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No sleep with APAP after 5 days, any advice?
#1
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No sleep with APAP after 5 days, any advice?
Hey everyone. I hope you are all doing well.

I've now had the APAP machine for 5 days and I've not managed to sleep much at all (literally 5-10 mins total).

I'm hoping that you may be able to help me with this. Here is everything you to know:I'm hoping that you may be able to help me with this. Here is everything you to know:
* Home sleep study showed 25 and 42 AHI over two nights
* I bought an APAP while waiting for treatment through the NHS
* The machine is the F&P Sleep style and the mask is the dreamwear full face
* My settings are:
Ramp= off
Pressure range =7-15
Exhale relief =2/3

*I have Generalised anxiety disorder which is due to Sleep apnea and I have mild insomnia even without the APAP
I feel mostly fine wearing the mask but the sensation of pressure and how uncomfortable it is overall makes it very difficult to fall asleep. When I do finally fall asleep I wake up within a minute. I'm not certain why but I suspect it is the pressure shift and that I have a low arousal threshold due to the anxiety.
I have tried wearing the mask during the day and I have tried only letting myself sleep with the mask on but after being awake for 36 hours I had to sleep without it.
I'm not sure what I can do? Any suggestions? Are there any good supplements or medications that may help?
Thanks for all your help.
Thanks
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#2
RE: No sleep with APAP after 5 days, any advice?
Are you on any meds at all for Anxiety?

Have you tried the ramp at maybe 5cmh2o for maybe 15 min?  See if that lets you fall asleep.

This may sound dumb but have you told yourself you must wear the mask?
Since you AHI is so high you need to fight tooth and nail to wear the mask or find one that a least helps. 

You know what I mean here its like telling your mind it must calm down.  Anxiety and fear are of the unknown and bad things in life.  The things you are scared of.. You need to explain to yourself the mask and the machine are saving your life.  Explain the pressure is not a bad thing that brings on fear and anxiety.  It is like bringing the life saving oxygen to your body.

Have you tried Meditation or Yoga?  

Have tried just the nasal dreamwear mask?
Maybe it would make you not feel as anxious.  Did someone tell you you are a mouth breather?  Is that why you got a FF mask?  its my understanding most people are mouth breathers.  Only at first or only if congested.  In general the body wants to breath through the nose.

Also it a Marathon not a Sprint.  I may take months to get better.  

Hang in there Mate
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#3
RE: No sleep with APAP after 5 days, any advice?
How did you determine your pressure range?

Not sure what you mean by exhale relief "2/3". Do you mean level 2 of the 3 available?

If your pressure setting is just a guess, try this: Set SenseAwake to 6.0, Minimum pressure to 6, and Exhale relief to 1. This will reduce the number of pressure changes which may be more comfortable.

You say you have tried wearing the mask during the day. Do you mean just the mask or with the CPAP running? Wearing the mask without the CPAP is probably not going to help if you need to adapt to the feeling of pressure. When I started using a CPAP, it did take me several days before I was no longer always conscious of the pressure.
Useful links
Download OSCAR (current version is 1.2.0)
Best way to organize charts
How to attach charts to your post

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#4
RE: No sleep with APAP after 5 days, any advice?
Have you downloaded OSCAR and looked at your data? If not do so to see if it has flagged any events on the nights you have used it. I know you said you haven't really slept yet but sometimes you sleep a bit more then you think you do and if you are having apnea (which could potentially be caused by or worsened by the CPAP machine) then it could be awakening you quickly and you may not even realize you were asleep momentarily.

If no signs of apnea or issues in OSCAR data then I would minimize your pressure swings. First I would change the machine to CPAP mode at 7 cm pressure. Then while awake with the mask on and machine running I would adjust the EPR setting to see what feels most comfortable for you. The easiest way to see if EPR is comfortable for you is to set EPR at 3 and then while using the mask turn EPR setting off (so it goes from 3 to 0) then back on and do this a few times until you determine if off or 3 is your more comfortable EPR setting. From there you can try to fine tune a bit, if off was more comfortable try off to 1. If 3 was more comfortable try 2 vs 3. I am guessing you might find 1 or 2 to be the most comfortable based on your description but try them all out.

Then you just need to force yourself to use it. As mentioned start wearing it with the machine on for a few hours before sleeping (watching tv, reading a book etc), if CPAP use becomes second nature while awake it shouldn't affect your ability to fall asleep. One concept of CBTi is to tell yourself you are fine even with reduced sleep and if you can pick a weekend or something where it isn't going to have a huge impact on daily capability then just do not take the machine off and if you don't sleep you don't sleep. Eventually after a bad night or two you will get very tired and being able to sleep easily, make sure you wear the mask when this moment comes. Soon as you are able to get a chunk of data (couple hours at least, preferably a full night) then should review OSCAR to see what your results look like to know if settings are close.

Regarding drugs you could ask doctor to try something like Ambien which helps with insomnia if you feel it is necessary but I would first try without.
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#5
RE: No sleep with APAP after 5 days, any advice?
He has a SleepStyle machine which is not currently supported by OSCAR.

When he gets to the point where looking at the CPAP data in OSCAR, I can look at his data with an in-development version of OSCAR.
Useful links
Download OSCAR (current version is 1.2.0)
Best way to organize charts
How to attach charts to your post

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#6
RE: No sleep with APAP after 5 days, any advice?
(07-01-2021, 12:56 PM)factor Wrote: Are you on any meds at all for Anxiety?

Have you tried the ramp at maybe 5cmh2o for maybe 15 min?  See if that lets you fall asleep.

This may sound dumb but have you told yourself you must wear the mask?
Since you AHI is so high you need to fight tooth and nail to wear the mask or find one that a least helps. 

