The more I try, the worse it gets.

I agree

So, just to check in. I tried the new full face Airfit last night. Did you hear me screaming? I lasted about an hour or something. The leaks, burps, and popping noises had me constantly fiddling with it. There was a brief period when I hit a sweet spot but then I moved and that was that. I may try a nap today and do auto 15/9/4ps and maybe have the full face pad a cheek. But if it makes those noises (exact same issues I had with quattro FX), then the mask is a no go. The good/bad news was I was never asleep long enough to have an event. The bad news is I slept without a mask.

And so it goes......

so yesterday was a strange day. Started a nap with the full face and an old fx liner. It didn't really work but maybe enough potential improvement that I ordered some Remzzz liners to try before I give up on having a full face back up mask. My allergies and itching were up so I had a doxepin 10mg and that made me sleepy/lethargic much of the day.

At night I said something like nuts to you full face and put my zest back on. I also reset my pressures to auto 15/9/4ps. and saw that the ipap bounced on the 15 ceiling several times but mostly was ok? And the ipap seemed happy around 11.(yes?) I had a some centrals and a bit of a cluster with some making that 10 sec or more (I could be blowing apnea air out of my whatever but this is what I think I can interpret so far altho I don't feel sure about any of it) My zest kept crawling up my head. (I had my bed on a slight slant) and so it kept moving and I am thinking that could be why there were so many events that could have been centrals or could have been me trying to get the mask back in place? I noticed I exhaled often and long then. Short inhales and longer exhales. I was more awake than not during that time. I think when I am awake I don't take a lot of breaths and I spend more time on the exhale and then slowly inhale when I get the message that I have stayed too long in exhale. (just trying to see if I have a breathing style/trend)

Anyway here are the charts. Kind of this and that and not quite something?

lliann wrote:so yesterday was a strange day. Started a nap with the full face and an old fx liner. It didn't really work but maybe enough potential improvement that I ordered some Remzzz liners to try before I give up on having a full face back up mask. My allergies and itching were up so I had a doxepin 10mg and that made me sleepy/lethargic much of the day.

How much did you actually sleep during the nap? I'm still trying to get a feel for how many of those CAs are just mis-scored wake breathing.

And I know you're on the doxepin for the itching. But I'm wondering something: Is there any correlation between taking the doxepin and having more centrals in your data? I'm not saying there is, but I'm wondering about it.

At night I said something like nuts to you full face and put my zest back on. I also reset my pressures to auto 15/9/4ps. and saw that the ipap bounced on the 15 ceiling several times but mostly was ok? And the ipap seemed happy around 11.(yes?)

You IPAP was AT or ABOVE 14.10 for at least 50% of the night (Median IPAP = 14.10). And yes, you hit 15 a number of times. In light of all the centrals AND the fact that the OAs are well controlled at 15/11 AND the fact that you have had aerophagia problems, there is NO reason to increase the max IPAP further. Additional IPAP pressure would likely NOT make you feel any better and it may make you feel worse.

Your IPAP was NOT "around 11" at any point in the night except briefly during ramp. Your min IPAP pressure is min EPAP + PS = 9 + 4 = 13cm.

Your EPAP, however, was between 10 and 11 for much of the night.

My zest kept crawling up my head. (I had my bed on a slight slant) and so it kept moving and I am thinking that could be why there were so many events that could have been centrals or could have been me trying to get the mask back in place? I noticed I exhaled often and long then. Short inhales and longer exhales. I was more awake than not during that time. I think when I am awake I don't take a lot of breaths and I spend more time on the exhale and then slowly inhale when I get the message that I have stayed too long in exhale. (just trying to see if I have a breathing style/trend)

All those things can indeed lead the machine to score CAs that are NOT real CAs.

Anyway here are the charts. Kind of this and that and not quite something?

Major observations:

There's a lot of CAs, but you say you were really restless or awake when they were happening, AND your description of your wake breathing style makes it more likely for the machine to score parts of your "normal wake breathing pattern" as SDB events, so I'd discount the CAs for now.

The OAs are under control, but it's clear the machine wants you at 14/10 much of the night and at 15/11 for part of the night in order to keep the OAs under control. How did the stomach feel this morning? Any significant problems with aerophagia? Or was the fact that you had some stretches at your min pressures of 13/9 helpful in keeping the tummy happy?

Leaks are nicely under control at all pressures used. So they're not a problem from a therapy point of view. But did any of the small leaks contribute to the restlessness?

