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CPAP- CPAP help
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #1
CPAP- CPAP help
[parts of this thread were copied from our old forum]
Sep 2 2005
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coco wrote:
I have just been given a new CPAP at level 15.
It seems when I use the CPAP my right ear fells like it has alot of pressure on it, from the inside. Does anybody have any Ideas?
Also can somebody explain how CSA events can be reduced with CPAP.
This is what I was told. They said they got me to go into REM at level 15, But just for a short time. They also told me that my CSA events where better at level 14, so they advised me to try both levels.
Right now I get about two to three hours of sleep a night with that snort every few minutes that wakes me up. I have tried CPAP the last few nights and am going through hell. I don't snort any more but I still snore through the mask and wake up every few minutes. How long did it take you to get to where the CPAP did not bother you anymore? With this CPAP on I maybe get two hours of sleep a night. I wake up wide awake at about 2:00 to 3:00 in the morning with or without CPAP and then fight to try to go back to sleep tell 5:00 maybe 15 minutes of sleep per hour, tring not to wake the wife.
any advise would help
thanks
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Jean wrote:
What exactly is waking you up? Is your brain just active, in which case your doctor may want to prescribe something that stops alpha wave intrusion if that was detected during your sleep study. I could not tolerate the usual medicine they give for this but do well on Doxepin, [a prescrption] which seems to have no addictive, habituating or lingering effects, [at least for me and others I know who have tried it.]

If it is physical discomfort, be very specific and I may be able to suggest an alteration. Just post a reply same strand. I started with CPAP 12 years ago and had pressure points, sweating, and chafing in several places. Worst, the thing kept leaking because it would not move with me and displaced with every movement. At first I felt like maybe if I adjusted something some sort of warranty would be affected. They never take back parts or pieces of the headgear or masks anyway so I have just been careful not to ruin anything functional and have gradually been able to adjust for most every discomfort. However, I realize every piece of equipment and every facial type is different.

To me it sounds like there may some sort of physical obstruction...an enlarged bony part or unusually small passageway perhaps. Have you had the inside of your nose and throat examined? I am beginning to snore through my mask and need to find out if I have something like this developing or maybe my uvula is causing problems or if I may just need more pressure. I want to caution you that it sometimes takes awhile to adjust to keeping your mouth closed and chin staps, even a very light one can help you subconciousy habitutate to do this. Overhead hose presentations with very low placement of the jaw level straps also help. It sounds like not snorting is a good beginning.

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ConnCarl wrote:
Coco, I would suggest a consult with a board-certified sleep specialist to check for some of the issues Jean mentioned.

I presume that by "level" you mean "centimeters of pressure". 14 or 15 cm is a substantial amount of pressure. Generally speaking, the higher the pressure, the tougher it is to get desensitized to xPAP. Luckily, the technology involved has improved significantly over the past few years, and you can use this fact to your advantage.

With effective, reasonably priced autopap machines available, there is no reason to have to "choose" between one pressure and another. Most autopaps will also detect snoring, and adjust your pressure as needed to compensate.

As Jean suggested, we can provide more targeted suggestions if you can share the specific problems you have encountered. Are you experiencing mask leaks? Do you have trouble exhaling against the continuous pressure?

Good luck!

Carl
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coco wrote:
Well I have tried CPAP for about a week with no help.
First thing is it takes me about a hour to go to sleep and then when I finally get to sleep I wake back up a short time later. The worst thing about it is that now I wake up with a mask on gasping for air. In return I throw the mask off my face.
I think the doctors are wishing I would go else where.
The ENT I went to was most likly the top ENT in my area he is the ENT for wash -u school of med for apnea. He informed me that it was to severe after putting a scope down my nose. He also told me that he would like to pull me into the group of doctors at the washington university school of medication. So now I go see the head of the sleep center on thursday. The last time I talked to the doctor I see now, she informed me that the pressure was most likly was not anough at 15, but she did not want to go any higher on the pressure. After cleaning my ears and useing nose spray the pressure in my right ear has allmost gone away. Now if I would only sleep. The problem is I wake up all the time. A normal night for me is go to bed around 10:00pm and I will remenber waking up around 20 times tell about 2:00 then I wake up wide awake about that time sometimes I might make it to 3:00. Then I try to go back to sleep tell 5:00 so I do not wake the wife. I get most likly about 15 minutes of sleep per hour. By the time I get up I am sick of the whole thing. I think CPAP just makes me sleep lease then I did before. The last doctor told me that is it is the worst sleep study she has ever seen. What the hell you go to a doctor for help and get what?
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coco wrote:
the setting on the resmed is 15 not sure if that is pressure or just the Cflex machine setting.
I got the two sleep study reports.
first on said at a setting of 5 I had 77events per hour sateration was at 77 they where a combination of OSA and CSA but the got no results with the tritration. I also got just over a hour of sleep 97% in stag 1 and about 3% stag 2. very fragmented.
the second study also said it was every fragmented sleep but got over 3 hours of sleep with lunesta sleeping pill as a aid. They said that they got the events down to about 4 per hour at level 15, but CSA was a problem at that level so they wanted me to try both 15 and 14. They said the got me into REM sleep for a short time but no real results they could study.
Please can anybody tell me how long it took for CPAP to be easy to use, by this I mean not taking a hour or so to fall a sleep?