You know what I mean here its like telling your mind it must calm down.  Anxiety and fear are of the unknown and bad things in life.  The things you are scared of.. You need to explain to yourself the mask and the machine are saving your life.  Explain the pressure is not a bad thing that brings on fear and anxiety.  It is like bringing the life saving oxygen to your body.

Have you tried Meditation or Yoga?  

Have tried just the nasal dreamwear mask?
Maybe it would make you not feel as anxious.  Did someone tell you you are a mouth breather?  Is that why you got a FF mask?  its my understanding most people are mouth breathers.  Only at first or only if congested.  In general the body wants to breath through the nose.

Also it a Marathon not a Sprint.  I may take months to get better.  

Hang in there Mate



I'm not on any meds atm. Hoping my doctor will prescribe one that helps.

Ramp seems to be set to 20 mins but it usually takes me an hour to fall asleep ( even without the APAP ).

Yeah I get what you mean. I did try that but it didn't work. I'll keep trying though. The biggest problem is waking up straight away with it on - even more so then getting to sleep in the first place.

Yeah I do meditate - especially when I get to bed. Yoga not so much.

I'm tempted to try the nasal only as it may make enough of a difference but I often wake up with my mouth open and my nose is fairly obstructed as I have a deviated septum. It could be just habitual though but I'd likely need a chinstrap or tape across my mouth. 

Cheers mate, I'll do my best.
Thanks
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#7
RE: No sleep with APAP after 5 days, any advice?
(07-01-2021, 01:04 PM)GuyScharf Wrote: "How did you determine your pressure range?

Not sure what you mean by exhale relief "2/3". Do you mean level 2 of the 3 available?

If your pressure setting is just a guess, try this: Set SenseAwake to 6.0, Minimum pressure to 6, and Exhale relief to 1. This will reduce the number of pressure changes which may be more comfortable.

You say you have tried wearing the mask during the day. Do you mean just the mask or with the CPAP running? Wearing the mask without the CPAP is probably not going to help if you need to adapt to the feeling of pressure.  When I started using a CPAP, it did take me several days before I was no longer always conscious of the pressure."

I got advice off people on here. 

Yeah I mean 2 out of 3. 

Yeah it's just a guess, cheers I'll give that a go but what about maximum pressure?

I mean with the machine running. I could try doing it more though but the problem is really when I wake up straight away even more than getting to sleep is.

Thanks, I'll give it time.
Thanks
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#8
RE: No sleep with APAP after 5 days, any advice?
well dang

Quote:often wake up with my mouth open and my nose is fairly obstructed as I have a deviated septum.

maybe just strap that thing on and get p*ssed  Dielaughing Sorry Mate I am kidding..  
Listen to the good folks here and I know you will get there.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
Post Reply Post Reply
#9
RE: No sleep with APAP after 5 days, any advice?
(07-01-2021, 01:30 PM)Geer1 Wrote: "Have you downloaded OSCAR and looked at your data? If not do so to see if it has flagged any events on the nights you have used it. I know you said you haven't really slept yet but sometimes you sleep a bit more then you think you do and if you are having apnea (which could potentially be caused by or worsened by the CPAP machine) then it could be awakening you quickly and you may not even realize you were asleep momentarily.

If no signs of apnea or issues in OSCAR data then I would minimize your pressure swings. First I would change the machine to CPAP mode at 7 cm pressure. Then while awake with the mask on and machine running I would adjust the EPR setting to see what feels most comfortable for you. The easiest way to see if EPR is comfortable for you is to set EPR at 3 and then while using the mask turn EPR setting off (so it goes from 3 to 0) then back on and do this a few times until you determine if off or 3 is your more comfortable EPR setting. From there you can try to fine tune a bit, if off was more comfortable try off to 1. If 3 was more comfortable try 2 vs 3. I am guessing you might find 1 or 2 to be the most comfortable based on your description but try them all out.

Then you just need to force yourself to use it. As mentioned start wearing it with the machine on for a few hours before sleeping (watching tv, reading a book etc), if CPAP use becomes second nature while awake it shouldn't affect your ability to fall asleep. One concept of CBTi is to tell yourself you are fine even with reduced sleep and if you can pick a weekend or something where it isn't going to have a huge impact on daily capability then just do not take the machine off and if you don't sleep you don't sleep. Eventually after a bad night or two you will get very tired and being able to sleep easily, make sure you wear the mask when this moment comes. Soon as you are able to get a chunk of data (couple hours at least, preferably a full night) then should review OSCAR to see what your results look like to know if settings are close.

Regarding drugs you could ask doctor to try something like Ambien which helps with insomnia if you feel it is necessary but I would first try without. "


Sadly my machine doesn't support OSCAR and the sleepstyle app is pretty limited. 

Thanks I'll try doing that. 

I do use the machine during the day but I could do it more. 

Yeah I get that and I  survived off of 2-3 hours sleep a night despite having sleep apnea ( which gave me fibromyalgia and apparently my friends at one point thought I was having a stroke) but as damaging as sleep apnea is, staying up for 36 hours was about as far as I was willing to take it with the APAP and even then it was actually worse when I tried it. Lack of sleep makes my anxiety much worse so that may be why.

Yeah I'm going to ask for medication and then what you suggested may work. 
Thanks
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#10
Wink 
RE: No sleep with APAP after 5 days, any advice?
(07-01-2021, 04:23 PM)factor Wrote: "well dang


maybe just strap that thing on and get p*ssed  Dielaughing Sorry Mate I am kidding..  
Listen to the good folks here and I know you will get there."

Lol it's all good ? I need a good laugh!
Cheers mate. I'll get there,  I've been ill over 10 years so a few more months won't kill me and if it does then I won't have sleep apnea anymore!
Thanks
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