Total time using the machine at night is short: You go to bed at 23:45ish and turn the machine off at 3:55. That's a bit more than 4 hours. Did you get up at 3:55AM? Or did you take the mask off and got back to sleep?

Bottom line: We need to figure out a way of getting you to be more comfortable (with less severe itching) when you put the mask on AND a way of increasing the amount of sleep you get with the VPAP each night.

robysue wrote:

lliann wrote:so yesterday was a strange day. Started a nap with the full face and an old fx liner. It didn't really work but maybe enough potential improvement that I ordered some Remzzz liners to try before I give up on having a full face back up mask. My allergies and itching were up so I had a doxepin 10mg and that made me sleepy/lethargic much of the day.

How much did you actually sleep during the nap? I'm still trying to get a feel for how many of those CAs are just mis-scored wake breathing.

And I know you're on the doxepin for the itching. But I'm wondering something: Is there any correlation between taking the doxepin and having more centrals in your data? I'm not saying there is, but I'm wondering about it.

I don't know but I think thats a question worth persuing. The last week, I have learned how to split my doxepin into a smaller dose of 5mg or less. Sunday was the first time I took a full 10mg. I did seem to have a lot of centrals but I was having a lot of trouble with masks, even the nasal one.

At night I said something like nuts to you full face and put my zest back on. I also reset my pressures to auto 15/9/4ps. and saw that the ipap bounced on the 15 ceiling several times but mostly was ok? And the ipap seemed happy around 11.(yes?)

You IPAP was AT or ABOVE 14.10 for at least 50% of the night (Median IPAP = 14.10). And yes, you hit 15 a number of times. In light of all the centrals AND the fact that the OAs are well controlled at 15/11 AND the fact that you have had aerophagia problems, there is NO reason to increase the max IPAP further. Additional IPAP pressure would likely NOT make you feel any better and it may make you feel worse.

Your IPAP was NOT "around 11" at any point in the night except briefly during ramp. Your min IPAP pressure is min EPAP + PS = 9 + 4 = 13cm.

Your EPAP, however, was between 10 and 11 for much of the night.

Think I am still getting my ipaps and epaps mixed up. But yes, it seems like a 15 ceiling on the Ipap is working well enough for now. (altho, and I don't know if this was real or not, but it seemed like the inhale pressure was almost constant. I thought I felt the variations more when it was 17/10/4. I know I slipped into the 16 a few times but never as high as 17. I wonder if 15 ok but 16 is better?

Aerophagia was not an issue last night. But I did not use the full face and that seems to be a real villain in causing aerophagia in me. I also was very restless, so I dunno.

My zest kept crawling up my head. (I had my bed on a slight slant) and so it kept moving and I am thinking that could be why there were so many events that could have been centrals or could have been me trying to get the mask back in place? I noticed I exhaled often and long then. Short inhales and longer exhales. I was more awake than not during that time. I think when I am awake I don't take a lot of breaths and I spend more time on the exhale and then slowly inhale when I get the message that I have stayed too long in exhale. (just trying to see if I have a breathing style/trend)

All those things can indeed lead the machine to score CAs that are NOT real CAs.

Anyway here are the charts. Kind of this and that and not quite something?

Major observations:

There's a lot of CAs, but you say you were really restless or awake when they were happening, AND your description of your wake breathing style makes it more likely for the machine to score parts of your "normal wake breathing pattern" as SDB events, so I'd discount the CAs for now.

The OAs are under control, but it's clear the machine wants you at 14/10 much of the night and at 15/11 for part of the night in order to keep the OAs under control. How did the stomach feel this morning? Any significant problems with aerophagia? Or was the fact that you had some stretches at your min pressures of 13/9 helpful in keeping the tummy happy?

Leaks are nicely under control at all pressures used. So they're not a problem from a therapy point of view. But did any of the small leaks contribute to the restlessness?

Total time using the machine at night is short: You go to bed at 23:45ish and turn the machine off at 3:55. That's a bit more than 4 hours. Did you get up at 3:55AM? Or did you take the mask off and got back to sleep?

Bottom line: We need to figure out a way of getting you to be more comfortable (with less severe itching) when you put the mask on AND a way of increasing the amount of sleep you get with the VPAP each night.

