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Can't adjust to the CPAP
#11
Just a quick update...

- the sound machine seems to make a big difference (in the past I never like the sound machines, and my wife is giving me the I told you so speech - she suggested it in the first week). But it is nice I'm not able to hear myself breathe through the machine as much.
- larger pillows - much better on the breathing, I feel like I can get into a more relaxed state quicker with the larger pillows. I still wake up, and feel some difficulty inhaling, but can usually get relaxed after a couple minutes (With the medium pillows I just felt I had problems overall (inhaling and exhaling) and could not really pinpoint the concern. Hopefully the nasal mask will make it that much better.
- now for the strange trial. I put two small pieces of medical tape over my mouth last night. It was a little strange but not to bad. My leak rate last night was 0. Yes 0. It was averaging between 18-24 l/hr before last night. I am thinking by doing this it may help me adjust quckier. Usually I wake up after a period of mouth breathing (waking me up or my wife waking me up). Last night was different. I woke up with a small hyper ventilating feeling. I was then able to relax some and go back to sleep. At first I used the chin strap and tape. - but the last two hours just tape. I think I prefer the tape over the chin straps

I was also able to get to the store today and got good news.
- I explained how my A10 CPAP only gave compliance data and what I really wanted was the Elite model. They didn't really believe me at first (that the data reporting was different between the two). The rep told them there was only a small difference between the two so they never carried the Elite model. They said since I was renting to own they can order an Elite and next week I can pay the difference. Then I can get the detailed data
- also picked up a WISP nasal mask to try for a week. I'm hoping for good things with the WISP.

I have my follow up with the Dr next week. Hopefully I can tell him things are improving. Otherwise we might need to try increasing the pressure (like what was suggested)

Again thanks for all the support.

Happy sleeping...

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#12
Well I've tried the WISP three days now. Don't think it's really giving me different results.

I think the sound machine has made a big difference and my leak rate has been great.

Now, what I really feel is after sleeping a couple hours is I wake up and just feel resistance during my inhale. Then today on a day I get to sleep in, I can't because after about 6.5 hours I just feel worn out with dealing with the resistance during inhale. Once I take the mask off I feel I could fall right back to sleep.

My machine is set at 6. And I have my Dr follow up next Thursday. Any suggestions if I should -
- adjust my pressure now or wait until the Dr prescribes it?
- or will my breathing eventually adjust to the lower pressure (I think ideally that would be best, I just don't know if it will do that)

Also on the WISP - I'm just borrowing this. How many days should a try before I decide or try something else?
(I was hoping it would help with the inhale issues but it doesn't seem like it has)
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#13
I would think the resistance to inhale could be caused by too low of a pressure. It's hard to say without data though, and seeing the break down of the apneas. When I try new masks I like to give that a week or so to see how I adjust. Best of luck on your journey.
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#14
MY first suggestion is to take that machine back and tell them you want a data capable machine other than compliance because this one is not working for you and your sleep is worse than it has ever been. the DME gets paid the same amount of money for the machine they gave you and for the other cpap machines.

If they refuse, leave the machine with them and find someone else that will give you a better machine (I would do this before I go to the DME that you got your machine from so if they will not cooperate, you have a back up plan in place).

Then, once you get a data capable machine, look at your data in either ResScan or SleepyHead and post it here if you need to and we can help you out with what might be going on during your sleep.

(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

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#15
Thanks for the help...

- Truetopath - thanks for the advice. I have a question. I've been trying the WISP. I was also looking at the Eson. I wasn't that impressed with the WISP. I'd just like to get your thoughts on the WISP vs Eson ( I noticed you used both in your mask type). I would just like to know if it is worth trying out the Eson for a while. Thanks

- ME50 - hopefully I'm one step ahead. The DME has agreed to order an A10 Elite model for me. It should be in this week. The place I went didn't carry the Elite model. The ResMed rep told them there were only minor differences between the CPAP and Elite model. I explained about the reporting differences. I'm not really sure if they believed me, but they were ok with me exchanging with the Elite model

Thanks again for the help.
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#16
I do like the eson as well. It is very comfortable and doesn't have to be tightened much to get a great seal. It's definitely worth giving it a try.
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#17
(03-28-2015, 04:57 PM)theroefam Wrote: I've been trying the WISP. I was also looking at the Eson. I wasn't that impressed with the WISP.

