Hello! I'm new to CPAP

[SDCarter13]

Hello everyone! My name is Shelia & I'm 49 yrs old. I've always snored & had lots of sinus issues my whole life. I started my sleep study journey in 2021 because I was having heart palpitations so bad I was passing out multiple times a week. My doctor referred me to a cardiologist who had me wear a heart monitor for 6 weeks. Then he ordered a sleep study. I had the 1st in lab sleep study done on 10/13/2021 which showed an AHI of 28.8 events per hour-108 obstructive apneas & 74 hypopneas. I had a CPAP titration on 11/29/2021. The recommended pressure was 15 cm H2O.

After the tests, nothing happened. No one contacted me, so between life & getting Covid for the 2nd time, I forgot about the tests.

Fast forward to Jan. 2023. I passed out a work & hit the floor. Was hurting for a few days. Then my right shoulder started hurting at night so bad I could barely sleep. I finally got approved to have an MRI done which showed a rotator cuff tear. I did 4 months of physical therapy to no avail. Finally got approval for surgery & had it done 05/11/2023. Damage was worse than thought. Three of the 4 tendons were torn, my long head bicep was so damaged that it had to be released from the bone & set free in my arm. Lots of screws & stuff plus biologic grafts. During the surgery, they put too much weight on the traction of my arm so I have permanent nerve damage in my hand & wrist. Recovery was big fun lol! I have about 75% of the use of my arm back, but rarely any pain so I guess I'm good with it.

On 12/29/2023 I had a heart monitor implanted in my chest so they can figure out why I keep passing out. My cardiologist asked about the sleep study at my 2 week follow-up. I said no one ever contacted me about it. He told me to check on it. I tried calling the lab that did the study but they never answered or called back. I found my paperwork from it with the name of a DME on it so I tried calling them. I kept getting a message that said their phone isn't available yet. GRRR! So I found a website for the main company & sent a detailed message of what I needed to know. Three weeks go by & I haven't heard anything. Finally on March 19th I get a call from the local DME office. My appt to get my CPAP was set for March 22nd. I was in & out in 30 minutes. I was given an AirSense 11 & a DreamWear FFM. 

After using it for the weekend, I remember that I'm not supposed to have magnets near my hear monitor so I had to send a message asking someone to call me. The lady from the local DME shows up at work with another mask with magnets & an F&P Evora FFM. I try the F&P for 3 nights & no matter what I do it digs into my face on either side of my nose. I go back to using the DreamWear mask. There is not another DME company that has CPAP supplies in my town. The next closest is over an hour away so for now I'm stuck with the DreamWear. Any suggestions on how to try other masks without buying each of them? All of this is coming out of my pocket because I have a high deductible.

Last night was the 1st night I put an SD card in the machine. I've attached my OSCAR graphs to see if I need to change anything. This board has been super helpful already so thank you to all the people that work on it.

[HalfAsleep]

I believe Supplier#1 gives you a 30-day trial. Actually, for a look-see I would go to their site anyway to see the range of masks available and find one that looks more or less right, then request it specifically from your DME.

You could extend that little piece of research into the realm of nasal masks (pillows or cushions). If you have mouth leakage, there are ways to resolve that without going the FF mask route. This ApneaBoard site has tips and hacks.

A mask that's just in your nose area (and not near your neckline), might also create less interaction with your shoulder injury. I find jaws and necks and shoulders all go together, and mask design on the back of the neck really matters. IMO you might be able to eliminate all that by just using a nasal mask, and free yourself up to manage your shoulder injury without complicating issues. This is a thought, though, and not a recommendation: I'm not even a quasi-doc.

There's trial and error in everything. Unfortunately.

In a strange convergence of your story and mine, I have heart attack symptoms like crushing a pop can (I keep getting rushed to the ER after passing out), but no sign of heart issues. Like at all. Total head scratch in every which hospital department. Turns out, it's a spasm behind my shoulder blade from an old injury. It's so bad it cramps my diaphragm and disables my swallow mechanism. I'm thinking it's also possible there's a relationship to apnea, since it often happens at night, but this thought is a work in process.
I guess my question would be, "Could you have something like this going on, namely a shoulder thing-y that's messing with your heart, or vice versa?"

[Jay51]

Welcome to ApneaBoard, Sheila.  There is something called POTS (postural orthostatic hypotension).  Basically, blood pressure gets really low fast when a person changes positions (especially from sitting to standing quickly).  I fainted right after I had an angiogram and also fainted once in my home a few years ago.  

Just as a precautionary measure, try to rise from sitting to standing very slowly from now on.  Take your time.  You may not have this, but it might be.  Try not to stand in one position too long either.  Try moving around to keep the blood flow moving better.

[Deborah K.]

You have what we call positional apnea.  This shows on your chart where obstructive apneas and/or hypopneas are clustered together.  This means you are dropping your chin toward your chest.  The result is much like a kink in a hose and makes it harder for you to breathe.  No setting can correct this.  Most folks solve this by wearing a soft cervical collar.  In my case, I solved it by sleeping on a child-size pillow that has a raised front area that keeps my head tipped slightly back.  Solving positional apnea will result in lowering your AHI, so it is well worth doing.