Hello, everyone, glad to be aboard. I have gathered lots of information from this site over the last few months, and look forward to even more.
A brief intro: I am a 51yr old male, Air Force Veteran. Probably about 40 pounds overweight. The nature of my job, both prior to and since my AF retirement has me working shift work, for the last 30 years. Unfortunately I change shifts on a day to day basis, not weekly or monthly. According to my wife, I have had Sleep Apnea for the last 15 or 20 years, which has worsened considerably the last few years as I put on more extra weight. During the times I lost weight, it appeared to reflect positively on my symptoms, as they lessened in severity.
I finally became concerned enough myself to have a sleep study done June 3rd. The experience was not a pleasant one, as many here have said, and although I apparently gave the techs enough info to work with, I experience no REM sleep and not much sleep at all. I received my machine and mask the beginning of July. Tricare paid up front, not rent-to-own, along with my co-pay. No need to report back with compliance, etc. More about the equipment later. It was fairly hard to chase down my report, and I finally got my hands on it last week. It was a shocker to say the least. Now if it could only shock me into successfully using it!!
Anyhow, here are some of the numbers:
Total Sleep TIme 143 minutes (Pre-mask N1 sleep 59.4% - N2 40.6% - N3 None - REM - None)
( Wearing Mask N1 36.9% - N2 46.3% - N3 16.9% - REM - None)
AHI was 123.4 (Most apneas were OSA, about 10% were CSA)
SpO2 Nadir was 79% with 10.1 minutes <85%
CPAP was titrated to 11cm with a Total AHI of 11.6. SpO2 stayed above 90% during mask wear.
ECG Arrythmias noted with/without mask, sustained tachyrcardia, isolated PVC's.
Interestingly, Restless leg movements increased during mask wear.
AHI scores slightly lower when I slept on my side, but not significantly.
Scary stuff!!! I have not seen too many AHI's on the forum higher than mine.
Regarding my equipment, (hopefully showing up under my info) I got the PR System 60 Plus "Brick" that only records usage and is not compatible with any other software. It did come with C-flex which I like, and the heated humidifier, also cool. They have it set to 11 with a 30-minute ramp from 4. I also like that feature so far. My mask is the PR ComfortFull2
FFM and I feel like I have been able to get a pretty good fit and seal on it. I bought a hose hanger thingie which allows me to turn around in bed without major mask leakage issues.
So.....I have had it a few weeks now, and have only used it 7 or 8 times. The most I have been able to wear it so far was 3 nights ago when I wore it for 45 minutes, and then, a few minutes later, for another hour. Why such a poor job?
Because I have not been able to sleep with it on yet. And (although I know this is WRONG thinking) being a shift worker, I feel that even a few hours of poor sleep is better than none. And regarding the poor sleep, it usually does not seem that bad to me. I only wake up 3-6 times per night, have dreams, and feel at least somewhat rested in the morning. My poor wife knows otherwise though as she is privy to the numerous SA events that are hurting my body even if I am "sleeping" through them. Yes, I am also claustrophobic, and that is an issue, although, gladly, the mask is becoming less "alien" to me, and most of the claustrophobia I feel is when the machine is running full blast. At that point it feels hard to regulate my breathing with the air pouring into my mask. I am a mouth breather, with a slightly deviated septum (surgery NOT recommended) who has always felt like I don't "move" enough air through my nose, and am more comfortable augmenting it with mouth breathing. I was very worried about having panic attacks, but got over that pretty quickly.
I DO NOT want to give up on this. (Having not really started!) Knowing my apnea is bad enough that I actually probably need an EVEN HIGHER setting scares me, but so far it is hard to tolerate the 11cm.
I just want to get some sleep with the mask on. And slowly get more.
In the meantime, I am going to ramp up my attempts at losing weight, something I have a little more control over.
Thanks for listening, and glad to be here!!
WELCOME! to the forum.!
I'm sorry you are having such a rough time with CPAP therapy but I encourage you to stick with it. The mask is the most difficult part of this therapy.
Hang in there for more responses to your post.
07-28-2013, 07:04 PM
(This post was last modified: 07-28-2013, 07:11 PM by Tez62.)
artension, welcome, for some people it takes a long time to get used to for others they take to it like a duck to water so you are not alone. We have all been through it and let me say the benefits in the long term are fantastic compared to how I used to live. I can now live life. Most of us will tell you that we can now no longer sleep without our CPAP's, to me it is just another part of my body. I have named my machine 'Silvie' as I use a silver Resmed CPAP, she is fantastic, she never complains, she does her job everynight and all she askes for is a bit of water and electricity but most of all, she keeps me alive what more could I ask for?
