First Night on CPAP

[lytepole]

I think my first night went well - I kept the mask on all night, woke up a few times, but I'm still totally exhausted. According to the machine, my AHI was only 0.36. I'm so glad I started reading here before starting - I think it definitely helped me know what to expect going into things. My RX was for a straight 12 cm of pressure, my DME set me up with EPR of 3, and I set my ramp for either 15-20 minutes - can't remember exactly what it was.

Thanks so much to the people that participate in this forum!

My big question for this morning is: What should my expectations be for when the exhaustion will stop?

I've attached my Sleepyhead data for last night.

[DeadlySleep]

Age? Any other health issues?

[Pugsy]

How was your sleep quality last night? Did you have a lot of wake ups for some reason? If so, any idea why? How many is "a few times" and were you able to go right back to sleep or did it take a little while with each wake up?
Did you have trouble getting to sleep?

Do you take any meds of any kind (even OTC) and if so...what are they?

Obviously your report isn't very exciting. Nothing on it screams out "fix me".

Also....you know that there really isn't any sort of "expected time frame where we finally notice improvement".
It varies between people and there's a lot of factors that can affect how we feel.
Even if OSA is the only issue involved the time frame to feel the good reports can vary between 1 day to 1 year or never when we see boring reports.

[palerider]

I think my first night went well - I kept the mask on all night, woke up a few times, but I'm still totally exhausted.

presumably you didn't get totally exhausted overnight, so you can't expect to recover from it overnight, yes?

however, hopefully you'll start to feel an increasingly better state as things go on.

[lytepole]

Thanks all -

I have several other issues all finally discovered around the same time as my sleep apnea - Vitamin B deficiency, Vitamin D deficiency, swapped out my thyroid meds - all being newly treated. For meds - I'm on a bunch of vitamin supplements, naturethroid, allergy meds - nasonex, patanase, singulair, and then sleep doc put me on Trazodone (which I don't like taking, but have the last few nights to see how it felt).

I'm not expecting to feel better overnight with CPAP (although I wish I did!), but I guess I'm looking for some guidance as far as how far out to go before complaining to doc that I'm still tired. I tend to trivialize the symptom of being tired, and I want to make sure I don't keep doing that. I know I have a follow up appt with sleep doc in a month, but if I am still feeling exhausted in two weeks, should I call back sooner?

As to the quality of sleep questions, I woke up at 1:30, checked my clock to see if I had reached 4 hours, hadn't and went back to sleep (4 hours on the mask was my goal for the first night). Then, I woke up one other time and realized I was holding my mouth shut, did a mental reminder that I had a chin strap on and didn't need to do that and went right back to sleep. Then woke up again at 6:30 and took off mask.

Sounds like I probably just need to keep doing what I'm doing for awhile and see if I can figure out why I'm not sleeping through the night

[Pugsy]

Give yourself the full 30 days or so till that scheduled follow up appointment comes around.
With everything that you have going on I would be really surprised if there was much of a turn around within 2 weeks.
The doc will just tell you to "give it time" anyway.
Take some time and research each and every one of your meds for potential impact on sleep and how a person feels the next day.
So look for insomnia, trouble sleeping, fatigue, daytime sleepiness as potential side effects.
The trazodone for sure impacts how a person feels during the day. Anything that promotes sleep at night has the potential for it to have a drowy/fatigue side effect during the next day depending on dose and how long it stays in the system.

Did you know that patanase has a known "drowsiness" side effect?
Thyroid meds sometimes cause "nervousness" which can translate into poor sleep quality. Sort of like speed might feel. I know you can't quit taking it or your other meds (except maybe the trazodone) but little side effects can add up when put with other side effects. Not everything can be fixed with the cpap machine and a nice low AHI. It's unfortunate but that's just the way it goes. If we have bad sleep from something besides sleep apnea the cpap machine can't fix it. I know that we tend to want to lump all of our unwanted symptoms in the "sleep apnea basket" and expect cpap to fix them but sometimes it just can't.

The vitamin D thing...known to cause extreme fatigue and it takes a while to get the vitamin D levels up so that they stay up.

Learn the difference between fatigue and being sleepy or wanting to nap...

Give yourself some time and 2 weeks really isn't long enough to expect much given what all you have going on.
I know that's that what you were wanting to hear but often it takes months for the cpap machine to work its magic and that's with no other complicating factors going on.

If it's any help to you...it took me months to feel the energy increases I wanted to feel...Initially the morning killer headaches and the nocturia (both related directly to sleep apnea) took 2 weeks to go away with optimal therapy but the energy levels took a lot longer and sleeping longer took months and months to get me from 4 hours to 6 hours and now to around 7 plus hours which is what I have learned my body needs. If I have a short night for some reason...like 5 or 6 hours of sleep...I feel it the next day.

Hours of sleep is VERY important as is the quality of those hours of sleep. 8 hours with a gazillion wake ups is going to leave a person feeling like a truck ran over them during the night...no matter how pretty that cpap report looks.

So give yourself some time and try to come up with an extra dose of patience. Your body didn't get this way overnight and it can't be fixed overnight....or even in 2 weeks.
You may be like me....the improvements in energy were so slow that I really can't pin point when I first noticed the change but one night I had to sleep without my machine and I got a sudden reminder as to just how bad I could feel. Big wake up call for me because I had been feeling a bit sorry for myself because I didn't have the energy I wanted.
I have come to accept that while I don't wake up rearing to go run a marathon...at least I don't wake up feeling like I just ran that marathon. I am 62 years old now....my body simply has other issues that impact how I feel.

[lytepole]

Thanks for the encouragement and insight!

