Trouble blowing up balloons? (Not *LIKE* a balloon)

Ever since childhood, I've had some difficulty when I try to blow up a balloon. I am able to do this, but after just one or two balloons, I am left with a lingering, dull soreness in the area of my face just below and slightly behind my ears. Here is an image if that helps:

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I generally refused to blow up balloons as a teenage, but now (I'm 44 years old) I seem to be able to do one or two balloons before I look for help.

I seemed to have managed getting this far in life without being seriously impacted by this conditions. (Friends, air compressors, friends with air compressors, etc.)

Although I think I have probably had sleep apnea for the last 15 years, I was only recently diagnosed in a home sleep test with the following:

• Average AHI: 65.5 per hour
  Central Apneas: 7.3/hour
  Obstructive Apneas: 29.9/hour
  Mixed Apneas 10.7/hour
  Hypopneas: 17.6/hour
  Average O2 Saturation: 94%
  Desaturation Index: 63 per hour
  Lowest O2 Saturation: 72%
  Minutes at less than 90%/85%/80% Saturation: 69/11/2

I did a second home sleep test with a Resmed S8 AutoSet Spirit and a Resmed Ultra Mirage II nasal mask. The sleep doctor's office told me that, in the second test, I averaged fewer than 3 AHIs per hour, had much better oxygen numbers, and these pressures:

• Median:11
  95th% Percentile: 12
  Peak: 14

The morning I completed this second test, I woke up at 5:30 a.m. after a truly wonderful night of 7 hours of sleep. The mask and the machine worked great! The only problem I noticed in the morning was the same dull, aching soreness below and behind my ears, described above. The soreness is relatively minor--certainly not debiliating--but it did linger for the next 2 days, gradually fading away. I predicted to my wife that, if I owned this machine, I would likely use it one out of every 2 or 3 nights to get some good sleep, but using every night would make me sore all the time.

My supposition is that this soreness came from me not being used to exhaling against the pressure of an xPAP machine. Based on the reading that I've been doing http://www.cpaptalk.com (thanks for all of your extremely helpful advice, especially rested gal, wulfman and dsm), I think I would benefit most from APAP with A/flex but am wondering if CPAP with EPR might be a better option. I am hoping to receive a prescription from the sleep doctor in the next couple of days and want to make sure I get the best machine for me. I have insurance, but am not likely to meet the high deductible so I plan to buy from an on-line DME. Comfort and ability/desire to use every night are more important to me than price.

My questions:

• Have any of you ever experienced this symptom?
  Will it likely go away?
  Do you agree that APAP with A/Flex is the best choice, or is something else better?
  Any other advice you can offer?

Thanks everyone! Sorry to be so long-winded in my first post.

NiteOwl (with exactly one day of xPAP experience)

It is possible that EPR would be better for you, as it relieves the pressure for 1, 2, or 3 cms of pressure for your entire exhale. With A-flex or C-flex, you only get pressure relief at the beginning and/or end of the exhale, not through the entire exhale. I'm not sure, but I think it is also less of a drop in pressure than with EPR. EPR has been compared to a mini BiPAP. A BiPAP, which has completely separate setting for inhale and exhale, might be another option, if you find your issue does not improve with time on CPAP or APAP.

Usually people have to fail regular CPAP or APAP (auto PAP) before the BiPAP will be given. I can't tell from your descrption whether your tenderness will improve over time or not. However, with your untreated AHI, it will be important for you to use CPAP every night, to protect your health. Untreated apnea hurts your heart, your blood pressure, and your brain.

Thanks, riverdreamer, for your advice. I ordered my Resmed S8 AutoSet II and mask yesterday--I can't wait to use it!
I definitely want to do all I can to try and be successful at this. Hopefully the EPR will help enough so that I will want to use it every night.

Good luck, NiteOwl! I hope your CPAP journey is easy for you, and you start to feel the benefits soon!

I think, considering where your carotid arteries and other important structures lie, that it would be a very good idea for you to ask an MD, possibly a neurologist, about the areas you mention. Could be nothing, but why not find out properly - it's not a symptom of OSA if that's what you were thinking.