Its odd the leaks were ok because I kept having to pull my headstrap down. The nasal mask must be pretty forgiving for me. I also did not use tape or chin strap because the aerophagia is not worse without those things and the leaks are not indicating my mouth breathing is getting in the way(I do think I am in the process of retraining myself to keep my mouth shut with only small slips into open mouth) I did not sleep during the nap or if I did, it was only until my first movement and then the leak went nuts. I did sleep later but no dreaming that I remember and a lot of wakee wakees with the nose cone trying to be a hat. So maybe some leaks got my attention. Maybe I am hypersensitive to leaks?

I don't seem to be able to sleep much passed 4 or 5. No, I don't get up but I do take the mask off. I think I do that because I can't fall asleep quickly with the mask (its like starting from scratch) whereas without the mask, I can hardly miss a beat. I know I have to work on that altho not sure yet how one does that. But just the 4 hours sleep with therapy is an improvement for me. already.

I need to learn how to cut and paste quotes better.

lliann wrote:

robysue wrote: And I know you're on the doxepin for the itching. But I'm wondering something: Is there any correlation between taking the doxepin and having more centrals in your data? I'm not saying there is, but I'm wondering about it.

I don't know but I think thats a question worth persuing. The last week, I have learned how to split my doxepin into a smaller dose of 5mg or less. Sunday was the first time I took a full 10mg. I did seem to have a lot of centrals but I was having a lot of trouble with masks, even the nasal one.

So track the following things in a simple spread sheet: Did you take doxepin on Day DATE? What mask did you use on NIGHT DATE? And what was CAI on NIGHT DATE? Look at the data after you have a good couple of weeks or so of data.

liann wrote: Think I am still getting my ipaps and epaps mixed up. But yes, it seems like a 15 ceiling on the Ipap is working well enough for now. (altho, and I don't know if this was real or not, but it seemed like the inhale pressure was almost constant. I thought I felt the variations more when it was 17/10/4. I know I slipped into the 16 a few times but never as high as 17. I wonder if 15 ok but 16 is better?

Yes, you are still a bit confused at times about IPAP and EPAP. IPAP is always the HIGHER of the two numbers.

It could be that at max IPAP = 17, min EPAP = 10, and PS = 4 that your pressure was varying a bit more. Or you're more sensitive to 16 than to 15. Or this night was simply a night where the pressure bothered you less for what ever reason. Or it could be that as you've gotten control over the leaks, you're not opening your mouth up when the pressure hits 15 and so you're not noticing a gush of air coming out of your mouth.

Personally, I don't see any reason to increase the max IPAP from 15 to 16 yet. At this point restlessness and sensitivity to leaks are the issues, not the number of OAs. And increasing the max IPAP to 16 could create more problems with leaks and more problems with aerophagia, both of which are going to increase the restlessness.

Aerophagia was not an issue last night. But I did not use the full face and that seems to be a real villain in causing aerophagia in me. I also was very restless, so I dunno.

With the leak lines you now have, there's no pressing need to use a full face mask. Since it seems to create aerophagia problems, that's a good reason to NOT use a FFM.

Its odd the leaks were ok because I kept having to pull my headstrap down. The nasal mask must be pretty forgiving for me. I also did not use tape or chin strap because the aerophagia is not worse without those things and the leaks are not indicating my mouth breathing is getting in the way(I do think I am in the process of retraining myself to keep my mouth shut with only small slips into open mouth) I did not sleep during the nap or if I did, it was only until my first movement and then the leak went nuts. I did sleep later but no dreaming that I remember and a lot of wakee wakees with the nose cone trying to be a hat. So maybe some leaks got my attention. Maybe I am hypersensitive to leaks?

Perhaps. Some people are. Others can sleep through hurricane sized large leaks. It's highly individual.

I don't seem to be able to sleep much passed 4 or 5.

Is this an old pattern that predates starting PAP therapy or is a new pattern?

I don't seem to be able to sleep much passed 4 or 5. No, I don't get up but I do take the mask off. I think I do that because I can't fall asleep quickly with the mask (its like starting from scratch) whereas without the mask, I can hardly miss a beat. I know I have to work on that altho not sure yet how one does that. But just the 4 hours sleep with therapy is an improvement for me. already.

Ok, you know you need to break this bad habit of waking up right after 4 hours of mask time and then consciously making the decision to take it off just so you can quickly get back to sleep.

And that's what it is at this point: A bad habit. And as silly as it sounds, you may be training your body to wake up at 4:00 or 5:00 (about 4-5 hours into therapy) by giving into your desire to take the mask off when you have that early morning wake.

