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New CPAP user - how do I fix my messed up sleep rhythm?
#1
New CPAP user - how do I fix my messed up sleep rhythm?
Hi,
I was recently diagnosed with severe OSA based on a home test. Prior to this, I felt like I was sleeping well but was occasionally drowsy in the afternoons and attributed it to a sedentary (desk-based) job. Importantly, I was feeling sufficiently rested in the morning and did not wake up at night except occasionally to use the toilet. 

After my diagnosis, I started using a CPAP machine (ResMed Airsense 10) about three weeks ago and have had the usual mask/pressure/air leak issues that others have had. Struggling with mask adjustments, I was able to get to a point where I would sleep continuously till 4-4:30AM and be woken up by increased air pressure/air leaks. This happened for 4-5 nights. I had started with the ResMed Airfit F30 mask and after a week of disturbed sleep due to these air leaks, decided to switch to the F20 full face mask. This mask worked a little better but when I experienced air leaks with this one, I tried tightening the straps. I was able to extend my use to about 6.5-7 hours for a couple of nights but it left pressure marks/sores on my nose. Frustrated with my experience, I decided to stop using the CPAP machine about a week ago. 

To my surprise, I could not sleep continuously and was wide awake around 4-5AM but feeling sleep deprived. I would keep lying down (on my back, side, then other side) and possibly doze off intermittently until 7AM and feel like I did not get a full night's rest when I eventually got out of bed. Taking melatonin for a couple of nights improved my experience, but not appreciably. Not wanting to build a dependency on melatonin anyway, the following night, I tried taking a glass of warm milk instead. That didn't help much either. After a week of not using the CPAP machine, last night I used it again and although I was not wide awake early morning as I previously had been, the sleep was not very restful (I was aware of my turns and had to adjust my mask for a small air leak once) and I woke up around 6AM feeling very tired.

So now, I can't get back to the restful sleep experience I have enjoyed most of my life, with or without the CPAP machine. Has anyone experienced this? If so, how did you resolve it?

I will add that for the last 2 nights, I used the Wellue O2 ring to test my O2 levels - one night with and one night without the CPAP machine. My O2 score was 5.8 without CPAP and 9.8 with CPAP - so the data does show good improvement with CPAP, but my sleep experience has become very crappy. 

Thank you for reading - any tips, tricks, or advice would be highly appreciated!

Thanks,
Sleepless in Seattle
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#2
RE: New CPAP user - how do I fix my messed up sleep rhythm?
Welcome to Apnea Board,

I'd suggest getting this, the free OSCAR program. This program is used in conjunction with a dedicated to your PAP SD card that is used to store data from the PAP. It is far more detailed and useful than the MyAir app BTW.

OK just in case you need the specs of an SD card that's suitable, it can be SD or SDHC, capacity of 2-32GB, any brand, these can be found on Amazon, Best Buy, WalMart, Staples, or your digital camera stores like B&H Photo. You must have the SD in the PAP before sleeping to capture the data. You use the machine overnight with the SD in it and then you can eject the SD and insert it into your PC and upload to OSCAR. From there you can do the New Attachment Choose File, etc. It seems like a lot of work, but isn't good sleep worth the effort?

The reason we need to see the data? We can suggest pressure edits by what we see and by what you tell us are issues on your sleep. The data will point things out that just cannot be picked up by your telling us, but this doesn't do away with your symptom description. If you've had a sleep study, I suggest getting the detailed report on it. You should then attach the files here as well in a post. We can help decipher what the report found. If you spend enough time on this forum, you'll quickly find out most docs that script the PAP, do not know the right setting for you specifically. Scripting 4-20 machine defaults for you as an example is not specific to you.
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.
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#3
RE: New CPAP user - how do I fix my messed up sleep rhythm?
Thanks for your response, Dave! 

An SD card is on my to-do list but I would need an SD card reader as well for my PC as well. If I understand you correctly, you are implying that this is a machine setting issue? I'm just floored by the fact that a PAP machine could knock my prior sleep rhythm out of whack with 2 weeks of partial use.
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#4
RE: New CPAP user - how do I fix my messed up sleep rhythm?
It would be my educated guess that yes it is most likely a setting issue. Almost every board member has some issue that sounds like what you're saying, when they first started PAP therapy that is. It's a setting optimization thing. I don't know if you'd done a titration, but I'm basically saying you can do your own titration. US has HIPAA laws regarding your test results that states you're "permitted" copies upon request. I say do that twofold reasoning, you can post this here and you need it in your personal health folder. Docs office may close permanently or record not found thing. But you can whip out your copy and voila the data is there.

Short answer is yes settings may very well be the cause.

BTW card readers can be found on Amazon for about $7 or so. And if your mask issue is part of your issue, look up Fisher & Paykel medical to take a look at their masks. I've got the full face Vitera and Simplus. Wow much better IMO than the ResMed F20 that was my go-to. And I think your Wellvu can upload data to OSCAR too.
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.
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#5
RE: New CPAP user - how do I fix my messed up sleep rhythm?
Welcome to Apnea Board!    
I am a fairly new member.
I was started out with an F20 Air Fit size medium mask.    I had a short experience with a sore on the bridge on my nose.    This isn't good, since we use our machines every night.
I changed to an  F20 Airtouch size medium mask.    It has foam touching the  face.    It is my  "favorite mask"   for past  three  years.      I am not happy with it  but so far it has been the best that I have tried.     I have a small collection of masks that I was unable to use so far.     The Air Touch cushion  is expected to need replacement every 30 days.   ! !       ( I read  that other  CPAP users  are using their  various masks for several months   or longer.)
When I tried the   F and P Simplus    full face mask,    it directed  the exhaled air into my eyes.    I tried to improvise a small plastic piece to direct the vent in another direction but haven't been successful yet.      Someone on this forum may have a suggestion for that.     Simplus full face mask is mentioned frequently on the forum--it works well for many people.   
Sometimes a different size headgear works better.     For example,  a size small headgear may work  better with  a  medium size mask.    
Masks/mask fit/leaks are a  common problem, it takes some trial and error.
When I get to sleep,    some of the annoyances are less bothersome.      It is easy to get frustrated/ discouraged  when tired.
I have ordered a different kind of mask to try, and in the meantime will continue with what I have.    
Best wishes for good sleep!     These folks here are very helpful,   and there is much information on this website.
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