jaredtaskin - Therapy Help

[jaredtaskin]

Last night I decided to start adjusting the humidity. I read that at maximum tube temperature (86) the highest humidity level you can set without getting rainout is 5. So I set the machine to these settings. In the morning, I found the water level in the tank to be at the same level it has been on Auto. So I conclude from this that the Auto setting was already giving me the maximum humidity possible without rainout.

My symptoms today are the same. Sinus pressure, post-nasal drip, and an occasional queasiness that comes and goes. I have now been having these symptoms for 13 days, since day 6 of starting therapy.

I guess the next thing to try is turning down the humidity? If I plan to turn the humidity down to level 1, what tube temperature should I set?

[TechieHippie]

That must be so frustrating. If nothing helps you probably should see an ENT to see if something structural is going on. Otherwise, I'd suggest approaching this as a puzzle. Don't look for a single cause, it may be more complex than that. Try to find what improves or worsens it as a clue. Perhaps keep a log and rate your symptoms.

The nausea is likely from the dripping nose but could be aerophagia. Has your weight changed significantly anytime in that interval? (Water retention).

You could try OTC guafinesin and see if anything changes.

Just throwing out more ideas...

Do you have a full face mask you can try to see if overall pressure helps compared to just nasal pressure? Does the pressure level seem to effect symptoms?

I know the following are my "hammer," not yours, but... I don't have a heated tube but I have a humidifier preheat option and didn't like it because the heat offgassed more chemicals. You've probably already tried without the heat in a freshly washed tube but try no heat if your haven't.

I think one thing to try would be a Neilmed nasal rinse with warmed distilled water to eliminate other variables (plus the packet of course) both an hour or two before bed (to give any sniffles time to subside) and then first thing in the morning, to see if the symptoms are related to contaminants.

I'm assuming you've washed all the parts regularly. Does the soap have any scent or chemicals? If any are still stinky of plastic or musty you can soak in 1/3 vinegar for a couple of hours.

For a more woo-woo thing to try... It's possible that focusing on the symptoms and worry is contributing. As someone who has been told symptoms are all in my head, I'm not saying that at all .. But it's very possible that fear and stress amplifies and increases them. Convince your mind and body that it's all okay and you are safe... And belly breathing could take pressure off the sinuses; if you are pulling air through the nose see if you can use the bellows of the abdomen instead. Maybe a guided meditation right before bed and put a warm rice bag on your feet and then focus on the feeling in the soles of your feet. This will draw awareness out of the head and let the sinus area relax. It won't be a solution by itself undoubtedly, but it could give you good clues.

Let us know what you try and how it works.

[jaredtaskin]

I don’t think the queasiness is aerophagia because I don’t have any of the other symptoms. Probably just from drainage I guess. As I mentioned previously, it seems to feel better not worse after eating, which in my experience is consistent with nausea resulting from drainage.

I don’t have another mask at this time. I’m sort of nervous to try another mask, because objectively (very low AHI, sleeping through the night) it’s going extremely well with the P10.

[jaredtaskin]

Last night, I decided to go all in and turn off the humidifier and heated tube.

The result was that I really had trouble falling asleep. The air seemed much colder than I was used to. I don’t know if it was ACTUALLY colder, or if my brain was just hyper aware because I started making manual changes. I’ve read that the heated tube shouldn’t noticeably change how the temperature of the air feels. Is that true?

Eventually I set the machine to level 2 and 80 degrees, and was able to sleep for 4 hours, although I woke up at 5am and couldn’t get back to sleep.

Subjectively, I don’t know whether I feel any better this morning. I definitely don’t feel significantly worse or better. 

So this leaves me feeling completely lost as to what settings to go with tonight. I know I could go back to Auto and sleep comfortably, but what if that high level of humidity is causing my sinus problems?

I’m open to any suggestions.

[PeaceLoveAndPizza]

Given you have only been using the machine just over 2 weeks and your settings are dialed in, there is not much we can do from a settings/machine perspective. For the humidity/tube temp, you can set it to manual and tweak as you like. Humidity of 4 and tube temp of 27C is what the auto setting uses, so you can match it with manual settings. Taking them up/down is a worthwhile experiment.

CPAP may take weeks to a few months to get used to once settings are dialed in. Your general discomfort is not a typical response to CPAP, but it does happen. It would be worthwhile discussing with your GP or sleep doc.

One thing we have not considered is sleep hygiene. The usual suspects include eating/drink too close to bedtime,  alcohol and caffeine consumption, exercise regime, bedroom temp/humidity, etc. Many variables impact sleep to consider. No words of wisdom here other than to focus on a stress-free sleep environment.

[TechieHippie]

My gut instinct says go with a low level of humidity but not none, and turn off the heated tube. Clean the tube and mask, consider clean sheets, taping lights on devices in bedroom, anything you notice to improve your environment for you, then go do something enjoyable, get it in nature, etc . Reduce the stress and fear - it could be a larger impact than you think.

Take that for what it's worth!