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ConnCarl wrote:
Coco, please keep in mind that it may take a while to get used to CPAP at the pressures you seem to require.

The good news is that your AHI apparently went from 77 on 5 cm all the way down to 4 on 15 cm. An AHI of 4 is really, really good...good enough to make me absolutely green with envy. Smile A good night for me is anytime my AHI is less than 15. Perfectly healthy people don't often have an AHI less than 4.

So it sounds as though what you need is the right interface, careful fitment, and some desensitization.

You don't mention the type of mask you are currently using. There are many, from nasal and full-face masks, to nasal pillows, and unique products such as the Oracle. Within each type, there are usually at least three or four offerings from different manufacturers. And of course, some masks come in a number of differnt sizes. Don't be shy about asking to try out different interfaces. XPAP is one area where the squeaky wheel really does get the grease.

A good sleep lab, combined with a good DME provider, should go the extra mile to induce compliance. That means they should sit you down with a spare CPAP machine and a few masks to see what fits you comfortably and seals well. They should provide an autoPAP instead of a straight CPAP if that's what your doctor orders. They should suggest supports such as a chin strap if they think you need them.

Lousy masks and the wrong machines kept me from effective therapy for years and cost me my job, to say nothing of my health. Don't let that happen to you.

Good luck! Carl
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coco wrote:
have the mirage swift nasal mask.
I guess I forgot to mention the PLMs after looking at the report last night, I had 13 times I woke up from PLM and a total of 53. I really had about 4 hours of sleep time.
I think whats really hard is finding a doctor that really wants to help.
I know I let this go too long, but most of the problems are with doctors.
5 years ago when this got severe they went has far has wanting to but a scope in my lungs. I have seen so many differant doctors.
4 years later a lady doc I was seeing. said it sounds like you need a sleep test. That is when it finaly made since.
I tried for an hour last night and through the mask to the floor and gave up.
I hope my new doctor tomorrow is the one!!
coco
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ConnCarl wrote:
Coco, can you tell us how things went for you with the new doc, and give us an update on your XPAP therapy?

Carl
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coco wrote:
I see the doc on the 7th, so in about two weeks I hope to hear what ideas they have. They did another sleep study on me. The doctor told me that she has some ideas for treatment.(can't wait to hear them)
The good thing is I started treating myself with melatonin and iron pills ( lunesta does nothing for me tried it for a week). I now sleep tell 4 or 5 in the morning. With no real fight to stay a sleep. I still wake up all the time in the night but I do not wake up wide awake anymore. So going back to sleep is easy now.
that fight to stay a sleep was about to drive me crazy.
I have given up on CPAP for now, only because I need some sleep for work.
I am sure I will give CPAP a try again after I see the doctor and come up with a game plain. I think I will take a little time off work so I can work on treatment instead of work.
For those of you out there that take it one day at a time, Like I did. Knowing something was wrong. Please get help!
My first sign was high blood pressure and I would wake up when I fell a sleep on my back. at first it was every few minutes. Now it is almost instant and if I sleep on my side I was ok, I thought.
the thing that scares me the most is when I get sick. I can not beath at all when I fall a sleep. So I don't really sleep. I just wake right back up gasping for air. what ends up happening is my mental state goes too hell. My blood pressure goes through the roof, and so on.
I figure at the state I am in, the next time I get sick might be my last. I hope I just end up with a trach. what the hell life is coming to when you say somthing like that!!!
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ConnCarl wrote:
A trach is a big step. Be sure to do a lot of research before considering one.

Here's a very helpful page from a fellow OSA sufferer with a trach:

Mike's Trach Page

Carl
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reedstein wrote;
Carl,

Thanks for the link to Mike's Trach Page, I bookmarked it. I don't want to have one, but there may be no other alternative.

I am changing my primary care dr and seeing a new one this week, I want him to figure the sleep thing out on his own and refer me to a sleep dr. I don't plan on telling him my history, because I want my treatment to not be prejudiced by my history. Does that make sense? My appt is Weds.

Mike
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ConnCarl wrote:
Mike, if you think it's a good idea, give it a try.

Personally, I'd pee on a spark plug if I thought there was a chance it would resolve my OSA.

Carl
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03-26-2012 05:42 AM
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