Unsure about CPAP

kteague · Post by **kteague** » Sun Feb 09, 2020 10:24 pm

Just a few things... not all those who mouth breathe at night have to use a full face mask. It depends. Sometimes the night mouth breathing is the body's attempt to bypass obstruction. Stop the obstructions and the mouth doesn't have the need to open. And there are other aids like chin straps if you find a full face mask not a good option for your face shape. If you have nasal blockage and you must mouth breathe, that's another story. At least with nasal pillow masks face size and shape aren't much of an issue. There are all kinds of comfort aids like mask strap covers and mask liners - there's a wealth of options. I would like to tell you there won't be a need for trial and error, but getting a best mask probably won't happen first try. If so, please do come back and tell us so we can celebrate with you.

Hopefully people here with petite faces will have some input about masks recommended for that facial type.

Getting your sleep study report will likely be enlightening for you. Many of us didn't get this education until we were having a miserable CPAP experience and found our way here. Sometime the smallest bit of info can hold a significant clue. You seem to be one who likes being informed about your health and your interest in the details of this treatment may what helps you make this treatment more than just tolerable. Before I was diagnosed I was young and fit and there seemed no obvious explanation for my invasive sleepiness. Turned out I had more than one sleep disorder. Also have limb movements during sleep, but effectively treating my sleep apnea began my turnaround. This forum has heard from quite a few people who don't fit the old school expectations of who might have sleep apnea. People who have benefitted from treatment. Let's expect you to find the answers you need to begin feeling better.

Ht538 · Post by **Ht538** » Mon Feb 10, 2020 8:31 am

full results of my study:
Some notes that may or may not be helpful - Prior day i went to bed at 10, but was up at 4. I have frequent nightmares (PTS related) and typically sleep primarily on my left side, rarely on my back. One of the electrodes made left side sleeping super uncomfortable. I also woke with a horrendous headache ( luckily I usually do t get). Headache persisted the entire next day despite OTC meds. Tech said I slept well but it felt like I got zero sleep.

Any insight would be helpful and much appreciated! I am an engineer and data geek so I am very comfortable with “tech” speak.

Also I suspect that my nightmares may have something to do with the OSA normally during my REM sleep or the other way around. I also know ADD has sleep connections but not clear how might impact the study.

kteague · Post by **kteague** » Mon Feb 10, 2020 6:31 pm

Because of the presence of limb movements, I would suggest you do get an official titration in the sleep lab with your legs wired. Maybe your limb movements will resolve with CPAP. Sometimes that happens, but sometimes one can see more limb movements once they are sleeping better with fewer apnea events. While your AHI is not alarming, do consider that if you had no limb movements it's possible you would have had more apneas. Just the act of movment could help obstructions. Apneas and limb movements each can mask the other. I wouldn't dismiss your "mild" diagnosis. It may not be fully reflective of your situation.

Ht538 · Post by **Ht538** » Mon Feb 10, 2020 6:41 pm

That makes sense about the leg movements. I also know I had a nightmare during the study, but I have no idea what sleep phase or if there was movement (my bf says I twitch like a dog when dreaming

) so maybe I should ask if that was a factor?

I think the thing that puzzles me is that my AHI in non-rem sleep is not considered consistent with OAS, but only in REM sleep. However I didn’t get to REM until 3hrs into the study and only spent a little more than an hour there. So does that mean I get pumped with air for 5 hrs to deal with one hour of apnea?

BTW, you have been super helpful in settling me down about this!

zonker · Post by **zonker** » Mon Feb 10, 2020 7:08 pm

Ht538 wrote: ↑
Mon Feb 10, 2020 6:41 pm

BTW, you have been super helpful in settling me down about this!

we don't see nearly enough of her around here.

Becca8104 · Post by **Becca8104** » Mon Feb 10, 2020 8:52 pm

I am a military retiree spouse & was active duty myself at one time. I get my equipment from CPAP Military Medical.com, but I am on Tricare, but I think we would have the same DME list to choose from. There are brick and mortar suppliers as well if you prefer that. Since you are still active duty, you won't have any co-pays. You should be able to try both a full face mask & nasal mask. A lot of "mouth breathers" successfully use nasal masks with the addition of chin straps and other methods they prefer. You can read up on some of those methods on this forum. Also, no matter what mask or masks you start out with, if you are not happy with them and you want to try another model or style, you have that right. Don't let anyone bully you into "settling" on a particular mask. Good luck to you on this journey.

snfrd84 · Post by **snfrd84** » Tue Feb 11, 2020 11:02 am

A lot of great info in here. Recently got my Resmed Auto10 machine, (whatever the name is, lol) and this coming thurs will be a week on it. Got the Dreamwear mask with the nasal cushion and then tried the nasal pillows for a few nights. Although the mask is comfy, the nasal cushion and pillows, to me, sort of rubbed a bit under my nose, on the lip part. Felt uncomfortable, so trying to change to the F30i mask, but getting in touch with my Respiratory therapist is being more challenging than I thought.

I'm 36, 5'10", 200lbs and no mouth breather, but a nose breather and 85% side sleeper, and for me I think the F30i mask will help me more for side sleeping.

