Machine causing insomnia

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Machine causing insomnia

Post by Pugsy » Fri Jul 15, 2022 2:30 pm

joepublic23 wrote:
Fri Jul 15, 2022 1:53 pm
The start pressure is 4.

It is set for EPR full time

EPR level is 3

It says my AHI is 6.4, although my sleep study said 6.1
Doesn't matter what the machine says your AHI is if you didn't sleep. That's why I said the data shown is useless.
The machine can't tell if you are awake or asleep ...it only measures flow rate and our breathing while awake is very irregular when compared to asleep breathing and the machine can and will flag awake breathing irregularities as some sort of apnea event. I call them false positive flags.

Explained a bit in the videos here
http://freecpapadvice.com/sleepyhead-free-software
and while it talks mainly about Clear Airway/Central apneas the false positives aren't limited to centrals...we can have false positive OAs and hyponeas as well. I know because I have had them myself.

Yes...EPR is set to 3 cm but you aren't getting that 3 cm reduction during exhale when the machine is still in ramp because the ramp pressure is 4 cm and the machine simply can't go below 4 cm.
When ramp ends and the pressure is at 5 cm...you get only 1 cm of that 3 cm EPR available again because the machine can't go below 4 cm.
To get the full benefit of EPR at 3 cm you need to be at 7 cm.

What position do you primarily sleep in? Does the wife say if you snore much when you are on your side?

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Re: Machine causing insomnia

Post by joepublic23 » Fri Jul 15, 2022 2:35 pm

I usually sleep on my back. That’s generally my best bet for falling asleep. If I sleep on my side I am less likely to snore, but it’s hard for me sleep that way. I never sleep on my stomach.

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Re: Machine causing insomnia

Post by mummmz » Fri Jul 15, 2022 2:37 pm

Straight from the CPAP Definitions at the top of the page: AHI (Apnea Hypopnea Index) is the number of apneas and hypopneas per hour. Or an index for sleep apnea. 5-20 mild, 21-50 moderate, above 50 severe.
So AHI will change nightly/minute by minute. Your machine is using the little bit of time you are using it while you are still awake to come up with the 6.4.

Are you against using an SD card? If so, why? My doctor asks that I bring my card to every appointment. The DME can monitor you remotely but I doubt the doctor will bother. They want to see it on the screen or a printout easily.

Others can correct me if I am wrong but the way I understand it your pressure is set at 5-15. The start pressure is 4, I assume that is your 20 minute ramp. EPR would normally reduce the pressure by 3 on exhale but it cannot because the pressure setting of 5 is too low already. EPR will not go down any further.

If your minimum setting was higher...say 7 or 8...EPR could reduce the pressure when you exhale by 2 or 3 and you would be able to exhale easily.

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Additional Comments: Autopap Min 8.4, max 15, ramp off, flex 3, heated humidity off, O2 therapy added 5/20/22 & discontinued 8/26/22 after asthmas dx/treatment

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Re: Machine causing insomnia

Post by joepublic23 » Fri Jul 15, 2022 2:54 pm

I didn’t know if the AHI of 6.4 meant that it was set for someone with a AHI of 6.4 in a sleep study or if that’s what it recorded during the maybe an hour (at best) that I was actually able to fall asleep.

I am not against an SD card, I just have not had time to go buy one. I didn’t realize how much data and stuff there was to these things. My concern was and is that my body is physically unable to sleep with so much stimulus.

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Re: Machine causing insomnia

Post by mummmz » Fri Jul 15, 2022 4:46 pm

When you go to your mask fitting tuesday tell them you NEED an SD card so you can bring the data to your doctor's visits. I bet you and your insurance already paid for it so you should get it. Don't let them tell you it will transmit the data. You should be able to see your own data. The MyAir app doesn't begin to show everything you need.

If they didn't already give you replacement filters get those too.

Oh, it's Friday...if you are off work tomorrow you can try to use your machine longer. Try some of the hints you were given. Get in bed a relax a while but before you fall asleep put your mask on.

