last few nights have sucked :(

[Denial Dave]

at 11 days, you are doing really great.

my 1st 2 weeks of CPAP were spent trying to overcome claustrophobia with my mask.

I switched masks (mask #1 was a Quattro FX) after 30 days due to issues with being able to control leaks. no matter what I did, I couldn't get my 95% leak level under 24.

My 2nd mask (Comfortgel Blue) lasted 5 days. It was awesome for 3-4 hours and leaks were everywhere. It had major scratches in it from bouncing off of bedroom walls after being thrown.



Since I was asking for a 3rd mask in 40 days, it took a bit of work on my part during the appointment to convince my DME to issue me the Quattro with forehead piece. But after speaking to a manager, they issued me the mask.

There is pure joy felt when you finally find the mask that works for you.

keep working at it.....

Dave

[pandatx]

I have zero idea what this means:

If diagnostic NPSG showed only flow limitations, and the current D/Ls only show (fixed) flow limitation, then xPAP therapy is ("IMHO") just a BFWOT.

And no, I was unaware that GD causes fragmentation b/c this thryoid stuff is very new to me and I've only found out that there was even anything wrong with it in the past couple of weeks and then we weren't sure what it was or what was causing it and I only just did the radioactive uptake scan yesterday. So no...I'm not aware of everything about Graves Disease yet. And its not that I don't want to get back to figuring out CPAP. I just had a day where I needed to process something that was unexpected and scary. I would think that could be understood.

The CPAP even on my bad nights has shown a dramatic decrease in the number of apneas. My AHI dropped from 15 (and 26 during REM) to under 2. My diagnostic test show no PLMD.

[mollete]

I have zero idea what this means:

If diagnostic NPSG showed only flow limitations, and the current D/Ls only show (fixed) flow limitation, then xPAP therapy is ("IMHO") just a BFWOT.

OK, let's say that something causes you to stay in light sleep, and you have a low arousal threshold. Every minute or so, you pop out of sleep briefly (an "arousal"). During the arousal you breath a little deeper such that the sleep breaths are relatively smaller. Consequently, these could be interpreted as respiratory events. However, the succession of events would not be respiratory event causes arousal, and treating the respiratory event would correct the arousal; rather, the arousal makes it look like there are respiratory events, but the treatment must be geared at treating the sleep fragmentation.

Based on all the information you have presented thus far, it is suggested that you got some major league nasal problems. If the obstruction is "fixed" (immovable), you can CPAP it all day and it won't make a difference. If it isn't fixed (and the suggestion of applying traction to the cheeks presented earlier might test patency of nasal valves), then maybe CPAP might have a place (although arguably this goes back to an ENT problem cause CPAP is not indicated for nasal narrowing).

Looking at that lithe neck, it would be (superficially) easy to say you're NOT an OSA candidate. However, that bit of retrognathia might be doing some stuff.

[pandatx]

So basically I wasted all that time and money for a problem that it won't help? And now I have that diagnosis on my record? And the sleep study place should have diagnosed this?

[mollete]

So basically I wasted all that time and money for a problem that it won't help? And now I have that diagnosis on my record? And the sleep study place should have diagnosed this?

Right now, we are "gathering information". Let's see what's on the diagnostic NPSG.

[mollete]

So basically I wasted all that time and money for a problem that it won't help? And now I have that diagnosis on my record? And the sleep study place should have diagnosed this?

Right now, we are "gathering information". Let's see what's on the diagnostic NPSG.

However, make sure you get both studies while you're there.

[pandatx]

what exactly (give me the actual words) should I be asking for b/c I will do this today.

[SleepWellCPAP]

Hello Panda,

Sorry to hear things aren't going well yet. 11 days, though it's of little consolation at this point, really isn't very long in terms of acclimating to CPAP.

It sounds like you're approaching this from many different angles and that's wonderful. Regarding usage of your device, if that's ultimately the route you take, what I've always suggested in the beginning it to try to build on what works. No matter how small or insignificant it may seem. I remember when you tried the nasal, though it made your nose sore, I heard "night went much better", I'm paraphrasing what I hope is correct. Based on that, you might try going back to that mask. Do keep in mind, in my experience working with people, it takes them 3 to 7 days to get used to a single interface. They'll use it for a while, if it keeps them awake they'll put it down and try the next day.

