CPAP compliance - please help

SleepHQ data: https://sleephq.com/public/teams/share_ ... 59a68efcc5

Summary:
I have felt literally zero positive effects from the CPAP after a few months of use. I put the mask on when I go to sleep, but I always take it off in the night, usually within a couple hours. If I try putting it back on e.g. after getting up to pee, I often am unable to go back to sleep, so I give up and take the mask off (or I do fall asleep again, but take it off again in my sleep).

As you'll see in my data, I've skipped the CPAP entirely the past few days because the situation isn't improving, and I genuinely have no idea what else to do. The handful of nights where I managed to wear it > 5 hours, I have no idea how I managed to do it, and I also felt worse the following day. In general, I feel that CPAP usage has pushed me over the line from being tired but functional/sustainable, to being non-functional, and having unsustainable levels of fatigue and mental health issues.

I have an appointment next month with an oral surgeon to be evaluated for an oral appliance or possibly surgery. It's not something I want to do, but as I said, I feel like I'm running out of things to try.

I'm desperate for help. My sleep doctor is absolutely worthless. I will provide you any additional information as needed. Thanks

Sleep-related health Issues:

• Nocturia (this is the original problem that led me to getting a sleep study. CPAP has not helped)
• Fatigue
• Depression/Anxiety - greatly exacerbated by poor sleep
• Reduced effectiveness of ADHD medication
• Sleep Study AHI: 14.8

CPAP Issues:

• I have non-allergenic rhinitis (and maybe some mild seasonal allergies as well) making it hard to breathe comfortably with the CPAP.
• Even when the rhinitis is manageable, I generally feel like I can't breathe freely enough when wearing the mask, like there's too much resistance. Both when breathing in and when breathing out. As soon as I take the mask off, my breaths feel comfortable and natural, and I can fall asleep.
• I am a side sleeper and have had difficulty learning to sleep on my back.

Solutions tried:

• Septoplasty and turbinate reduction surgery
• Chin straps
• Rhinitis medication - singulair tablet, nasonex spray, astepro spray, atrovent spray (Ipratropium bromide)
• Multiple mask types (nasal, full face, nasal pillow)
• Heated tubing w/insulation sleeve

Current medications:

• Vyvanse 20mg - morning
• Singulair - before bed
• Nasonex - before bed; not every day - doesn't feel very effective
• Topicals for psoriasis (fluticasone, ketoconazole, clobetasol) - as needed

How old are you?
Male or female?
Are you still taking the ADHD medication? If you are, what is the name and dosage and when do you take it? How long have you been taking it or did you take it (if you have stopped it)
Any other meds besides what you listed?
Any other physical or mental health issues?

Do you really expect to see any improvement with such a sporadic usage of the cpap?

When was the last time you had routine blood work? Like....routine labs (including glucose levels) and non routine labs like Hormone or vitamin D levels?

Pugsy wrote: ↑

Wed Jul 01, 2026 11:10 am

How old are you?
Male or female?
Are you still taking the ADHD medication? If you are, what is the name and dosage and when do you take it? How long have you been taking it or did you take it (if you have stopped it)
Any other meds besides what you listed?
Any other physical or mental health issues?

Do you really expect to see any improvement with such a sporadic usage of the cpap?

When was the last time you had routine blood work? Like....routine labs (including glucose levels) and non routine labs like Hormone or vitamin D levels?

I'm a 37 year old male. My current medications are listed in my post. I take Vyvanse 20mg once a day at around 9-930am.

I do not expect to see improvement with my current usage. My goal is to wear consistently wear the CPAP throughout the night, but I've been unable to do so despite my best efforts.

(My actual goal is to reduce/eliminate nocturia, and wake up feeling well rested with reasonable consistency. My hope/assumption is that wearing the CPAP will help me accomplish these these goals.)

I had blood work done last November as part of my annual physical. Now that you mention it, my thyroid (TSH) was slightly elevated - 6.14 u[IU]/mL, so I'm going to have a followup test done soon, hopefully tomorrow.

I did a bit of Googling....... some snippets and/or quotes from a few different websites. Talk to your doctor before making any changes to meds.

- Vyvanse may cause insomnia and could worsen sleep apnea.

- "In fact, up to one-third of patients with ADHD may actually have sleep apnea and be misdiagnosed as having ADHD.
Similarly, many people with sleep apnea may be misdiagnosed as ADHD patients.
This underscores the importance of accurately diagnosing both ADHD and sleep disorders when considering treatment options."

