Montacute's Therapy Thread

[PeaceLoveAndPizza]

First thing to do is take a breath and count to zen. Next, watch some YouTube videos on sizing and wearing your specific mask as it may be sized or set up incorrectly. LankyLefty27 usually has good videos for this. Lastly, give yourself time and learn to breathe with the machine, not against it. It takes some practice to learn to relax and do this, but it makes it so much easier. Let your mind wander instead of focusing on the mask and pressure. It can help quite a bit.

The symptoms you describe may be related to the leaks and gulping air. One thing we can try is to reduce the pressure and set it with a smaller range to allow you to get comfortable with it again.

Give this a try.

Mode APAP
Min pressure 7
Max pressure 8
EPR 3 full-time
no ramp

This will tell us if the pressure swings are the problem or if there is something else going on. I also noticed on the 7/11 chart around 06:00 you had some positional apnoea going on, so something to monitor closely.

Your flow limitations are a bit more than we like to see, which adds to the problem. It may be related to your nasal issues, but let’s see how it goes with lower pressure. You may need to consider a bilevel as it will allow more fine-grained controls of the transitions from IPAP to EPAP and vice-versa, which in turn allows for lower pressure.

If you have not done so, try wearing it during the day whilst watching telly or reading. Not quite the same as sleeping, but it will help you regain your confidence.

[Montacute]

I am just back from a weekend out of town, where I gave myself a 2 night CPAP break. Nightynight, thanks for the suggestion. I will give the Flonase a try. I have had a turbinectomy in one of my surgeries, but I'll see if it helps anyway. I will report back--thanks for caring.
PeaceLoveandPizza, nice to see you. I will try the settings you suggest tonight. I am quite nervous about using the machine at all after last time. I'll put the mask on shortly and try to make friends. Is positional apnea what it sounds like, caused when I move? Thanks so much for your help.

[Narcil]

you can read more about Positional Apnea here https://www.apneaboard.com/wiki/index.ph...onal_Apnea

but the tldr is PA happens when your sleeping position is impeding your airway. like sleeping on your back or kinking your airway if you "chin tuck". Pressure alone can't solve it.

[HalfAsleep]

Your mask is leaking big-time. That would definitely make a mess of your night.

Look at LankyLefty's YT videos for your mask model, on fitting, placement, etc.

In my experience, if the exhale pressure is not quite right, it can be panic-inducing.

FWIW I had septoplasty, and it didn't entirely enable me to breathe through my nose. No matter, I use a full-face mask: it is what it is.

Sleeping on the couch tends not to be productive of apnea-free sleep, because it promotes poor head and neck posture. This makes for apneas. It may also be clogging your nostrils if you have allergies, a dog, cat, etc.

Also, in my experience, feeling better with CPAP doesn't happen over night. It may take a month or two of consistently sticking with the unit and mask for multiple hours a night. If you're having a hard time adjusting, wear the whole get up during the day when you're reading or watching TV.

Then, do a "stack" every night of bed time preparations that are conducive to you getting good sleep. Folks have all different "stacks", but they might include reading, a saline wash of the nostrils, a snack, music, graduated doses of melatonin, taking a shower, lowering house lights, turning down the thermostat, careful set up of the machine, all kinds of things. It's very personal.

PS your current symptoms e.g. headache, may be a sinus infection or allergy and not a CPAP problem. See your doc.

Also, try adjusting the humidifier and xPAP temp: they can exacerbate sinus issues.


PS the pressure on your avatar is different than the pressure you are using. Make sure your unit is set to the mask you are using.

[Weld3z]

99% of us are here for the same Goal, It’s to sleep well like a normal person.
Some have bigger problems than others, Sometimes my day dreams is to just sleep 5 hours continuously.
Nothing made me happy on any day more than a good sleep the day before.

To Op, I hope I can help you with advice or something to make your life better but I can't although I feel your pain and I already put myself in your position just double-check on depression or anxiety,
hey keep it up stay strong and good luck, hope a good doctor can solve your problem soon.

[OpalRose]

Montacute,

Your two threads have been merged.  This makes it easier for those that wish to advise to see your history in one place.

Please continue to use this thread.

Thanks!

[HalfAsleep]

I want to emphasize that it can take several months on CPAP to get past the stuporous phase. I want to emphasize stuporous.

IMO you’re wanting your experience with XPAP to change too urgently, without the rigor needed. That’s never going to work. Every night, no matter what, wear your mask and run your unit. Teach yourself not to take it off. Do NOT take a day off for many months, otherwise you’re teaching your body bad habits. Two days off, at this stage of noob, and you’re back to square one. Do NOT fall asleep on the couch for longer than a momentary nap, especially without your unit. Follow the settings provided by official advisers here to the letter. They are trying to help you. Work on lowering mask leaks, and don’t let up. Learn about how to ameliorate them. Learn about pillows, collars, whatever. There are plenty of ideas here and on LankyLefty’s videos. And stick with that mask until further notice (it seems FFM is required for you because of the mouth breathing, so stick with that model). If it seems too tight, loosen it; if it seems too loose, tighten it; if both, go for somewhere between.

