. The latter test finally picked up hypopneas, only during REM. AHI was only 2, but had 30 events per hour during REM, the longest of which was 57 seconds (and this was not on my back, as I could never fall asleep that way, so may even be an under-representation of the issues?).I received my CPAP this past Monday, and have yet to fall asleep with the mask on. I know this will be a more difficult process due to the insomnia issue, but I am motivated to fix things. However, realistically, I need sleep to function in my job (which is more stressful this month than most), and the added sleep loss from trialing the CPAP now is making things nearly unsustainable. I have used Nuvigil the past year or so to make it cognitive- and energy-wise through my days, but with the additional sleep loss this past week, even that is not enough. I need to fix these issues ASAP.
I have a feeling that if I could fall asleep with the mask on, I will sleep (relatively) well, but my main issue is falling asleep. Without CPAP, even with insomnia, I fall asleep within 5 minutes of hitting the pillow. Now, I have made it to over 3 hours of using the mask, without falling asleep, before I give up for the night and get at least some sleep before the alarm blares in the morning.
My main issue with the CPAP I think is claustrophobia (which I don't normally have an issue with). Maybe this is not the correct term, but to me, it feels like I am breathing through straws. When I first put the mask on, I can find a position on my back where breathing feels relatively easy, but after a couple hours, it gets harder and harder, and feels like I am breathing through straws. A secondary issue is the loud-ish (admittedly subjective) sounds of hearing my own breathing, which I generally don't like. The noise from the machine itself doesn't bother me at all, just the noise of breathing in and out of the mask. However, I imagine the sounds of breathing I would eventually get used to. I can't see myself being able to overcome the breathing through straws issue, however.
Here is what I have tried so far:
--Humidity started at 5, then upped to 6, now at 7.
--Played with mask tightness. Was definitely too tight first night and hurt nose. Have mask where it feels fine on my head now, but that doesn't prevent the straw breathing sensation. No issues with leaks at all.
--Machine is set for expiratory relief and warmed hose.
--I tried ramp. My pressure is only 5, so honestly didn't make much difference ramping at 4. So have it off at the moment. The pressure at 5 doesn't really bother me, it's just the increasing sensation during the night (awake) that I can't breathe easily.
--Will be trying a contoured pillow tonight hopefully (that tilts head back some). I think that position generally helps a bit, but can't naturally hold that position through the night. Also tried a ramp-style pillow, but felt that made things worse.
--Tried SomniFix mouth tape last night. I do generally wake up in the morning with a slightly stuffy nose (never enough to treat before CPAP), so I wondered if opening my mouth eventually during the night might have been preventing my falling asleep. While I tolerated the mouth taping with no issues at all overnight, didn't help CPAP tolerance. I have also tried saline spray, antihistamines, and decongestants, but given mouth taping is not an issue, I don't think any minimal nasal congestion is my issue.
--I have tried Restoril for one night, still couldn't fall asleep.
--Ear plugs. Limit some noise, but can still hear my breathing, which is the noise that bothers me.
I'm sure I'm forgetting something, but that's where I'm at. I have an appointment Wednesday at the medical supply store to possibly try another mask (I'm assuming nasal would be best, since I clearly don't NEED to breathe through my mouth given mouth taping isn't an issue?). My current thought is that maybe I need a different sized nasal pillow? I have the small (both headgear and actual pillows). I think the mask should have also come with M and L pillows, but the respiratory therapist didn't give me the additional sizes. I will also see if I can get those to try on Wednesday.
I want (and need) this to work, but I'm so frustrated and barely hanging on during the day
.Thanks for any feedback!
