New CPAP user frequent waking

[Spike9726]

Hello all,
Today is my first day on the board. Already learned a lot from reading. I finally decided to ask my MD about sleep apnea in late September, did my sleep study about 2 weeks ago. It took a while for me to even fall asleep for them. Ironically the first time I dozed off it didn't even register as sleep.

I have always struggled w/ wintertime congestion. Cold n flu season would be a special kind of hell. I would occasionally wake up feeling as if I was not breathing. It would occasionally work it's way into the dream. 

I blamed anxiety, I suspected seasonal affective disorder (lost my mom on Sept 30 a few years back, then generally hate the cold and the early darkness, not to mention the holidays. OTOH I am fortunate to enjoy my business and my general daily life. I judge High School Powerlifting which starts in Mid January. Between the group I work with plus working with the kids seems to pull me out of the winter blues. Yes I know Texas barely has winter as many of you know it). 

I finally got my machine last Thursday. First night was hell. I could not get comfortable, felt very congested. I kept having to go to the bathroom plus the dog did not want to settle. He still chews and I'm paranoid about him getting at the machine.

I prefer a bigger mask and it's made by Resmed. I don't necessarily breathe through my mouth. I am too a point where I can sit still with the mask on but I'm wide awake. It's a waking experience, especially if it leaks. 

My biggest concern is that I never stay asleep more than about an hour at once. The other night I slept almost 2 hours at once. I am not very energetic in the day time. My bases settings are from 8 to 20. I generally don't feel that I need much over 8, but often when I wake up it's higher. Last night I kept waking, the air was coming out a bit cold and blowing a bit too intense. I seemed to have just a little leakage around the mouth area. I don't think I've had a dream yet. A couple of times I've taken the mask off briefly and passed out. I don't feel very rested at all when I sleep w/o the mask.

I look forward to interacting with you guys.

[Walla Walla]

You might want to try a pillow mask like the Resmed P10. They're smaller and more comfortable. Many people who have problems with stuffy noses on full face masks actually do better with pillow masks. The reason is the pillow mask provides a more direct airstream which helps open up the breathing passage.

[OpalRose]

Hello Spike9726,
You should try living in Ohio if you want to experience “winter blues.” I can relate though, I also hate the cold and I especially don’t like dealing with time changes.  Coupled with having to adapt to using a new machine and wearing a mask at night doesn’t help with anxiety.

But you are fairly new at this, so take heart...it does get better.  

Your many awakenings could be from the congestion you suffer with, as many of us do.
Try nasal rinses.  Use the squeeze bottle type with premeasured saline packets.  Also talk to you doctor about using a nasal spray for awhile.  

Adjust the humidity level.  Too much is not better than too little.  See what works best for you.  
If I use too much humidity, I actually become more congested.

Now to the real problem for your awakenings may be that your machine pressure is not set optimal for you.  

For us to advise on pressure settings, we would need to see some data.  Download the free #SleepyHead software.  Then learn to organize your #SleepyHead graphs and use the attachment feature to post your daily page here.  See the instructions in my signature line.

[Spike9726]

Thanks guys!

I have had sporadic anxiety bouts for years which probably helped disguise the apnea. Hating the holidays has been a relatively new phenomena after losing mom and more recently step father. The worst thing about Texas winter (or maybe the best) is that its so intermittent. It may be 75 one day and snowing 2 days later then within a few days it's nice again.

Last night I slept for 3 hours on the first go around, and then I was able to go right back to sleep. What I had been doing was totally reramping every time I woke up. Last night I woke up and just reset it to 8 and I was back alseep w/in a few minutes. Last night I slept most of the night and I am as alert as I've been in months.

[OpalRose]

Thanks guys!

I have had sporadic anxiety bouts for years which probably helped disguise the apnea. Hating the holidays has been a relatively new phenomena after losing mom and more recently step father. The worst thing about Texas winter (or maybe the best) is that its so intermittent. It may be 75 one day and snowing 2 days later then within a few days it's nice again.  

Last night I slept for 3 hours on the first go around, and then I was able to go right back to sleep. What I had been doing was totally reramping every time I woke up. Last night I woke up and just reset it to 8 and I was back alseep w/in a few minutes. Last night I slept most of the night and I am as alert as I've been in months.

Yep, holidays are rough when we are missing loved ones.

The most important thing is that you wake up and are able to go right back to sleep. This is important, as I’ve heard so many say they wake up, take off their mask, and either never get back to sleep...or worse, decide to sleep without the mask. So it sounds like you are on the right track.

[Fats Drywaller]

Last night I slept for 3 hours on the first go around, and then I was able to go right back to sleep. What I had been doing was totally reramping every time I woke up. Last night I woke up and just reset it to 8 and I was back alseep w/in a few minutes. Last night I slept most of the night and I am as alert as I've been in months.

