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New to CPAP and not much is happening
#1
Gross 
New to CPAP and not much is happening
I can remember the last time I actually woke up refreshed, 21 years ago after doing yard work.  Never since.  I am always tired when I wake up and always want to hit the snooze.  I am constantly yawning.  My sleep hours are pretty constant. 8pm - 4am.  I don't eat after 6pm, I don't drink (anymore).  I kept a town in Ireland employed when I did Rolleyes .  I go to the gym 5 days a week, eat decently, and have lost a considerable amount of weight (before the sleep studies).  Even lost 20 lbs since the sleep studies.

I have done 3 sleep studies (Oct 2019, Sept 2020 [efficacy studies], and Dec 2020 [A titration study]) the last 1 1/2 yrs (thanks Covid for making this such a long process), had a tonsillectomy and Septoplasty for a severely deviated septum fixed Feb 2020.  My oxygen saturation was 80% during the 1st study and it was 83% after my surgery.  I had to wait until Sept 2020 to have the 2nd sleep study (Covid).  After my consultation of the 2nd sleep study the Dr said CPAP was the most effective therapy.  So I have been using the machine since Oct or Nov 2020.  Only after the 1st night using it I woke up ready to go.  I was still a bit tired and not totally refreshed, but not wanting to hit the snooze. The pressures then were 4 ramp to 12.  At the titration study they found that 15 stopped me from snoring.  They reprogrammed my machine to 7 ramp to 15.  I am still waking up tired everyday.  The only thing I notice is I am not as crabby, in the morning, when I use the machine. Still yawning, tired and can always take a nap at break and/or after work.

I do wake up at least once to go to the bathroom around midnight.  I have for years.  I get woken up when the mask leaks hitting me in the eye or when the mask makes a fart sound as the seal vibrates against my cheek.  I have tightened down the mask tight, but then my nose is sore where it hits in the morning.  Also, my jaw gets pushed back if I tighten it too tight. That seems to me to close my throat which seems counterproductive to a good night sleep.  The Dr. said I shouldn't have to do that because the mask has the pliable rubber to seal it to your face.  If I don't have it tight, it leaks, farts and makes all sorts of noises that wakes me up.

I have my reports from the studies that show AHI, supine index, O2 nadir, PLM index. I downloaded OSCAR and have days of info and graphs, but have no idea what I am looking at.  Any info that I can post to help the experts, I will.  Not sure what numbers help someone to give me some suggestions.

I am ready to throw this in the garbage, give up on getting a good night sleep and just say it is what it is.  I don't want to take prescriptions (pills) to get a good night sleep.  Ready to spend the money on a dental appliance to see if that helps. 

Thanks for taking the time to read this and any insight you all may give me to get a good night sleep,
Ken
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#2
RE: New to CPAP and not much is happening
Don't take this the wrong way. You are using a Philips CPAP, with a pretty wide spread of pressure. That would work with a Resmed Autoset, but if your Philips is not set so that the minimum pressure does everything, it does nothing. It is slow to respond to events, vs the Resmed which is preventive, and actually detects and reacts to flow limitations which are the root of respiratory effort related arousals, hypopnea and obstructive apnea. It has a capability for up to 3-cm of bilevel pressure the Philips can't touch.

You can post your daily details in Oscar and we can probably identify where the problems lie. Tutorials for Organizing your Oscar Charts and attaching files are in my signature links.
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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#3
RE: New to CPAP and not much is happening
Thanks for the response and the info on the CPAP machine. I don't know anything about this stuff and am trusting the sleep Dr to lead me the right way to get a good nights sleep. I will read on posting Oscar daily reports and post them here.

Thanks,
Ken
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#4
RE: New to CPAP and not much is happening
The sleep doctor set your pressure to a very wide range, and doesn't know what you need until you see him next month. We can get you there sooner if you choose. By learning to understand the data on the forum, you will become more independent and able to make good decisions when and as needed.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#5
RE: New to CPAP and not much is happening
Kinda upset with the time this has taken.  Even with Covid happening.  He was recommended by my ENT so I went with him.  Main problem with this Dr he is only at the office by me 2 days a week.  Otherwise he's an hour south of me.  Here are the last 3 days of my CPAP use.  I have been keeping a written log on my nights sleep as well the last few days.