Hope that helps. Your patience is admirable and I do hope you find a resolution sooner rather than later.

Jim

[pandatx]

Thanks Jim. Yeah, I just wasn't up to another night of it last night. Today my Aloha nasal pillows mask will be here and I will give it my all again. The first night with the nasal mask was good for me (other than the soreness) but the second time I tried it, it leaked a lot and kept waking me up. I switched to the Swift in the middle of the night but that still wasn't good. My throat hurts this morning so I'm sure I was snoring like crazy last night. I hadn't felt that in a couple of weeks

[Pugsy]

You have probably already seen this generic overview of Graves disease but here it is just in case.
http://en.wikipedia.org/wiki/Symptoms_a ... 27_disease

Some things that jump out at me. This is just a small part.
Insomnia
A distinctly excessive reaction to all sorts of stimuli
A marked increase in fatigability

And I copied this from the neuropsyschological part
Varying degrees of anxiety, such as a very active mind,irritability, hyperactivity, agitation, restlessness, nervousness, distractible overactivity and panic attacks.
The pathological well-being (euphoria) or hyperactivity may produce a state of exhaustion, and profound fatigue or asthenia chiefly characterizes the picture.

With the side effects that are possible byproducts of Graves disease I suspect you are going to have to sort through that aspect of things before you are really going to be able to figure out what is going on with the insomnia and hyper sensitivity to various stimuli. Having to wear the mask is just adding another distraction for your brain to have to deal with. It's making a bad situation worse.

My personal opinion is that you need to concentrate on getting the Graves condition under control before you go trying every mask out there beyond what you have in your possession right now. I don't think the mask is your primary problem.
If it were me I would continue to try to do as much cpap therapy as I could because a few hours of no apnea events is till better than going all night without the cpap machine and having the apnea events put stress on the body.
Fix what you can now that is likely obvious big factor in your insomnia issues and that being the Graves condition and then see what is left over that needs fixing. Is very possible that the Graves disease is a big factor here in regards to mask and cpap issues in general. Making you over sensitive to things that wouldn't normally be a huge issue.

Just my own personal opinion here but you have a very real medical issue that affects your ability to be able to tolerate the equipment and get decent sleep.

And follow up with Mollete's thoughts on trying to determine if there really ever was/is an OSA issue here or was it just flow limitations and arousals going on during the sleep study.

[SleepWellCPAP]

Ah, okay got it.

Please keep posting, you have a very interesting story. Good luck!

Jim

[pandatx]

this is what I got when I asked for the full report last time:

I understand that you have the dictated report, and we will be more than happy to get you a copy of the raw data. However, you will not be able to see it unless you have Alice 5. This is the program we use and it is not compatible with other programs.

I just sent my reply:

Yes, I do still want the copy of the data (the NPSG) and whatever detailed narrative report there might be. My understanding is that it should contain this information.
Nocturnal Polysomnogram, NPSG – The standard overnight diagnostic sleep study used to assess sleep disorders, including sleep apnea, periodic limb movement disorders, insomnia, 24 hour sleep-wake cycle disruptions etc. The study includes various physiological measurements such as respiratory effort and airflow, EEG (brain waves), EKG (Heart), EMG (muscle movement), oxygen saturations, and snoring. These parameters are standard on every overnight sleep study both diagnostic and therapeutic

[Drowsy Dancer]

http://www.healthcare.philips.com/us_en ... efault.wpd

Not seeing so far that it's a "program."

The Alice 5 "system" uses "Alice Sleepware."

http://alice-sleepware.software.informer.com/

Press release, but fairly descriptive: http://www.talkaboutsleep.com/sleep-dis ... graphy.htm

Alice® Sleepware" is a Windows®-based software program designed to monitor, display, process and download polysomnographic data. The data is then presented graphically on a computer screen for diagnostic review, similar to traditional paper-based polygraph records.

But:

Respironics, Inc. announces the release of its Alice® 5 Polysomnography System which displays and prints physiological adult and infant patient information for clinicians or physicians.

[Pugsy]

If Mollete doesn't already have the software at his disposal...I am sure he can get his hands on it if he needs it.

[mollete]

If Mollete doesn't already have the software at his disposal...

I have Alice.