Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Headache, Brain Fog, Dizziness, Nausea after APAP Use
#11
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
Thanks again for the advice and for everyone's generosity and willingness to help me figure this out.

Yes, I'm well aware of the threat of noncompliance with their taking the machine away: it adds boatloads of anxiety to the whole process and I wish it was done differently, but that's a discussion for a different forum.  At this point I'm considering using some HCSA funds to outright purchase the machine from my DME, depending on how much of a remaining balance is left. Not having the stress of compliance hanging over my head while trying to figure things out, and being able to take a break and recover from the sleep deprivation, would be a tremendous help in all this.

I try to use the machine for a few hours during the day while working or taking a short nap, as many days as practical, to count towards my compliance and figure out fit issues, etc... and usually put it on a half-hour to hour before turning off the lights, so as to at least reach the minimum 4 hours even if I decide to not use the machine that night.

OpalRose-- I didn't see your suggestion about lowering max pressure until this morning. I wish I had seen it yesterday!

OSCAR graphs are attached from ~4 hours last nigh when I tried to use the CPAP. I also attached a zoomed-in screenshot of one of the pressure jumps. It seems that, besides mask discomfort and leaks, the pressure jumps happening in response to snoring as I start to drift off are what might be keeping me awake. Would lowering the max pressure, as OpalRose suggests, help with that? Should I increase the minimum pressure?

Notes: 

I think I was mostly awake during the entire time shown on the graph. I don't really have any memory of falling asleep w/ the CPAP on last night, just being woken up several times while drifting off or starting to snore. Being awake for one of the pressure jumps while I started to snore was interesting/fun. From the start until ~0:28 I was my adjusting the F30i mask to prevent leaks, etc...  I ended up having the mask pretty tight last night, as on previous nights having it sealed, but loose, led too too many leaks / blowouts during pressure increases.  At ~1:15 there was a sharp pain in my right nostril that the mask seemed to be causing, in addition to a small leak into my eye, so I took the mask off, used the bathroom, fed the woodstove, and switched to a Resmed F20. It's not the most comfortable mask for me and I wasn't falling asleep so at 3:10 I took it off.  The large leaks thereafter are the machine still being on with the mask sitting on my bedside table-- for some reason the auto-stop feature wasn't shutting the machine off.

Mask issues:

I really want the F30i mask to work, as it's the most comfortable mask I've worn, but it's just too leaky around my mouth: any movement of my jaw or cheek muscles causes a leak. The mask also forces my mouth to be more open than it normally would be. I'm running the wide / biggest cushion, as all the smaller ones don't cover my mouth and/or pinch my nose.

I had picked up a Resmed N30i mask kit yesterday from my sleep medicine practice / DME (pricey mask!) but the tech on hand insisted that a wide cushion for it didn't exist (one does) and wouldn't check their stockroom for one-- this sort of thing is typical of the sleep medicine practice that prescribed me the machine, unfortunately. None of the cushions in the kit fit my nose so I'm waiting for the wide cushion to come in the mail.

In any case I'm still waiting for the O2 monitor, though after last night I'm wondering if the headaches, fatigue, etc... after using the CPAP are more due to sleep deprivation than anything else. It will be fun to see what my SO2 is doing.

Thanks again in advance for any/all advice!

Geosyncline


Attached Files Thumbnail(s)
           
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
The reason your pressure is rising is to manage your snoring, flow limits and prevent apneas. You don't seem to be getting anywhere close to the max pressure, though. So limiting the machine might not be the way to go just yet. I mean, yes, it might mean you don't wake up, but then it might also mean that you don't manage your apnea, either.

It sounds that you aren't fitting your mask at full therapeutic pressure levels if that causes it to leak. Have you read the mask primer in the wiki? http://www.apneaboard.com/wiki/index.php/Mask_Primer If not, I'd recommend it, it explains how to properly fit your mask and that also means fitting it at full pressure and while in your sleep position. Actually overtightening can end up causing more leaks.

The problem with mouth movements is one I struggled with. Honestly, stopping my jaw from dropping was how I minimised that issue. For me, that was a soft collar, but there are other options like chinstraps etc. If it's forcing your mouth more open, I'm wondering if you have it too tight and it's pulling your chin back.
Post Reply Post Reply
#13
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
If you wanted to try lowering the max, try 15 or so. You can look at the OSCAR summary to find what Max pressure you have been at so you don't go too low.

If you consider lowering min, maybe 7 might be OK. But less than 7 means you have to drop down EPR 3 also.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#14
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
I'm curious: do folks get uninterrupted sleep with xPAPs? Because if my ~40 nights, so far, of attempting to use one are any indication of what it will be like going forward, the sleep deprivation from using it is having a much higher adverse affect on my health than my mild apnea...
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
Yes. It's definitely possible.

Not the last couple of days because I've moved on to a different type of therapy and I'm still getting it dialled in. But I would regularly have to wake myself up after 10 hours to restart my pulse oximeter so I could sleep more!