And bad habits are notoriously hard to break. And the longer you allow the bad habit to exist, the harder it is to break.

As for how to start working on breaking this bad habit: Have you ever successfully broken any bad habits in the past? What technique(s) worked for you? How could you modify or adapt those techniques to address this bad habit?

FWIW here. In case you are wondering where I am...or have been
I agree with all Robysue has said and I am just too lazy to type it again.

I wouldn't worry about the IPAP (to help you keep them straight think "I" is for Inhale IPAP and "E" is for Exhale EPAP) increase at this time.
I don't think it is needed nor do I think it is your problem and it might make the aerophagia problem worse.

I think primary goals now are get more sleep (hours of sleep) and better sleep (reduce the awakenings).
That's enough work to worry about and won't be easy figuring out how to get it done.

A while back, you stated

I have copies from all my sleep studies except the latest one.

Could you post them?

Also, exactly what medications, dosages and time of day are you taking them (i.e, which Allegra are you using, etc.).

Do you know what the half life of bendryl is?

BTW, have you ever spent an extended period of time totally cat-free?

Have a dr appt today so just a quick one. Last night didn't happen at all. I went to put the mask on and it was filled with water (well, if not filled, significanty wet and dripping) No idea why or what happened. I took everything apart this morning, washed, sterilized (that control II stuff from Cpap.com) I have that fine line of sleepiness and if I miss that boat, there could be no more boats for an hour or two so I have sort of learned to fall alseep fast if possible.

I keep thinking of the guy who says DO NOT MOVE HUMIDIFIER CHAMBER WITH WATER IN IT. Well I have to, a little but I am extremely slow and careful. The machine is under a shelf so the cats can't walk on it.. Hmm, I think Bed Bath Beyond has a sliding pull out thing for a Keurig. Maybe that would work?

Anyway. I must have at least 5 or 6 sleep studies. Most(all recent) are in the form of the doctors interpretations. The newest one revealed restless leg. Which I suspected but the data shows its one more thing to add to the pile of issues. The newest one was I think dumb. It appears he started me at a very low pressure (I remember having trouble breathing) and maybe toward the end we landed at 13/8 at which he called me levelled. I talked with another sleep tech that I like a lot and he said it could have been at 13/8 for the last half hour and boom, that was reported. And they charge $1150 with a $500 dr interpret fee for this?. (I;ll never get over being a former hospital insurance biller. I know the numbers are pumped and they won't get that but I'll still be hit for a ded of $500) There is no eob that is safe from my analyzing eyes. LOL

Cats. I no longer let them sleep with me. This is not a happy place lately. They miss their alpha. But I am definitely waking up less with them gone. The idea of no cats ever is just not going to happen. I have few lines in the sand, but that is one. They live as long as they live and Ill try not to get more (I don't want to underlive my pets anyway) I can be a bit of an animal activist so my feelings run deep on this.

We are still trying to find out why I get so itchy. I think they think I am not allergic to anything a lot per se. My theory is I was a low birth weight baby so my sensory issues are sensitive. I don't like loud noise, or too warm, too cold, itchy. Jeez, I am a pita.!I think the spring allergies have me right now. I know I am a little more itchy right now. The asthma goes up and down and I do have at least one autoimmune thing that they don't know much about that manifests in itching as one symptom. I live on a lake that semi flooded in 2011. I have been wondering about mold or maybe just living too close to water?

Yes, I have broken some bad habits. Oh boy oh boy.<g> I have actually kept the mask on sometimes, but not enough. I have been a bit under disciplined on that one. The only thing vaguely ressembling an excuse would be that the longer I remain awake, the harder it is to fall back to sleep. Maybe that mask insomnia you write about Robysue. I have come a long way in the last 2 months. Before I could not tolerate a mask, then I had to really learn how to tolerate a nose mask. That seems to be my winner. But I know if and when I get sick, a nasal mask won't work. Probably nothing will because I get ..well messy and coughy.

What else. Ok, I will try to trend the conditions of each nights sleep. I have the graphs but I have not noted which nights I took doxepin or benadryl (no I don't know the half life of benadryl but I am a real lightweight with drugs) I also am very aware of the addictive properties of these kinds of medicines and I am very very careful. Maybe over careful but I think not.

lliann wrote:I keep thinking of the guy who says DO NOT MOVE HUMIDIFIER CHAMBER WITH WATER IN IT. Well I have to, a little but I am extremely slow and careful. The machine is under a shelf so the cats can't walk on it.. Hmm, I think Bed Bath Beyond has a sliding pull out thing for a Keurig. Maybe that would work?

