2 months in and struggling

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: 2 months in and struggling

Post by Pugsy » Mon Dec 06, 2021 12:23 pm

packfan23 wrote:
Mon Dec 06, 2021 11:55 am
Id love to make it through an entire night and maybe it is unrealistic. Ill settle for a few hours straight at this point.
In the grand scheme of things you really haven't been on cpap all that long.
Accept that an occasional awakening is normal...like the normal awakening after a completion of the REM stage in sleep.
Eventually you will probably find that you join the rollover and go back to sleep people more often than the remembering the wakening people.
We don't remember awakenings when we aren't awake long enough to form a memory of the awakening.
Eventually you will likely have a night where you close your eyes and wake up and it's morning kind of thing....
assuming you don't have to wake up and pee during the night.
While OSA is a common cause for nocturia and can be reduced or eliminated with optimal cpap therapy...there are other reasons for nocturia that cpap can't fix. If male and of an age where the old prostate messes with sleep...that will always be present and obviously needs to be maybe addressed by other measures if at all possible. There's also the over active bladder thing that can affect both men and women.

Devote your "worry energies" to stuff that you actually have some sort of chance of impacting. No sense in wasting energy on something that is out of your control. I realize that this is much easier said than done but we can keep trying.

Try to look at the positives as much as possible. I know negatives are always much easier to find than positives but try to look for them. Like when I don't dwell on not feeling like super woman but instead I am glad to say at least I don't feel like death warmed over. :lol:

The turning the brain off thing....geez that is a tough one for sure. Most likely a war we won't have a lot of success in winning those battles but it doesn't mean we quit trying.

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zonker
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Re: 2 months in and struggling

Post by zonker » Mon Dec 06, 2021 5:19 pm

Pugsy wrote:
Mon Dec 06, 2021 12:06 pm


I don't expect to be super woman....
hey! you're super woman to US!!
:lol: :lol: :lol:

don't remember exactly where in the process it was, maybe 6 month in(??), but i masked up for bed and slept straight through! i thought to myself "well, this is the stuff right here!".

have.never.had.another.night.like.it.

can't even remember what my ahi was.
<sigh>
people say i'm self absorbed.
but that's enough about them.
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GrumpyHere
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Re: 2 months in and struggling

Post by GrumpyHere » Mon Dec 06, 2021 10:07 pm

packfan23 wrote:
Mon Dec 06, 2021 11:55 am
I completely understand as I have issues turning my brain off at night. Constantly thinking about upcoming things at work or just general things. I have trouble turning my brain off to let go and completely relax.
Dan Harris - 10% Happier has an approachable take on meditation and a 5 minute daily routine. A quick read.
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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Tue Dec 07, 2021 6:31 am

Here was last night. Overall, I feel a little better. I will take note of how I feel as the day goes on, but I dont feel as tired as the last few days. I dont know or remember how many times I woke up, but I know it wasnt nearly as much as Saturday and Sunday. I also never had to get up to use the bathroom at any point before my alarm went off. I see the leaks especially later as I know I turned and slept more on my stomach, likely pushing the mask. I remember waking up and the mask was leaking out the side. There are some flow limits but way better than last week.
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zonker
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Re: 2 months in and struggling

Post by zonker » Tue Dec 07, 2021 12:23 pm

packfan23 wrote:
Tue Dec 07, 2021 6:31 am
I see the leaks especially later as I know I turned and slept more on my stomach, likely pushing the mask.
is your stomach sleeping position like this?

http://www.uarsrelief.com/sleeppositions.html
people say i'm self absorbed.
but that's enough about them.
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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Tue Dec 07, 2021 12:36 pm

zonker wrote:
Tue Dec 07, 2021 12:23 pm
packfan23 wrote:
Tue Dec 07, 2021 6:31 am
I see the leaks especially later as I know I turned and slept more on my stomach, likely pushing the mask.
is your stomach sleeping position like this?

http://www.uarsrelief.com/sleeppositions.html
No, my right arm is fully under the pillow and my left is beside my face or sometimes my head rests on my left hand. I have no idea why but thats one of the few positions I can get comfortable and fall asleep. I tend to shift to this position after a few awakenings.
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Miss Emerita
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Re: 2 months in and struggling