Part of the issue is that it takes a certain amount of making yourself get used to it before you can do that. And because you're not able to do that right now, even during the day, you're not adjusting to having it on for any length of time. Hopefully but getting your settings more dialled in, and if you start to use it more regularly, with a well-fitting mask, you'll find that it doesn't wake you.

Sometimes you just have to push and I know it's hard - my dysautonomia makes EVERYTHING hard (I mean, for real, I can't even sit upright without passing out or throwing up after a few minutes). And being exhausted from trying to get CPAP to work for you doesn't help either, especially when you're not seeing any benefits. I know, I do. I cried so much that first few days and weeks - from feeling that I would never get used to the mask, that it didn't fit, and the farting noises, and waking me up with every tiny leak that didn't even register on OSCAR, and the soreness, the pressure sore on the bridge of my nose? MISERY. But you know what?

It got better. Right before I changed? I would regularly have to nudge my mask to make sure the machine was still blowing, and that was with a pressure of 15 constantly (or for a while 15-20).
Post Reply Post Reply
#16
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
It's possible to sleep 6-8 hours straight, if that's what your pattern was already. Me, I might go a whole night in one session, but other times I'd wake 1, 2 times.

Without PAP at my worst was a series of 2 hour naps.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#17
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
Thanks again, everyone, for the advice and sharing your experience.

To meet compliance I've been using the CPAP for a few hours each day while at work. I still have an appointment with a sleep dentist to look at getting an oral appliance, but it's unclear if my insurance will still cover it if I go back into compliance with the CPAP.  I would love to have it as a backup option and/or see if it works better or just as well for me.

In any case, I finally got my O2 meter in the mail!  OSCAR graphs are attached from ~4 hours trying to use the CPAP and the remainder of the night/morning without.  The CPAP is clearly making a difference in stabilizing my SpO2 when I "sleep" and I don't go below 90 at all with it on, even though I am still having several SpO2 drops while using it.  Nothing compared to when I'm not using the CPAP though!

I still feel like I'm still mostly awake with the CPAP on.  I've settled on the Resmed N30i mask for now as it's the most comfortable and least leaky for me... only had one OA (zoomed in graph attached).  I'm still having some pressure jumps that seem to be loosely correlating with flow limits.

Advice for fine tuning? It seems like the next step would be taking care of those flow limitations (also zoomed in on that part).  

I'm obviously still getting use to the CPAP and a lot of the lack of sleep is likely heightened cortisol and sensory input from having the thing on. The O2 meter didn't help: the rubber / silicone of the wrist strap and ring is very "grabby" and kept snagging on my sheets every time I moved, which consequently kept waking me from drifting off. I did notice last night after using it that my sides were sore / my torso felt like an inflated balloon and I felt almost caffeinated after using it. I don't know what that's about but it definitely interfered with sleep.

Thanks again,
Geosyncline

Graph of the whole night, with and without CPAP to show how it affects SpO2


Attached Files Thumbnail(s)
               
Noncompliant since 10/2021 and trying to change that.
Post Reply Post Reply






Donate to Apnea Board  
#18
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
Maybe put a sock or mitten over the oximeter?
Post Reply Post Reply
#19
RE: Headache, Brain Fog, Dizziness, Nausea after APAP Use
I mean it looks like your pressure levels are good. Normally it'd be to add in EPR or increase it for flow limits, but you've done that already. You don't need to worry about the pressure jumps - that's the whole point of APAP - it gives you extra pressure where you need it, and less when you don't. It looks like the one obstructive apnea happened pretty much at minimum pressure. You could try increasing the minimum a little more, but if it's only one event a night, It's not a huge deal.

Honestly, right now I'd concentrate on learning to sleep with the equipment on. These setting seem to be good, and you're not going to get a good idea of how you're feeling until you can sleep through better. That will come with time. And yes, if the rubber strap is bothering you, cover it with something perhaps,either a cloth wristband or something like that to stop it gripping the sheets. I sleep with my hands out but I've never noticed it clinging onto the duvet cover.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  new APAP user.. Resvent 8000 ibreeze pjhiett 6 117 01-17-2022, 02:02 PM
Last Post: Jeff8356
Wink newbie apap user sb0623 8 165 01-12-2022, 11:55 AM
Last Post: Ratchick
  Replacing PR system one apap 560p Apnea_GM 6 160 01-06-2022, 03:42 PM
Last Post: SideSleeper
  [Treatment] Newly diagnosed and using APAP cummings66 11 289 12-24-2021, 08:11 AM
Last Post: cummings66
  Brain Fog - seeking guidance in optimizing my therapy deocder 33 1,856 12-24-2021, 07:46 AM
Last Post: eriks
  Switched from APAP to BIPAP AmirKas 320 9,516 12-16-2021, 08:22 PM
Last Post: Geer1
  [Pressure] Help with dad's APAP to BPAP transition electric.sheep 6 234 12-08-2021, 04:33 PM
Last Post: electric.sheep


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.