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Can't adjust to the CPAP
#1
OK, I'm about 6 weeks in with the CPAP and it's been a rocky road. Not sure if I should try other mask or keep trying to adjust.

Before CPAP - my AHI was relatively low - 15. My sleep time is pretty limited due to having to get up early - so my sleep window is usually 7 to 7.5 hours sleep. I always slept hard and really didn't feel like I woke up a lot, but was getting more tired over the last two years. So I was hoping the CPAP would make my sleep more efficient and I would feel better after my 7~7.5 hours.

The Doc agreed and set the CPAP at 6, and I screwed up a little with the machine that was picked out for me got the ResMed A10 CPAP model (only compiance data available). My mask is the AirFit P10. In general I like it because of the size.

My problem is when I go to bed. I just lay there and hear myself breath most of the night. Once I do get to sleep, I am usually up 2 hours later and just hear myself breath more. I just can't get relaxed while breathing with the CPAP

Since using the CPAP I've never felt more tired in my life.

I tried using the Wisp mask for a couple days - and really didn't notice a difference.

About the only thing that has helped is taking AlevePM or benedryl. If I take that I will get to sleep wake up 2 times a night, but can usually get right back to sleep.

I also tried the larger size pillows (med --> large) and I breathed more comfortably but my leak started going up and was averaging about 24l/hr

Overall, my numbers have been good - AHI between 0.5~1.5 and leak around 18l/hr, but it definitly doesn't reflect how a feel.

I also tend to open my mouth some (that's what I think I keep waking up). I have a chin strap and have tightened it a couple times. That has helped some.

With the pressure so low - I am having a hard time figuring out why I can't adjust to it. I turned the ramp up off (it was set to go 4-->6). Instead I just get in bed put the mask on, read for about 20 minutes then lay down.

So what are my best path forward options-
- stick with it, I'll get used to it?
- stay with the larger pillows, and don't worry about the leak going up?
- try other masks (?? non pillows? , full face?)?

Sorry for being so long...any help that can be tossed my way would be greatly appreciated.

Thanks



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#2
Welcome to the board! Sorry you're having a difficult time adjusting to therapy. Have you tried some soft music or white noise to kind of drown out the breathing sound? I had a problem with nasal pillows popping my mouth open which would wake me up. I now alternate between the eson and wisp and the combo works well for me, but YMMV. Best of luck with your therapy, just don't give up!
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#3
(03-22-2015, 06:59 AM)theroefam Wrote: OK, I'm about 6 weeks in with the CPAP and it's been a rocky road. Not sure if I should try other mask or keep trying to adjust.

Before CPAP - my AHI was relatively low - 15. My sleep time is pretty limited due to having to get up early - so my sleep window is usually 7 to 7.5 hours sleep. I always slept hard and really didn't feel like I woke up a lot, but was getting more tired over the last two years. So I was hoping the CPAP would make my sleep more efficient and I would feel better after my 7~7.5 hours.

The Doc agreed and set the CPAP at 6, and I screwed up a little with the machine that was picked out for me got the ResMed A10 CPAP model (only compiance data available). My mask is the AirFit P10. In general I like it because of the size.

My problem is when I go to bed. I just lay there and hear myself breath most of the night. Once I do get to sleep, I am usually up 2 hours later and just hear myself breath more. I just can't get relaxed while breathing with the CPAP

Since using the CPAP I've never felt more tired in my life.

I tried using the Wisp mask for a couple days - and really didn't notice a difference.

About the only thing that has helped is taking AlevePM or benedryl. If I take that I will get to sleep wake up 2 times a night, but can usually get right back to sleep.

I also tried the larger size pillows (med --> large) and I breathed more comfortably but my leak started going up and was averaging about 24l/hr

Overall, my numbers have been good - AHI between 0.5~1.5 and leak around 18l/hr, but it definitly doesn't reflect how a feel.

I also tend to open my mouth some (that's what I think I keep waking up). I have a chin strap and have tightened it a couple times. That has helped some.

With the pressure so low - I am having a hard time figuring out why I can't adjust to it. I turned the ramp up off (it was set to go 4-->6). Instead I just get in bed put the mask on, read for about 20 minutes then lay down.

So what are my best path forward options-
- stick with it, I'll get used to it?
- stay with the larger pillows, and don't worry about the leak going up?
- try other masks (?? non pillows? , full face?)?

Sorry for being so long...any help that can be tossed my way would be greatly appreciated.

Thanks

Welcome to the forum!
Have you asked your doctor if they can trade your machine for an Autoset model? Using Sleepyhead (software I downloaded thanks to this forum) I learned that my pressure rate numbers change depending on mask used and even from hour to hour.

Also, some software considers anything higher than 24% leak rate higher. Read the insert that came with the mask and find out what the expected built-in leak rate is.... then you will know whether that was a positional leak vs. normal leak, (if you hear it, then it is non-intentional).

Good luck to you! Hang in there.
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#4
Did you actually have a sleep study done? What did it have to say? If you don't have a copy, get one.