There ya go! I've said all along, ever since I started my own CPAP adventure early this year, that the ramp feature of CPAP machines is a boondoggle. It's just completely unnecessary, like training wheels on a bicycle that's being ridden by someone who is more than old enough to ride without 'em. Ramp is an irrelevant distraction that has no therapeutic use (unlike EPR).

Another thing I always recommend, after permanently disabling ramp, is to put the mask on and switch the machine on early in your going-to-bed routine. Read for a while or watch TV or let your mind wander or whatever you usually do before going to sleep, have the light switch within reach, and just get used to breathing through the mask at your prescribed pressure or range of pressures, that's all. Pretty soon it'll become normal and routine. At times, I have even done this for as much as a couple of hours before falling asleep. No big deal. It becomes a lot like the not-so-weighty question (!) of "Do I change into my pajamas now, or an hour from now?"

[Spike9726]

I've been sleeping progressively better each night. Even had to sleep in a hotel for business the other night and it went well.

Couple of questions:

1. Sometimes I wake up and I have taken mask off and fallen back asleep w/o even knowing it.

2. The harder the machine blows, which for me is 11 to about 13, the more I feel it blowing through the mask and possibly waking me

3. Last night was best night yet, but it seems that the more I sleep the more tired I am. I wanted to go to bed at 6:45pm my time after waking around 8ish.

[mesenteria]

Your first item:  This is surprisingly common as reported by some members here.  Some outgrow it, especially after getting more used to the machine, letting it gain 'face validity' by apparently reducing your AHI, and if you're lucky, you'll sense an improvement in your overall health.  I believe some of the machines have the capability to sound an alarm if there's a substantial leak, and that might be all it takes; a few alarms until you are more aware of your effort to remove the mask.

There are two strong components to therapy with PAP, and they are efficacy in reduction/control of AHI and consistent and tolerable usage.  First, the machine has to do what it purports to do once set correctly for the wearer, but secondly the wearer actually has to...well....WEAR the mask and get the therapy.  An unhappy, doubting, anxious, or annoyed user is not going to succeed in the long run, so the fit and feel have to be right.  If the numbers each morning say your AHI are under 5, then the machine is doing its job.  Additionally, the settings are correct...so far.  It could be that, in order to get you to the place where you are also happy to continue the treatment, that you tolerate it well, and that you don't have lasting and intrusive doubts or vexation about it, the experience has to feel 'good'...or 'right'.  If the pressure seems to be too high, and you know you have the correct mask and fit, and the machine knows which mask you are using, then perhaps you can tweak the settings down a half cm at a time until your AHI is still below 5 and you don't feel the mask wants to take off like a rocket.

Third point.  This is also surprisingly common.  I didn't know I had apnea until I was tested.  My adult daughter, her fiancé, and I shared a cabin two summers ago and she finally told me that I was like a buzz saw all night long.  I knew I snored...some...but this drove them both crazy.  I thought I had been sleeping well.  Not long, but well.  Ever since commencing PAP, I have grown more tired during TV watching and have to slump for about 20 minutes.  I feel somewhat foggier all day long.  Never had that prior to two summers ago.  In fairness, I am also on rate control medication and on a statin now, and those two can gang up on a body.

Best I can offer is that you try to 'go with the flow'.  Keep telling yourself that the science and your machine both say you are getting better sleep, and that your overall health might be better...ought to be, anyway.  Maybe you are more relaxed during the day now, not subject to the stress hormones caused by frequent arousals when you're trying to get into deeper stages of sleep.

[Fats Drywaller]

3. Last night was best night yet, but it seems that the more I sleep the more tired I am. I wanted to go to bed at 6:45pm my time after waking around 8ish.

That happens a lot with people who have been chronically sleep-deprived and who are starting to get some good sleep again. After some number of days or weeks, it'll fade and you won't be feeling that residual fatigue often.

[Fats Drywaller]

2. The harder the machine blows, which for me is 11 to about 13, the more I feel it blowing through the mask and possibly waking me

What kind of mask? Earlier you said it's a Resmed, but what model? Please update your profile/sidebar with that. Thanks.

If it's noisy, have you tried using earplugs, or do you mean that the noise is transmitted through the hose and/or the frame of the mask so that you'd hear it anyway?

About the dog: I have a similar problem with my cat, who is playful and adventurous. I don't want him pouncing on the hose and biting it, and so on, also cords, so ever since starting with CPAP I've had to exclude him from the bedroom with the door shut when I'm sleeping. During the day with the door open, I keep the machine, hose, mask, and all cords shut away from him in a bedside drawer or on a shelf with a panel covering the front, not only inaccessible but invisible.

Edited to add: Some surgery on the back panel of the piece of furniture is necessary to pass the power cord through. My CPAP setup and the cat's safety are much more important to me than the trivial non-problem of having to damage (inexpensive) furniture by drilling holes in it.