Hey all.

Firstly, I am new here and new to OSA.  Its really cool to find a place to talk to others about my OSA problem.

I was diagnosed with "severe" OSA with an AHI of 47 a month ago.  My average desat was 92% with the worst at 87%.  They titrated me at 9 and sent me home on a resmed S7 lite with heated humidifier.  I have worn the machine 8 hours a night like clockwork.  I tried 3 different masks and have settled on one that I can live with.  I fall asleep without any trouble in about 10-15 min.

Ok, now my problem:  I wake up at least 10-15 times a night that I can remember.  Way more than with no CPAP.  I think I actually dream a little now, but cannot stay asleep for any length of time.  Prior to the last year, I have always slept the entire night.  My only other problem has been allergic rhinitis and nasal congestion for the last year or so, which is being treated for a few months without much relief.

About 2 weeks into CPAP, I consulted with my MD and they upped it to 11.  No changes.

I had them switch me out to a ResMed Autoset Spirit set at 7-15, thinking my varying congestion might be a problem.  Been on that for a week.  More comfortable, but still no change.

When I wake up, I have no mask leak, no dry mouth.  I check the machine to see if it powered up due to some apnea, and it is usually around 9-10.

Why am I waking up?
How long did it take you to sleep all night after you got over the initial machine woes?

I am committed to the PAP (for now) and think I have adjusted to it well.  But I just can't sleep!

Your thoughts are appreciated.

Dirk

Hi Dirk!
Can you get a hold of your complete reports?  There might be something helpful there.
Get the AL Canada Sleep Apnea Handbook in the FAQ, there's a lot of helpful info in there.  Being on CPAP has now probably changed your sleep architecture at least somewhat, so things that were not necessarily problems before could be problems now.  Like medications, PLMs. too much caffeine or alcohol, eating at the wrong time, GERD, or overall poor sleep hygiene.  In other words, CPAP might not be the culprit, so while "wait and see" could very well be the answer, it certainly doesn't hurt to check these things in the meanwhile.
Eventually, you might want to consider another sleep study to try to zoom in and determine the cause of these awakenings if they don't improve.  Check back.
sleepydave

I have been on CPAP for 3 weeks.  I noticed an improvement the first night.  I no longer have to take naps during the day.
I still have mild insomnia, takes an hour or so some times to fall asleep. I still am hard to wake up, but I think that is because I'm only getting about 7 hours sleep.  I have been hard to wake up all my life though so I don't expect CPAP to fix that.
I do wake up aprox 1 time a night from a dream state.  I would say that I am having more dreams and more vivid dreams since I started CPAP. I don't think it is apnea that is waking me up, it seems to be the vividness of the dreams, but I could be wrong.

Once I am up, I have energy.

One of the things that the therapist told me when we were setting up my machine was that it may
take quite a while to feel any improvement, depending on how long you had been sleep deprived.
He mentioned that for him it was in the 6 month time range.

I have been on my machine faithfully, with the exception of this past week, since the end of May,
and while I can definitely see improvement in some things (no night sweats, no twitching muscles,
no need for afternoon naps) I'm still not at 110%     My pressure is set at 14 for now, but last
Tuesday, I had UPPP, so I am hoping to bring that pressure way down, if not get rid of the machine
altogether. The doc that did my sleep study seemed to feel that removing my "overly large" tonsils
might add to my relief. The ENT thinks that I will most likely still have the machine but be able to drop
the pressure.  I certainly HOPE I get SOME benefit from this pain  

WOW... all that rambling to get to the point... You most likely aren't going to be at optimum the first
week after you start on the machine. I look at it this way: any improvements are worth it. My main
one is waking up with dry sheets in the morning.


_________________
=^) Valerie

What is wierd is that I wake up so much.  Before CPAP, i only woke up a couple times a night that I can remember, but now it is 10+ times.  I have no trouble falling alseep and do not seem to be bothered by the mask at all.

I slept in the chair the other night and slept uninterrupted for about 5 hours.  Could I still be having apnea with the CPAP?  Maybe good old gravity is enough to help with this?

Has anyone else had better results sitting up while sleeping?

Is it possible/likely that I would still have episodes of apnea with an auto and good mask seal?


Thanks for the thoughts......

sleepydave wrote:

Get the AL Canada Sleep Apnea Handbook in the FAQ, there's a lot of helpful info in there.  

Hey Dave.  I can't find any such handbook.  Can you point me in the right direction?

Thanks

Dirk~
I'm not familiar with any other machine but mine, so please forgive my question:
is yours a straight CPAP? or is it a CPAP with C-FLEX? Mine is a REMSTAR with
C-FLEX which means that the pressure drops when I exhale so I don't have to
push against the PAP. My machine is set at 14 for normal, and I think it drops to
8 for exhale. If yours doesn't do this, that could be a contributing factor.

