Getting used to it - need tips and tricks (would like to avoid Lunesta)

[shewhorn]

So... when I was first diagnosed 2011, and the CPAP prescribed, I gave it a whirl and I didn't really tolerate it all that well. My AHI was 18ish on the 2011 sleep studies. Two different doctors said (paraphrasing) "You should use the CPAP, but if you can't tolerate it, it's not the end of the world". So they didn't really push it, or say anything to convince me that it was terribly important. I thought it was really annoying to sleep with so after trying it for a while, I gave up.

Fast forward to today, In December I found myself in front of a neurologist. I brought a binder full of records in that I thought would be useful... what I didn't know I had with me was a sleep study from 2011. It was just in there by chance. THAT was what he was interested in. Not a terribly high AHI... 18ish if I remember correctly, but his mandate was to deal with that before diagnosing anything else and he made a MUCH bigger deal of it than either of the sleep doctors I saw 4-5 years ago did. He quickly figured out that I like science so he gave me the run down of what happens during an event. I'm sold. Breathing is kind of important!

So... I'm now convinced I need to give this a go. I've been at it for 43 days this time around and I'm having the same problem. I attached a screen shot from SH that says a lot... I'm waking up multiple times a night... taking the mask off in my sleep, etc. I don't have a single night where I've slept the whole night through and I'm once again wondering what's worse, the condition, or the cure? (clearly I have to make this work this time, or else my future health will be severely compromised)

One of the things he did was to prescribe a short course of Lunesta. Lunesta has a high correlation with Dementias if taken for 90 days. This is only a 30 day course BUT... I have enough cognitive issues as it is. I don't want to take any risks. The reasoning for the Lunesta (as I'm sure you all know) was "to help get your body used to sleeping with the mask".

So, with that in mind... my question is... given what my session times look like, based on people's experience, is my compliance going to get better if I just keep plowing ahead stubbornly, even though it might take longer, or is it a case of "no... you need an assist"? I'd also be interested in hearing other people's experience of what helped them to tolerate the CPAP.

Thanks all!

[shewhorn]

Oops, forgot the screen shot:

[attachment=2175]

[green wings]

I have been using CPAP regularly for about three weeks now. Before that, I spent a couple of months wrestling with it, taking the mask off at 2 am because I had a stuffy nose or sometimes for no reason that I could remember the next morning.

I feel like there are two issues here. The first is working out any comfort issues you have with the therapy. I had lots of problems initially with my nose getting stuffed up at night and finally got that to stop (for now) by taking a warm shower at bedtime and using a steroid nasal spray as needed.

Even after I got these problems worked out, I think I have benefitted from using a sleep aid. I have noticed that I am forming a positive opinion of CPAP therapy the more nights of good sleep I get with it.

My impression is that when I don't sleep well (like last night), I am tending to think "I hate this CPAP device").

I tend to be pro-sleep aid, maybe because I have fibromyalgia and have a long history of insomnia of the delayed-onset sleep type.

I think the "z drugs" are okay personally, although I have tried them all and zolpidem/Ambien is the only one that works for me.

If you don't want to take Lunesta, there are antidepressants available that work well as sleep aids. I think one of the best ones is mirtazipine/Remeron, because it works for sleep at a fraction of the therapeutic dose for depression. I have taken 7.5 mg or even 3.75 mg and had it work really well. (30 or 45 mg is a typical dose for treating depression.)

I also don't find it to be drying like some of the psych meds prescribed for sleep like hydroxyzine.

I think some of the question of whether you should avoid sleep aids while getting used to xPAP therapy depends on how bad you feel if you don't get a full night's sleep. I get an increase in chronic pain and anxiety, so that REALLY doesn't help me to form the habit of regular CPAP use.

Okay, now you've heard a strong "pro" opinion for using a sleep aid while you get used to using xPAP. I'll be interested to hear what other users have to say.

[surferdude2]

If you haven't been told to sleep on your side as opposed to your back to minimize sleep apnea events, consider it done now. That is the single most important thing you can do to make the therapy less bothersome. It will lower the required pressure quite a bit and make mask leak management easier and strap tensions more comfortable.

The attachment you posted is of no value. If you can post the detailed graphs of a typical night's session, it may give us some insight into how to help you. Upload the screenshots to some hosting site such as TinyPic or equal and link to it in your post. There are some good heads here than may be able to direct you for some help with comfort issues.

Dude

[Sleeprider]

Shrewhorn, the use pattern for your CPAP clearly shows a very sporatic pattern of use and a lot of disruption. It would be more helpful to see what is going on in some typical daily detail reports. This link shows how to format a useful screenshot of Sleepyhead data: http://www.apneaboard.com/wiki/index.php...ganization

Try to think what makes you remove the mask and break therapy. If you feel like you're struggling for air, it's because your minimum pressure is too low. If it is because of leaks and noise, your mask does not fit or does not fit your needs. Have you ever tried nasal therapy (pillows or mask)? Have you ruled out that you can use nasal therapy which is less obtrusive and more comfortable for most people?

[bikerjoe]

I've been on the hose since August 1999. I've also Beta tested over 40 interfaces for manufacturers, (probably more like 60 but my interface list is in the desktop computer). One of the tricks to learn to keep the mask on is slipping a stocking over your head after you put the mask on. As with opening your mouth while you sleep and using one of the many devices to keep your mouth closed it's only a short training period of around 2 weeks. If the mask is adjusted properly, changing your sleep position should not be a problem. Recommended sleep position is on your left side, especially if you have reflux problems.

[shewhorn]

I think some of the question of whether you should avoid sleep aids while getting used to xPAP therapy depends on how bad you feel if you don't get a full night's sleep. I get an increase in chronic pain and anxiety, so that REALLY doesn't help me to form the habit of regular CPAP use.

I don't feel any different in the morning. With my most recent sleep study there were 191 events over the course of 4.7 hours. Without the machine I typically get about 5.5 hours of sleep... with it, I'm getting more, but I'm also waking up (consciously) and having trouble getting back to sleep. I suspect the two are probably a wash at the moment.

[shewhorn]

Dude... I'll prep another screen shot.

BikerJoe and Sleeprider, nasal therapy is completely ruled out as I have asthma/allergies and usually can't breath through my nose (which also means my mouth can't be closed). I also find I need to be able to quickly get the mask off in order to cough so something like a stalking (while a great idea) would get in the way of that.

[PaytonA]

Shewhorn,

Why do you take your mask off to cough??

[shewhorn]

Shewhorn,

Why do you take your mask off to cough??

Because if I didn't my ear drums would explode! With the Airfit F10 (I think that's the model) I just unplug the hose.