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First week hell

Talk about all aspects of sleep apnoea. Request help from others with the same problem, tell your story, exchange tips & techniques ..
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First week hell

Post by JDRB » Sun Mar 04, 2018 10:18 pm

Hi all,

I was diagnosed with an overnight pulse oximetry as part of a workup for gastric bypass surgery (i'm BMI 50.6). I never considered I would have OSA, but it wasn't a surprise (and I'm a doctor). The technician told me that my average SaO2 was 83% during sleep, and that I had on average 75 'dips' lasting over 15 seconds per hour.

I had no problematic daytime sleepiness but do think I had fatigue, difficulty waking, poor concentration, irritability, lower mood, less motivation. 

Anyway, I was given a Philips Respironics DreamStation for a week set to AutoCPAP to check my necessary pressure. I was given a DreamWear mask. 

Well, the first week has been horrible. I have struggled with it, but the DreamMapper app says it's not going well. I think it majorly due to me being a mouth breather, and when trying to drift off and testing the nasal pillows, feeling really congested. I usually use a very strong antihistamine (fexofenadine 180mg) and Avamys steroid nasal spray all year round for allergies. 

The first night I was so conscious of the mask being in the right place I kept waking up to reposition it. That was my best night. The rest og my nights it has felt that the mask hasn't been in the right position or that I'm mouth breathing, as the stats are terrible. I kept it on for the whole night (at least 8 hours a night for 5 nights), but the machine registers only 1-2 hours of use. My AHI is still quite high too. Last night I was so p*ssed off with it all, trying to use my nose to breathe that I took it, and at least slept a long time. The first night is the only night I woke up feeling good although i had insane dreams. The rest have just felt like worse sleep. It's been freezing in the UK recently and the second night caused my nose to feel painful and icy, so I left the heating on for the rest of the week, but then it was too hot to sleep. 

I have a review with the technician tomorrow to see how it's gone, and I want to ask for a full face mask. I have a beard - will this affect things? Trying to breathe out against the nasal mask (along with my blocked nose) felt suffocating. Are mouth/full face masks like this? 

I'm a side sleeper, no partner. My apple watch shows I'm quite a restless sleeper (whatever that is measuring), and that only about 30% of my sleep is restful. 

Basically, I don't think the first trial week has been good as the mask feels like it's not on or not working, and I am just mega disturbed by having to have to smush exactly into the right place on my nose, even when I don't know if I am nose breather. 

Any ideas or help? I have attached some pics from my app if they're any use.

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Re: First week hell

Post by Sleep2Snore » Thu Mar 08, 2018 5:19 pm

For a start it looks as if you have the wrong type of mask for you.
Secondly, I know it is to try to set up a machine for your pressures, but giving someone a machine with pressures as low as 4 is just silly. I would have it a minimum of 8 and maybe even 10 just so the machine does not hunt around to much and it might even catch a lot of the apnoeas before they even happen.

You should use a full-faced mask or even a total face mask if you have a heavy beard (though I doubt the NHS will pay for that mask).

The only other mask is a Hybrid mask that is between Nasal Pillows and a Full-faced mask.

I would try to get an ResMedAirsense10Autoset, even if you have to pay for one yourself.
It is the best option and best machine I have ever used. It is also Sleepyhead compatible for data and you can use this data to treat yourself after you get used to using it. The guys on the other bard will help you get close to your goal and you can do the fine tweaks yourself after you get some data.

Beards do affect things a bit, however, I had/have one and I have nights these days thanks to the Resmed10 Autoset of 0.0 which means I had no events on then night at all. I have a virus just now and a heavy cold so I had 0.5 last night, just because I couldn't get breath and I kept knocking the mask.
However, I had 7 days in a row with 0,0 AHI.

The Dreamstation is not a bad machine, but it does take a bit longer to respond, not drastic, but noticeable, it has one advantage, it will try spiking the pressure to see if your breathing improves, if it does not it will settle down again, I did notice it doing this and found it annoying, but after I was asleep I don't think it disturbed me.

It is maybe to late now, but I would have increased to low pressure to see if that had helped you.
If you think you breath through your mouth, you should ask for a full-faced mask.
I am not sure if you are in the UK or not, but there are options open to you in America that might not be an option here.
If you have the option, go for the ResMed Arisense10Autoset with a full-faced or Total mask, but a Fullfaced mask should be fine unless you have a heavy beard.

Let us know how you get on. Sorry for the late reply, I have been ill.

I need a doctor! :lol:
S2S - Sleep2Snore

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Re: First week hell

Post by CPAPPED » Sun Mar 11, 2018 4:49 pm


Sorry to hear your not getting on with the CPAP treatment in your first week, I have recently been diagnosed with SA as well, I'm 49 not over weight and have snored my head off for years with constant complaints from partners who ended up in the spare bed on most occasions. I initially had a sleep study done a few years ago and the results were negative for SA but I didn't really sleep that night, anyway having found myself being sleepy in afternoon meetings I had the SA check done recently and was found to be having SA periods of 27 times an hour (moderate SA). I have the Resmed airsense 10 with humidifier and full face mask as I'm a mouth breather. I've been using it for 2 weeks and today I feel shattered and the report on mysleep says high air leak. I do find myself waking up to adjust the mask as I feel air leaking from it but have tightened it too much and now have a red mark on the bridge of my nose. I stayed at my partners last night for the first time with the machine and instead of complaining about my snoring she left the room complaining about the noise of the machine, it seems I cant win either way and will just have to get used to living and sleeping alone as I don't want a life of arguments about keeping partners awake.
Hence, I come back to your issue about a bad nights sleep. I think the biggest issue with the CPAP is getting the right mask seal with no leaks during the night, it seems that there are special pillows available to provide room for the mask to sit without being nudged by the pillow. If your a mouth breather during sleep then you most likely need a full mask and especially if you get a blocked nose as I do.

I think the key to a good sleep is a clear unblocked nose, the question is why do we get blocked all the time. I have an appointment with my doctor to get an allergy test as I get blocked at random times and cannot associate it with anything in particular.

I hope you get things sorted and start getting the benefit of the CPAP treatment soon.


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