Troubleshooting...advice?

So I've had my machine and mask 3 weeks and haven't slept a wink. I try for at least 3 hours each night, longer if I don't have to work the next day. I have a Swift LT for Her, and I just love it. It's comfortable, I can get in all my positions ... but I have yet to sleep.

I feel like it's a mental block, but there are a few contributing factors:

*I think I might be afraid my mouth will fall open. I got a chin strap, which has helped quite a bit to relax. Still, I'm wondering if a hybrid might be better, so that the mouth falling open isn't on my radar...? Apria said they'll give me another mask to try, since it's still in my first 30 days. What's your favorite Hybrid mask? They carry the Mirage, I think, but will try to get me whatever I want.

*I do a lot of breathwork because I'm a yoga practitioner. I have always noticed my weird breathing pattern. I have a very short inhale, and then can exhale for a super long time. When the yoga teacher has us try to match inhale length to exhale length, it is VERY difficult for me to do. I notice with my machine that the air starts pushing in before I'm really done exhaling. I still want to exhale, and the machine is already pushing the inhale in. What would be a solution for this? Would a bipap machine address this issue? Basically, I want me to be able to initiate when the air pushes in and when it doesn't. Sometimes I think I subconsciously resist falling asleep because I feel like the rhythm of the machine is uncomfortable for me, and I don't want it "breathing me" - does that make sense??

Any insights you can give would be appreciated -- I WILL figure this out, I WILL!!!!!

Lisa...

I have never noticed the exhale / inhale problem - I have also done lots of yoga. But I use a full face mask.
I don't thnk I have EPR on. At this point I don't even notice the air.

I can tell you to just relax but I can still remember when I tried to ride a horse and I thought I was relaxed until the instructor told me to make a circle with my toes and all my muscles from my toes to my hips seized up.

Try to do some mediation before bed time and add affirmations like "I breath easily with my CPAP", "I fall asleep easily ..."
Use what you have learned in Yoga to get at that block.

At night breath WITH the machine instead of on your regular rythm and repeat you affirmations.

Lisa,
I did not sleep for the first month and found out after the fact that my doc had not prescribed enough pressure. Get the software and make sure you are making progress. If not, pester the doc for a change. Many people on this forum change their own pressure. I learned to do it on the machine, but I do consult with my doc. She is working with me. I am just now, after two months, beginning to sleep. I wish I had purchased the software sooner. I just did not know enough. This forum is great.

I learned from the software that I was leaking. I tried taping my mouth shut and it made a difference. I resisted at first because taping seemed so extreme, but when I tried it, it worked.

Good luck. Keep at it. But, make sure you have the information you need to control your own therapy.

Cecile

I am working on getting the software (I only have Apples, so I had to get a whole new computer setup) -- but how does the software even help if you never fall asleep? I mean, I can see using the software to make sure you are not having leaks as you move around during sleep, and to adjust pressures to limit AHI, but if I never fall asleep, what info could help?

Right now I'm taking my Smart Card to Apria once a week, and they print it all out for me, until I get my own software. But until I actually fall asleep, I don't see how it can help. Maybe I'm missing something. I AM much more comfortable on a higher pressure, once the ramp is off after 20 minutes. Only problem is that the machine gets MUCH louder with the higher pressure, so I'm breathing more comfortably, but I'm more irritated with the noise! (My machine is on the floor, on a little table, halfway under the bed).

I do use meditation and affirmations/mantras. I am VERY relaxed and VERY comfortable. I'm in that zone just before you fall asleep, very restful...just never do cross over into sleep...

Lisa..

psychomamma wrote:So I've had my machine and mask 3 weeks and haven't slept a wink. I try for at least 3 hours each night, longer if I don't have to work the next day. I have a Swift LT for Her, and I just love it. It's comfortable, I can get in all my positions ... but I have yet to sleep.

I feel like it's a mental block, but there are a few contributing factors:

*I think I might be afraid my mouth will fall open. I got a chin strap, which has helped quite a bit to relax. Still, I'm wondering if a hybrid might be better, so that the mouth falling open isn't on my radar...? Apria said they'll give me another mask to try, since it's still in my first 30 days. What's your favorite Hybrid mask? They carry the Mirage, I think, but will try to get me whatever I want.

*I do a lot of breathwork because I'm a yoga practitioner. I have always noticed my weird breathing pattern. I have a very short inhale, and then can exhale for a super long time. When the yoga teacher has us try to match inhale length to exhale length, it is VERY difficult for me to do. I notice with my machine that the air starts pushing in before I'm really done exhaling. I still want to exhale, and the machine is already pushing the inhale in. What would be a solution for this? Would a bipap machine address this issue? Basically, I want me to be able to initiate when the air pushes in and when it doesn't. Sometimes I think I subconsciously resist falling asleep because I feel like the rhythm of the machine is uncomfortable for me, and I don't want it "breathing me" - does that make sense??

Any insights you can give would be appreciated -- I WILL figure this out, I WILL!!!!!

Lisa...

Lisa,

Don't feel to odd about your breathing - went thru similar frustration myself. I obtained several models of one brand & no matter which model the machines would always stop the inhale cycle while I was still breathing in. It took me a long time (years) to figure out exactly what was happening but in the meantime I moved on to another brand that worked for me.

