Just for the sake of curiosity, I have partial diaphragm paralysis (I am normal body weight and build, bordering on athletic), due to a combination of traumatic nerve damage and degenerative autoimmune disease damaging peripheral nerve tissue. However, this condition was not recognised by many sleep specialists - even to the point I was told I had Munchausens disorder (!!) and told reproachfully to go home and “have a cup of tea and settle down”.
Despite this, I didn’t give up and eventually a very smart sleep specialist saw I was very unwell and prescribed non invasive ventilation device which instantly made me feel like I wasn’t about to pass away each night from suffocation.
I have ipap max of 35, which is perfect (sometimes I top out, but not often - when this happens, I up the ipap max for a while and then take it down again…my machine max setting is 40cm H2O), however the bilevel nature of the volume delivery (680ml) on a timed rate once I fall asleep (12 breaths per min) took me a couple of months to really settle in to.
For the last 8 years or so I feel as if I’ve been given an extended ticket to life, because I have a machine that takes over the job of breathing for me while I go ahead and get some sleep.
Mask fit is essential, though, and I mostly use good fitting, super clean (cleanliness affects adherence of silicone seals) pillows as a stomach sleeper (vent patients get better inflation face down, which translates into better blood oxygen/CO2 transfer), combined with a homemade custom chin and mouth strap (reducing cheek inflation and eliminating most if not all bypass mouth leak) and mouth guard to protect my teeth from clenching. Pillows and chin/mouth strap are easier for me at high pressure as otherwise I have lots of cheek inflation leading to full face mask dislodgement and resultant high leak.
I only use ffm’s when I am in hospital and require supplemental oxygen (which can be integrated into my machine).
I use the bed head to strategically position the tube (heated and wrapped for insulation and quietness on the bed head) so it doesn’t drag from the side of the bed, instead it drapes from above me, so I can turn my face side to side without my mask pulling off.
And I use a bacterial filter in between the end of the tube and my mask tube to remove any impurities (I also have bronchiectasis), so the air feels gentle, pure and fresh.
Without this intervention, I pretty much wouldn’t be around today, so becoming compliant on my machine was a must…having and keeping a positive attitude regarding therapy allows your body time to accept it, and then you start to sleep without being disturbed by the equipment. I only wake up if the pressure is maxed out for prolonged periods now, and all I need to do is touch the ramp button which I have set for 5 mins, and I go straight back to sleep.
In Australia, these machines cost upwards of $10,000AUD, however I have saved up and bought two, with backup battery modules for both, so I am confident that I’ll be safe and sound through the night. Nothing is worth more than your health, and a good night sleep means everything