It actually sounds to me like your pressure is too low and you're fighting for air. If it were me, I'd use the large pillow, try some HPA Lanolin on the nostrils to help them seal (a tiny bit), and raise the pressure to 7.

You do need to move up to a different machine if you can, so that you can really see what's going on, but for now, the cpap will work for you, it just takes a little screwing around.
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#5
Hi theroefam,
I know CPAP therapy can take some getting used to, I'm sorry you are having such a difficult time .
You might try one of the smaller pillows and see if that will help you. If that doesn't work, you may need to try another mask, there are lots of them out there, so don't be shy about asking to try a different one. Same thing with the chinstrap, there are a few out there so, ask to try another one of those as well.
Another thing you can do is, set up during the evening wearing your mask and using your machine as you read or watch tv. Sometimes this will help your body get used to this new way of sleeping.
You haven't been doing this that long, so don't give up, it does get better.
Hang in there for more suggestions and much success to you as you continue and fine tune your CPAP therapy.
trish6hundred
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#6
Welcome to the board. If Benadryl and CPAP give you rest, you can safely use the antihistamine for a period of two weeks. Shifting between AlevePM and Benadryl keeps you taking diphenhydramine, so I would beware of continued use. Try low dose acetaminophen and low dose 5-HTP (50mg or less) as alternatives to take during the period you are not taking either Benadryl or AlevePM. Of course, you really should check with your doctor.

And I agree that white noise or placing a sound barrier between you and the machine can reduce the lying awake listening. Some have put their machines on a short pedestal next to the bed (lowered), or in a drawer. Using an ear plug in one ear might be enough.

Good luck and continued success with your treatment.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
Hello and welcome to the board. Your not the only one I've had read about having difficulty adjusting to using the therapy. Keep using it. You will eventually get used to it. A lot of advice was given here for you to try.
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#8
Thanks for all the quick and great replies...

Retired_guy - I did have a sleep study. One without a CPAP then one with. Without I had a little over 15 AHI (small compared to many on this board), with the CPAP it dropped to 1.5 AHI at a pressure of 6. During the CPAP sleep study, I had problems sleeping and they finally gave me a pill to help me sleep. I assumed I would have gotten over that by now.

Mich - I wish I could go back and get the Autoset version. I love looking at data - and I was really irritated to find out my machine only did compliance data. My check up is coming up soon. But I don't think they take back old machines and I'm not sure if I want to spend the money for a second machine at this point

Trish6 - Just want to understand - why might smaller pillows work better. That seems opposite. Also with the chin straps - at least at the store I went to they don't have a trial or return policy for chin straps. At $20 or $30 a pop those are expensive trials after 2 or three. Any suggestions how to go about this.

Again thanks for the replies - I will try some of them and reply back... Maybe until I can get to the store and try some mask I think I'm going to try the larger pillows with some white noise...

Thanks
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#9
(03-22-2015, 06:10 PM)theroefam Wrote: Thanks for all the quick and great replies...

Retired_guy -

..........I think I'm going to try the larger pillows with some white noise...

I think that's a good plan. I also think you might do well to increase your pressure to 7.

Why? Just from my experience I know about laying there listening to yourself breath. A critical issue with me thanks to COPD. With me if I use a pillow size of anything other than large, my brain thinks I'm not necessarily getting enough air and should therefor spend all my time focusing of breathing in and out. With the large size, I don't have to think about getting enough air and I can do other stuff like sleep.

That's pillow size along with my particular pressure setting. In your case you're on a fairly low pressure (6). I think going to 7 will allow you to get enough air with the medium or the large pillow so that you don't spend all your time "listening to yourself breath."
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#10
(03-22-2015, 06:10 PM)theroefam Wrote: Thanks for all the quick and great replies...

Retired_guy - I did have a sleep study. One without a CPAP then one with. Without I had a little over 15 AHI (small compared to many on this board), with the CPAP it dropped to 1.5 AHI at a pressure of 6. During the CPAP sleep study, I had problems sleeping and they finally gave me a pill to help me sleep. I assumed I would have gotten over that by now.

Mich - I wish I could go back and get the Autoset version. I love looking at data - and I was really irritated to find out my machine only did compliance data. My check up is coming up soon. But I don't think they take back old machines and I'm not sure if I want to spend the money for a second machine at this point

Trish6 - Just want to understand - why might smaller pillows work better. That seems opposite. Also with the chin straps - at least at the store I went to they don't have a trial or return policy for chin straps. At $20 or $30 a pop those are expensive trials after 2 or three. Any suggestions how to go about this.

Again thanks for the replies - I will try some of them and reply back... Maybe until I can get to the store and try some mask I think I'm going to try the larger pillows with some white noise...

Thanks
Hi theroefam,
Yes, I know that is opposite, I was just thinking that since you had tried the larger pillows and that didn't work, you might try the smaller pillows. Sometimes things work for some people and not for others, just a thought.
Trying the larger pillows with white noise would be a better idea so you don't hear your breathing.
As far as chinstraps, I know they don't have return policies for them, you could make one out of an ace bandage and see how you do with that, it would b a lot less expensive, that's for sure.
Good luck to you.
trish6hundred
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