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Re: Machine causing insomnia

Post by joepublic23 » Fri Jul 15, 2022 5:10 pm

Thanks for the advice

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Re: Machine causing insomnia

Post by mummmz » Fri Jul 15, 2022 6:16 pm

You're welcome. If you'd like to learn more about the terminology used to discuss sleep apnea and CPAPs read through the CPAP Definitions at the top of the page
wiki/index.php/Category:CPAP_Definitions

And read some of the sticky messages at the top also. That way you'll be able to understand more of what your doctor and DME are saying and be able to ask questions.

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Machine: AirSense 11 Autoset
Mask: ResMed AirFit™ F30 Mask + 2 Replacement Cushions Bundle
Additional Comments: Autopap Min 8.4, max 15, ramp off, flex 3, heated humidity off, O2 therapy added 5/20/22 & discontinued 8/26/22 after asthmas dx/treatment

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ozij
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Re: Machine causing insomnia

Post by ozij » Fri Jul 15, 2022 9:05 pm

joepublic23 wrote:
Fri Jul 15, 2022 2:54 pm
My concern was and is that my body is physically unable to sleep with so much stimulus.
It's not your body, it's your brain. And the way your mind interprets the situation.
joepublic23 wrote:
Fri Jul 15, 2022 10:54 am
Of course my only criteria is 1) Can I actually fall asleep? If yes, then 2)Is the wife complaining about snoring? If no, then all set.
You cannot actually fall asleep with the machine and mask it at this point. That is absolutely clear.

Learning to sleep with CPAP requires training, just like your jogging does.
But before you even think of using CPAP when asleep, you have to learn through experience that it's a tolerable stimulus, even a boring one. Do not try to used CPAP in bed at all at this point.

A word about exhaling, and exhaling against pressure:
Normal human exhalation is a relaxation of your muscles that lets your rib cage contract thereby pressign on your lungs, and diviing the air out.
Without EPR - exhale pressure relief - you feel as though you're struggling against the incoming pressure.
I started therapy at a pressure of 6.6. a machine without pressure relief, and I was terrified of my "inability" to exhale.

If you want to start training for using CPAP, set your pressure at a static 7 (either min=7 and max=7, or CPAP mode at 7), and EPR=3, That way, each time your inhale stops, the incoming air pressure drops, and you will feel exhale is more natural.

Focus on using the machine with these settings, until exhale feels natural. That's all. Do not do this in bed. Do not do this when attempting to sleep.. Choose the situation which you think will make this training be as successful as possible, and do it, patiently and consistently.

The goal of your training is to get used to exhaling in this totally unnatural, highly stimulating situation.

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joepublic23
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Re: Machine causing insomnia

Post by joepublic23 » Mon Aug 01, 2022 12:41 pm

Update- so the DME gave me a ResMed AirTouch F20 mask. It leaks less than the prior one, but seems even more uncomfortable to wear.

I was on vacation last week and had lots of trouble sleeping without the mask, due to being in a different bed in a somewhat stuffy room. I would wear the mask for a little bit before bed to try to get used to it, but sleep is still a non-started with it. The good news is that the exhaling doesn’t seem as bad as before but I am still a long way from being able to use it. I am seeing the doctor on 8/11. He said we can work on desensitization techniques. I am hoping he will prescribe sleeping bills since melatonin or Benadryl are not usually enough to allow me to sleep with the mask on.

What are peoples thoughts/ experiences with dental devices? Are they less uncomfortable or more? Do they normally trigger a gag reflex? I am wondering if that is worth pursuing before Inspire.

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Re: Machine causing insomnia

Post by Brad S » Sat Aug 06, 2022 8:29 am

joepublic23 wrote:
Mon Aug 01, 2022 12:41 pm
Update- so the DME gave me a ResMed AirTouch F20 mask. It leaks less than the prior one, but seems even more uncomfortable to wear.

since melatonin or Benadryl are not usually enough to allow me to sleep with the mask on.
Hi Joe-
Any updates?
I woke up this morning and read this entire thread. There is so much good information people are suggesting. (And some attitude too) but that's ok. I feel like over in my topic I am becoming a "BUTTHEAD" to some by the lack of responses to my specific questions. BUTT, you know what? I don't care. I will continue to ask my questions and I will continue to work through this. I am here for me. No one else. ME. If I can help someone else with my twisted points of view, all the better. It is a great place to write feelings, successes and failures. Last night I failed miserably, BUTT I tried. I will get there and so will you. I fell asleep with my mask on and it lasted all of 13 minutes before I took off my mask. I put it back on at 3:30 and made it an additional 45 minutes. Frustrating? FOR SURE! I am determined to beat this. BTW I know my times from using OSCAR.

