Eight months of cpap with frustration!

So I started using my cpap last Sept. Since then I have gained 15 pounds. I exercise regularly...usually 3-5 days per week which consists of a 30 min, 2mile walk or work out with dvd program that is 30 min. I also play tennis at least weekly with nice weather. I have depression which was diagnosed around 10 years ago and also a disease called thryroiditis that was diagnosed 3 years ago. Thyroid levels are currently completely normal. With my cpap I use a ffm---ultra mirage ( I am a mouth breather). I am comfortable at night with the ffm except dry mouth. Pressure-8, ahi runs around 4-8. I know the AHI seems high to some but according to RT advice....less than 10 constistently is fine. I really feel pretty good most of the time...I mean I feel like I sleep fair. I don't feel the greatest but nothing like before cpap. If I turn up cpap to 9, the AHI is much improved but major dry mouth to the point I can not stand it plus major leaking of mask. I really am bothered by the wt gain and despite exercise and dieting I can not lose the wt. I always hash around ideas like the pressure is currently too low or maybe too high...(I was titrated at a pressure of 7 at sleep study). Overnight pulse ox on pressure of 7 showed pulse ox low at 91% which I thought was rather low but according to parameters of RT/DME it was ok. I just wondered what kind of advise you all would have for me. Since Sept, 2008, I have only went one night without cpap.
Jen

reefdreamer wrote:....the AHI is much improved but major dry mouth to the point I can not stand it plus major leaking of mask. Jen

Jen, I am really impressed with your diligence in working on your health! Keep it up and try not to let discouragement creep in. This cpap stuff is truly a journey we take to fine tune everything to an optimal point. The mask leaking is most critical, and must be gotten under control. Do check the search of this forum for suggestions for this, as it is clearly the most important factor for decreasing your dry mouth and your effective treatment.

I would also then suggest experimenting with your humidifier setting, one step at a time and for a few nights at each setting, so that you find an optimal setting for decreasing dry mouth but not contributing to rainout.


Keep up the good efforts and stay tuned!

You might consider getting a stand alone heated humidifier, trying it and if that isn't enough then adding it is a circuit with your humidifier so there are two in use.

reefdreamer wrote:So I started using my cpap last Sept. Since then I have gained 15 pounds. I exercise regularly...usually 3-5 days per week which consists of a 30 min, 2mile walk or work out with dvd program that is 30 min. I also play tennis at least weekly with nice weather. I have depression which was diagnosed around 10 years ago and also a disease called thryroiditis that was diagnosed 3 years ago. Thyroid levels are currently completely normal. With my cpap I use a ffm---ultra mirage ( I am a mouth breather). I am comfortable at night with the ffm except dry mouth. Pressure-8, ahi runs around 4-8. I know the AHI seems high to some but according to RT advice....less than 10 constistently is fine. I really feel pretty good most of the time...I mean I feel like I sleep fair. I don't feel the greatest but nothing like before cpap. If I turn up cpap to 9, the AHI is much improved but major dry mouth to the point I can not stand it plus major leaking of mask. I really am bothered by the wt gain and despite exercise and dieting I can not lose the wt. I always hash around ideas like the pressure is currently too low or maybe too high...(I was titrated at a pressure of 7 at sleep study). Overnight pulse ox on pressure of 7 showed pulse ox low at 91% which I thought was rather low but according to parameters of RT/DME it was ok. I just wondered what kind of advise you all would have for me. Since Sept, 2008, I have only went one night without cpap.
Jen

First I am tempted to say just loose that RT.
Sounds to me like a lazy RT and you are on your own, whether you know it or not.

Where does the doc fit in all of this? Esp. with the O2? RT's don't script O2.

Personally, I don't feel good unless my AHI is below 1, but that is me.

Dry mouth - sounds like you are mouth breathing to me. Do you mouth breath during the day? You do huh? Work on teaching yourself to breath thru your nose, I did it. Keep your tongue planted to the roof of your mouth when going to sleep. I keep a bottle of Propel by the bed just for the dry mouth, deal with it.

Weight gain - my doc told me the body is like a black box. Makes sense.
So something changed - either you are putting more in or not burning as much.

If dry mouth persists (FFM it seems) after using two humidifiers in series, then I would talk to the doc about being checked for sjogren's syndrome.

All of the above(including drop the RT), plus:
Nasal rinses (see http://www.neilmed.com for example) to get your nose as clear as possible
A heated hose the will let you add humidity without running into rainout problems.
Raise your pressure 0.5 cms.
O.

Yes, I mouth breath during the day. I have tried all the nasal rinses out there. I have chronic sinus congestion and use nasonex at night and claritin d during the day. The dr that ordered my cpap is just an internal medicine doctor and has not a clue about cpap. I am an RN so I like that...he lets me do whatever I want and pretty much tells me that. The RT also knows I am going to do whatever I want. I think they go by certain protocols but not every patient is the same. If I make changes and let the RT know...which is not very often...that I let her know that is....but if I do make changes she just calls the dr and he says ok. I have tried everything imaginable for my nose congestion and just said screw it and sleep comfortably with mouth breathing. I do attempt to keep mouth closed but in the night it drops open due to congestion.

Oh, and I have a padacheek hose cover so rainout is not ever an issue but I have humidity at 3 right now and at 4 it seems to be too much and also becomes too warm for me so I have messed around with it and settled on a setting of 3 currently.

Try taking your Claritin before bed instead of in AM. See if that helps with congestion. Yea congestion will do it, so work on that too.

Thanks for all the replies. The claritin d is the 24hour formula and I have to take it in the am or I am up all night.

I guess you really need a sleep doctor.