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Questions from a new user - sore eyes and sleeping pills
#1
Hello Apnea Board,

I have been struggling to get used to CPAP for almost 3 months now. I went through 7 different "interfaces", as my provider calls them, and am still having difficulty sleeping - both falling asleep and staying asleep.

I never had issues with sleep before. The sleep apnea was diagnosed after I was asked some screening questions by the respirologist I see for my asthma. I did not have typical symptoms, such as falling asleep during the day, but I did have low energy levels in the morning, so he thought I should have a study. I was recovering from a bad bout of asthma and had been on steriods for several weeks, causing a weight gain of about 30 pounds. My husband had complained that I was snoring.

By week 4 with the CPAP, I was having difficulty making it through the day at work. I was so very tired - the treatment seemed worse than the condition being treated!

It took me a couple of weeks to see my sleep doctor. In the meantime I was visiting my provider every week. Eventually my machine was exchanged from a very basic model that just indicated how long I wore the mask to one that provided more detailed downloads. The new machine showed that I was having about 25-30 AHI even with the CPAP on, down from 51 during my sleep study but having apnea with the mask on was an awful experience.

When I finally got in to see the sleep doctor, I was hysterical! I had had almost no sleep for weeks and needed to reduce my hours of work to cope with the increased fatigue. It turned out that the titration study had indicated a range between 5-6 for the pressure setting and the prescription had just said 5. The pressure was increased and the next download showed improvement in my AHI (averaging 4.4).

The problem by then was that after so many weeks of difficulty sleeping, I had developed insomnia. I am doing everything that I have been taught about "sleep hygiene", regular routines, exercise, avoiding caffeine etc...

Nothing helped, so eventually the doctor gave me some sleeping pills, but only a few and warned me they were habit forming. Honestly, the only time I can get any sleep is when I use the pills (zopiclone).

I know that my health will improve if I keep using the CPAP, so I am continuing with it, but if I don't take a sleeping pill, I lay there all night struggling to try to fall asleep.

Have others on the site had issues with trying to sleep?

Another issue is that I have really sore, runny eyes. I read somewhere that conjunctivitis was a possible side effect of CPAP. It is hard to keep the mask away from my eyes and whenever the mask leaks, that seems to be where the leak is, even with a very small nasal mask.

Any ideas or solutions?

Thanks,







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#2
Of course many of us have difficulty sleeping. I understadn what you mean about the treatment being worse than the condition. Just keep with it and it'll get better. You are doing all the right things. There are sleeping pills that aren't habit forming, like Ambien and Lunesta.

The mask leaking into your eyes is something that needs attention. Have you tried a nasal pillows mask?

Keep seeing your doctor for the sleeping pills and your provider for the mask.

Remember that without CPAP therapy you are damaging your body.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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
Hi Suzanne, welcome to apnea board
the clinical manual is available via Email (scroll down to section three)
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Icon info video and masks fitting instructions videos
http://vimeo.com/20560260

its essential to find a mask works well and feel comfortable so you can keep all night every night

at your pressure leak should not be a problem
leak to the eyes is a no no ... not to be tolerated at all

large leak can affect the accuracy of AHI value
I've found masks with forehead dial works better for me as it can be turned one way or another to stop leaks to the eyes
when had leaks goes to my eyes used to cover eyes with a folded cotton hanky ... suppose one can use sleep eye mask/cover



