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Having to get up at night to clear passage ways

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redwood +0 points · almost 6 years ago Original Poster

I'm wondering how common this is. I have a ResMed auto sense 10, using a nasal mask. I've been using CPAP for almost 2 mos. now. I don't usually have too much of a issue going to sleep, but I wake up usually in 1 - 3 hours. Often times it seems uncomfortable to exhale, making it hard to go back to sleep. The simple solution is to just take the mask off and go back to sleep. Obviously, that is probably not the best for me. Instead, I get up in the middle of the night, take a couple of shots of saline solution and sit until I feel my passageways are clear enough to use the machine again. This works, but I hate getting up.

My pressure setting is 12, using autoramp. My humidity level is 6. Pressure relief is on. Smart start is off.

According to myAir, my AHI's average between 2-3 per hour.

Any suggestions? Comments?

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wiredgeorge +0 points · almost 6 years ago Sleep Enthusiast

I tried a nasal mask and just couldn't use it due to inability to exhale sufficiently and a LOT of moisture. Went with a full face mask and problem solved.

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Sierra +0 points · almost 6 years ago Sleep Patron

I suffer from some congestion, and use a ResMed P10 nasal pillow mask. I find if I can get my nose reasonably clear before I go to bed, I will stay clear all night. I do use a chin strap and tape on my mouth to ensure I breathe through my nose. I will occasionally use a decongestant like Otrivin in the more congested nostril occasionally but not as a matter of routine.

My experience with a full face mask (F20) was not so successful. I couldn't find the happy medium between a comfortable fit and no leaks. Also, it seemed to promote breathing through my mouth and I think that was causing a sore throat.

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snuzyQ +0 points · almost 6 years ago Sleep Commentator

Hi redwood:

Have you mentioned this to your clinician, especially the part about it seeming uncomfortable to exhale? Your clinician may respond by suggesting some changes, perhaps to auto instead of fixed CPAP or increasing the EPR or doing something else to your therapy according to your particular needs and after reviewing your current sleep data.

I wouldn't leave this to amateurs such as ourselves here on this forum - even if you think the changes would be just for comfort. Besides, any changes will go into your medical record, which will leave you at a distinct advantage in a medical emergency or when you get passed around among providers. If you live in Canada, well...it would seem your medical record doesn't matter and your clinicians don't care...you're left to your own devices.

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Cpapian +0 points · over 5 years ago

Little concerned about you sharing false information about Canadian health care. Particularly when it was pretty much gratuitous. Why ever would you say such a thing. We have excellent care and follow up, our medical records matter and our clinicians care. We are not "left to our own devices".

I suggest you limit your comments to matters in which you are knowledgeable.

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Sierra +0 points · over 5 years ago Sleep Patron

SnuzyQ may be referring to my comments about how sleep apnea diagnosis and treatment happens in Alberta. It is frankly a bit dodgy in some ways. Yes, everyone gets a sleep study, diagnosis, and initial prescription at no cost through the provincial health care system. The study is typically done at home, and the prescription is for an APAP without any titration study. I have no problem with that as an APAP is virtually the same cost here as a CPAP. I would dread the US DME system where you have to get an in clinic sleep study, then an in clinic titration study, and then it seems a battle with the DME to avoid getting a CPAP instead of an APAP. And if the CPAP doesn't work, then a rinse and repeat with the in clinic studies to move to an APAP. In Canada, or at least in Alberta, we cut to the chase and go straight to an APAP typically of your choice, right from the home sleep study. BUT, and it is a big BUT, in Alberta at least, you or your insurance company has to pay for the APAP and mask. I believe in Ontario the provincial health care system pays up to 75% if you buy from an approved vendor, but in Alberta the health care system pays nothing. This said, it is not all that bad, as I have found Cadillac insurance is very expensive, and if you pay your own way, it can be much less expensive in the long run. Plus you can buy what you want. The only thing is that you have to go it alone for support for your machine. For those that can use SleepyHead and do it, it is fine. You can buy the whole initial package for about $850 CDN on line, and SleepyHead is free. For someone who wants the sleep clinic to look after them, the same equipment package costs $2400. So yes, to some degree we are left to our own choices. Pay the $2400, or do the support yourself -- at least in Alberta.

As far as medical records go I have no concerns at all. Alberta has an electronic record system, and I think were first out of the gate with that. Ontario tried to copy it, but bungled it big time and ran up a huge cost (debt). Don't know if they have it fully working yet. It is too bad that our medical system was not federal instead of provincial. I think there could be huge cost savings. But things are looking pretty good in Alberta. I believe they are close ( a year of so) to giving patients on line access to their own medical records. Now it is restricted to doctors, pharmacists, and other health care providers. I'm sure my current medical records show I have been prescribed an APAP and am using one, but that is it. It certainly does not contain detail like pressure settings and compliance. The compliance thing seems to be a US concern. Big brother watches to see if you are using your CPAP, and if not cuts you off. I am not aware of any such big brother process in Canada, but some province may do it.