Thanks again,
Ken


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#6
RE: New to CPAP and not much is happening
Did anyone mention sleeping position to you at any time?  How long do you spend on your side, or on your back?  If you're a back sleeper, chances are very good that you sag and your head gets forced toward your chest, meaning as your sleep deepens your chin gets forced down toward your sternum.  This closes off the windpipe some, just enough to cause hypopneas and snoring if your nose is constructed, or altered, just right.  By altered, I mean a previous accident that altered its septum.  

Do you sometimes awaken with one or both nostrils plugged?  Many people have this problem, and that will cause snoring as you struggle to breathe.

Your chart says you have some substantial leaking going on, but it doesn't look like a show-stopper. Your machine should be able to compensate.

Others will offer their opinions, so please be patient.
Contrite, and wiser.
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#7
RE: New to CPAP and not much is happening
(01-24-2021, 06:45 PM)mesenteria Wrote: Did anyone mention sleeping position to you at any time?  How long do you spend on your side, or on your back?  If you're a back sleeper, chances are very good that you sag and your head gets forced toward your chest, meaning as your sleep deepens your chin gets forced down toward your sternum.  This closes off the windpipe some, just enough to cause hypopneas and snoring if your nose is constructed, or altered, just right.  By altered, I mean a previous accident that altered its septum.  

Do you sometimes awaken with one or both nostrils plugged?  Many people have this problem, and that will cause snoring as you struggle to breathe.

Your chart says you have some substantial leaking going on, but it doesn't look like a show-stopper. Your machine should be able to compensate.

Others will offer their opinions, so please be patient.

Hi, I am a side sleeper. I do wake up and rollover to the other side throughout the night at least once.  I don't remember waking up on my back, so I'm not sure if I end up there in the night at any time.  When I sleep on my right my right nostril gets plugged, but not my left.  I couldn't breathe through my right nostril before the Septoplasty. 

The Dr said I might have to shave my beard because of the leaks.  I thought I can't be the only person with a beard that uses a CPAP and there must be a mask for those of us that have one. 

Ken
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#8
RE: New to CPAP and not much is happening
I have a large full beard, sleep mostly on my sides and wake and roll over many times a night.

at my titration they tried a bunch of masks on me and all leaked until the resmed p10 nasal pillow mask which I've used for more than 4 years now. it's light, has a small footprint and easily overcomes congestion. I don't have the kinds of physical nasal passage issues you describe but only once in 4 years has it failed to clear any congestion I've had.

the mask itself almost never leaks but apparently I have a floppy palate that lets air into my mouth, forcing my lips apart. I can't tape or master the tongue suck technique. instead, I've been completely dependent on a soft cervical collar to minimize these lip leaks (and reduce oa clusters).

to me a nasal pillow mask is a no-brainer unless you mouth breathe, in which case you have to tape, be able to maintain your tongue up against the roof of your mouth, use a chin strap (that pulls your chin up not back) or wear a soft cervical collar.

other bearded folks have had some luck with a few full face masks but I can't tell you which ones offhand. I think one is an amara.
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#9
RE: New to CPAP and not much is happening
I have a full beard, I use the P10 nasal pillows as my mask but I have an Amara View which seals well for me as a backup mask which I haven't used for 4 or 5 years.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#10
RE: New to CPAP and not much is happening
(01-24-2021, 07:49 PM)sheepless Wrote: I have a large full beard, sleep mostly on my sides and wake and roll over many times a night.

at my titration they tried a bunch of masks on me and all leaked until the resmed p10 nasal pillow mask which I've used for more than 4 years now.  it's light, has a small footprint and easily overcomes congestion. I don't have the kinds of physical nasal passage issues you describe but only once in 4 years has it failed to clear any congestion I've had.

the mask itself almost never leaks but apparently I have a floppy palate that lets air into my mouth, forcing my lips apart. I can't tape or master the tongue suck technique. instead, I've been completely dependent on a soft cervical collar to minimize these lip leaks (and reduce oa clusters).

to me a nasal pillow mask is a no-brainer unless you mouth breathe, in which case you have to tape, be able to maintain your tongue up against the roof of your mouth, use a chin strap (that pulls your chin up not back) or wear a soft cervical collar.

other bearded folks have had some luck with a few full face masks but I can't tell you which ones offhand. I think one is an amara.

I am a mouth breather, but that I believe it is because I could never get enough oxygen through my one clear nostril before the surgery.  Also, I used to get head colds often throughout the year, but I blame that on my love of Guinness, poor diet and not exercising.  The love is still there, but I quit last April..

I will look into soft cervical collar, the tongue suck technique, and nasal pillow and ask my Dr about them.  Anything to get a good night sleep.

Thanks,
Ken
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