As I began reading this morning I was in bed and sat up against the headboard and put my P10 on and began reading. I spent an hour and 12 minutes reading this and other topics trying not to focus on my breathing. Ignoring the octopus on my face. I have put on my mask and laid on the bed for short periods of time before, but this was the first time I have had the opportunity to take this much time to do this. I was able to purposefully analyze how it felt to breathe while awake. When it was time to get up, I concentrated on how I was really feeling and how I was breathing. I could definitely tell that I had something on my face, but it seemed far less labored. Not bad at all and I am looking forward to trying again tonight. I will probably fail again, but maybe not. Maybe I can make it an hour or two. That is a win at this point. One thing I am is a fighter. I believe FSE. Fighting Solves Everything. This will be interpreted in many ways. I don't care what others think. Take it for what it is worth. It came from an acquaintance that had throat cancer and beat the living sh*t out of it. Apply it to your daily life and fight for what you want. Like your life depends on it. If you want this, you can do it. I am a scrapper and I have had to fight for everything I have in life. I want this and I will kick it's @ss too.
My advice to you is coming from a point of struggle and failing not one of I did it, so can you. Even though I am having a very hard time, I consider waking up with the will to try again a success! We have very different problems, but we are on the same road. Let's be the people that are here in the future to help others like us figure this out. We all have unique situations and points of view.

Have you downloaded OSCAR yet? Do you have an SD card for your machine? It is a great way to understand all of this information.
Hang in there. It is going to take time.

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Re: Machine causing insomnia

Post by joepublic23 » Sat Aug 06, 2022 10:39 am

I have Oscar and an SD card. There really isn’t any data to look at yet, since I have only managed to actually fall asleep once using the machine.

I am trying to decide if the high costs of continuing to try are worth it or not.

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Re: Machine causing insomnia

Post by mummmz » Sat Aug 06, 2022 11:23 am

Did you look at your data with OSCAR? Check the sticky posts at the top of the forum to see which graphs are most useful to post then let's see what you have.

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Machine: AirSense 11 Autoset
Mask: ResMed AirFit™ F30 Mask + 2 Replacement Cushions Bundle
Additional Comments: Autopap Min 8.4, max 15, ramp off, flex 3, heated humidity off, O2 therapy added 5/20/22 & discontinued 8/26/22 after asthmas dx/treatment

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Re: Machine causing insomnia

Post by joepublic23 » Thu Aug 11, 2022 12:26 pm

Update- the pulmonologist prescribed me some Ambien today. I will try it this weekend. He said if it doesn’t work I can return the CPAP and see an ENT who deals with more complex cases that may have me try the dental device. He said that the guy also does Inspire, but I found out at the front desk that he does not. I did get the name of the doctor in my area who does Inspire as well.

The good news is that my AHI of 6.4 is low enough that not treating it probably won’t cause me to have serious long term health consequences from it.

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Re: Machine causing insomnia

Post by mummmz » Fri Aug 12, 2022 11:33 am

You've never uploaded an OSCAR report for anyone to help you. Since your goal all along was to have surgery you might want to look for a different support group.

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Machine: AirSense 11 Autoset
Mask: ResMed AirFit™ F30 Mask + 2 Replacement Cushions Bundle
Additional Comments: Autopap Min 8.4, max 15, ramp off, flex 3, heated humidity off, O2 therapy added 5/20/22 & discontinued 8/26/22 after asthmas dx/treatment

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Re: Machine causing insomnia

Post by Janknitz » Fri Aug 12, 2022 12:15 pm

I am not a candidate for an oral appliance because my OSA is severe, but here's what my dentist told me: He said that the dental appliance works for some people with mild OSA (but not all, so consider the financial investment not covered by insurance). He gives his patients some jaw mobility exercises to do every morning when they remove the device, to reduce the chances of TMJ issues. So it may be worth a try for you, but also something you have to get used to sleeping with.
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