New CPAP user having problems.

Sleeprider wrote:Looks like the next step is to start looking at your data in Sleepyhead, and taking control of this.

Right-o. That's if I can manage to wear it through the night without the aforementioned problems.

Well, first night with the new mask and adjusted settings. My nose was stuffy and I struggled for over an hour to get to sleep. Used some Vicks and cleared the nose somewhat but still felt like I was struggling to get enough air. Must have fallen asleep at some point but not for long. Woke up gasping, belching, farting. Still getting a lot of air into the stomach.
I talked with the sleep tech yesterday about LES issues and "swallowing" air. She had never heard about the LES. She insisted that you swallow air, it doesn't just steadily flow into the stomach. I could tell that she was not believing what I was saying but she did say she would check into it.
I know that my stomach is in worse shape since I began therapy. I seem to have a lot more reflux, heartburn...etc.. My fear is that this is making my previous issues with the LES worse. I've been dealing with these stomach issues all of my life and was at a point where they were tolerable. I don't need them to get worse.

When is the last time your MD checked you for a hiatal hernia? It's very common and probably more so in older OSA patients who gained weight at some point, whether or not they lost it afterward. You need to get that cleared up one way or the other because it's affecting your apnea therapy and can be fixed (whatever the underlying problem is, LES or not).

Julie wrote:When is the last time your MD checked you for a hiatal hernia? It's very common and probably more so in older OSA patients who gained weight at some point, whether or not they lost it afterward. You need to get that cleared up one way or the other because it's affecting your apnea therapy and can be fixed (whatever the underlying problem is, LES or not).

I don't think I've ever been checked Julie. I last saw the Gastro MD back in 2012. I had another dilation done then. I'm calling this morning to see when I can get in.

Called the Gastroenterologist and can get in tomorrow. Yay!

Mike208 wrote:Well, I had a visit with the sleep specialist this morning. She said the high pressure was definitely the cause of the air in the stomach. It was lowered to 11 and the ramp time was changed to 45 min. instead of auto. I also have a new mask, one that does not have the forehead support. She thought that was putting too much pressure on the bridge of the nose. So, we'll try it tonight and see what happens. Oh, she also raised the temp. to 86 and the humidity down to 2. That was because of the congestion I have.
I asked her about changing to the biPAP if need be and she said she didn't think there was a need for it, that we can make the necessary adjustments with the present machine.

1) not sure how ramp can help with air swallowing
2) are you positive that 86F, humidity 2 can care of your congestion?

Mike208 wrote:I talked with the sleep tech yesterday about LES issues and "swallowing" air. She had never heard about the LES. She insisted that you swallow air, it doesn't just steadily flow into the stomach.

That is typical. Get what you can out of the tech and then move on.

It's a good move to have an appointment with your gastro doc. He can also check you for a hiatal hernia, although I think if you had one it would have already been diagnosed.

Have you seen an ENT about that nasal congestion? (Sorry, the thread is six pages and I did not read it all.)

tan wrote:

Mike208 wrote:Well, I had a visit with the sleep specialist this morning. She said the high pressure was definitely the cause of the air in the stomach. It was lowered to 11 and the ramp time was changed to 45 min. instead of auto. I also have a new mask, one that does not have the forehead support. She thought that was putting too much pressure on the bridge of the nose. So, we'll try it tonight and see what happens. Oh, she also raised the temp. to 86 and the humidity down to 2. That was because of the congestion I have.
I asked her about changing to the biPAP if need be and she said she didn't think there was a need for it, that we can make the necessary adjustments with the present machine.

1) not sure how ramp can help with air swallowing
2) are you positive that 86F, humidity 2 can care of your congestion?

I'm not either but I assumed she knew what she was doing. I could tell there was a change in temp and humidity. It seemed to make the congestion worse.

Cereal Killer wrote:

Mike208 wrote:I talked with the sleep tech yesterday about LES issues and "swallowing" air. She had never heard about the LES. She insisted that you swallow air, it doesn't just steadily flow into the stomach.

That is typical. Get what you can out of the tech and then move on.

It's a good move to have an appointment with your gastro doc. He can also check you for a hiatal hernia, although I think if you had one it would have already been diagnosed.

Have you seen an ENT about that nasal congestion? (Sorry, the thread is six pages and I did not read it all.)

I think seeing him is a great move. Like you, I would have thought a hernia would have been diagnosed years ago. But you never know.

I have an ENT and he prescribed nasal spray that really doesn't help very long. I guess it lasts maybe 3 hours or so. He says I have no serious issues with the sinus area. One thing I just realized is that he has never suggested a prescription allergy medicine. All I have ever taken was over-the -counter and it doesn't work well.

