[CPAP] How do you get used to CPAP?

[dannyhawaii]

Thanks for the responses, everyone.

OpalRose, I like your idea of using the machine while awake to speed up getting used to it so I started doing that last night. And my EPR was set at 2 so I tried changing it to 3.
eddie, that's a great article, although I don't know how I can figure out the causes myself. It does make me think that having the previous settings at AUTO 6-13, and now at a fixed 8.6, that maybe that's too high for me.
Forgot to mention that I use Nasonex every night to help open up my nasal passages and have been doing so for about six months now. Not sure if that's a factor here though, as I asked my sleep specialist about it and he said if I felt some benefit from it that I should continue using it.

After reading some more about GERD and the esophagus, it does sound like the body needs to adjust to this new way of breathing.

Anyway, gave it a good try again last night. I think I actually feel worse today than I did yesterday. I wonder if the EPR being set to 3 did that. I also seem to be turning the machine off although I don't recall doing that. When I get up for a toilet break, I turn it off then pull the tube out of the mask and when I return I put the tube back in and turn the machine back on.

Here are my Sleepyhead results from last night. They look even worse than when I was using the F&P Eson nasal mask. Not sure what to make of it all. Maybe EPR is better for me at 2? Maybe I'm better off without the ramp on?

Ignore the part before 11.30pm, that was me watching TV.



And here's my report from the previous night where I had the ramp turned off:

[OpalRose]

What was the reasoning that your pressure was changed from Auto 6-13 to fixed 8.6?
Your charts are a little fuzzy, but it looks like most of your events are clear airway, and a higher pressure won't treat clear airways.

In one of your posts, you said that while on auto 6-13, you hovered around 6 or 7. Do you know what your 90% pressure was while on auto setting? It is possible that the 8.6 may be too high.
Are you able to post a day that you were using the auto setting?

As far as EPR goes, it is a comfort setting, tune it back to 2 if that is what you are comfortable with.

You have a lot going on, with finding a mask that works for you, nasal congestion issues, and getting your pressure settings right. All of this takes time.

[FullyAwake]

Forgot to mention that I use Nasonex every night to help open up my nasal passages and have been doing so for about six months now. Not sure if that's a factor here though, as I asked my sleep specialist about it and he said if I felt some benefit from it that I should continue using it.

I have been at this since April & a month after the rental finished to find a machine. I am not used to it yet and my body, especially my legs, feeling very tired. My brain/mind is fine, generally, and sharp on most days when my body feels like it needs more sleep!

I'm going to keep going until 3 months is up on my machine/masks/specialist reviews and then start posting here for advice if I don't get this therapy working or tweaked to the best possible delivery.

With Nasonex you can use two sprays each nostril AM/PM - that is a total of 8 sprays. Once upon a time in Australia - last year(!) - this was prohibitive to do at $55 a bottle. Last week Chms in Oz had Nasonex listed at $15.99 a bottle - now not as expensive to get a good dose. The "oil" that is in Nasonex has given it an edge over competing brands. It is the best on the market at the moment - especially to keep nasal polyps at bay after surgery.

You should also be irrigating your nostrils in these early days of CPAP. Generally it's recommend one hour before bed - I'd say - try it 2 hours before bed to give your nasal passages a chance to clear as much as possible before bed. It's a few minutes a day to do, AM/PM and you'll notice the difference if you add to your morning and evening maintenance routine.

Buy a squeeze bottle. Stay away from netti-pots - too much work to get used to, messy and little control if you have slight congestion. Although there is one advantage, you can tilt your head further to the side when using a netti-pot - with a squeeze bottle - this takes a bit of work to get used to.

FLO, NEILMED, FESS SINU CLEANSE, etc., have good squeeze bottles.

FLO has the better salt/Xylitol--sugar/bicarb packets, they're a bit more expensive than the competing brands.

I use the Neilmed packets. They do not have Xylitol & I add the Xylitol to each irrigation with the salt to save on the cost of what the FLO packets are currently listed at.