If the cats have no access to the bedroom, then you don't need to keep them from walking on the machine.

Ban the cats full time from (just) the bedroom. Seriously, you need a cat-free room in the house for sleeping and there's good reason to suspect that you'd do better if your sleeping room were totally off limits to the cats even in the daytime.

Anyway. I must have at least 5 or 6 sleep studies. Most(all recent) are in the form of the doctors interpretations. The newest one revealed restless leg. Which I suspected but the data shows its one more thing to add to the pile of issues. The newest one was I think dumb. It appears he started me at a very low pressure (I remember having trouble breathing) and maybe toward the end we landed at 13/8 at which he called me levelled. I talked with another sleep tech that I like a lot and he said it could have been at 13/8 for the last half hour and boom, that was reported.

You need to request the full summary---all the summary graphs and all the statistical data, not just the doc's interpretation. Full report will run somewhere between 3 and 7 pages and most of it will be data, data, data.

My first titration pressure of 9cm was based on a whopping 15 minutes at the very end of the night.

Cats. I no longer let them sleep with me. This is not a happy place lately. They miss their alpha. But I am definitely waking up less with them gone. The idea of no cats ever is just not going to happen. I have few lines in the sand, but that is one. They live as long as they live and Ill try not to get more (I don't want to underlive my pets anyway) I can be a bit of an animal activist so my feelings run deep on this.

You need to ban the cats from the bedroom 24 hours a day, seven days a week. Spend time with them outside the bedroom. They'll adjust. They may not be happy about it, but they will adjust.

Think of it this way: To guarantee that you outlive those cats by a nice long margin, you need to look after your health as a first priority. And if the best way of doing that is to ban the cats totally from the bedroom, then it's in the cats' best interest to do so.

We are still trying to find out why I get so itchy. I think they think I am not allergic to anything a lot per se. My theory is I was a low birth weight baby so my sensory issues are sensitive. I don't like loud noise, or too warm, too cold, itchy. Jeez, I am a pita.!I think the spring allergies have me right now. I know I am a little more itchy right now. The asthma goes up and down and I do have at least one autoimmune thing that they don't know much about that manifests in itching as one symptom. I live on a lake that semi flooded in 2011. I have been wondering about mold or maybe just living too close to water?

All of which makes some sense. But don't overlook the fact that you are also likely sensitive to cat dander and dust bunnies whose major component is cat fur.

Yes, I have broken some bad habits. Oh boy oh boy.<g> I have actually kept the mask on sometimes, but not enough. I have been a bit under disciplined on that one. The only thing vaguely ressembling an excuse would be that the longer I remain awake, the harder it is to fall back to sleep. Maybe that mask insomnia you write about Robysue.

NOT sleeping for excessive periods of while lying in the bed masked up and FIGHTING for sleep is also counter productive. You have to teach your body to fall back asleep with the mask on in much the same way you had to teach your unconscious mind and body to fall asleep at the beginning of the night. But right now, you're letting your unconscious mind and body learn that there's a "reward" for waking you up at 4:00 or 5:00, and that "reward" is that you'll free them from the damn, hated mask if they simply wake you up at that ungodly hour.

My suggestion is NOT an easy one. But if you are patient and have the discipline to do it, it will eventually help you break this bad habit that you have. Here's my suggestion:

When you wake up at 4:00 AM or whenever, you need to NOT take the mask off immediately. And do NOT look at the clock. And do NOT try to figure out why you woke up---except for comfort issues. If there's a leak, fix it. If you need to turn over, do so. Feel free to turn the machine OFF and back ON so you know the pressure is at its minimum so your tummy is not in danger of getting aerophagia. And then turn over and try to get back to sleep. Give yourself what you think is about 20 minutes (NO clockwatching, just estimate the time in your head.) If you are still awake after about 20 minutes, then take the mask off and GET UP out of bed. Leave the room and pet the cats or read or make a cup of tea. Just do something relaxing and soothing. When you start to feel sleepy enough, go back to bed and mask back up and try again to get back to sleep. Give yourself another (estimated) 20 minutes or so. If you are still not asleep, get back up. Repeat as many times as necessary. And then get up at your usual time. Yes, you'll be exhausted and feel lousy all day long. But it may make it easier the next night to fall back asleep with the mask on after that 4:00AM wake.