I think I was able to identify a couple things last night that are causing me to wake up during the night:

1. The head strap on my mask touches the lower back part of my head/very top of my neck and its giving me a headache. This area is really sensitive on me. I'm thinking about trying one of the Pad a Cheek neck cloths. Any other suggestions?

2. I woke up feeling like I was holding my breath at one point last night - I supposed it could have been an OA event? I didn't check to see what time it was, so didn't get to see if it correlated to an event in SleepyHead.

My AHI was only 1.12 last night, but I need to keep working on why I'm waking up multiple times during the night.

I did not take any Trazadone last night to see how it went without it. I'm thinking about taking a full dose tonight to see if it helps me get through the night while I'm getting used to the machine.

[DeadlySleep]

get through the nigh

You know it is OK to wake up a few times during the night? Don't try too hard.

Standard advice around here is to google sleep hygiene and then practice it, moderate exercise, good diet, etc. Review those drugs you are taking. I sleep well but certain allergy meds will interfere.

Your chosen name might also interfere with your sleep.

[Pugsy]

Those lower straps on the masks that have them (full face and a lot of nasal cushion masks) gave me horrible headaches.
Or what I call "neck" headaches. They simply put pressure and caused torque in an area of my body that didn't like it.
I have a bad cervical spine and any sort of pressure at the base of the skull and that upper C spine area would give me a headache.
You could try the Pad a cheek strap covers for that back strap. I never did because I just opted to use masks that didn't have that strap to start with. If you like the mask otherwise then you could maybe fix your own strap cover out of some fleece wrapped around it to see if it helped at all before spending the money.

If you aren't "in love" with the mask...maybe try a different mask that doesn't even need that back strap.

Your profile shows the Mirage FX nasal cushion mask. It's of the old design and a bit heavier than the new designs are.
If you like the cushion in general you might look at the ResMed Swift FX Nano cushion mask...the back strap is tiny and doesn't touch that area of the skull/neck. It sits up higher. It's a nice little mask. I have successfully used it. Still won't displace my preference for nasal pillow mask but if I had to use a cushion nasal mask...I can use it successfully. Spent about a week with it trying various headgear setups with t.

[lytepole]

Your chosen name might also interfere with your sleep.

Luckily, I don't have my name sake shining in my bedroom!

[lytepole]

Your profile shows the Mirage FX nasal cushion mask. It's of the old design and a bit heavier than the new designs are.
If you like the cushion in general you might look at the ResMed Swift FX Nano cushion mask...the back strap is tiny and doesn't touch that area of the skull/neck. It sits up higher. It's a nice little mask. I have successfully used it. Still won't displace my preference for nasal pillow mask but if I had to use a cushion nasal mask...I can use it successfully. Spent about a week with it trying various headgear setups with t.

I just got done looking at your reviews for your experiments with that! I'm going to call my DME and see if I can try it.

Thanks for the suggestion! The headache you are describing is exactly what I've got!

[Nick Danger]

Lytepole, you're off to a great start! I love the way you are identifying what is causing discomfort and working at fixing it!

As to what is causing the daytime drowsiness, there are a number of candidates.

1) your body needs a few more nights of good sleep to recover
2) using the full trazadone dose may help you stay asleep, thus cutting down on the drowsiness
3) using trazadone may increase your daytime drowsiness (note this one could go either way!!!!)
4) patanase can cause daytime drowsiness
5) one of singulair's side effects is "tired feeling"
6) interactions of the above
7) something else

[kruzer]

Those lower straps on the masks that have them (full face and a lot of nasal cushion masks) gave me horrible headaches.
Or what I call "neck" headaches. They simply put pressure and caused torque in an area of my body that didn't like it.
I have a bad cervical spine and any sort of pressure at the base of the skull and that upper C spine area would give me a headache.
You could try the Pad a cheek strap covers for that back strap. I never did because I just opted to use masks that didn't have that strap to start with. If you like the mask otherwise then you could maybe fix your own strap cover out of some fleece wrapped around it to see if it helped at all before spending the money.

If you aren't "in love" with the mask...maybe try a different mask that doesn't even need that back strap.

Your profile shows the Mirage FX nasal cushion mask. It's of the old design and a bit heavier than the new designs are.
If you like the cushion in general you might look at the ResMed Swift FX Nano cushion mask...the back strap is tiny and doesn't touch that area of the skull/neck. It sits up higher. It's a nice little mask. I have successfully used it. Still won't displace my preference for nasal pillow mask but if I had to use a cushion nasal mask...I can use it successfully. Spent about a week with it trying various headgear setups with t.

Just found this site, got a new machine to replace my res8 and I have a stiff neck and headaches since the first night......My new mask does fir lower so this may be my issue....I still have new stock of my old style masks and am going to try...tanks for some great info. I'll keep this thread posted on my progress.....my head is killing me I hope this works...........

[lytepole]

Just found this site, got a new machine to replace my res8 and I have a stiff neck and headaches since the first night......My new mask does fir lower so this may be my issue....I still have new stock of my old style masks and am going to try...tanks for some great info. I'll keep this thread posted on my progress.....my head is killing me I hope this works...........

Please do update here - I'm still playing around with masks myself to find the "right" fit for my neck and would love to hear what mask is working for you. I got the Swift FX Nano over the weekend, but they gave me a small and I'm finding its irritating the bottom of my nose, so I switched back last night to Mirage FX (I did love the feel of the headgear though). Will call DME today to get the standard size to see if that feels any better. May also retry the Resmed N10.

When I switched back to my Mirage FX last night, I loosened up the back straps a bit and switched my pillows around again to something very, very thin behind my neck. It seems to hurt less this morning.

Good luck!

[tan]

As to the quality of sleep questions, I woke up at 1:30, checked my clock

don't do it. Remove your clock and urge to check it and make your bedroom as dark as possible.