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New to APAP - 50 days in
#1
New to APAP - 50 days in
Mainly I just wanted to say hello, and I'm glad to have found this site. The VA issued me a Philips DreamStation and I've been using it for just coming up on two months now. I had to dispense with the nasal pillow, I'm apparently a mouth breather and now I'm on a mask. That solved the dry mouth so at least that. So much to learn! I manage to keep my mask on all night but overall I feel more tired during the days than without APAP, although the one night I went without my wife told me my snoring was horrible. Odd thing is that even with the snoring, I woke more refreshed than any day with therapy. Somewhere in all this there is a solution, and I'm looking forward to finding it!

So, Hi! My name is Steve and I'm a hose-head ;-)
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#2
RE: New to APAP - 50 days in
Hang in there. It takes some time to adjust to a mask being on your face. After awhile you'll get to the point where it's second nature and will sleep better. You can post a chart from sleepyhead here and see if there's any adjustments needed for comfort. The links on how to arrange charts and post are below.
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#3
RE: New to APAP - 50 days in
(12-29-2018, 09:17 AM)Walla Walla Wrote: Hang in there. It takes some time to adjust to a mask being on your face. After awhile you'll get to the point where it's second nature and will sleep better. You can post a chart from sleepyhead here and see if there's any adjustments needed for comfort. The links on how to arrange charts and post are below.

I'd intended on hitting the WIKIs and FAQs before asking for help, but I certainly won't turn down someone looking at my chart and thank you. I haven't slept well for most of my adult life, and snoring is in the genes in my family (The men are known for bringing down the roof). I'd pretty much resigned myself to "This is the way I am" but if there's a chance I can resolve this chronic fatigue I'll take it! Anyway, here's what my nights look like:
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#4
RE: New to APAP - 50 days in
(12-29-2018, 12:25 PM)Bakagan Wrote: How is your first feelings with it?

<Laughing> Feeling angry, resentful, and hopeful. Truthfully, my pride doesn't like the idea that I have to wear this machine at night to sleep. I'm not at a point yet where I'm seeing any real benefits. I feel like I'm suffocating when I first put it on, I get tangled it in during the night, and going to the bathroom it's an additional thing to deal with, I have to actually wake up enough to take it off and put it back on. And I certainly don't feel attractive with this thing on my face. Now stepping beyond the first feelings. I'm hopeful. I've dealt with snoring and chronic fatigue for the better part of my adult life. What brought me here is talking to friends and coworkers who wear a CPAP at night and they told me what a difference it made in their lives. At around 45 days I "took a night off" and left the mask on the bedside table, and my wife knew from my snoring what I'd done. And she sleeps in another room because I snore so loud. So despite my resistance I'm choosing to believe there is an answer here somewhere to finding the right mask and the right sleeping position, and just maybe my quality of life will go up a bit.

Steve
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#5
RE: New to APAP - 50 days in
Steve, there is nothing that really stands out as a problem with your therapy at 9-13 pressure except I think there may be some flow limitation not being identified by the machine. If you can zoom in on the flow rate for a 2-minute segment we should be able to see if the inspiratory peaks are flattened or downward sloping. The Wiki on Flow Limitation shows some examples. AHI is well controlled and the only respiratory statistic that is a bit wonky is the inspiration time is longer than expiration. This is almost always an error and much more common on Philips machines. If the flow limitation is present, it explains your lack of enthusiasm for how you feel as this reflects a lot of respiratory effort to overcome an upper airway restriction. We can talk more if that is where we go.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: New to APAP - 50 days in
(12-29-2018, 12:42 PM)Steve.G Wrote: So despite my resistance I'm choosing to believe there is an answer here somewhere to finding the right mask and the right sleeping position, and just maybe my quality of life will go up a bit.

Yep, it's very likely. But you do have to give it time (and possibly try a few masks to find one that's right for you). The results after a few months of consistent use, 8 hours per night, can be pretty amazing, and they're worth all the hassles & discomfort along the way. No longer being tired all the time is the most obvious thing, but there can also be other beneficial effects resulting from the entire body getting oxygenated properly and excreting the excess carbon dioxide that had been building up. If nocturia or acid stomach or gastric reflux (in any combination) have been problems for you, I think you can expect those to diminish eventually.
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#7
RE: New to APAP - 50 days in
(12-29-2018, 01:23 PM)Sleeprider Wrote: Steve, there is nothing that really stands out as a problem with your therapy at 9-13 pressure except I think there may be some flow limitation not being identified by the machine. If you can zoom in on the flow rate for a 2-minute segment we should be able to see if the inspiratory peaks are flattened or downward sloping. The Wiki on Flow Limitation shows some examples.  AHI is well controlled and the only respiratory statistic that is a bit wonky is the inspiration time is longer than expiration. This is almost always an error and much more common on Philips machines.  If the flow limitation is present, it explains your lack of enthusiasm for how you feel as this reflects a lot of respiratory effort to overcome an upper airway restriction.  We can talk more if that is where we go.

I'm off to go read the Wiki on Flow Limitation, but in the meantime here's a zoom. I included 3 images because although things are pretty much consistent I get some pretty wild waveforms (Yep, radio electronics guy) intermittently.

You sir, btw, are my hero for the day. Thank you for sharing your experience.

Steve
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#8
RE: New to APAP - 50 days in
Bad last night. Now that I know I can see how things affect my sleep in SleepyHead I tried a positional change. I normally sleep with two pillows either on my back or on my side, to keep my head elevated so sinus drainage doesn't collect in my upper sinuses. Last night I tried sleeping instead on a foam wedge for elevation with only a single pillow to try to straiten my neck and open my airway a bit. AHI went way up, significantly more events, and very few long term stable flow rates. I won't be doing that again, but at least I've proven to myself I can make a change and see the result.
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#9
RE: New to APAP - 50 days in
It sounds like it may be positional apnea which you didn't show in the charts above. Post a chart and we can confirm. Positional apnea is typically demonstrated by clusters of events. The best fix we have seen though your pillows may have been doing the job is a soft cervical collarvfitted looselyvto keep the chin from tucking.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: New to APAP - 50 days in
(12-30-2018, 09:37 AM)bonjour Wrote: It sounds like it may be positional apnea which you didn't show in the charts above. Post a chart and we can confirm.  Positional apnea is typically demonstrated by clusters of events.  The best fix we have seen though your pillows may have been doing the job is a soft cervical collarvfitted looselyvto keep the chin from tucking.

Fred

This is what starting a night on a foam bed wedge looks like. I woke up around 2pm as usual and got rid of the wedge. I didn't see any any major difference around that time though. I'm starting to understand how there can be an entire science discipline on sleep alone. Tonight I'm going back to just the two pillows and I'll check my chart in the morning. Oddly enough I'd expect the taller than normal pillow height to cause the chin to tuck and exacerbate the problem.

Steve
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