The point of this (additional) torture is to teach your body and unconscious mind that your conscious mind is in charge and that Being in Bed = Time for Sleep = Must be Masked Up. Seriously---your body and mind (both the conscious and unconscious parts) have to accept that Sleep without the mask is unacceptable and Lying in bed getting anxious about NOT sleeping because the mask is on is also unacceptable. Your body and mind will (eventually) sort out that it is better to just fall back asleep with the dang mask on rather than face getting out of bed yet again. Once that happens, you may still wake up, but you'll also be able to quickly get back to sleep. And eventually those not-so-random wakes at 4:00 will shorten to the point where they're not that important in terms of sleep disruption.

I have come a long way in the last 2 months. Before I could not tolerate a mask, then I had to really learn how to tolerate a nose mask. That seems to be my winner. But I know if and when I get sick, a nasal mask won't work. Probably nothing will because I get ..well messy and coughy.

You have come a long way in the last two months.

Worry about what to do when you are sick after it happens. Yes, I know exactly what you mean by "messy and coughy", but some of us manage to muddle through with a nasal mask or nasal pillows in spite of being "messy and coughy" when we've got an cold or the flu. In my case, the "messy and coughy" feeling causes enough sleep disruption that the added problems triggered by dealing with the mask on top of it are marginal. And the humidified, filtered air seems to help in all but my worst illnesses.

The last time I had the flu, I wound up sleeping in a recliner for 2 or 3 nights with my Kaa (my BiPAP) by my side because I was so miserable: I couldn't lie down (with or without the mask) at all, but in the recliner I would start to doze (and snore). When the snoring woke me up, I'd put Kaa on and continue to doze until waking up needing to hack my guts out. And then after I'd dealt with the immediate problem I'd start to doze and snore, and wake up enough to put the mask back on. The point being: I was no more miserable with Kaa on my face than I was miserable without Kaa on my face. My AHI and leak lines were pretty awful, but the AHI was still not as high as my diagnostic sleep studies and I do think sleeping with Kaa on my face meant that what little rest and sleep I got was better than what I would have gotten had I simply chosen to not use Kaa at all.

robysue wrote:

lliann wrote:I keep thinking of the guy who says DO NOT MOVE HUMIDIFIER CHAMBER WITH WATER IN IT. Well I have to, a little but I am extremely slow and careful. The machine is under a shelf so the cats can't walk on it..
Ban the cats full time from (just) the bedroom. Seriously, you need a cat-free room in the house for sleeping and there's good reason to suspect that you'd do better if your sleeping room were totally off limits to the cats even in the daytime.

I understand the validity of your thinking. And I will try to make that a goal, but it may take a little time. The cats are already upset that I am putting them out of the room at night. 4 cats have certain dynamics. Its just the way cats are. So I will try to do that, but that will have to be on a slower process. (house layout, other person living here all factor in also)

You need to request the full summary---all the summary graphs and all the statistical data, not just the doc's interpretation. Full report will run somewhere between 3 and 7 pages and most of it will be data, data, data.

My first titration pressure of 9cm was based on a whopping 15 minutes at the very end of the night.

And I think that is what happened to me which tells me the report isn't accurate for an average time. I will call and ask for copies of the graphs.


[
You need to ban the cats from the bedroom 24 hours a day, seven days a week. Spend time with them outside the bedroom. They'll adjust. They may not be happy about it, but they will adjust.

Ha. Cats don't adjust. We do.

Think of it this way: To guarantee that you outlive those cats by a nice long margin, you need to look after your health as a first priority. And if the best way of doing that is to ban the cats totally from the bedroom, then it's in the cats' best interest to do so.

Logical. Not to a cat tho.<g>

Yes, I have broken some bad habits. Oh boy oh boy.<g> I have actually kept the mask on sometimes, but not enough. I have been a bit under disciplined on that one. The only thing vaguely ressembling an excuse would be that the longer I remain awake, the harder it is to fall back to sleep. Maybe that mask insomnia you write about Robysue.

NOT sleeping for excessive periods of while lying in the bed masked up and FIGHTING for sleep is also counter productive. You have to teach your body to fall back asleep with the mask on in much the same way you had to teach your unconscious mind and body to fall asleep at the beginning of the night. But right now, you're letting your unconscious mind and body learn that there's a "reward" for waking you up at 4:00 or 5:00, and that "reward" is that you'll free them from the damn, hated mask if they simply wake you up at that

oops, I deleted a bunch of what you said while trying to reduce the quote. I got the drift tho.