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#4
Hi Suzanne, WELCOME! to the forum.!
I'm sorry you are having such a rough time with CPAP therapy. It can take LOTS of TIME and PATIENCE, so I encourage you to stick with it.
The mask is a big part of this and sometimes, it takes MANY different ones 'till you get just the right one for you so just keep trying.
Best of luck to you and don't give up.
trish6hundred
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#5
Well Suzanne, we all can understand your trials and efforts as a new CPAP'r. Yes, we all have issues with sleeping. Some are easily overcome while others nag us for years. The mask issues are usually the hardest to find a solution for. The leaking has got to be contained or it will not allow for the proper pressure, if the leaks are too large. The leaks will also constantly interrupt your sleeping. Much experimentation is sometimes necessary which includes different masks, strap tensions. Your mask (fx) is a good one but only if its 'right' for you.
Sleeping pills, are used by many, whether or not we are CPAP users. They (sleeping pills) are a very good, efficient and necessary drug if used properly. I don;t think that Zopiclone is widely used here in the US (however, I'm no doctor). Most popular, I think is Lunesta and Ambian here on the US market. I know that I took Ambian for a short period. They helped me through some tough times.
Conjunctivitus is normally a viral or infection result. I can't see any connection to CPAP useage. Dry eyes can certainly be caused by leaking masks.
It is of my opinion that another small increase (1/2 or1) in your pressure may be all that you need along with control of the mask issues toward a more healthy and restfull life. I wish you well.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
Reply
#6
Thanks, Sleepster.

Ambien is another name for the sleeping pill that I am taking zopiclone is the generic name. I am not sure why the stern warning from my sleep doctor. I can sleep with the mask on if I take something to help me sleep, so that has to be better for me in the long run.

The doctor says that if I am not feeling better by my next appointment in January, there will be a prescription for stimulants to help me menage during the day. I hate that idea!

I have tried several nasal pillows. The one I like the best is the Aloha, but I seem to bump it out of place whenever I turn over in the night. The last time I tried it an then went to my provider for a download the leak level was 39%. My mask has a leak level of 21%, so the doctor has asked me to stick with it for now.

This mask is size small. The standard sized one was worse. I have tried every interface stocked by my supplier.

I am really liking this site. The professionals don't seem to provide much in the way of support or information.

Thanks!
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#7
I second Sleepster's statement about the leaking at the eyes. Have you tried nasal pillows? I went through a LOT of nasal masks and each one had the same issue - leaking at the top of my nose so the air blew right into my eyes. I tried nasal pillows and fell in love. Since I do not snore with my mouth open or breathe with my mouth open at night, nasal pillows work for me.

Interface? What are you, a computer? Tell him they're called masks. It's a tough word to say for some people, I guess. LOL

I have insomnia but have all of my life. I tried sleeping pills briefly a very long time ago but hated them. Luckily, I now have a non-existent schedule and go to bed when I need to.

Keep working on the sleepy hygiene bits. It really does matter. Go to bed earlier than you need to, to give yourself time. If you don't fall asleep within half an hour or so, get up. Do something that makes you sleepy like read or watch presidential debates. Then try again. Repeat if necessary. Get up at the same time each day, even days off, no matter what time you fell asleep, until you get your internal clock reset. If it wasn't broken before, it is "easy" to fix again.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#8
Hi Suzanne, welcome to apnea board
I didn't have to much trouble geting use to CPAP however I did have a lot of trouble with leaks I guess it took me a few months my DME told me I may have to try a different mask my leaks were 28 to 50 a lot of nights ,I was pulling it off and weaking up a lot, one night I
moved the head piece up and that fixed my leaks and the mask felt fine so you never know when you may adjust it to were it stops leaking so bad, but stay with it, you may have to try even more different mask, I have been taking Ambien and or zopiclone for about 10 years and without them I would not sleep and at times have trouble going to sleep even after taking one.I hope you get your leaks fixed and you get the CPAP working for you.
Sleep-well
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#9
Suzanne, the most often prescribed stimulants are Provigil and Nuvigil. They are actually wakefullness agents. Nuvigil is the long acting version. I took them for years until finally I just didn't need them anymore. They can give you your life back. If you are prescribed one of these start wih 1/2 or 1/4 the dose the doctor prescribed until you see how you react to the med. They are not like dexidrine or "speed".
I take Lunesta every night right now- I go through phases of insomnia. With that AHI it's no wonder you felt bad, you were essentially not receiving effective therapy. A stimlulant is not for the rest of your life, but only until your treatment is on track.
Good luck,
Mary
Also, about your eyes -you can take a piece of Macks Silicone earplugs, roll into the size of a pencil and place on the mask where it leaks into your eyes. Be careful that they don't get worse. Maybe some eydrops or gel may help protect them during the night.. Congratulations on the improved
AHI
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