Good luck with your therapy.

[PollCat]

Everytime I read these stories of newbies having problems adjusting to the therapy, I wonder why some of us adapted to the therapy so easily. I've successfully slept every night since I was given my first machine (way back in 1995). Apparently, some of us are just wired differently; or, the sleep docs (and possibly the DMEs) back then took more time with each patient to get them comfortable with the machines and/or therapy.

As to comments made by FullyAwake, I've been using Neilmed's sinus rinse every morning since my latest polyp removal surgery, two years ago. It was the third time I had to have them removed in 20 years. I've used Nasonex for longer than I can remember. Whatever you do, DO NOT use Nasonex after rinsing with Neilmed. I inadvertently did this once and it was not a pleasant experience.

[wrlc56]

Yeah, I was using a nasal mask before but my nose would get blocked with it. I hear some people have great success with nasal pillows and maybe a chin strap but I'm not so keen on that after my week or so with the nasal mask. I guess that's another option though.

ive used nasal pillows for 15 years. my mouth never comes open during treatment in bed but it does happen very rarely when sleeping in my recliner. sometimes i sack out in my chair for a bit when my back is out

[FullyAwake]

...I've been using Neilmed's sinus rinse every morning since my latest polyp removal surgery, two years ago. It was the third time I had to have them removed in 20 years. I've used Nasonex for longer than I can remember. Whatever you do, DO NOT use Nasonex after rinsing with Neilmed. I inadvertently did this once and it was not a pleasant experience.

Most definitely!

I did ask one of my surgeon's when would be the best time, the reply was about an hour later.

I start the nasal wash early as possible in my day and some 2 hours later - Nasonex.
Or I use Nasonex very late in the morning.

Irrigation early evening, Nasonex two or three hours after.

Not to one up you PollCat - more to add to your comment - that I inadvertently used Xylitol on it's own without salt and sodium bicarbonate - big PAINFUL mistake!

Also recommended for the management of Nasal Polyps, especially polyps that have become resistant to fluticasone sprays - ask your doctor to prescribe Pulmicort Respules to add to your nasal rinse water. One Respule a day is all you need on one of your daily irrigation sessions.

[dannyhawaii]

What was the reasoning that your pressure was changed from Auto 6-13 to fixed 8.6?
Your charts are a little fuzzy, but it looks like most of your events are clear airway, and a higher pressure won't treat clear airways.

In one of your posts, you said that while on auto 6-13, you hovered around 6 or 7. Do you know what your 90% pressure was while on auto setting? It is possible that the 8.6 may be too high.
Are you able to post a day that you were using the auto setting?

As far as EPR goes, it is a comfort setting, tune it back to 2 if that is what you are comfortable with.

You have a lot going on, with finding a mask that works for you, nasal congestion issues, and getting your pressure settings right. All of this takes time.

Hi OpalRose, sorry I haven't replied in a while. Work has been crazy and I've been taking a break from the CPAP as a subsequence.

My CPAP clinician was using the autoset as a sort of titration tool from what I gather. She prefers fixed pressure and came up with 8.6 based on my data. Here's the one day I had with the F10 mask before the pressure change:



So 7.56 was my 95% pressure on that day. I guess it makes sense. I've been attempting to contact the clinician with no luck so I'm going to try setting back to auto this weekend to see how it goes. I just tried a nap at 6-9cm auto and it stayed mostly around 6. I think I'm going to try 6-9 tonight and see how it goes as I'm still doing this as a trial to rule out breathing issues related to idiopathic hypersomnia. Sort of sick of the lack of support and thinking of taking my business elsewhere at the moment.

Meanwhile I've been trying to get in an hour or so in front of the TV at 8.6 fixed but I find I feel nauseous afterwards.

EPR I've set back to 2 as it didn't seem to make any difference going to 3.