Any chance the diagnoses of ADHD may have been incorrect since some of the symptoms appear similar to sleep apnea?

- "Stimulants like methylphenidate (Ritalin, Concerta), amphetamine salts (Adderall), and lisdexamfetamine (Vyvanse) can be used in patients with sleep apnea, provided that the sleep apnea treatment is optimized before starting stimulants"

We're you on CPAP therapy prior to starting the Vyvanse?

- A side effect of Singulair can be sleep problems.

The sites I looked at which may be worth looking at....
https://int.livhospital.com/sleep-apnea ... nse-works/

https://bcoh.com/understanding-the-link ... eep-apnea/

https://www.droracle.ai/articles/125168 ... ts-safe-to

Are you eating or drinking anything before bedtime? My worst sleep nights are usually if I overdo it with snacks.
I typically make 2-3 bathroom trips a night (enlarged prostate likely doesn't help). Before CPAP I was doing 5-6 trips. CPAP helped.
Have you tried a Neti Pot for the nasal issues?

Grumpy48 wrote: ↑

Wed Jul 01, 2026 5:54 pm

I did a bit of Googling.......

Respectfully, I would like to focus on the CPAP itself first.

What I originally was hoping for is for someone to review the CPAP data I uploaded to SleepHQ and linked at the top of my post, as recommended by ChicagoGranny in my previous thread here, to see if there is some insight that can be gleaned from my data, to tell me what exactly might be happening at night and help point me in a direction for possible solutions.

I've done lots and lots (and lots) of Googling myself on my struggles already. I'm posting in this forum because Googling hasn't helped, nor has my sleep doctor.

Edit: RE: Vyvanse. I tried CPAP before I took Vyvanse (or any other stimulant medication). I had the same overall issues then, as I do now. That led to the turbinate reduction, and straightening a partially deviated septum I had no idea bout. That surgery kinda-sorta helped, maybe. But it didn't do enough. Vyvanse helps me with other issues that I've had throughout my entire life.

I just tried taking an afternoon nap with the CPAP and had the same overall problem:

if I try to relax and stop thinking about my breathing, my tendency is to not inhale for some time after each exhale. I can feel my pulse and blood pressure rise with each natural breath, and eventually I feel the urge to consciously take a full, deep breath. The deep breath feels good, except I wish I could exhale naturally afterward instead of pushing against the CPAP resistance.

My assumption is that this sensation means I'm not getting enough oxygen. The sensation sometimes wakes me up right as I'm falling asleep, which is very frustrating.

So, today for this nap, I tried turning off the "pressure relief" setting on the Airsense 11. That helped the inhale issue a little bit, I think, but it introduced its own discomforts. I think I even started snoring (???) at one point? Or, maybe I was opening my mouth more due to the pressure on exhale. But, I don't really know what was going on, or if I'm even in the ballpark with trying that setting??

That's what's so frustrating about this thing!! Every "solution" comes with a trade-off, everything is at least a little bit uncomfortable, there have been no clear solutions. And in the meantime, I have felt no benefit so I'm asking myself why I'm even bothering.

Took another shot at using it in the afternoon to try different settings.

I turned Pressure Relief back on to make exhale easier.

I set the minimum pressure up to 12. Below 11 or so, I had the inhale issue described in my previous post.

But then, the increased pressure caused my mouth to open when I started to fall asleep.

So I put on a chinstrap. But then I found it impossible to get a good seal on the Philips Dreamwear pillow. Futzing with the cushion to get a good seal is genuinely infuriating, because any adjustment I make means that air is suddenly blowing into my face and eyes. Plus the whack a mole of fixing a leak in one spot introduces it in another spot. So I try to adjust it without pulling the cushion away but that doesn't work either. After a few minutes of failing to get a decent seal I have to rip the mask and chinstrap off in frustration.

"Try a different mask" - I have. I tried the Resmed N20i (the equivalent to the Dreamwear) and the Medium frame (largest they have on Lofta) is too short. The top of the mask where the tube connects sits too far forward on my head. I've tried other nasal and full face masks but they're a no-go due to leaks and side sleeping.

Last night I made it 1h40m, before I suddenly woke up gasping for breath, like I was suffocating. I have no idea why this was happening, because I was asleep.

Here is my data from last night (July 6) https://sleephq.com/public/9575c307-47e ... 96f3a8ba4c

Any insights would be deeply appreciated.