Post by Miss Emerita » Tue Dec 07, 2021 12:46 pm

Very good to hear you had a better night. Here's to more of same!
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zonker
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Re: 2 months in and struggling

Post by zonker » Tue Dec 07, 2021 1:16 pm

packfan23 wrote:
Tue Dec 07, 2021 12:36 pm
zonker wrote:
Tue Dec 07, 2021 12:23 pm
packfan23 wrote:
Tue Dec 07, 2021 6:31 am
I see the leaks especially later as I know I turned and slept more on my stomach, likely pushing the mask.
is your stomach sleeping position like this?

http://www.uarsrelief.com/sleeppositions.html
No, my right arm is fully under the pillow and my left is beside my face or sometimes my head rests on my left hand. I have no idea why but thats one of the few positions I can get comfortable and fall asleep. I tend to shift to this position after a few awakenings.
was wondering because i use this position and doesn't push my mask. then again, i have a nasal pillow mask so maybe that has something to do with it too.
people say i'm self absorbed.
but that's enough about them.
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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Fri Dec 10, 2021 6:32 am

Therapy is going the same. Ive attached last nights goodies. I had some leaks which Ive come to realize is merely a positional thing. The large leaks early on are from sleeping on my stomach versus later on my side. Ive also noticed the flow limits are much greater during this time as well. The 5 minute window was a bathroom break which was the only bathroom trip of the night. Overall, I feel mostly the same. Im waking up 4-5 times during the night but I dont feel the same rush that usually accompanies my awakenings. Its much calmer and just opening my eyes and realizing "hey Im awake again". Just a different feeling than when not on CPAP. Ive been on these settings about a week now, the only change I plan on making is adjusting the humidifier. Ive also resumed taking Trazodone since Monday night. I'm curious to see how it goes this weekend when I can sleep in a little longer.

The biggest takeaway is Ive been persistent and completely compliant the last couple of weeks. Still not sure what I need to tweak (settings, mask, comfort) or if there even is anything. I have an appointment with my sleep doctor right before Christmas, so I will have a nice sample size of data to go over and discuss.
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Miss Emerita
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Re: 2 months in and struggling

Post by Miss Emerita » Fri Dec 10, 2021 12:43 pm

It sounds to me as though you're doing a really good job of understanding how you're doing and the reasons for issues like leaks and flow limitations.

It is quite normal to wake up multiple times during the night. Often people don't remember their wake-ups; next best is remembering them but realizing they were short, as you're doing.
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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Wed Dec 15, 2021 10:03 am

Miss Emerita wrote:
Fri Dec 10, 2021 12:43 pm
It sounds to me as though you're doing a really good job of understanding how you're doing and the reasons for issues like leaks and flow limitations.

It is quite normal to wake up multiple times during the night. Often people don't remember their wake-ups; next best is remembering them but realizing they were short, as you're doing.
There's been zero change with my therapy and results. I still wake up 5-7 times a night and feel the same if not more tired. Ive noticed an uptick in hypopneas in OSCAR and some RERAs (forgive me for not attaching pictures, I can do this later when Im at home), but overall feeling is still the same. My bathroom trips have almost been eliminated, maybe once a night. I saw my PCP yesterday and my BP was rock solid, which shocked me considering I had just had a strenuous day at work. I have my followup with my sleep doctor next week, and Im guessing the next step is possibly treating insomnia. I appreciate everyone's suggestions/comments. I keep thinking Im missing something or not doing something right with my therapy, however I likely have other factors contributing to my poor sleep. Its taking a greater toll on my body now, as Im experiencing more brain fog/zoning out, just completely void of any energy, among other things. It feels like its gradually getting worse.
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Pugsy
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Re: 2 months in and struggling

Post by Pugsy » Wed Dec 15, 2021 10:24 am

Fragmented sleep itself will trash overall sleep quality and make us feel like total crap.

There's a good article here that explains why we need the nice normal progression of each sleep stage and needs for the usual amount in each sleep stage for us to have the optimal benefits of the restorative powers of sleep.
I know it relates to alcohol but if you just substitute "anything" for alcohol....the effects are the same. We feel like crap.
https://www.sleepfoundation.org/nutriti ... -and-sleep

Now figuring out the cause of the fragmented sleep isn't always so easy and even when we know the cause it isn't always easy to fix things.