Get the Resmed Mirage FX instead. The Eson is good, but the Mirage FX has a better free flowing feel to it. I have my machine and mask dialed in so well that I don't even know I'm wearing anything. Even when I wake up and see the mask on my face it still seems like nothing is there.

I know how you feel, I spent many nights waking up feeling like I was fighting the machine. This was when I was using certain full face masks. Eventually I would just take them off in my sleep after a couple hours and have no recollection of it.

When you get your data machine you'll be able to see what happened each morning and you can play around with the pressure. Bumping it up to 7 certainly won't hurt anything.

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#18
As much trouble as you are having, I would order the auto and not the elite not sure if you have insurance or not if you do have insurance you're not going to have to pay any extra or you shouldn't and if the DME tells you that you have to then they're wrong. the billing code is the same for an elite and auto set.


(03-28-2015, 04:57 PM)theroefam Wrote: Thanks for the help...

- Truetopath - thanks for the advice. I have a question. I've been trying the WISP. I was also looking at the Eson. I wasn't that impressed with the WISP. I'd just like to get your thoughts on the WISP vs Eson ( I noticed you used both in your mask type). I would just like to know if it is worth trying out the Eson for a while. Thanks

- ME50 - hopefully I'm one step ahead. The DME has agreed to order an A10 Elite model for me. It should be in this week. The place I went didn't carry the Elite model. The ResMed rep told them there were only minor differences between the CPAP and Elite model. I explained about the reporting differences. I'm not really sure if they believed me, but they were ok with me exchanging with the Elite model

Thanks again for the help.

Post Reply Post Reply
#19
(03-28-2015, 07:58 AM)theroefam Wrote: Now, what I really feel is after sleeping a couple hours is I wake up and just feel resistance during my inhale. Then today on a day I get to sleep in, I can't because after about 6.5 hours I just feel worn out with dealing with the resistance during inhale. Once I take the mask off I feel I could fall right back to sleep.

My machine is set at 6. And I have my Dr follow up next Thursday. Any suggestions if I should -
- adjust my pressure now or wait until the Dr prescribes it?
- or will my breathing eventually adjust to the lower pressure (I think ideally that would be best, I just don't know if it will do that)

Hi theroefam,

I recommend you should not wait for your appointment before contacting your doctor or therapist.

I suggest calling the doctor/therapist and requesting an immediate increase in pressure because you are having serious difficulty inhaling with such a low pressure as 6. Raising the pressure will definitely make it much easier to inhale.

Yours is a very common problem that tragically causes some patients to quit completely (and later to die an early death from medical problems caused by untreated OSA).

Essentially, by failing to follow up with a few phone calls within the first weeks of the beginning of therapy the medical profession fails to provide adequate care to these patients.

However, if an increase in pressure causes an increase in the AHI, proceed slowly and cautiously.

It is when increasing the pressure worsens the AHI that having a fully data-capable machine is most important, to see whether most of the apneas were obstructive in type (which would be helped by raising the pressure) or central in type (higher pressure may worsen the number of central apneas we get).

In my experience, as long as unintended Leak is low and does not vary too quickly the data-capable machines do a very good job in telling the difference between obstructive apneas versus central apneas.

Take care,
--- Vaughn



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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#20
Wow thanks for all the great advice.

I understand about the Elite vs Autoset. The DME said that my prescription was for a CPAP not an Autoset (that's why I was going for the Elite). Maybe I'll discuss it with the Dr and see if they can change the prescription.

I went ahead and changed my pressure to 7. I didn't think the Dr would want to change it over the phone, especially when I have an appt on Thursday.

Anyway the results were unbelievably GREAT. I slept close to 6 hours without waking, then when I did wake I was not fighting with the machine I just felt like I was breathing normal. Then I was able to get another 1.5 hrs of sleep in. AHI - 0.9 and Leak rate 2 L/min. AHI down from about 1.5.

This is definitely the most positive I've felt since Feb 10.
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