Mike208 wrote:

tan wrote:

Mike208 wrote:Well, I had a visit with the sleep specialist this morning. She said the high pressure was definitely the cause of the air in the stomach. It was lowered to 11 and the ramp time was changed to 45 min. instead of auto. I also have a new mask, one that does not have the forehead support. She thought that was putting too much pressure on the bridge of the nose. So, we'll try it tonight and see what happens. Oh, she also raised the temp. to 86 and the humidity down to 2. That was because of the congestion I have.
I asked her about changing to the biPAP if need be and she said she didn't think there was a need for it, that we can make the necessary adjustments with the present machine.

1) not sure how ramp can help with air swallowing
2) are you positive that 86F, humidity 2 can care of your congestion?

I'm not either but I assumed she knew what she was doing. I could tell there was a change in temp and humidity. It seemed to make the congestion worse.

That is what I am talking about... You should be able to choose your settings. Different people benefit from different combinations of humidity and temp settings. Having a ramp in your case is a kind of self-deception.

tan wrote:

Mike208 wrote:

tan wrote:

Mike208 wrote:Well, I had a visit with the sleep specialist this morning. She said the high pressure was definitely the cause of the air in the stomach. It was lowered to 11 and the ramp time was changed to 45 min. instead of auto. I also have a new mask, one that does not have the forehead support. She thought that was putting too much pressure on the bridge of the nose. So, we'll try it tonight and see what happens. Oh, she also raised the temp. to 86 and the humidity down to 2. That was because of the congestion I have.
I asked her about changing to the biPAP if need be and she said she didn't think there was a need for it, that we can make the necessary adjustments with the present machine.

1) not sure how ramp can help with air swallowing
2) are you positive that 86F, humidity 2 can care of your congestion?

I'm not either but I assumed she knew what she was doing. I could tell there was a change in temp and humidity. It seemed to make the congestion worse.

That is what I am talking about... You should be able to choose your settings. Different people benefit from different combinations of humidity and temp settings. Having a ramp in your case is a kind of self-deception.

Well, I'm new to all of this so I was relying on her to be the expert.

Mike208 wrote:I have an ENT and he prescribed nasal spray that really doesn't help very long. I guess it lasts maybe 3 hours or so. He says I have no serious issues with the sinus area. One thing I just realized is that he has never suggested a prescription allergy medicine. All I have ever taken was over-the -counter and it doesn't work well.

Here is what I would try,

1. 24-hour generic Zyrtec once in the morning. Shop around and you should find it cheap.

2. Neti pot rinse in the morning. (See https://www.youtube.com/watch?v=H9i6x6uGm2k - Buy the single-use packets of salt. That way you get the correct amount and the correct salt. They are cheap. Get generic pot and salts.)

3. Follow the rinse immediately by your corticosteroid nasal spray. The rinse will help clear the membranes so the spray medicine can get into them and do its work.

4. You might want to repeat the neti pot rinse after dinner but not too close to bedtime.

ChicagoGranny wrote:

Mike208 wrote:I have an ENT and he prescribed nasal spray that really doesn't help very long. I guess it lasts maybe 3 hours or so. He says I have no serious issues with the sinus area. One thing I just realized is that he has never suggested a prescription allergy medicine. All I have ever taken was over-the -counter and it doesn't work well.

Here is what I would try,

1. 24-hour generic Zyrtec once in the morning. Shop around and you should find it cheap.

2. Neti pot rinse in the morning. (See https://www.youtube.com/watch?v=H9i6x6uGm2k - Buy the single-use packets of salt. That way you get the correct amount and the correct salt. They are cheap. Get generic pot and salts.)

3. Follow the rinse immediately by your corticosteroid nasal spray. The rinse will help clear the membranes so the spray medicine can get into them and do its work.

4. You might want to repeat the neti pot rinse after dinner but not too close to bedtime.

Nothing is ever easy is it? LOL I've been using the Zyrtec. It really doesn't help much. I've heard about Neti pots but never tried it. Thanks.

Mike, I think it's great you're seeing the Gastro so soon. I hope you'll have a complete discussion about your LES concerns that I think are real, and may have an underlying cause he can help with. Beyond that he is the guy who can make a professional recommendation (prescription) for bilevel PAP therapy to try to relieve the gastro symptoms, while still treating your apnea. Be sure to try to get that. No one on the DME or insurance side of things can do this, it has to come from a physician.

Mike208 wrote:

tan wrote:

Mike208 wrote:Well, I had a visit with the sleep specialist this morning. She said the high pressure was definitely the cause of the air in the stomach. It was lowered to 11 and the ramp time was changed to 45 min. instead of auto.

1) not sure how ramp can help with air swallowing

I'm not either but I assumed she knew what she was doing. I could tell there was a change in temp and humidity. It seemed to make the congestion worse.

that's a dangerous assumption.