What does your water reservoir look like at the end of the night? Has the level
dropped? or is it the same as when you went to bed? I dunno why I'm asking...
I haven't had difficulty with mine, I just plugged it in, filled it up, and started using
it until this last week. It may be that you still have something mechanically not
cooperating in your airway...

Sorry I couldn't be of more help...


_________________
=^) Valerie

Hey.

I am using a ResMed Auto.  Set at a range of 7-15.  The pressure does not drop when I exhale like a bipap.

I usually go through about half the water in the res.  No sore throat or anything.  Sometimes my tounge gets dry.  I wonder if my mouth is coming open or my tounge is still blocking.

Could be...
do you use a full face mask? or just a nose guy?
I know that the outside humidity/weather conditions
often influence how much water I use during the
night. And how dry my throat is when I wake up,
even with the humidifier going.

You might have the sleep doc take a look at the
structure of your mouth. Some people have a tongue
that sits really high in the back, so they often still
have trouble with the machines.  Me, I had large
tonsils and lots of excess palate tissue. I was getting
good results, I thought, with the machine, but the
sleep doc suggested I see an ENT about having the
tonsils removed. One way to see if your tongue may
be the problem is to take a look in the mirror with
your mouth open like you are saying "aaahhh". If
you can see most of your uvula, then you are most
likely in good shape. If not, then you might talk with
someone about your options there. You might also
see about getting a machine with C-FLEX. It might
be that you are waking up because you are having
trouble fighting against the PAP and your brain knows
you are building up CO2 in your system.

Just some thoughts... nothing really educated about them.


_________________
=^) Valerie

Good points.

I use a nasal pillow most of the time and switch to a nasal mask when my nose needs a break.

It does seem like my lungs gradually fill more and more when I am falling asleep.......

A wierd side note.  The other night I taped my lips thinking that my mouth was coming open.  I woke in a panic thinking someone was stabbing me to death..... Ripped off my mask and basically freaked out for about 10 sec.  I think it is safe to say that was a hypoxic event.  What was wierd is that how could that happen with the maching pumping air in me full blast?  I wonder if I had another obstructive event and my natural reaction to gasp and open my mouth was messed up by the tape?

What a strange and troublesome journey this has been...........

hmmm... there is no gradual fill for me... I can immediately feel my throat
and chest expand as soon as the machine kicks on.  Of course, I use a full
face mask, so that is definately gonna make a difference.

Dirk:

Quote:

A wierd side note. The other night I taped my lips thinking that my mouth was coming open. I woke in a panic thinking someone was stabbing me to death..... Ripped off my mask and basically freaked out for about 10 sec. I think it is safe to say that was a hypoxic event. What was wierd is that how could that happen with the maching pumping air in me full blast? I wonder if I had another obstructive event and my natural reaction to gasp and open my mouth was messed up by the tape?

You mentioned in your first post that you are dreaming more... maybe that
has something to do with it? Kind of like your body waking you up because
of the apnea, maybe it is your subconscious dealing with the dreams... dunno...
interesting thought tho.

I always thought it was really cool that I could remember the details of every
dream I had before I started on Pappy, but after looking at the results of my
sleep study, I realized that I could remember them because they were so
infrequent it was an abnormal occurance!

You might check in to getting a full face mask to see if it helps...


_________________
=^) Valerie

Hi Dirk (and everyone)!

I'm new to this forum and it is good to find so many tips as I am starting my treatment. I was diagnosed with moderate sleep apnea 1yr after a sleep study at Beth Israel Medical Center in Boston. During a second study to try the CPAP, the doctors could not find a good pressure (too much obstruction), and we opted for a septoplasty to alleviate some obstruction. I had the nasal surgery in January and I am scheduled for another study at the end of the month.

A few things were mentioned to me that may address your question: Why do you weak up at night while using a CPAP?

1- If you use a nose mask, it may be simply that you open your mouth during the night (even only periodically). That would render the CPAP more or less useless. A chin strap or a full mask may help, if you can support it.

2- The CPAP helps alleviate obtrusive apnea by opening the throat. However, in some instances (and it looks like that may be my case, more on that after my third study) the CPAP may cause central apneas, i.e. the brain stops sending signals to the breathing muscles and you weak up. In effect, the CPAP causes you to hyperventilate, which triggers a drop of your carbon dioxide level, to which the brain is even more sensitive than to oxygen levels, which in truns sends a signal to hold your breadth. For my next study, the doctor has recommended that we try a mask with an added "pocket" in the front that plays the role of carbon dioxide regulator and can prevent central apneas caused by the CPAP. Another option that we are also investigating is the use of a dental devise that could alleviate the obstruction without generating central apneas. I'll let you know the results of my tests and what worked, or did not work for me.

Michael-

PS: For the sleep apnea handbook, I searched with Goggle and found a "Sleep Apnea Action Handbook" from "The Lung Association" in Canada. Was that what Dave mentioned?