wickedsleepy - Sleep Therapy Analysis

[wickedsleepy]

Hi, I'm new to using a CPAP machine.  I've known I've had some form of sleep apean (obstructive or perhaps mixed) for a number of years, but I finally got in for a sleep study, and it was confirmed that I do indeed have sleep apnea.  I was told its not severe but (at least for that night) it was enough to warrant a prescription for a CPAP.

I've had the machine (Resmed Airsense 10) for just over 1 week, and it has been pretty miserable to try to get used to.  I was already sleep-deprived, but this week has been hell.  There are a number of issues, but I think the worst issue is that almost every time I start to doze off to sleep, I half-consciously notice that I pause breathing after exhale, and my brain jolts me awake to inhale.  This makes it pretty impossible to fall asleep and stay asleep.  During the course of the night, this happens over and over, and the auto-feature on my CPAP (I'm set to auto between 5 and 20 to start out) start cranking up the pressure to 11 or 12.  By the time I reach that point, I've been awakened over and over many times and now the pressure is so high that I can't fall back to sleep.  I shut the machine off, turn it back on, and the whole cycle repeats.  Most nights, I hang it up after a few hours and try again in an hour or two.  Its pretty bad.  I feel like I'm starting to get sick and have a hard time focuing my vision.  I have talked to my doctor a few times, and nothing he's suggested has helped.  He's now on vacation for the week, and I'm ready to throw this thing out the window.

Anyone else have this issue?  Did it resolve?  How?  Does this sound like central sleep apnea or what I've read is called "Treatment Emergent Central Sleep Apnea"?  I am otherwise relatively healthy (sleep-deprived but healthy).

Thanks, everyone.  I was really gung ho about diving into using the CPAP, because I am desperate to feel better, but every night is still a total battle.

[Gideon]

First set your min pressure to 8 and turn the ramp off.

Now post your daily screenshot from OSCAR and that will give us a good idea of what is going on. Then we can take a dive into your issues.

[wickedsleepy]

Thanks, Gideon.  Ramp was off, but I also turned off EPR (was at 1) because of other things I have read.  Set the min pressure to 8.  

Once I figure out how to get the OSCAR screenshot, I’ll do that, but overall this was an improvement, I think.  I had some episodes as described at first, but I was actually able to fall asleep and stay asleep!  This yielded one of the other problems, however.  When the pressure increases as I sleep, the air eventually moves my tongue, fills my mouth, and blows my mouth open.  Dry mouth, loud, not super restful, and my wife is not a fan .  

Chin strap?  Move to full face mask?

[wickedsleepy]

Hi everyone,

It's been two months since I began this journey into CPAP-land.  I have struggled every single step of the way.  I don't have a personal computer (only a work machine) and so I can't install Oscar, so I'm not sure how much advice any of you can give, but it's worth a shot.  I have tried four different masks, and it's like trading one set of problems for another, with nothing really working consistently.  I am exhausted and, in spite of what the MyAir report shows on my phone in the morning, know that I am having apneas and other weird things happening on most nights, still.  I have huge bags under my eyes and struggle to mentally function on probably half of the days each week.  

I am currently swapping back and forth between the P10 nasal pillow mask and the Airfit F30 hybrid full face mask.

The P10 mask is way more comfortable and would be my preferred solution.  However, once I fall asleep, the tongue, which normally rests so well against the roof of my mouth, relaxes and falls when I drift off to sleep, breaking the seal and allowing all of that lovely pressurized air to blow out through my lips.  I keep hearing from both online and the home health care CPAP supplier how chin straps are the solution for this.  I have no idea how.  They barely help at all.  I have been using a chin strap for weeks, and while it might keep my jaw mostly closed, the air still rushes through my lips when this happens with my tongue.  No chin strap on earth will stop that.  Plus, after nights of wearing the chin strap I start having really painful symptoms with my jaw, almost locking and sending shooting pains up the jaw and into the ear if I chew something too much.  FYI, as far as I can tell I am not currently a "mouth breather".  I had a septoplasty and turbinate reduction about four months before I started CPAP, so my nose and sinuses are generally clear.  Still, the mouth leaks basically render the CPAP therapy ineffective, not just waking me up over and over all night, but resulting in feeling like I've been having higher apneas (but which I swear are not detected and recorded by the machine).  I've tried also taping my mouth, which takes some getting used to, but it either freaks me out too much or in the night a flap will loosen and the air blows right out through the corner of my lips, again.  So, that doesn't really work long-term.

