New CPAP user feel like crap

[markrb]

I just started on my F&P Icon auto and the good news is that my worst fear turns out to be a non-issue as I can use the machine and get to sleep.

However I wake up worse off than without the machine.

My pressure is set to auto with a range of 4-20. It's been averaging a 7.
My AIH has been 13.2, but the machine shows I am in compliance. Keep in mind during my sleep study my average was 95 per hour.

I took a nap today and near the end I noticed my mouth was open, although I don't remember it happening before.

I am pretty sure I am going to have to stop using it until next weekend as I can't feel this bad at work.

I am going to email the doctor and see what she says. I do have the DME manual, but I am worried about changing anything during the first 90 days as all the information is going to the doctor and the insurance company. Although I am really thinking of slowly raising the min pressure.

I am going to keep a closer watch on my mouth and if it happens again get a strap to keep the mouth shut or look into a full face mask.

Any thoughts as to what else I can try to actually get a full nights sleep?

Thanks,
Mark

The "adult/swear" word from your subject line has been removed. The rule of thumb for language here is to keep it clean enough for an 8 year old granddaughter. Thank you for understanding. - Moderator

[oak]

Any thoughts as to what else I can try to actually get a full nights sleep?

Thanks,
Mark

How many hours of sleep are you getting?

[markrb]

7 hours and even a nap for a few hours doesn't help.

[oak]

in what way do you feel worse? are you more tired than you were without the CPAP? How many nights has it been. many people say it takes about two months to feel better. is your mask working out for you? do you think your pressure settings are wrong? your AHI is pretty high so I am not surprised you are not seeing results. Post your difficulties on the forum and see what answers you get. there are some pretty knowledgeable people on this board. i would hate to see you discontinue treatment during your work week as you definitely wont get better not using it.

[Airstream]

Markrb: Regarding oak's questions, is there any way you can pinpoint what may be causing you not to sleep well? If your mouth is open and you are not wearing a FFM, I think you will wake up real quick. On a positive note, the fact you can fall asleep is half the battle. /Jeff/

[pgw78]

AHI of 13 is still pretty high. But it's way better than 95.

For me, I can go for an extended period not sleeping well and sort of run on adrenaline. But as soon as I start to sleep well again, the accumulated sleep debt crashes in on me. I feel really bad for several days (sometimes more, sometimes less, depending on the circumstances). But once I rest up, I feel better. Is there any chance that's what's going on with you? If you've been sleeping that poorly for a long time, you may just need to crash for a bit.

Compliance just means that you're using it at least four hours (or whatever your machine's programmed minimum is) per night. It doesn't say anything about how well you're sleeping. Just that you're actually using the machine. (A lot of people decide they don't want to sleep with it, and insurance doesn't want to pay for a machine that you're not using.)

4 - 20 is quite a range. Some people (myself included, but my doctor told me I'm far from alone in this) actually get worse results on Auto PAP than they do on a steady pressure. Talk to your doctor, but it may be worth just setting the machine to 7 and seeing if your AHI goes down.

[Paptillian]

I felt like crap after my first day on therapy. It's been slowly getting better (1 month now) but still have a way to go.

I notice that if I sleep 7 or fewer hours, I don't feel rested. I personally feel best when sleeping 8-9 hours with the mask on. My theory is that it has to do with sleep debt, and 7 or fewer may not be enough.

I agree that the 13 AHI needs to come down. Your goal is to be below 5.

[markrb]

When I say like ass I mean completely exhausted. I don't think I have ever felt so tired before and I had a pretty bad headache.

I didn't use it last night and I felt worlds better today.
I have to go on a road trip for work and don't won't to be a zombie for the trip.
After I get back I will start back up.

I was taking a nap yesterday with it on and as I woke up I found my mouth to be open.

I am thinking of trying a different mask, maybe even a full face one and I can't believe I am considering that because the last time I tried CPAP I couldn't even take the pillow, but that was many years ago.

[JJJ]

I was taking a nap yesterday with it on and as I woke up I found my mouth to be open.
I am thinking of trying a different mask, maybe even a full face one ...

Rather than go to a full face mask you might consider a nasal or nasal pillow mask plus a chinstrap.

No one who has ever slept with me has said that I sleep with my mouth open. During my sleep study they videotaped me and no one said I was a mouth breather. But occasionally I would wake up with a dry mouth. And I had a hell of a problem with leaks. Finally I broke down and tried a chinstrap. Problems solved. Leaks under control and I never wake up with a dry mouth. I don't think I sleep with my mouth wide open, or open all the time, but enough to cause problems.

You're supposed to put the chinstrap on first, then the mask. I put the chinstrap over the mask because I find it helps hold the mask in place.

I just offer this as a suggestion. Chinstraps are not terribly expensive. You could even fashion one yourself out of a flexible "ACE" bandage.

[DreamDiver]

Greetings markrb,

A couple things come to mind.

First, please consider editing your equipment profile to include what you're using. That way, those who try to give feedback may see gather what your tools are at a glance and have an idea what we might do in your shoes.

1. Click "User Control Panel"
2. Click "Edit Profile"
3. Add your equipment, using the exact name on the packaging. Occasionally, you may find the name on DME receipts. Alternatively, find an online vendor with good images, and compare your model with what you see there. Once you cut and paste the model for your mask, blower, humidifier, and your pressure settings and save your profile. You're good to go.

Here's an image that will help you locate the links to click:


Additional notes follow after the quotes.

My pressure is set to auto with a range of 4-20. It's been averaging a 7.
My AIH has been 13.2, but the machine shows I am in compliance. Keep in mind during my sleep study my average was 95 per hour.

I'd fire my doctor, if after having had a sleep study, she gave me beginning settings of 4-20. If your doctor gave you decent therapeutic settings, but the DME didn't put them in, I'd fire the DME and notify the doctor, so they don't recommend that DME again. If you don't have a doctor and you're self-titrating, no worries. This happens sometimes. Since you have an Ikon, that's made by DeVilbiss. Google for Devibliss SmartLink 2.0. You can buy it on line. If you need a prescription for the software (I don't think you do.) just ask your doctor to prescribe it.

When you start at a pressure of four, but spend most of your time at 7, you spend the first hour or more starving for air until the machine finally gets up to therapeutic levels. There is no point in putting your body through that. If this were my machine, I'd start at 6.5cm for the lower setting and bring the upper setting to 15. Do try to get the software, because I don't think SleepyHead (open-source free software) will work yet with the Ikon model.

I took a nap today and near the end I noticed my mouth was open, although I don't remember it happening before.

I am going to keep a closer watch on my mouth and if it happens again get a strap to keep the mouth shut or look into a full face mask.

You are likely mouth leaking, meaning you're probably using a nasal mask. Welcome to the world of people who probably need full face masks. Try the Quattro FX. I love it.

Any thoughts as to what else I can try to actually get a full nights sleep?

Reduce your large leaks first, including mouth leaking. A mask that's too tight can be as leaky as one that's too loose, so try to find a middle ground. You cannot get any therapy unless you eliminate large leaks. If that means mouth-taping until you can try a full face, then that's up to you. Never worked for me. Once you have leaks under control, your numbers will be more valid. Once you have the software, feel free to post images and outcomes of what you're seeing numerically, and perhaps someone will be able to give you feedback.

Sleep well.