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Lygodia Therapy Thread: Optimizing My Airsense 10 - lygodia - 12-04-2023
Hello all. New to CPAP & this forum.
I received my CPAP a few weeks ago, and I have yet to fall asleep while using it. I have always been very sensitive when it comes to sleep. My most relevant anecdote is that I could not use a retainer after getting my braces off as a teenager; having the retainer in my mouth physically prevented me from sleeping. (No one believed me & asserted I wasn’t trying hard enough, but that’s another story.) I similarly failed to use two separate at-home sleep tests over the past few months for sensory reasons. The only reason I got any data from my in-lab sleep study was because I was stuck there for 8 hours with no other option but to persevere.
That brings me to now. I have been trying very hard to sleep with my CPAP, but I have been unable to physically fall asleep. Once I remove the mask, I fall asleep as I usually would. I have been trying to make adjustments - changed pillow arrangement, lowered room temperature + added fan, turned off ramp, adjusted initial pressure + temp + humidity, swapped masks - but I’m still not falling asleep. After around 90 minutes, I end up throwing in the towel, because I live alone and work for a living and need some sleep to function, even if it is mediocre.
I like my current mask (Resmed Airfit P30i), but I am waiting for a cozy (should be here tomorrow). I also have another mask on the way to try out (Dreamwear Gel Nasal Pillow) (should be here Wednesday). I’m still making adjustments - before I take the mask off, I make sure to write down why so I can review it the next morning.
My compliance window starts later this week, and if I cannot fall asleep, the 4 hour minimum becomes extremely difficult to meet. I’m lucky I have an office job and can bring my CPAP to work to grind out hours if I need to, but something has to give.
My medical “team” (if you can call them that) has been exceptionally unhelpful. I don’t have a sleep doctor, even though one reviewed my sleep study; I saw a nurse practitioner once, and she has had no suggestions except to take something OTC like melatonin (which does not help; this isn’t an issue of being tired). My DME is even more unhelpful; they had no suggestions since I like my mask.
I know this was very long, but I’m so worried about meeting compliance and I feel like a failure. I’m looking for advice, especially if others went through a similar situation. Thank you.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - PeaceLoveAndPizza - 12-04-2023
It is a familiar journey for many of us, but we need data to help. If you have not put an SD card please do so. Please download OSCAR and post some charts so we can help figure things out.
The links in my signature provide the info you need for downloading and installing OSCAR, and how to produce the charts.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - Nightynite - 12-04-2023
Sorry you’re going through all this. It sounds like you have some anxiety and rightfully so. I would think your PCP would have been a little more understanding and give you a 30 day prescription of something that would help you relax and get comfortable with your new equipment.
Sometimes when our health care providers don’t help, it’s time to move on and find someone who does understand and helps.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - staceyburke - 12-04-2023
Try reading or watching tv with it on. Sounds weird but it does 2 things. First it gets you use to the pressures and the feeling of the mask and machine and second it counts as time spent using the machine.
The machine can only tell if it is on and you are breathing, it can’t tell if you are asleep or awake - only if you are using it
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - lygodia - 12-04-2023
I do have OSCAR! I was really excited to use it to analyze my data... but there's nothing to analyze, since I'm not asleep. I'll include my data from trying to sleep last night anyway, if you want to see it.
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I didn't mention my PCP in my post, but she's even more useless than the other medical professionals I've mentioned. I'm waiting to get a new PCP. I have an appointment scheduled, but that's nearly 3 months away.
I do see my psychiatrist this week. I don't know if he'll be able to do anything.
I have been practicing with it, though it is a major pain to have to haul everything out of the bedroom & back into it. (Like I mentioned in my post, I plan to bring it with me to work. Compliance has to happen one way or another.)
To be honest, though, I don't fully understand the rationale behind the practice - I find the mask comfortable, and nasal pillows especially sit very differently (to me) when I am sitting fully upright (vs. sleeping on my side, which I usually do).
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - PeaceLoveAndPizza - 12-04-2023
Quite a bit to unpack there.
First thing, please read the link in my signature about “Organise your OSCAR Charts”. We only need to see a few of the graphs to get started. In particular Event flags, flow rate, pressure, flow limits, leak rate, and snore. The rest folks may ask for after reviewing those six.
It takes a while to adapt to any mask. Many wear it whilst watching telly or reading. Don’t worry about the statistics during this adaption period. Awake breathing is far different than during sleep.
It is hard to discern anything from a 90 minute session. Basically a few arousals, but I’m not sure there is more than 30 minutes or so that are true sleep breathing. What is there looks fine, but it should not be interpolated to an entire evenings data.
Two comments on masks. It is of utmost importance to not only have the right mask for you, but to also make sure it is the proper fit. Many online retailers on our Suppliers list have 30-day trials for masks. There are quite a few YouTube videos explaining how to fit and adjust masks. Many on this forum can help as well.
Hang in there. I suggest focusing on getting comfortable with the wee beasties and adjusting to sleeping with them. It pays off in the end for most, but it is a process that requires patience.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - UnicornRider - 12-04-2023
I fully support everything PL&P has said.
Your time at the office will help even if you are sitting up. At home you could try using it while in a recliner watching the TV. to enhance your learning time.
Some of us took months before one day, the realization hit, that we actually look forward to our mask.
It will take time.
Hang in there.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - paulag1955 - 12-04-2023
Am I correct in understanding that you were fully away for the entire session?
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - SarcasticDave94 - 12-04-2023
Most unfortunately for CPAP users is that doctors you're dealing with are not very good at helping. Also it doesn't require a sleep doctor to script CPAP and supplies.
It sounds like you're in need of firing and replacing several Dr. DoNothings.
What mask did you select? Nasal pillows would be great to reduce negative interaction with it. There's exercises you can try if you mouth breathe, to attempt to keep the natural tongue seal.
Nasal pillows, to nasal, to full face masks, in order of least to most cumbersome and also in the same order on sealing difficulty.
What are all the settings you're using. We can see pressure of 6.6-15. Are you using EPR at all? Ramp? Humidity and heated hose? All but ramp may help comfort and therapy efficiency.
RE: I haven’t fallen asleep with my CPAP yet. Seeking advice. - lygodia - 12-04-2023
Thank you for taking a look. I have OSCAR set up for next time. I'm not surprised there isn't must to go off of - I was fully conscious while using it. I was pretty relaxed, but didn't manage to drift off. (It's been like that every night so far.)
Thank you for the reassurance. I'm hoping compliance will help with just the sheer hours. (And hey, I do sit at my job for a while... so that should help a bit.)
Not the entire session, but most of it. Looking at my data, they coded me asleep for about 4 hours (45 minutes in REM & 200 minutes in NREM), though I recall being conscious for much more of that. My deep sleep was extremely fragmented - it took 2 hours for me to get just a hint of N2 sleep, and I spent a lot of the night crying out of frustration.