So, all that meaning to say that yes, changing to a mask that will work with you will take some time, but hopefully the new mask will help me out and being on the machine for almost a week, I DO feel better mentally, but physically, with so many months not sleeping well, seems my body is taking more time to catch up. Some days I still have taken a nap

palerider · Post by **palerider** » Tue Feb 11, 2020 1:43 pm

snfrd84 wrote: ↑
Tue Feb 11, 2020 11:02 am
A lot of great info in here. Recently got my Resmed Auto10 machine, (whatever the name is, lol)

It is actually important that you figure out "whatever the name is" if you want to get accurate help, or want to be able to find the right info on the web.

It's not hard, it's printed right on the lower right front of the machine.

snfrd84 · Post by **snfrd84** » Tue Feb 11, 2020 1:45 pm

palerider wrote: ↑
Tue Feb 11, 2020 1:43 pm

snfrd84 wrote: ↑
Tue Feb 11, 2020 11:02 am
A lot of great info in here. Recently got my Resmed Auto10 machine, (whatever the name is, lol)
It is actually important that you figure out "whatever the name is" if you want to get accurate help, or want to be able to find the right info on the web.

It's not hard, it's printed right on the lower right front of the machine.

When it comes time, I'll get the correct name, when I'm actually near it.

Julie · Post by **Julie** » Tue Feb 11, 2020 2:03 pm

If only because there are lots of diff. models from lots of diff. yrs of all equipmt and they do different things.

Ht538 · Post by **Ht538** » Tue Feb 11, 2020 2:05 pm

I’m getting the sense that I’ll understand better about all the masks when I finally get to try one one at my titration study.

Ive also seen folks recommend the auto pap machines particularly among the ladies here. From what I gather in my study results only a small portion of my sleep REM is affected by hypopneas, no apnea.

Does auto pap in the opinion of folks here work well for you when only smaller portions of your sleep is disturbed? I feel like I’m treating myself all night for an hour of disrupted sleep...do folks notice a difference even when their OSA is “OSA-REM”? It looks like even for folks with the ‘right’ mask there is still and amount of disturbed sleep from fiddling around with things during the night as just a matter of life with PAP. Do those of you with positional, or stage related apnea’s find that the extra fiddling is just as disruptive as the period of disturbed sleep you were treating? Or do you see overall benefits in all of your sleep?

Dog Slobber · Post by **Dog Slobber** » Tue Feb 11, 2020 2:22 pm

Ht538 wrote: ↑
Tue Feb 11, 2020 2:05 pm

Does auto pap in the opinion of folks here work well for you when only smaller portions of your sleep is disturbed? I feel like I’m treating myself all night for an hour of disrupted sleep...do folks notice a difference even when their OSA is “OSA-REM”?

Auto is particularly desirable when only parts of the night you need higher pressure.

For example:
Let's say you have minimal pressure needs through out the night, but during REM, approximately 20% of the night you need 16cm of pressure.

With fixed pressure your solution is 16cm of pressure all night, or inadequate pressure while in REM.

With Auto your device can supply minimal pressure, then during REM it senses more pressure is required and then will deliver the needed pressure. Then as your needs change reduce pressure.

There are a lot of other reasons why our needs change night to night and during the night. For the absolute majority, Auto adjusting should be the way to go.

Pugsy · Post by **Pugsy** » Tue Feb 11, 2020 2:26 pm

It's very common for OSA to be worse in REM stage sleep. I am a member of that group myself. Documented by an in lab diagnostic sleep study....in REM my OSA is about 5 times worse than in non REM sleep.

There is a reason hyponeas are counted during sleep studies...they matter and they matter a lot so don't be thinking that just because you only had hyponeas that it doesn't matter.

Obstructive apnea.....80 to 100% reduction in air flow that lasts at least 10 seconds.
Hyponea....40 to 79% reduction in air flow that lasts at least 10 seconds. Think that a hyponea that is a 75% reduction in air flow wouldn't hurt you because it missed OA criteria by 5%??? Think again.

zonker · Post by **zonker** » Tue Feb 11, 2020 2:31 pm

Dog Slobber wrote: ↑
Tue Feb 11, 2020 2:22 pm

Auto is particularly desirable when only parts of the night you need higher pressure.

you forgot the number 1 reason.

chicks dig guys who use the "for her" model!!\

Ht538 · Post by **Ht538** » Tue Feb 11, 2020 2:46 pm

Ha! Dog slobber...I almost think that’s intriguing enough to start a new thread!

Pugsy, I don’t discount that hypopneas need to be addressed! My 02 sat stayed above 90% all night save a minute in the 89% range. I also don’t have any BP or heart issues....but I don’t think we truly understand what other systems are impacted. My real reason for even considering the pap is that there is some evidence that PTSD, nightmares and OSA, particularly in REM are related. So even if the usual health related concerns don’t *seem* to be an issue, I am still going to put aside my enormous pessimism about the treatment addressing physical health issues (I don’t appear to have any other than the OSA) in order to maybe address the mental health ones. It’s actually the only reason I was even able to get the study. i was repeatedly told I didn’t have any risk factors. I’ll keep folks posted on how things go to addressing my nightmares as none of the usual PTS treatments are helping.
I would also urge folks with any mental health issues to get a study....there are numerous mental health comorbidities. Physicians shouldn’t deny us slender young non snorers the benefit of poly sonno graphs or pap treatment where indicated!
So yes, I totally agree with you.

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