Please ask any questions as we are here to help and support others with our illness which no one else understands what it's like, keep at it you'll get there it will just take time.
They say that another benefit of CPAP is that it helps to break the cycle of weight gain -> worsened OSA -> further weight again. Of course it takes discipline just like it does for anyone trying to lose weight, but OSA sufferers need better sleep to give us that edge to take charge of the situation.
I am not familiar with your machine, but with your situation I would demand a data capable auto machine with EPR.
This will allow the machine to help you find the proper settings for you and monitor your own progress. Anything less will be even more of an uphill battle.
My sleep study AHI was only about 85, and I to am about 40# overweight.
I understand what you are going through but the first step is accepting the diagnosis. Next educate yourself. This site is a great start. Now you have to take charge of your own health. No one cares more about than you, except maybe your wife. Trust me a nagging wife can be an asset getting through this.
Now just decide you are worth it and make it work.
(07-28-2013, 07:55 PM)bwexler Wrote: Trust me a nagging wife can be an asset getting through this.
This man speaks the truth.
I heartily agree with all the statements above. Thanks for the warm welcome and advice, everyone!!
artension, the severity of your apnea has nothing to do with the pressure. They determined that 11 is the right pressure for you, so that's the pressure it takes to keep your airway open. If you lose weight you may be able to lower your pressure, but that's an issue for another day.
All you can do at this point is make every effort to adapt to the mask. Try a different one that may be more comfortable. I suggest you try a hybrid mask.
Your assumption about some sleep being better than none is not correct. When you sleep without your machine you are doing three things to yourself. First, you are getting interrupted sleep to the extent that you never get into the deep levels of sleep needed, so the sleep you do get isn't really doing you any good. Secondly, you are wearing out your cardiovascular system and as a result increasing your chances of a heart attack or stroke.
Third, you are depriving yourself of the opportunity to acclimate yourself to the CPAP therapy. It took decades for your body to get used to sleeping with apnea, and now you need to give it a chance to acclimate to sleeping without apnea. Every time you sleep without your mask you are teaching your body to sleep with apneas. The exact opposite of what you want to teach it.
Please make a commitment to wear your mask every time you sleep.
Contact your doctor and equipment provider and explain that you are unable to sleep with this machine and mask. They will not be surprised as this is a very common problem among patients. They will be willing to do whatever it takes to get you in a state of compliance. If they won't then get a new doctor and a new equipment provider. See if you can get a new machine that's data capable. Explain that the high pressure is intolerable. There are machines that can lower the pressure when you exhale (BiPAP) and machines that will automatically lower the pressure when you are not experiencing apneas (APAP).
See archangle's machine choices here: http://www.apneaboard.com/wiki/index.php...ne_Choices
The key to success with CPAP therapy is to stay in communication with your doctor and equipment provider. Your insurance company is paying them to provide this service for you. Make them earn that money the same way you have to earn yours.
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A popular misconception is that REM sleep is the be-all and end-all of sleep. That is actually not true. It is N3 (or so-called "delta") sleep that is the deepest and most physically restorative sleep.
While this isn't a competition, I will point out that my sleep study gave an AHI over 100 with an SpO2 nadir of 80%. I was titrated to 13 cmH2O, but found that I actually needed more and bought an AutoCPAP unit to provide variable pressure. [ My 90% pressure point turns out to actually be around 17, although I often need less. ] I used to get up around 6-8 times every night to urinate. Now I occasionally get up once. My AHI readings stay below 3, and most often below 2.
If you have read other threads on this board, you'll see that you do eventually get used to the pressure. In fact, when I wake up, I often have to concentrate on whether the machine is actually working or not, and that at a pressure (from later data analysis) of 17 cmH2O. In the meantime, that ramp button is your friend. Use it. As well, feel free to set your CFlex setting to its maximum of 3. That provides exhale relief only, and does not interfere with your treatment. [ Actually, there is at least one study that says that it improves treatment. ]
As for getting used to your mask, don't just wear it at bedtime. That is eating into valuable sleep time to acclimate yourself to the treatment. Wear the mask and turn the machine on while watching TV or some other distracting activity. Learn to treat the mask as your new normal.
As others have said, getting the right mask and getting used to the mask is the hardest part. Don't feel that absolutely every leak has to be fixed. The machine can easily compensate for small leaks, just as it does for the intentional "leak" from the vent in the mask. But do make sure that you don't get a leak that blows into your eyes; the morning will be very unpleasant if your eye(s) get dried out. Don't over-tighten the mask. It should be as loose as possible while still keeping most leaks in check.
Above all, persevere. Don't give up. That arrhythmia and those PVC's? While it obviously is not certain, untreated apnea is known to cause cardiac arrhythmia.
It's good to have you join us at this board.