First thing to look at though....medication side effects....do you take any medications of any kind (even OTC) and if so, what?

Then we look at other physical or mental health issues that might be a factor in our sleep quality and how we feel during the day. Aches, pains, etc......

Google "sleep maintenance insomnia" and start reading. The list of potential culprits is miles long and sleep apnea is but one item on that very long list.

CPAP machines can only fix insomnia issues related to the airway. It doesn't do a darn thing for some other cause no matter how much we might want it to.
There are lots of causes of "bad sleep" and cpap can only fix "bad sleep" that is bad because of apnea/airway issues.

I always tell people that getting nice low numbers is the easy part....feeling them is the hard part.

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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Wed Dec 15, 2021 12:51 pm

Pugsy wrote:
Wed Dec 15, 2021 10:24 am
Fragmented sleep itself will trash overall sleep quality and make us feel like total crap.
Oh it definitely does that!
Pugsy wrote:
Wed Dec 15, 2021 10:24 am
Now figuring out the cause of the fragmented sleep isn't always so easy and even when we know the cause it isn't always easy to fix things.

First thing to look at though....medication side effects....do you take any medications of any kind (even OTC) and if so, what?

Then we look at other physical or mental health issues that might be a factor in our sleep quality and how we feel during the day. Aches, pains, etc......
I know I have anxiety issues and struggle to turn my brain off when laying down. You and I have talked about that before. I havent had that issue lately, as Ive been so tired Im usually asleep pretty quickly. Its just the constant awakenings. Now like ive said, theyre different that before. usually I jump up or sit up quickly and feel a rush sensation. I dont have this anymore, if I do its very rare. Although last night I caught myself snoring as I dozed off but it could have been a mask issue in that instance. Im just trying to understand why my sleep is still fragmented. I know it isnt easy but hopefully it can be resolved.
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Pugsy
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Re: 2 months in and struggling

Post by Pugsy » Wed Dec 15, 2021 1:06 pm

There are 2 kinds of arousals.
Those related to airway/breathing issues and what we call spontaneous arousals which just means we don't know the cause.
Could be anything and that's what makes it so difficult. The figuring out part of what is causing the spontaneous arousals.

We fix the breathing/airway related arousals with cpap.
Spontaneous arousals are a whole different beast because figuring out the cause isn't so easy.
And heck, even if we know the cause it isn't always an easy fix.

Add in the fact that it's normal to awaken after REM stage sleep and if we are already predisposed to have difficulty going back to sleep...just another problem to try to sort out.
Add in the fact that as we age we just seem to experience more "stuff" to mess with our sleep and we sleep "lighter" and more easily woke up and have more difficulty going back to sleep for any number of reasons.

Maybe you should be talking to your doctor about how to sleep more soundly.
A few of those 5 to 7 awakenings you remember might be end of REM related but normally we aren't awake long enough to form a memory. I bet there are more awakenings/arousals that you don't remember as well as those you do.
They all do the damage of messing with those sleep stages we need though.
I remember 5 to 8 arousals each night...most due to pain and needing to change position but when I look at the flow rate it's pretty obvious I have at least 3 times more arousals than I remember. Add that to short hours of sleep and I feel like crap.
I have discussed this with my doctor and we are trying various sleep meds in an effort to sleep a little "sounder" but it's been a challenge because sleep meds come with their own baggage/side effects that aren't wanted.

So maybe time to talk to your doctor about your options. The cpap machine seems to have done its part though so I don't know if a minor tweak here or there is the answer to your problem. Doesn't mean you can't try it but just means you have more detective work to do. To fix any problem we have to first identify the problem.

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packfan23
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Re: 2 months in and struggling

Post by packfan23 » Tue Dec 21, 2021 12:33 pm

Pugsy wrote:
Wed Dec 15, 2021 1:06 pm

So maybe time to talk to your doctor about your options. The cpap machine seems to have done its part though so I don't know if a minor tweak here or there is the answer to your problem. Doesn't mean you can't try it but just means you have more detective work to do. To fix any problem we have to first identify the problem.
Well I had my appointment and she wants me to do a titration study, which is what I was expecting. She said she couldnt get a good read on my data and that was the best option, so we will see about that likely after the holidays.
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