Long winded snorer seeks advice...

Greetings to one and all!

I am new to these forums and new to CPAP. You all seem so helpful and caring that I thought I would share my story and see if anyone had any input. I will apologize in advance for being long winded, but I want to try to put in as many details as possible.

For the last few years, I have been dealing with fairly severe depression. My blood pressure has been slowly rising as well as my cholesterol levels and I have put on more weight in the last two years than I ever have. After running thru just about the full spread of anti-depressant drugs out there (without success), my GP thought that having a sleep study done may be beneficial. I made an appointment with a neurologist that he recommended at a local sleep disorder clinic.

The neurologist did a quick exam and talked for a while with my wife and I. He asked about my sleep habits, snoring, gasping, etc. He concurred with my GP's thought that a sleep study my indeed provide us with some helpful information. I made an appointment and went in for a sleep study. The report for this study is as follows:

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“The overnight sleep study consisted of left and right EOG, sub-mental EMG, left and right anterior tibialis EMG, central and occipital EEG, ECG waveform, airflow and respiratory effort assessment, oximetry and video monitoring.

The study started at 22:08:00 and ended at 6:26:30. The total recording time was 499.00 minutes with a total sleep time of 446.00 minutes. The patient’s sleep latency was 18.50 minutes with 34.50 minutes of wake time recorded after sleep onset. The sleep efficiency was 89%.

Total wake time during the night was 34.50 minutes, which was 6.91% of the total recording tim. The sleep stage percentages are as follows:
Stage 1: 7.96%
Stage 2: 71.19%
Stage 3: 3.59%
Stage 4: 0.78%
REM: 16.48%

The patient had a total of 20 respiratory events for a RDI of 2.69 per hour. There were 0 obstructive apneas, 2 mixed apneas, 0 central apneas and 18 partial apneas. 14 events occurred in Stage REM, 6 events were noted in NREM.

The patient spent 101.50 minutes supine with a positional RDI of 10.64 events per hour. A total of 285.00 minutes were recorded on a side body position with a positional RDI of 0.42 events per hour.

The average O2 saturation for the night was 95%, with the minimum being at 88%. For 99.8% of the night a saturation over 90% was monitored, for 0.1% of the night the saturation ranged between 80% and 90% and 0.0% of the night was spent at a saturation between 50% and 80%. 0.0% of the night had invalid SpO2 readings.

There were a total of 99 periodic myoclonic events, 0 of which were associated with arousals, which calculated to 0.00 evens per hour during sleep. 34 spontaneous arousals were noted with an index of 4.57 arousals per hour of sleep.

Comments:
Mild respiratory disturbance with events occurring only during Supine REM sleep.
Continuous snoring was noted throughout the study.
Intermittent runs of PLM(s) noted throughout the study.
Excessive fragmentation and minimal delta sleep.
No alpha intrusion was detected.”
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Shortly after this study, I had another consultation with the neurologist and he interrupted the report for me. In his opinion, I did not have a problem with Apnea, but that the noise of my snoring was keeping me from staying in the deeper more recuperative stages of sleep. His recommendation to me was to see an ENT doctor to see what he could do to reduce my snoring.

An appointment with the ENT was scheduled. After reviewing my sleep study, the ENT concurred with the neurologist conclusion regarding snoring and deep sleep. He told me about quite a number of different surgical and non-surgical treatments for snoring. He also told me that since snoring was not considered a “medical problem” that my insurance would not cover any of the solutions. The UPPP procedure was almost a guaranteed fix, but quite expensive to pay out of pocket. A CPAP would work as well, but could be expensive and inconvenient. His recommendation was Sclerotherapy (AKA: Snorplasty). Unfortunately the drug for this procedure was currently unavailable due to some type of recall and will not be available until sometime in July. This was to be a series of 2 or 3 injections in the soft pallet that would cost me about $500 per session and may or may not actually work for me. I really didn’t like the idea of spending money on a gamble.

I did some research on my insurance company’s web site and found some information that lead me to believe that they may actually cover a CPAP for me. With this information in hand, I went back to the sleep clinic and asked them what they could do to help me with this. They were all very helpful and were able to get a preliminary pre-approval from my insurance company and were able to schedule me for a 2nd sleep study with CPAP that night. (Someone else had canceled).

I jumped on the opportunity and was there and ready to go at 9 PM on a Friday night. They hooked me up to the 10 million wires and leads and set me up with a CPAP that they are able to control remotely from their observation room. I seemed to sleep pretty well that night and when they woke me Saturday morning at around 6:15, I felt better than I had in years! I couldn’t remember when the last time I had that much energy was. The staff doctor stopped in and went over the initial report and told me it appeared that I had gotten quite a bit of stage III and IV sleep. I left the office convinced that I had finally found the answer to the problems that had been plaguing me for years.

Waiting thru the weekend to have my prescription for a CPAP sent to a DME was the hardest thing. Come Monday morning, I was on the phone to the sleep clinic badgering them to get my information faxed to the DME. After about a dozen or so phone calls to the sleep clinic and the DME I had finally gotten every thing taken care of and was able to go pick up my CPAP! The unit given to me was a REMstar Pro2 w/C-Flex and a heated humidifier. As per the sleep center, the pressure on the machine was set to 8. I was given the same mask that I used at the sleep clinic, a ResMed Mirage Activa. I was so excited about going to sleep that night!

I set everything up at home as instructed and couldn’t wait for bed time. That night I put on the mask and turned on the machine and laid down ready to feel great the next day. Evidently I did not have the mask adjusted properly because I woke up a couple of time during the night to find the mask lying on the bed beside me. The following night was much better, as far as the mask goes. It feels fairly comfortable. When I wake up, my upper lip is slightly irritated but the feeling goes away pretty quickly. I don’t think I have a problem with the mask.

Once the problems with the mask were straightened out, I figured I would feel rested and energetic in the morning as I had at the sleep center. That most definitely has not happened. I thought maybe it will just take a couple days to get used to sleeping with this thing on my face, but it has been a week now and still nothing. I am starting to get pretty discouraged with the whole situation. I know this works, 2 doctors have said it would and the way I felt after the 2nd sleep study confirmed it for me. Is there something I am missing here? Why did it work at the clinic but not at home? In my opinion it should have worked better at home because I am in a much more familiar and comfortable environment.

If anyone has any insight that may help me out here, I would really appreciate it. Thank you for taking the time to read this whole long winded message.

You might want to take a look at this thread. It covers alot of what youa re asking about.

viewtopic.php?t=3153

I am no authority, but ask your wife if you are still snoring or does it sound like the air is leaking out. If either is happening, you are not getting the complete effect of the treatment. If you are snoring, try a chin strap. If leaking, tighten the mask a little so it won't move on your face.

Also, you will not always feel the effects every day. you will have both good and bad days. You will notice the diffence when you sleep without the mask after using it awhile.

Good luck.