Your mask is not blowing off because of a pressure of 8. Otherwise, the masks of everyone on this board would be airborne. It’s being dislodged or you don’t have the skills yet to address the leaks. You learn those. You’ve already got past mask choice for now. Maybe not perfect forever, but good enough for now.

If your mouth goes dry, learn what it takes to keep it juicier, but don’t switch the whole apparatus around. If your nose gets plugged, either find a solution to unplug it (that doesn’t involve the ENT, since there’s nothing more s/he can do for you), using suggestions here. Try them. All of them, if necessary. Don’t worry about one night or another; just keep plugging. Spend your entire evening getting in the mode for sleep if that’s what it takes.

Trust that whatever you learn is a transferable skill. You can use those skills in a new context later. For now, follow guidance, and limit the variables.

All of this takes time. At some point it comes together. Everyone is different, but it doesn’t come together for anyone without practice.

XPAP is habit. It isn’t natural to sleep with a mask on. You have to train yourself. You’ve had tools from here, and tools from the ENT.

IMO you are talking yourself out of therapy every night and slicing and dicing details, when the most crucial thing here is to actually USE the xPAP. HABIT. DOING. Not telling yourself the thousand reasons, with new ones everyday, why it can’t work for you or it’s not possible.

The one thing you will not get support for from, I think, anyone on this board, is being haphazard about using the equipment.

I know this is tough love, but self-tough-love is what is required for most of us to develop this habit. That, a bit of faith, patience, and commitment to teach ourselves how to adapt the tools to our individual sleep.

[Montacute]

Thank you for all the responses, which I have been carefully going over and re-reading.  Thank you so much for the ideas and just plain support too.  I waited to reply until I had two nights of CPAP data at the new settings suggested by Peace, Love and Pizza and using Flonase per Nightynite.

I think I can see positional apnea and of course massive leaks.  I never sleep on my back, only my side.  I am knocking the mask around.  I have watched many videos and read the wiki on mask fitting.  I believe I am fitting the mask correctly--making sure I can fit 2 but not 3 fingers, making sure the mask top is between my eyebrows.   I believe I am knocking it around in my sleep and the only thing that can help is keeping my head from doing this.  I had bought a cervical collar much earlier in my treatment and could not tolerate it.   I think I was making it too tight and will try again with it tonight.  Just as an aside, not sure how to say this, and did not want to, but I suffered a lot of abuse in childhood that left me very sensitive to feeling immobilized or locked up.  So this is really a big challenge and quite frankly makes me worry I am relapsing with depression--Weld3z that was very perceptive of you to see.  I am revealing this because CPAP may be more challenging for me than most, and I do not want it to seem I was noncompliant with treatment for the heck of it.  I have used my CPAP every day since March except these last 2 on the weekend.  That was more to give me a break mentally.  I had not stopped before, but when I woke up gasping with headache and ear pain, I needed the break mentally, I really did.  I was very anxious of a repeat on Sunday when I put the mask back on, but I still did it.  I have also just ordered a cervical pillow to see how that works for me as well.  I found a great deal and posted it on the Board.

I know falling asleep on the couch is not helpful.  I don't want to.  I am so exhausted from waking up so much with the CPAP--how do people deal with that and keep from falling asleep throughout the day?  I don't know how to.

I have been using the CPAP since March.  I will say that I had way fewer apneas when using the nasal pillows.  I don't know if that means anything given that with my full face mask I have had the leakage problems so I don't know how it will be once optimized.    I have been feeling that this far into treatment most people were further along than I am.  Perhaps that is my negative thinking rearing up, part of my problem.  I have been telling myself I am failing at this Half Asleep, you are right.  I am not giving up though.  I know my mask size of M is correct--I wonder if anyone has sized down a size anyway to help with leaks?
It seems like it might.  I'm also going to talk to my dr. to see if I can get some of the diabetes drug that has shown success in treating apnea in experiments.

Here are my Oscars.   Are all these apneas due to leakage and wakening, and positional?  I want to say yes, but I am not any good yet at reading the charts.
I appreciate all help with that.    Thank you everyone for sticking with me.

PS Thanks for the reminder. I edited my Avatar info.

[Weld3z]

If you are using the F20 mask give F&P Vitra a try actually it's my favorite, if you prefer the nasal mask give this a try
https://www.ebay.com/itm/285927927241?mk...media=COPY Drug for treating apnea update us on what your Doctor would say please!!

As I mentioned I'm not a doctor but why not ask your doctor to let you try Bipap instead of CPAP see what he would say.

Regarding my anxiety, Zoloft was prescribed to me in 2016 then I felt fine so (after talking to my doctor) I stopped taking it in 2019, things went upside down in 2021 so I'm back again until today with the minimum 50mg dosage.

[Montacute]

Thanks! I know someone else suggested Vitra to me as well. I don't honestly know what I prefer--whatever works! I wake up with equally dry mouth with both, but people here recommended a full face with my breathing/sinus issues.

I can ask my Dr., but I would need to give him a rationale. Is it just that CPAP is so far not working well for me?

Upside down--I have been there. I actually just stay on my antidepressant since that tends to be what happens when I go off. An old-school one has been best for me--Parnate. A big hug to you! Glad you are right side up!