Greetings From India - Is it Sleep Apnea or GERD or Anxiety ?

[EastWeekender]

I have been using Resmed Airsense 10 since past 6 days and I do sleep for 6-7 hours easily but every day after waking up, I am extremely tired and sleepy.

What do you think can be the reason ?

[SarcasticDave94]

We'll need some recent OSCAR charts to assist.

[EastWeekender]

Hi everyone,

I have recently been diagnosed with sleep apnea and my AHI is 14 but I don't suffer from any symptoms like daytime fatigue or headaches etc.

I used the ResMed Air sense CPAP machine for a week and now I am using ResMed Air Start CPAP machine and I am just not able to sleep properly.

I am using a nasal mask currently and I even tried a full mask, and it doesn't work. I am more comfortable with a nasal mask.

But I am waking up briefly multiple times in the night and just not getting any interrupted sleep. I get uninterrupted sleep when I sleep without a mask.

Infact, I sleep at around 12.30 am and wake up at 5.00 am with my nose blocked so I remove my CPAP mask then sleep again.

Is this a good practice?  Sleeping for half a night with the mask and then sleeping for the remaining part with no mask ?

Any thoughts or comments will be appreciated.

[Sleepster]

Hi everyone,

Hello, and welcome to ApneaBoard.

I have recently been diagnosed with sleep apnea and my AHI is 14 but I don't suffer from any symptoms like daytime fatigue or headaches etc.

But you are living with an increased chance of cardiovascular disease, stroke, and premature death. Plus, even though you don't feel tired it's still possible for you to feel less tired. In other words, better. It's possible that with proper CPAP therapy you will feel much better and look back at this time of your life and tell yourself that you haven't felt this good in years.

I used the ResMed Air sense CPAP machine for a week and now I am using ResMed Air Start CPAP machine and I am just not able to sleep properly.

ResMed makes, in my opinion, the best CPAP machines. I don't know what a ResMed Air Start CPAP machine is. Do you mean perhaps a ResMed AirCurve machine?

I am using a nasal mask currently and I even tried a full mask, and it doesn't work. I am more comfortable with a nasal mask.

Feeling comfortable is important, but it's not a measure of how well the CPAP therapy is working. For that you need the free OSCAR software so you can look at the data and determine what is working and what is not. (Also, please fill out your profile so we know the details of your therapy, we need that information to advise you properly).

But I am waking up briefly multiple times in the night and just not getting any interrupted sleep. I get uninterrupted sleep when I sleep without a mask.

That uninterrupted sleep is an illusion. It just means you have no memory of waking up. But 14 times per hour, on average, you are waking up to breathe. If you weren't, you'd be dead from suffocation.

In fact, I sleep at around 12.30 am and wake up at 5.00 am with my nose blocked so I remove my CPAP mask then sleep again.

Is this a good practice?  Sleeping for half a night with the mask and then sleeping for the remaining part with no mask ?

No, this is a very bad practice. You need to adapt to the CPAP therapy, which means you use it whenever you are sleeping, even for a nap. If you keep sleeping without it your body will never adapt to it and you will be stuck where you are now forever. It will be rough at first because the hose and the air pressure are new to you and you will get less sleep for awhile. But it will soon pay off with some awesome benefits.

If your nasal passages are blocked, CPAP pressure helps, not hinders, the passage of air through your nose. Try using the NeilMed Sinus Rinse Kit, available at any drug store. You should also visit your doctor with this complaint of blocked nasal passages. The doctor may prescribe oral antihistamines, an antihistamine nasal spray such as Asteline, or a steroid nasal spray such as Flonase. But the sinus rinse kit is a good practice regardless of what the doctor prescribes. You could also use a saline nasal spray.

[EastWeekender]

I sincerely appreciate your detailed response.