I do not have perfect sleep habits. I won't defend them. I know there is an optimal scenario. And then I know what is the reality. And what I can do about it. And what I will be willing to do about. I am pretty willing, but I may not be perfectly willing. I already learned a long time ago life is a bit easier not trying to chase perfect.

So yes, I have to get used to sleeping longer with the mask on. You will see by my daily data I did improve some. I believe I would have done better, but my new friend seems to be rainout? My new N10 airfit kept leaking on me (I woke one time, took it off to see what the heck was going on. It was a drop here and there but I put the mask back on and made myself do the 20 minute or get up thing. Rainout has occurred the last 2 times I slept with a mask on. Not sure why all of a sudden it is showing up. I did have my window open. I can't sleep well if I am too warm. I am going to guess it is something about inside/outside temps affecting the tubing? The n10 is still out to the jury. One night and I had rain out and more leaks than usual. I'll give it somemore tries. That soft cushion does not seem to work as well on me but I am sure there is more I can do to try it.


The point of this (additional) torture is to teach your body and unconscious mind that your conscious mind is in charge and that Being in Bed = Time for Sleep = Must be Masked Up. Seriously---your body and mind (both the conscious and unconscious parts) have to accept that Sleep without the mask is unacceptable and Lying in bed getting anxious about NOT sleeping because the mask is on is also unacceptable. Your body and mind will (eventually) sort out that it is better to just fall back asleep with the dang mask on rather than face getting out of bed yet again. Once that happens, you may still wake up, but you'll also be able to quickly get back to sleep. And eventually those not-so-random wakes at 4:00 will shorten to the point where they're not that important in terms of sleep disruption.


Ah, so you know you are torturing me. I advise people to change their approach to life and etc in a different field, so I really get the willingness to change vs the unwillingness. But more than anything, I get this is a process, even with people who know better. I may resist here and there because I am just human and we all know some of this stuff is not easy, it can be frustrating, and requires a lot of mental/emotional negotiating with ones self. So please know I understand all of your suggestions and know them to be valid. But some things will take a little time to change. If I had one more bedroom, that would help. But for now I am working with what I have as well as my learning process.

So I am really tired today. Not my usual feel not bad for 4-5 hours of being papped (is there a verb to this?) The drops of water kept waking me. The new mask leaked. But even so, I increased my sleep time and I did not take the mask off until I was ready to get up. But I feel a nap coming on.

Yes, you totally described the sick process. I tend toward bronchitis bordering on pneumonia. Even tho I quit smoking 14 years ago, my lungs seem to be getting more compromised with age. Like you, Ill be sitting up and coughing so the idea of a mask of any kind may be moot. My nose, oddly enough, has been less stuffy. I am wondering if the nasal masks and the air streams are being an added bonus in keeping my nose from acting up.

Anyway, my latest chart. I think I am reading that the pressure of 15/9 ps of 4.. is 95% or less at 15 and 95% or less at 11. So its a viable setting? Still a little aerophagia. May still be left over from the full face. Had a dry mouth last night so I think my mouth opened more than usual. Some days you move forward, somedays not so much, but just keep moving.


S9 VPAP Auto
Mode: Bi-Level
EPAP: 9.0 IPAP: 15.0 cmH2O
PS: 4.0
Date Sleep Wake Hours
4/29/14 22:25 04:48 06:22:04
AHIApnea / Hypopnea Index 7.69
HypopneaHypopnea 0.16
ApneaUnspecified Apnea 0.00
ObstructiveObstructive Apnea 2.83
Clear AirwayClear Airway Apnea 4.71