The mask I switch to after a handful of horrible nights with the P10 is the F30.  I have to strap the F30 on fairly tight to not leak all over the place once my jaw relaxes.  It's not that comfortable (though could be worse), and I have weird things happen in the night when I wear it.  A few times last week I noticed, while sleeping on my side, that I woke up because I was rapidly breathing in and out, shallow rapid breaths.  I've never experienced that before.  It kinda freaks me out and makes me not want to wear the FFM.  But honestly all I want is a solution that works so I can finally sleep well on a consistent basis and start feeling better.

Any advice?  Anything that has worked?  I wish there was something to hold my tongue in place or at least to hold my lips closed that could be removed easily in an emergency.  Am I destined to use the FFM and so better start getting used to it?  Anyone have any experience with the rapid breathing with a full face mask?

Thanks

[nightgagger]

I've struggled with the same issues. I had a septoplasty, laser ablated uvula...etc.

Once I finally got CPAP, and following the suggestions by those gurus on this board, I have now succesfully reduced leaks to nil.

First of all I use the following masks and alternate:
P10 and Brevida. I have found the P10 with a large pillow works the best.

I use the Knightsbridge chinstrap/cap. That holds my chin in place and it's comfortable for me. I haven't experience hot issues, or any of the things I've read on this forum. It works for me.

I do have Bruxism, so I also wear a custom mouthguard on my upper teeth.

Finally, the most important part I can convey, I tape my mouth using Smith& Nephew BSN Cover-Roll stretch. This was the game changer. Amazon sells it.
I'm not worried about the tape issue as you mention, I know my body will wake me up as part of it's survival instinct.

Now if I can sleep more than 6.5 hours, that's my next problem to deal with.

Anyway, it's a slow process and you have to really be patient with things to try to get great numbers, etc.

[wickedsleepy]

Thanks, nightgagger

I, too, use the large pillows with the P10.  I have that same tape - I found out about it in here.  How wide do you cut it?  Do you attach to your regular skin (and do you need to shave) or do you attach to the lips?  I recently saw the Knightsbridge chin strap.  It's pricy, but I might give it a try.  I'm bald, so maybe it will keep my head warm haha.

Thanks, again

[nightgagger]

I cut the tape about 2.5 - 3 inches wide.

I do attach it to my skin, and I get the best sealed right after shaving.  If I don't shave after about 2 -3 days, then my leaks start up.  Not always constant now, but I can see it ramp up in the Oscar data.

The Knights bridge cap is also a game changer.  It's the most comfortable one I've used, as far as holding the chin/jaw correctly.  The others were similar to what you described, they just pushed up in the wrong angle and would give the worst pain.

The KB cap is also something that you have to get used to as far as how much tension you'll put on...in other words not too tight, not too loose.  Something that will need a few times to adjust, just be patient with it.

I have this crazy regimen every night...takes about 5 or so minutes to put everything on...I also wear earplugs as my gf snores (no apnea according to her sleep study)...so I'm a bit of Tommy...deaf, dumb and blind boy(sometimes wear eye covers..especially if I nap in the day.) Ha!

[wickedsleepy]

My wife looks at me with all this gear on my head like WTH?  I got the earplugs, too.  Otherwise, the slightest thing awakens me. Yeah, I look like I'm ready to blast off into outer space.

I'll give the KB chinstrap a try.  Are there better online vendors than others for this?  I usually use Amazon, but I don't find it there.

Ah, for the tape... that is going to be my challenge.  I have a beard -it's not long, I keep it short, but it's there.  My wife won't be loving it if I shave it off .

[nightgagger]

Well I tell the GF to hang on to the joystick and get ready for the ride  
Actually she encourages as she wants me to have a better quality of life, as well as preventing a heart attack or any of that stuff.

Yes, a beard would be a challenge.   I think that Jason/LeftyLanky27 youtuber made a video on this issue.  There's no way I could use the tape with a beard.  I used to have a goatee and before I found this particular tape, trying other brands, I was not successful. 
Once I shaved, and started using the cover-roll,  I got much better results.

I usually use Amazon as well for supplies, etc.  but no KB chin strap.  I believe the manufacturer only sells direct.

Hopefully that will work for you!

[OpalRose]

Hi guys,
You can find the "Knightsbridge Sleep Solutions Chinstrap" at Supplier #37.