[Treatment] Struggling - any ideas what I am doing wrong

[davell]

Would love some advice on the CPAP usage

I have a deviated septum & ADHD stimulants so sleep is always a struggle
Diagnosis was mild/moderate 
Been struggling with my Resmed 10 CPAP for over a year now
Now have humidifier and full face mask, trying also a neck collar

I am not overweight don't drink coffee anymore

Any ideas on if it can help me stay asleep longer 
I seem to wake up when i'm struggling to breath and ears ringing
Also tried melatonin and diphenhydramine 
Long term I need to find a solution so any ideas much appreciated

I have left the pressure as set by my doctor, only changed the ramp up

Let me know if I should submit other images too as I couldn't spot the forum guide sorry!

   
   
   

[Deborah K.]

Here are some suggestions:

Your starting pressure is too low for an adult.  Raise it to 7.  That should make a good difference.

Most of your apneas are CAs.  Did you have a lot of CAs in your sleep study?  If you are not sure but have a copy of your sleep study, post a redacted copy of the study.  

I can't see if you are using ramp, but your therapy would be better without it. If the change to 7 pressure is uncomfortable, use ramp for maybe 10 minutes or so, but eventually turn it off.

As to your chart, it would be good to reformat it.  Use the F12 button to copy Oscar, and make sure we can see to the very bottom of Flow Limits.  That will help a lot.

As to your insomnia, I tried lots of different things, all of the herbal and over-the-counter things, but none of them worked very well.  I finally asked my doctor for help and he prescribed Trazodone.  That solved the problem for me.  I hope you find something that works well for you, whether natural, over-the-counter, or prescription.  

p.s. Some people find that taking Magnesium late in the day helps them sleep.

[davell]

Thank you Deborah!!

Brilliant things to try

Your starting pressure is too low for an adult.  Raise it to 7.  That should make a good difference.  

  Done, Maybe this will stop the pressure increase waking me up!

Most of your apneas are CAs.  Did you have a lot of CAs in your sleep study? 

I will try and get a copy of my study -  I don't think it had high CA


Here are the full pages with F12 screenshots

and I will try the other suggestions too

I wonder if my mask is too small as well I might try a large mask - I'm thinking the F30 as I can use it with glasses

   
   

[davell]

Here's what I got with the pressure increase - obviously it will take a few days to get good results

       

[HalfAsleep]

I'm impressed that you lasted a year with those gross settings! I'd have felt like I was suffocating every night.

See that long space with no pressure on your charts? You're taking your mask off in the middle of the night, or else it's becoming dislodged. So, while you're getting settings adjusted (and this chart is already starting to look way better than before), it's time to work on the mask.

1. Be sure SmartStart isn't on. SmartStart has a tendency to stop and not start.
2. If you take a bathroom break in the night, I recommend you keep the mask on. Unhook at the hose. Otherwise, it's too easy to get used to throwing the mask off when you're mostly asleep: that's a hard habit to break.
3. Once you get the pressure settings better, you won't be so apt to throw off the mask in the middle of the night: in other words, you will be moving in the direction of more comfort.
4. If you're an older person, make sure you check with your doc on taking diphenydramine on a regular basis. It's an anti-cholinergic, and there have been warnings about it, especially for older folks. Maybe try some alternatives first. Folks have favorite cereals and different kinds of sleep-inducing drinks.
5. You might have to really work on the wind down to bedtime. Consider staging melatonin, so you take gradual doses in the hours leading up to sleep-time.
6. Turn down the thermostat at night.
7. Try making the air cooler in your unit.
8. Make sure you're not fighting with your pillow. This takes some trial and error.
9. You have an insomnia plan if you wake up and can't get back to sleep? IMO that's a good idea.

Now that you have some experience with masks under your belt, you might indeed like to try a different one. Yes, fit is everything. I like LankyLefty's YT videos on masks, since he demonstrates pretty much all of them, at least the most popular models. Those might help with your decisions here. Personally, I'm a fan of the hybrid masks (my nose is not 100%), but there are several choices.

Once your xPAP set up gets in the groove, you may find it's conducive to helping you fall asleep. Before xPAP, it took me a lot longer, and I would get up more often. Just something as simple as turning the unit temp down, made a huge difference.

[Narcil]

1. Be sure SmartStart isn't on. SmartStart has a tendency to stop and not start.

he has an 11 so smartstart won't make it stop only smartstop would.

i recommend you turn off smartstop and turn ON smartstart. this way if the machine stops for any reason (voltage drop, power cut, w/e) it will at least restart.

i've been using it like that for 3 months without a single issue, or any failure to start and i turn it on every night by breathing in.

[davell]

[quote pid='522990' dateline='1721132796']

he has an 11 so smartstart won't make it stop only smartstop would.

Sorry thats a typo I have a 10!

[/quote]

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Yeah Thanks, staying asleep for longer is the main goal at the moment!

[Deborah K.]

I don't know about the UK, but here in the US, our doctors are required by law to provide us with a copy of our sleep studies if we request them.  Even if your doctor doesn't have to provide yours, explain your problem about needing to know the number of CAs you had during the study.  Hopefully, he or she will then give you an answer to that, or maybe they'll give you a copy of the study.  It can't hurt to ask.