[katbrat]

Hi EastWeekender, I get it! I go through periods where wearing the mask...and the mouth tape...and the cervical collar...and making myself sleep on my side...and using a special pillow...are more difficult than others. Occasionally I allow myself to remove all that stuff after some hours with it on and to roll over onto my back, and it feels like a huge relief! But I also know that I have no conscious memory of having the number of apneas I tested with (58 an hour) and I'd bet money when my equipment is off, even though I think I'm sleeping well, I'm not, I'm sleeping like I did for the test and for who knows how long before that. So, although I'll admit, I do it very occasionally, I don't allow myself to do it often because I know the realities of it. Also, I've used the machine long enough now that when I do take the equipment off, I can tell the difference and I really don't feel as well the next day. So, when I'm feeling uncomfortable and thinking I'd sleep so much better without all the things, I usually just I try to focus on something else and relax as much as possible, knowing that in the long run I do feel better for it, and I just try to get through the night without removing the equipment. I believe it can take some people a very long time to adjust to cpap therapy and it can happen slowly over time.

One side of my nose used to block up when side-sleeping until I started using Extra Strength plus Eucalyptus Simply Saline Nasal Mist twice a day. Now, as long as I use that regularly, I don't block up. I use it early in the morning and again mid to late afternoon. I can't use it too late in the day or my nose will run while I'm sleeping and you definitely don't want that to happen. I don't know if you'd have access to Simply Saline or not. But if not I encourage you to try other things like what Sleepster suggested, and to NOT give up!

[lonigan]

It just takes time and some experimentation with masks and settings to find a combination that works for you. There are many kind folks here on this forum willing to help you dial in your settings.

I think the kick in the pants for me was finally looking at the oscar charts and seeing a 5 minute cluster of central apneas where my breathing had stopped for periods between 37 and 46 seconds during each apnea. At my age i don't think I could voluntarily hold my breath for that long that many times in the same time period.

good luck weekender!!

[EastWeekender]

Hello,

I am 44 years old, non smoker and non drinker and no underlying health issues like diabetes or blood pressure etc.

I am overweight by 8 kgs and my BMI is 27.

I have been diagnosed with positional sleep apnea and my AHI when I sleep on the left side is 2.5 but very high when I sleep on the right side or in supine position.

Overall my AHI is 14.

My main symptom was that I used to wake in the middle of the night gasping for breath, in total panic and trying to wake my wife.

I am using a CPAP machine with a nasal mask but last night even with a CPAP machine on, I woke up gasping for breath and I was violently trying to wake my wife up. 

I then went to bed with my CPAP mask on but in the morning I woke up with no mask. I believe I removed it in my sleep.

Any thoughts .. why this might me happening.  How did I wake up gasping for breath even with my CPAP mask on ? Is this normal ?

Not sure what to do tonight.

Thanks,
East

[staceyburke]

To give you any help, we need DATA.  The program we use to get the data is OSCAR, it is totally free to download and use.  You need a SD card (32gb or less) in the machine when you sleep.  Then post with what you want to know and post the charts from OSCAR.

From what you told us I would suspect a couple of things.  First your min may be set to low.  Many people come here with a min of 4 and that is not enough pressure for an adult.  If your mask has a good fit all the air you are getting is through the mask.  Min 4 is for a child not an adult.  adults would be between 7 an 9 to get enough air.

The second thing you mentioned is sleep position.  It SOUNDS like you are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

AGAIN THIS IS ONLY A GUESS WE NEED DATA FROM OSCAR.

[DaveSkvn]

Hi East,

I wasn't aware of this until I read this board but positional apnea (which I also appear to have but just on my back) does not appear to respond well to pressure therapy.

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

It certainly matches my experience. I recently ramped up the pressure to the level air is starting to be pumped into the stomach (areophagia) and was happily having clusters of apneas until I rolled off my back.

A soft foam surgical collar is suggested - to try and keep the throat in broadly the right shape.

I bought one off ebay about a week ago for less than $10 (equivalent) and tried it last night for the first time. The difference in my Oscar graphs was stunning. In my view its definitely worth a try.

A couple of other things to try: vary height of pillows to see if it makes a difference, try to sleep on your left but that is often easier said than done (try a device like a SlumberBump, pillow between knees etc).

Good luck