suggestions please

[newbie wife]

Little background...My husband is 42, I would say overweight. Is being treated for low testosterone and has been on thyroid med's for many years. He finally has an appointment with an Endo doc in a few weeks to see if there is something else going on with his thyroid because he just keeps gaining weight and thyroid still not regulated on the top mg. Anyway, he took an at home sleep study due to the hours that he works...not suprising, he flunked -- I swear his snoring could wake the neighbors and we live in the country. 4 weeks ago he got a S9 series (I have looked everywhere and can not figure out the specific model that he has) with the cPAP and humidifier. They gave him nasal pillows to start with. First night in he complains the pillows hurt his nose wears the mask about an hour, I went and got some of the "nipple cream" people recommend that night he went to sleep and recorded about 1.5 hrs but took it off in his sleep. I told him if he didn't think he could adjust or even try then go back and get another mask. Didn't even try many nights after that. I tried to rig up a hose management system to get the hose off him thinking that may be why he is taking it off. His DME hasn't been very helpful and he actually just got a FFM two days ago because they didn't have any in stock. He got an Amara from Phillips and said it felt better cause there wasn't anything sticking in his nose. However, last night he was able to go to sleep rather quickly with it on but again took it off about 1.5 hours into it. I ordered him one of those pad a cheek things yesterday to try to make him more comfortable. We have a insurane through his work that is rather good so I am not sure that compliance is an issue with us but I am in need of any advice anyone can give me to help him. He says that if he wakes up and it's off he can't go back to sleep if he puts it back on. But from what I see he sits up and turns off the machine doesn't even try. He is on a 20 minute ramp and snores a little bit when he firsts goes to sleep. Do you think that the ramp time needs to be increased/decreased so he gets to deep sleep faster? I am still new to all this and trying to figure out how to help. Sorry for the long post.

[JJJ]

Four weeks ago he got a S9 series (I have looked everywhere and can not figure out the specific model that he has) with the cPAP and humidifier. They gave him nasal pillows to start with. First night in he complains the pillows hurt his nose wears the mask about an hour, I went and got some of the "nipple cream" people recommend that night he went to sleep and recorded about 1.5 hrs but took it off in his sleep. I told him if he didn't think he could adjust or even try then go back and get another mask. Didn't even try many nights after that. I tried to rig up a hose management system to get the hose off him thinking that may be why he is taking it off. His DME hasn't been very helpful and he actually just got a FFM two days ago because they didn't have any in stock. He got an Amara from Phillips and said it felt better cause there wasn't anything sticking in his nose. However, last night he was able to go to sleep rather quickly with it on but again took it off about 1.5 hours into it. I ordered him one of those pad a cheek things yesterday to try to make him more comfortable. We have a insurane through his work that is rather good so I am not sure that compliance is an issue with us but I am in need of any advice anyone can give me to help him. He says that if he wakes up and it's off he can't go back to sleep if he puts it back on. But from what I see he sits up and turns off the machine doesn't even try. He is on a 20 minute ramp and snores a little bit when he firsts goes to sleep. Do you think that the ramp time needs to be increased/decreased so he gets to deep sleep faster?

What you both need right now more than anything else is patience, and I mean lots and lots of it. It takes most people at least several weeks to get to the point where they can sleep comfortably with the mask. And if you ask anyone here they will agree that the mask is by far the hardest part of the process. I went through eight masks before I found one that worked well for me, and I am not unusual.

Regarding what machine you have, take the humidifier tank out and turn the machine upside down. The model number should be there. You can also look on this site for the pictures of various machines to help you figure out which make and model you have. Push come to shove you could call the people you got it from. It is important to put that information in your profile here because it will help people give you correct advice.

Another bit of information that would be helpful is the results of his sleep study. The most important part is the AHI (Apnea Hypopnea Index) that he incurred. Uusually there is a different AHI for sleeping on your back, on your side, or on your stomach.

There are over a hundred different masks currently on the market. Usually the DME (Durable Medical Equipment) supplier will let you try various masks for a week or so at no extra charge. However, I have discovered that most DMEs stock only a few masks, so you have to look online to see what looks good to you, then call your DME and ask them to order it if they don't have it in stock.

Hang in there. The benefits of getting this thing under control are that he will not die young from a heart attack or stroke brought on by the stress of poor sleep.

[newbie wife]

I will check when I get home for the model number. His AHI was 45 in 5 hours of sleep. The other thing I remember is out of 5100 breaths he had 3300 episodes of snoring. That can't be good for anyone. He is still in the denial phase I think and when he gets frustrated he is done for the night, nothing I can do to calm him down. He is very low on patience right now. I have done alot of reading on here and knew it could take awhile to find a right mask, he hated the pillows and it took me 2 weeks of him not using it to convince him to go try another one.

[PaulaO2]

With the S9, they go more by the name, not a model number like the Respironics. And the S9 stickers are on the back, not the bottom.

Look by the on/off button.

Above it will be the name. Below it will be EPR, which is the exhale pressure relief.

It should say Escape, Escape Auto, Elite, or Autoset. Not sure what the BPAP would say.

If the first two, take it back and ask for either the Elite or the Autoset. Escape models collect no data other than hours used.

[JudgeMental]

Right now, your husband has the very best support group anyone could hope to have. AND that is YOU. You are doing your very best and kodos go to you for that. The slow/long ramping time of 20min is causing him to snore at onset. Meaning that the low starting pressure is not reaching the pressure level that keeps his airway open yet. Agreed with other poster, give us a little more info about the sleep test and the results.
Patience is more then a virture when trying to learn to sleep with a hose stuck to your face.

[newbie wife]

I will post more about the sleep study results when I can get home and have the report handy. The only thing that sticks in my mind is that he stopped breathing between 45-50 times in 5 hours and had 3300 snoring events out of 5100 breaths. Will change the ramp time and see if that is any help to him. Thank you for the kuddos, it means alot. Most of my family would not agree with you, me having worked in the medical field for 20 years does not work in their favor as I do not allow them to let things go without harping on them:grin:

[idahocouchpotato]

I just started my therapy last night, and have a tip for your husband, Newbie Wife. You mentioned after he wakes up he has trouble going back to sleep with the mask on. If you have him push the power button to stop the flow, and then turn it back on it will reset the ramp time. I found it easier to get back to sleep by doing this.

Also, to add to what Paula said regarding the model name, I have an S9 bipap, and ResMed calls it VPAP. Above my power button it reads "VPAP Auto" as the model name.

Keep supporting your husband and hang in there. It took me a long time to come to terms with my need for therapy.

[PaulaO2]

It is a common thing for folks to remove the mask in the night.

Some people use velcro or string or whatever and pin the hose to the pillow. That way if he takes off the mask, the noise of the air doesn't go very far and it wakes him up.

And thanks, Idaho. I learned something new!

[newbie wife]

Thank ya'll so much! I didn't expect him to be able to put it on and sleep all night from the get-go so I understand there is an adjustment period. Will try the Velcro/string idea and see if that works. His new FFM he thought would be harder to take off without him knowing it but judging from last night he didn't have any trouble. LOL

He says he has a hard time going back to sleep when he wakes up but I have yet to see him put it back on after this happens, he will just turn off the machine and go right back to snoring. Can not convince him to put it back on and try again that this is the only way he is going to get used to it. That's usually when I get yelled at and told I am treating him like he's 5! haha

[PaulaO2]

He could also put on the mask, turn on the machine, and sit in the living room and watch television. This will get his brain and face used to the feeling.