Event Breakdown


Statistics
Channel Min Med 95% Max
EPAPExpiratory Pressure (cmH20)
W-Avg: 9.98 4.74 10.08 10.90 11.00
IPAPInspiratory Pressure (cmH20)
W-Avg: 13.98 8.74 14.08 14.90 15.00
Minute Vent.Minute Ventilation (L/min)
W-Avg: 5.63 1.38 5.50 7.75 11.12
Resp. RateRespiratory Rate (breaths/min)
W-Avg: 14.44 4.00 14.60 17.80 23.80
Resp EventsRespiratory Events
W-Avg: 0.00 0.00 0.00 0.00 0.00
Flow LimitFlow Limit Graph (0-1)
W-Avg: 0.00 0.00 0.00 0.00 0.11
LeaksLeak Rate (L/min)
W-Avg: 4.49 0.00 1.20 25.20 30.00
SnoreSnore (unknown)
W-Avg: 0.03 0.00 0.02 0.06 0.16
I:EInspiratory:Expiratory (ratio)
W-Avg: 43.50 8.00 43.00 63.00 89.00
Insp TimeInspiratory Time (seconds)
W-Avg: 1.25 0.46 1.24 1.54 1.82
Exp TimeExpiratory Time (seconds)
W-Avg: 3.00 0.58 2.84 4.34 7.62
Tidal VolumeTidal Volume (ml)
W-Avg: 390.38 100.00 380.00 560.00 780.00

Machine Settings
Pr. ReliefPressure Relief Easy-Breathe x1

Session Information
SessionID On Date Start End
CPAP Sessions
1398824703ResMed CPAP 3h, 29m, 2s 4/29/14 22:25 01:54
1398837326ResMed CPAP 2h, 53m, 2s 4/30/14 01:55 04:48

I had rain out yesterday morning. In the nasal pillows. I had turned the temp on the Climateline down to 74 (like it cooler in summer and warmer in winter) and it turned off cold here and window was open and bedroom was cold..and I got condensation in the mask as a result....last night increased the temp to 82...still cold outside and bedroom very cool and window still open but no rain out in the pillows this morning.

Are you using the Climateline hose? If so, in Automatic mode or manual mode? Settings?
If there is room for increasing the temperature to the Climateline hose...that will help reduce or eliminate any condensation.

Oh, I hear you about

lliann wrote:And then I know what is the reality. And what I can do about it. And what I will be willing to do about. I am pretty willing, but I may not be perfectly willing.

Baby steps...don't try to change everything all at once...don't kick yourself in the butt when the steps go backwards instead of forwards..and know your own limitations and accept them and the reality that might come with them.

Pugsy wrote:I had rain out yesterday morning. In the nasal pillows. I had turned the temp on the Climateline down to 74 (like it cooler in summer and warmer in winter) and it turned off cold here and window was open and bedroom was cold..and I got condensation in the mask as a result....last night increased the temp to 82...still cold outside and bedroom very cool and window still open but no rain out in the pillows this morning.

Are you using the Climateline hose? If so, in Automatic mode or manual mode? Settings?
If there is room for increasing the temperature to the Climateline hose...that will help reduce or eliminate any condensation.


No, I dont have a climatehose. All the DME 's I talked about it poo poohed me (could this be a low profit margin item?) This is sort of new territory for me. I think I don't prefer warm air. I feel less able to breathe? So for the longest time I just had a humidity setting 3.5 and no warm up. I think last night was 4.5 and no warm up. I think I have to revisit that scenario. Just don't know how yet. Temps here in upstate NY are up and down and up and down. I won't complain because I see whats happening to the mid country and I feel bad for them. I tend to like cold so I loved having the window open, but its too cold for anything but sleeping under warm blankets. (post menopausal if you catch my drift<g> Anyway, I wonder if I should get a climate hose? I could push the dme one more time or bite the bullet and just get one. Today I think I will do maintenance. New hose, new filter. And try to clean room. All bedwear in the laundry. I have a lot of books, so I will try to vaccumn them and then put my ionizers on. I guess the ionizers have been my concessions to the cats Gotta figure out how to discourage the rainout because that was truly annoying!!

Oh, I hear you about

lliann wrote:And then I know what is the reality. And what I can do about it. And what I will be willing to do about. I am pretty willing, but I may not be perfectly willing.

Baby steps...don't try to change everything all at once...don't kick yourself in the butt when the steps go backwards instead of forwards..and know your own limitations and accept them and the reality that might come with them.

Thank you. I know when I am working with someone who is not willing (and how frustrating that can be). You can only work within the parameters of what they are capable of in willingness. Until they can and will do more. The best I have is open thinking. But I know I will discourage myself if I try too many hoops at once. I don't want to seem ungrateful because you guys are amazing, but I know what I can do, what I can't do, what I won't do(that damn human in me) and what I'll eventually do. The goal is to keep me sitting on the horse even when the horse seems like it wants to throw me off. I think I have had just enough success to believe this is possible, but not enough to know I am at optimal level.

So today, I need to clean my room, learn about rainout and learn how to quote better in a response.