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Cpapian +0 points · over 5 years ago

I am in Ontario and between the gov't and private insurance I paid nothing. My sleep doctor did a titration and follows up every other year. My DME followed up for a while but she quickly realized I was capable of monitoring my own results with Sleepyhead. She was pretty awesome tho - gave me some good tips. Now they just call to remind me to change filters. I think for $35 they will monitor for 5 years.

Nevertheless, both our situations are a far cry from Snuzy's intimations.

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Sierra +0 points · over 5 years ago Sleep Patron

The lesson I learned is to get your hearing checked, and your sleep study done before you end your Cadillac insurance. I had that until I was 65 and it would have paid for everything too. But, I was avoiding the CPAP stuff for as long as I could. Did the same with hearing, and still holding out on that. Having an excuse to say "I did not hear that" is not all that bad...

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snuzyQ +0 points · over 5 years ago Sleep Commentator

I'm so sorry for my comments about Canada. From what I've read in just the last 2 days (on a separate apnea forum), Canada probably has the edge concerning how they are treating their patients and managing issues around CPAP treatment (and that's even with the problems getting treated that many obstructive sleep apnea patients experience there).

I've been posting without really being up to date. I used to help out on the ASAA forum in the 3 years before that forum disbanded. At the time, that forum was really into guarding patients in the areas of prescribed treatment and diagnoses and in the doing, actually discouraged patients from getting timely access to make their therapy more comfortable and limited learning about how their CPAPs work. Everything had to go through the doctors and respiratory/sleep specialists. That takes oodles of time, all of which was occurring in the critical CPAP adjustment period. Looking back, this was probably the #1 cause of CPAP treatment failures. Canada, on the other hand, has taken the bold step of empowering their OSA patients to learn for themselves, adjust their own pressures as needed and fine tune their machines to match their needs. I truly don't know how all the changes get noted, but somehow, everything seems to fall into place and the system with its' patients is so much the better off for it.

In the USA, we've been a little slow to catch on, due to all the dinosaurs living in the past on this issue. I've had it explained to me this way: If diabetics are allowed to adjust their own insulin doses to meet their own needs (and a mistake in the doing could cost them their lives), should we OSA patients be blamed if we tinker with our little blower? Well...my mind got blown away with that one!...which is a very good thing.

So, my sincerest apologies to any who've been concerned about my comments...and thank you again for pointing out my lack.

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Cpapian +0 points · over 5 years ago

Again. I don't think you get what Canada is about in terms of health care. We haven't taken any bold steps. My doctor still manages my health care and he doesn't want me to change the settings. I don't, but only because my AHI is so good, I don't need to. But if I decide to make any changes, it is against my doctors advice. Basically, we are pretty much the same as the US in terms of follow up and care. The only difference, and it is a big difference, is that our doctor visits, hospital stays, procedures, surgeries, etc are covered by our Provincial government. In terms of CPAP, a sleep test would be covered, probably in every province. My province negotiates the cost of xpap and pays 75%. No other province in the country is that generous. The range elsewhere is anywhere from 0 to our 75%.

Other than the $$$ part of health care, we are pretty similar to the US. I think in terms of worldwide ranking our health care is ranked higher than the US largely due to it's availability to all Canadians and the lower costs.

I am glad to see you found one of the other forums. I started xPAP a year ago and got right into the forums before I even got my first machine. I think it helped me have a positive attitude and success from the first day on.

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snuzyQ +0 points · over 5 years ago Sleep Commentator

This is all so interesting. I really do appreciate the information.

Even 6 years ago, getting on a forum made all the difference in our success with CPAP, too.

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Sierra +0 points · almost 6 years ago Sleep Patron

Your comment about using 12 cm pressure seems to suggest your machine is in fixed pressure CPAP mode. If your machine is capable of AutoSet mode you may want to consider having it put into that mode. It would allow you or your provider to determine if there is any opportunity to limit the pressures to a narrow band instead of one fixed pressure. You may also find out that the 12 cm may be higher than necessary.

I did a trial on a F&P SleepStyle machine that had a feature that the ResMed does not. It detected when you woke up in the night and then reset the pressure conditions to the startup mode. It made it more comfortable to get back to sleep again. The same is not available to my knowledge on the ResMed. However you could do it manually by just reaching over and shutting the machine of for a few seconds. When you restart it will go back into the AutoRamp mode. That should be more comfortable to go back to sleep.

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snuzyQ +0 points · almost 6 years ago Sleep Commentator

Great suggestion! Thank you, Sierra.

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SleepyMommy703 +0 points · almost 6 years ago Sleep Commentator

I get a little bit of congestion at night sometimes as well, but usually it's worse without the machine. I try to blow my nose and clear everything out before I put my mask on and usually do okay this way. But when I went to a fixed pressure (which was lower than the auto was going to) I had to get up during the night and blow my nose again because it wasn't enough to keep things clear. We put it back on auto with a lower range and it seems to work better.

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Cpapian +0 points · over 5 years ago

Have you tried changing the humidity. Some people stuff up on high humidity and do better on low humidity. Others - vice versa.

Another thing to try is a Neti pot or one of the similiars. Ask the pharmacist at a Walmart. Less than $10. Rinses out your sinuses.

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