APAP leaves me feeling wiped out

robysue wrote:

victormiller wrote:

Finding a mask that is truly comfortable to sleep in is the main key to "doing" CPAP. Saying that a person has to get used to wearing a mask while sleeping is true, but if a particular mask is very uncomfortable there's not going to be any "getting used to" that mask. That's when a person needs to either find tweaks, fixes, or modifications to make an "almost ok" mask into a "hey, this is ok now" mask. Or, try a different mask or perhaps just a different size of the existing mask.

When I read things like this I believe it's a cruel joke.

I agree with you: There are those who seem to think that all problems adjusting to CPAP must be related to mask problems. Yes, mask problems can and do lead to folks giving up on CPAP. But there are other reasons why people can be sorely tempted to throw in the towel that have nothing to do with mask problems. And you've clearly been working hard on resolving the mask problem:

I've now tried 7 different masks. The only one that's remotely comfortable is the one that I'm using now -- the mirage swift nasal pillows. Even that has its problems -- pressure on my top teeth. The FFM masks that I used (all six of them) either leaked like crazy, were painful or left big red welts on my face. I never thought of my face as being particularly unusual, but it clearly is as far as the designers of the masks. I only gave up on using the mirage swift pillows 3 1/2 years ago, because I thought that I might be a mouth breather -- since after 3 months I was feeling horrible. However, the data readout on my machine now shows that I have NO large leaks, so I'm obviously not a mouth breather.

I'd say you've got good solid evidence that mask leaks with the Mirage Swift are not the problem. Which Swift are you using? The problem with pressure on your top teeth needs to be addressed both for your comfort and for any potential dental problems it might cause. I personally haven't had any problem with that, so I don't have any suggestions on what might help. Does the problem start when you put the mask on even if the machine is off? Or does it start only after you start the machine and the pressure comes up? That distinction could be useful in trying to troubleshoot the problem you're having with the current nasal pillows mask.

And during my last sleep study/titration with nasal pillows six weeks ago there was no mouth breathing evident -- and I managed to sleep almost 8 hours. However, during that study I had 25 arousals associated with breathing events but 59 arousals which weren't. And even though I had long periods of REM sleep (according to the sleep doc when I met with him a week later) during that I felt like hell the next day.

I think this may be the crux of the matter: Are those 59 arousals just listed as "spontaneous" or are they related to limb movements? I too have had lots of "spontaneous" arousals in both of my titration studies with "spontaneous" arousal indices above the "spontaneous arousal" index on my diagnostic study. Like you, I had no trouble getting into REM on any of my sleep studies, but I never got into S3/4 (slow wave) sleep on either of the titration studies, although I did get a bit of S3 in my diagnostic study. What did your S3/4 numbers look like on the sleep studies? Is it possible you're not getting enough S3/4 sleep to feel rested in the morning? [That's what I strongly suspect is a major part of my problems.]

cflame1 wrote:Victor... your machine isn't in APAP mode... it's in Auto BiPAP mode, which is different.