But from what you are describing, yes a good bilevel will make a difference, but you need to choose carefully. MY advice would be to try 2 or 3 brands if you can. There is such a difference to how they handle soft breathing. I got lucky & got a Bipap Auto SV (not quite what you need) but it is sooo tolerant of my restricted breathing. Yet another model bipap I tried wasn't.

So my suggestion is, yes a bilevel will achieve better breathing out control BUT try a few different models / brands before choosing.

DSM

but how does the software even help if you never fall asleep?

You may drift off and not know it.... and knowing helped me get the right pressure.

The pressure itself may be keeping you awake. It made my AHI worse (it was too low and increased my apneas) which in turn kept me waking up...

Cecile

psychomamma wrote:So I've had my machine and mask 3 weeks and haven't slept a wink. I try for at least 3 hours each night, longer if I don't have to work the next day. I have a Swift LT for Her, and I just love it. It's comfortable, I can get in all my positions ... but I have yet to sleep.

I feel like it's a mental block, but there are a few contributing factors:

*I think I might be afraid my mouth will fall open. I got a chin strap, which has helped quite a bit to relax. Still, I'm wondering if a hybrid might be better, so that the mouth falling open isn't on my radar...? Apria said they'll give me another mask to try, since it's still in my first 30 days. What's your favorite Hybrid mask? They carry the Mirage, I think, but will try to get me whatever I want.

*I do a lot of breathwork because I'm a yoga practitioner. I have always noticed my weird breathing pattern. I have a very short inhale, and then can exhale for a super long time. When the yoga teacher has us try to match inhale length to exhale length, it is VERY difficult for me to do. I notice with my machine that the air starts pushing in before I'm really done exhaling. I still want to exhale, and the machine is already pushing the inhale in. What would be a solution for this? Would a bipap machine address this issue? Basically, I want me to be able to initiate when the air pushes in and when it doesn't. Sometimes I think I subconsciously resist falling asleep because I feel like the rhythm of the machine is uncomfortable for me, and I don't want it "breathing me" - does that make sense??

Any insights you can give would be appreciated -- I WILL figure this out, I WILL!!!!!

Lisa...

Lisa,

2 more suggestions

If you have A-Flex on, turn it off. Don't use it until you get past these issues.

If you can use straight cpap, do so & set C-Flex to a setting of 2

DSM

If you have a mask that is comfortable and you are used to, I would try to stick with it. If you think your mouth is or may come open, try some tape or polident strips to keep it closed at night. Perhaps some OTC or RX slep aids might help you relax and get some sleep. As far as noise, I use a fan for white noise which seems to do the trick for me.

My hubby has the same machine and described to me that the machine was inhaling before he had finished exhaling. I could hear it myself. Once we started experimenting over a period of time we found that he did better with both Aflex and Cflex turned off. He is also sensitive to pressure changes so does better on straight Cpap but can tolerate a very narrow auto range.

Ok, my paperwork from Apria says I have an M Series Auto with A-Flex, but Hawthorne emailed me the provider settings manual, and apparently I only have C-Flex! What cheaters!

ANYWAY, the point is that I went in and turned C-Flex completely off -- I am so excited because I can already tell it is going to be SO much better!! I can exhale as long as I want and I no longer feel like the machine is 'breathing me'. I am breathing totally normally!!! (I also changed my ramp to 6.5 from 4 while I was in there -- 4 is too low and I feel like I'm suffocating!)

I have great hopes for tonight! Thanks for all the suggestions, people!! My leak rate is about 22-24 -- but I figure I'll tackle that as my next problem once I can just sleep...

Lisa...

So you have an M Series Auto with C-Flex then. That's not so bad, except you can't try A-Flex.

It says, right on top of the machine (if it's an A-Flex) "Remstar Auto m series - A-Flex".

If you want A-Flex to at least have it to try, take the machine back with the paperwork and demand it.

It sounds like you are doing better without any flex, even C-Flex so that's up to you.

The Clinicians setup guide will still work fine - just ignore A-Flex references.

Raising your ramp was really good! A pressure of 4 is way to hard to breathe with even if it's just ramp (which you may turn of soon anyway). A pressure of 4 also makes it harder to clear the CO2 out of your mask and can make you feel rotten in the morning with things like headaches.

That leak rate doesn't sound too bad by the way.

Hope tonight is better!!

Good job, but just remember not to change too many things at once.

yup, I'm going to leave it at that for now. I'll mess with leak rates and min/max settings after I get some SLEEP!! Thanks so much for all the help and encouragement!

Lisa..

That C-Flex (or A-Flex) problem happens to some people, and has actually nothing to do with Yoga. Respironic's version of pressure relief simply doesn't work for some people - bothers them quite a bit, as a matter of fact.
Good advice from you, Dori , I was going to suggest the same.
I hope it works for you now, Lisa.

O.

I fell asleep with my mask without C-Flex on and slept for 4 and 1/2 hours!!!! First time I've really slept in 3 weeks! I am so so so so so excited and thankful to you all for the excellent advice. I would have never thought of turning C-Flex off, as it's billed as a comfort device. It is SO much more comfortable for me without it!!

And thank you Hawthorne, for emailing me the clinician's guide to the machine so that I could change it myself. I don't have my software yet, but will be anxious to see what kind of numbers I had when I get the card reader in a few days.

I'm on my way -- and just when I was giving up!

THANK YOU, THANK YOU!
Lisa....