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[CPAP] Lots of issues, getting very frustrated. Help?
#1
Lots of issues, getting very frustrated. Help?
Hi! I just received my ResMed AirSense 10 Autoset a few days ago and I'm off to a miserable start. I'm looking for suggestions on what to try.

My biggest issues are being unable to fall asleep, aerophagia, and air hunger.

Feel free to skip down to the next set of bullet points, but I'll just go through them one by one. All of these are occuring while awake, laying in bed.
  • I can't fall asleep due to discomfort. Part of it is the aerophagia and air hunger, part of it is just how awful it feels to have air blowing in my nose while the mask and head gear press against my face and head. I have sensory issues. Even during the titration, I slept for less than an hour.
  • I don't have much to say regarding the aerophagia itself, except that it's painful and also increases pressure in my ears. If it's this bad when I can only tolerate C/APAP for an hour, I can't imagine how I will deal with it for 8 hours +.
  • Air hunger. I will be able to breathe through my nose for a few minutes at a time, then I will start trying to breathe more deeply, and finally I can't bear it anymore so I will gasp for air through my mouth. Rinse and repeat until I give up and turn it off.
It sounds kind of dramatic, especially since I've just begun, but holy sh*t, I'd much rather keep suffering from the OSA than deal with CPAP.

What I've tried so far, all while awake in bed:
  • Confirmed that all of the settings are correct regarding mask type and tubing. Ran a mask fit check.
  • APAP 5-13, 5.6-13, 6-13, 7-13, 5-10. EPR 3. Humidifier both on and off. I tried each range for at least 10 minutes or until I couldn't tolerate the air hunger. None of the settings helped, although a min of 6cm stopped the feeling of immediate suffocation.
  • I haven't tried EPR off or lower because it felt terrible during the titration. I also haven't tried turning on the ramp because it's hard enough to breath as is.
  • CPAP 8 (as per Rx). EPR 3, humidifier on. Did not help at all. Haven't tried other pressure settings yet because I gave up for the night. Ear pressure was definitley worse than with APAP.
  • Mask is a good fit and strapping is not tight. No leakage from it or the tubing. 
  • Also tried melatonin. Almost fell asleep, turned APAP on, suddenly wide awake.
  • Different pillow configurations. One or two pillows and different head angles. No difference.
  • Different positions - right side, left side, and even on my back which I don't like. Back was noticeably worse, otherwise no difference.
  • Flonase and antihistamines each night. Much worse without them, A/CPAP or no.
Up next:
  • Wedge pillow to elevate head, then knees if no difference.
  • CPAP set to 9, 8.6, 8.4, 7, 6.6, 6.4, and 6. If anything <8cm works out I guess I will have to turn on ramp.
  • Continue practicing while awake to build up tolerance.
Sorry for the novel. I wanted to be as clear as possible. Also, please know that I am not up for trying different machines, masks, tubing, accessories etc. at the moment as I am a very broke grad student who had to buy the machine out of pocket. Also, my sleep doctor is useless and my PCP almost killed me a few months ago so they are not going to be very helpful here.

Please help? I have to be ~compliant~ for at least 30 days to be considered for Inspire by my clinic.
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