealing with clients. Some agencies are very mean and focus only on how much money they can make. They seem to focus on intimidating their clients. Other DME firms truly want to educate you and see you become successful in your CPAP therapy.

The same process can be used in evaluating sleep labs. You can have a great deal of control in how you are treated if you have the time to find the right providers for you.

[DavidCarolina]

have you tried a small dose of clonapin or a SSRI?

It sounds like some of your problem is a bit of anxiety and stress and feeling overwhelmed by all this.

Cant blame you, sleep is supposed to be the one time you FORGET the daily BS.

Curious why you want to avoid the hose. The air pressure is very re assuring to me anyhow, its become
like having a cool fan blowing on me. I like it.

There has to be a way to fix leaks. We've all gone through it and found a way.

Full face proper fit should NOT be leaking on you.

[Sir NoddinOff]

I don't have any advice for depression or anxiety but for mask leaks try this: Lansinoh, ie. a sheep lanolin preparation. Google it, make sure to spell it exactly. Put a tiny bit on the mask cushion where it touches your face and you'll find it helps stop leaks. It's generally found at Walgreen's in the nursing mothers section. Use sparingly. It's the closest thing to human grease which is what you want.

[Uncle_Bob]

Did your ENT tell you that due to internal swelling the recovery period can be upto 3 months?
My ENT warned me and he was right, my 2nd to 3rd month on CPAP following surgery was no fun.

[Pugsy]

Is it just a matter of finding the right pressure setting/mask? Also, I'd really appreciate any feedback on ...... effects of Prozac/Ativan.

The cpap machine primary function is to fix the sleep apnea problem. It isn't going to fix problems unrelated to sleep apnea.
Meds, insomnia or other issues...well it can't fix those problems. Best you can do is eliminate the sleep apnea from your problems but don't expect the machine (no matter how perfect it fixes sleep apnea) to also eliminate the factors that are unrelated to sleep apnea. It can't fix bad sleep unless sleep apnea is the sole cause for bad sleep and feeling tired the next day or whatever. We would like to think it does but it just doesn't.

The meds you take are known to mess with sleep and how a person feels the next day. If your problems are related to your meds....the machine isn't going to help but you need the machine for the sleep apnea part of the problem. Maybe with the use of the machine to effectively eliminate sleep apnea causative factors you might be able to handle or manage the meds effects better to the point that maybe the meds could be reduced or eliminated.

Side effects of Prozac are numerous. See this link.
http://www.webmd.com/drugs/drug-6997-Pr ... genumber=6
Damned if you do and damned if you don't with this one since it can mess with sleep and also have you feel crappy during the day.

Similarly Ativan also can mess with how a person feels
http://www.rxlist.com/ativan-drug.htm
confusion, depressed mood, thoughts of suicide or hurting yourself;
hyperactivity, agitation, hostility;
hallucinations; or
feeling light-headed, fainting.

Less serious side effects may include:

drowsiness, dizziness, tiredness;
blurred vision;
sleep problems...

[blueh2o]

You should certainly try an oral appliance if CPAP doesn't work for you. It's a lot less fussy though maybe not as effective in reducing AHI. But damn AHI if you don't feel good. If you go this route definetly find an orthodontist who specializes in oral appliances. Good luck...I know how you feel.

[mattd65636]

It takes a long time for swelling to go down after septoplasty. If the ent told you it would solve the apnea, then he should have done more research. All research I found was a good chance to IMPROVE my apnea. I had it in September 12 with great results on my breathing. Both sides have air flow. Success

[Jak3099]

Thanks so much for the replies and encouragement. I used to think I could avoid wearing a mask to bed, but I will do what it takes for a good night's sleep now.

I don't think I breathe through my mouth. I definitely did not feel comfortable breathing through my mouth the first week after surgery. I wonder if the original nasal pillow mask I used didn't work because of the septum.... maybe it might work now.

I'll keep at it and be assertive with the doctors and companies. The first ENT and sleep specialist I had seemed to just want to rush me out of the office and not explain things very well. Hopefully I will find the right mask/pressure combo soon.

[Julie]

There are many nasal (nose only) masks that are not pillows... and you should try as many as necessary to find the right one (same goes for FF ones too, of course).

[-tim]

Deviated septum surgery isn't fun. If you have it, get a thin surgical mask to wear if you go outside where bugs are. I managed to inhale a nat a week or so after surgery and that lead to complications.

If your settings are wrong with CPAP, it won't help. It is also very distracting. I didn't have a problem at all adjusting but my cat who can sleep through anything and prefers a warm body to sleep next to had problems for months and still isn't sure she likes it. If a cat is upset by the noise, I know it is going to cause lots of people problems too.

Try other masks if you can and make sure the settings are right for you is my advice.