New and dispirited

I was recently diagnosed with severe obstructive hypoapnea. The diagnostic came as a bit of relief, actually, as it explains why I have chronic depression that doesn't respond to meds, regular nightmares, never feeling rested in the morning, etc. I'm a man in my mid 40's. My doctor told me I needed to use a CPAP machine and sent me to a provider to get a machine for a titration test.

I'm not adverse to change, and in fact have taught change management in business. But I'm halfway through the two weeks test and I've rarely felt LESS rested! I didn't expect an overnight miracle, and realise it takes time to adjust to these things, but I'm really not seeing any sign of improvement.

Last night, I had the best night sleep since I started the test - and it was the first night I didn't use the machine I *should* have used it, but I needed somewhat restful sleep. Ironic considering the machine is supposed to improve sleep quality.

They gave me a Respironics System One, with minimal instructions on how to use it. Supposed to return the machine at the end of the two weeks and they will retrieve the data card, send it to my doctor who will then write a prescription. They first gave me a mask that covered only my nose (sorry, was not informed of make/model/size). Only my nose congests easily (always has), and on the second night I ended up having to breath through my mouth, which didn't work, created a major "leak" through my mouth: noisy and freaked out my spouse I called them and explained the situation, so they gave me a mask covering the nose and mouth at the same time.

This new mask is leaving me with incredibly dry and sore lips in the morning, despire generous use of chaptstick before going to bed. My tongue is also dry and feels very swollen. There must be occasional leaks around the top of the nose because my eyes also are very dry in the morning. I've tried adjusting the mask, to no avail.

The machine with the full face mask is a lot noisier than with just the nose mask. I'm somewhat ok with the noise, but it disturbs my wife who's always been a light sleeper. Neither of us sleep well with white noise so that's not an option to camouflage the CPAP.

I've tried adjusting the humidifier level from 0 to 5, makes no difference. Best night sleep was the first one when there was no water in the tank!

When I go to bed, it feels like the machine doesn't follow my breathing patter, which tends to be long and slow, so that's a fight that doesn't really allow me to relax.

Both my wpouse and I know that it is important for my continued health that I persevere with this. I also read somewhere that only about half the people who start using a CPAP end up going through. I want to be successful - gosh I could use decent sleep! But I don't feel like I'm getting very much support from the clinic providing the machine (also, they have only 3 different machines). I'm not sure how people actually manage to try different machines and masks that end up working for them without having to spend thousands on unusable equipment. Apart from "medicare" (I live in Canada), I don't have private health insurance to cover the costs of equipment.

Anyway, I have no real or specific questions I guess. I'm just finding myself at a loss and hope someone might have a good word of insight.

Welcome to forum... You found a good place. Work all your therapy issues out here. Lots of knowledge here.

Take 15 minutes and review this youtube video it will help you understand what is going on.
https://www.youtube.com/watch?v=-gie2dhqP2c

This video put the whole thing in perspective for me.

It should be required viewing for any one who is new.


I wish you well...

Hi, what I think you need to do first is find a mask that fits you properly, tried on when lying down as faces change a lot then. And you should play with the humidifier because even though you said your nose ran a lot even before Cpap (you could have allergies), using a high setting, or using the humidifier at all may well cause congestion as it does in many people (self included) especially in humid climates or seasons. The dryness is caused by mouth breathing, but that can be helped with Biotene from the drugstore, along with a better fitting mask and, if you are a back sleeper, something behind you to keep you off your back (that promotes more apneas in any case and is not recommended). You may also be one who should try a soft cervical collar as they keep your head up more than it might otherwise be when sleeping, and your airway will open up more then, plus it helps keep your jaw closed, more comfortably than a chin strap might, so minimizes leaks.

Oh just curious - were you really diagnosed with that many hypopneas vs apneas? If so, that could be another sign of back sleeping, etc. A diagnosis of "severe" + 'obstructive' usually refers to apneas, whereas hypopneas are sort of wannabe apneas - not fully obstructive, though can certainly result in arousals and tiredness.

You are mouth breathing which is why you get a dry mouth as you know.
The best thing is to try to prevent that with a chin strap. It also helps to sleep on your side (sleep on the edge of the pillow with the mask hanging over the side.

Find on old tshirt and use it to make a gasket to go between you and the mask. The mask sounds like it doesn't fit quite right. Finding a mask the fits right and is comfortable is like finding the right shoes to run a marathon or hike a 5 day mountain trail you have to try a lot of masks and when you do try them on you need to "walk" in them - in other words you need to be laying down with the machine at your required pressure. Note that a well fitting mask rides your face like a hovercraft.

Go and research nasal sprays - a simple salt water rinse spray can be all that one needs to keep the nose open during the night. Also play with your humidity some noses prefer a lot of warm moist air and other hate it.

If you find it hard to fall asleep try watching an exciting movie while you wear the system to get your body/mind used to the whole thing.

You can find out just how you are doing by using SleepHead software - see the first thread at the top called "Pugsy's Pointers"

Note that the Resperonics is top of the line. Make sure you understand the names and numbers before you get your real machine - you want a machine with full data, not just hours used. Let them make a profit from somebody else. Remember to deal with them the same way you would a used car dealer with the worst reputation in town (except that they would actually know about the product they are selling - cars)

You sound a lot like me, I have been on CPAP for less than a week and have been dealing mostly with issues in my head and not so much with the machine.

One thing I just realized is that I was thinking of CPAP as being a ventilator of sorts, as in fighting my breathing. Now when I just relaxed and let it do whatever it wanted, I next thought it had stopped working. Well it was working fine and doing exactly what it was supposed to do-provide pressure support and stop apneas.

The humidity is a big thing for me as my nose tends to clog up like yours. Personally I found that putting the machine on auto, temp set to 70, and most importantly keeping the room cool <70 works best for me. This was very important to my accepting the machine.

Mask fitting is what I am working on now and I am trying to understand just how important "mask leaks" are-big, small, quantity. I am thinking that big leaks are not good because the machine cannot over-power them, small-short leaks not so important.

Noise, I put a thick sock under the machine and that stopped a lot of the noise, "fixing" the big leaks got the rest.

Most of my issues are caused by being used to doing all manner of strange things trying to get sleep before the machine, trying to let go of these while still not really understanding what is "normal" with a machine.