Really the issue for me at the moment is that work is taking up a lot of energy and I can't afford to lose days with my CPAP trial. I'm probably going to revisit the whole process later in the year if I don't get somewhere soon. I always have my splint and modafinil to fall back on.

[dannyhawaii]

I have been at this since April & a month after the rental finished to find a machine. I am not used to it yet and my body, especially my legs, feeling very tired. My brain/mind is fine, generally, and sharp on most days when my body feels like it needs more sleep!

I'm going to keep going until 3 months is up on my machine/masks/specialist reviews and then start posting here for advice if I don't get this therapy working or tweaked to the best possible delivery.

With Nasonex you can use two sprays each nostril AM/PM - that is a total of 8 sprays. Once upon a time in Australia - last year(!) - this was prohibitive to do at $55 a bottle. Last week Chms in Oz had Nasonex listed at $15.99 a bottle - now not as expensive to get a good dose. The "oil" that is in Nasonex has given it an edge over competing brands. It is the best on the market at the moment - especially to keep nasal polyps at bay after surgery.

You should also be irrigating your nostrils in these early days of CPAP. Generally it's recommend one hour before bed - I'd say - try it 2 hours before bed to give your nasal passages a chance to clear as much as possible before bed. It's a few minutes a day to do, AM/PM and you'll notice the difference if you add to your morning and evening maintenance routine.

Buy a squeeze bottle. Stay away from netti-pots - too much work to get used to, messy and little control if you have slight congestion. Although there is one advantage, you can tilt your head further to the side when using a netti-pot - with a squeeze bottle - this takes a bit of work to get used to.

FLO, NEILMED, FESS SINU CLEANSE, etc., have good squeeze bottles.

FLO has the better salt/Xylitol--sugar/bicarb packets, they're a bit more expensive than the competing brands.

I use the Neilmed packets. They do not have Xylitol & I add the Xylitol to each irrigation with the salt to save on the cost of what the FLO packets are currently listed at.

Good luck with your therapy.

Hey there FullyAwake, I've also been trying irrigation with Fess w/xylitol or plain saline Fess. Nasonex reads as saying to never use more than 2 sprays per nostril per day which is what I'm using every night. Although I clearly have issues with nasal congestion, I think that a full face mask is helping me work around that.

Wow, sticking it out for 3 months! I'm impressed, I'm barely making the 1! Best of luck.

---

Everytime I read these stories of newbies having problems adjusting to the therapy, I wonder why some of us adapted to the therapy so easily. I've successfully slept every night since I was given my first machine (way back in 1995). Apparently, some of us are just wired differently; or, the sleep docs (and possibly the DMEs) back then took more time with each patient to get them comfortable with the machines and/or therapy.

As to comments made by FullyAwake, I've been using Neilmed's sinus rinse every morning since my latest polyp removal surgery, two years ago. It was the third time I had to have them removed in 20 years. I've used Nasonex for longer than I can remember. Whatever you do, DO NOT use Nasonex after rinsing with Neilmed. I inadvertently did this once and it was not a pleasant experience.

PollCat, seems to me that the lack of a night of titration and trying different masks is what's missing in Australian treatment - or just in mine! Still, everyone has different sensitivities and sometimes it takes more than a night to find each one of them.

[dannyhawaii]

Yeah, I was using a nasal mask before but my nose would get blocked with it. I hear some people have great success with nasal pillows and maybe a chin strap but I'm not so keen on that after my week or so with the nasal mask. I guess that's another option though.

ive used nasal pillows for 15 years. my mouth never comes open during treatment in bed but it does happen very rarely when sleeping in my recliner. sometimes i sack out in my chair for a bit when my back is out

Thanks for the input, I'll take that as another vote for nasal pillows!

[49er]

Whatever you do, DO NOT use Nasonex after rinsing with Neilmed. I inadvertently did this once and it was not a pleasant experience.

Hmm, I have heard differently even though trying that seemed to cause more stuffiness vs. less in my situation. What do you mean when you say it was not a pleasant experience?