DanM

Hi Omer, and welcome to MyApnea.Org. I am happy to hear that you were persistent with your concerns and have received testing and treatment. It sounds like you possibly received 2 diagnoses: Obstructive sleep apnea and Obesity Hypoventilation Syndrome. I will try to answer your questions as best I can.

1. There are many mask brands and styles available for purchase. The comfort of each mask is specific to how well the mask fits your face. If the company that is selling you a mask has options, you should try several of them on and see what type feels best. All masks usually take time to get used to, and there is some amount of pressure on the face when wearing a mask. However, a mask should not be so tight that it causes skin problems. The mask should be snug enough to prevent significant air leak.

2. Each mask style will sound different because the holes that allow exhalation of carbon dioxide are going to be made differently on each mask. This is another thing to consider as you try different masks. How comfortable is the mask? Does it seal well, or is there a significant amount of mask leak? How much noise do you hear and will that noise disturb your sleep? If possible, you should try various masks on and wear them in the same position as you normally like to sleep.

3. Some people experience a change after their first night on CPAP. For others, it may take several weeks to notice a difference. The key is to persist and wear your treatment whenever you sleep, including when you nap.

4. See number 3. For some people, the results of treatment are quickly noticeable, while others may not notice significant changes right away. If you continue to feel sleepy or tired after two or three weeks on treatment, I encourage you to talk to your doctor about other reasons you may be tired.

5. Patients with OHS sometimes require treatment that is different from CPAP. Generally, all equipment providers in the US who sell CPAP also sell BiPAP. The treatment you are provided should be based on the doctor's recommendation. It is not uncommon for OHS patients to use BiPAP, but the only way to know your needs is for your doctor to review your sleep study results and to continue to follow you to make sure the prescribed treatment is working.

6. CPAP or BiPAP treatment may improve your energy level so that you are better able to stay awake. It is not possible to say whether you will be able to drive for hours, as there may be other things that are contributing to your tiredness or sleepiness. I was originally tested for sleep apnea because I did fall asleep while driving. Thankfully, no one was injured and I woke up before causing a serious accident. I can say that my treatment with CPAP has improved my own level of fatigue, and I no longer worry about falling asleep while driving.

7. There is evidence that CPAP can contribute to both weight loss and weight gain. This is specific to each person. For some people, weight loss occurs because they have more energy and are able to exercise and be more active. CPAP alone is not likely to cause weight loss.

As for your sleep study results, the AHI is what is usually used to gauge the severity of your sleep apnea. It does appear that you had 33 minutes of REM sleep. Hopefully, with treatment, your sleep and your blood oxygenation levels will improve. Please let us know how things progress for you, and I do encourage you to continue to be followed by the sleep doctor to make sure your conditions are treated properly. Best wishes!

Hi WarmheartedTaupeEland7664. Generally, manufacturers recommend that nothing is added to the water in a humidifier chamber. However, there are products available to add aromatherapy to CPAP treatment. Most involve using the external filter. If you do a quick internet search on CPAP aromatherapy, you should be able to find additional information. Best wishes!

Hi Verne7. Glad to hear you are sleeping better. Most prescriptions use a starting pressure of 4 or 5 cm for patient comfort. The majority of patients I have worked with over the years find anything more than that too uncomfortable. For other patients, higher pressures are more comfortable. My low pressure is currently set to 6 cm because I have the same problem you describe. I feel like I'm not getting enough air at lower pressures. For patients who experience this, most physicians and home care companies will work with you to adjust settings to prevent the feelings of "air hunger" you describe.

Hi Wiredgeorge. A trach would serve as a cure because it is usually placed below the area that commonly obstructs in patients with sleep apnea. The surgery was more common many years ago before there were alternative treatments like CPAP and mandibular advancement devices. It is much less common now and tends to be used in patients with problems that are more complex than sleep apnea alone. It is generally not presented as an alternative to PAP therapy or other treatments that are much more feasible and easier to manage. Hope this helps!

I agree with wiredgeorge's advice to give it a week or two to see if you continue to adjust to treatment. If you are still feeling tired, a follow up with your doctor to discuss other possible causes might be needed. Please let us know how you're doing!

Hi PioneeringSapphireTiger2107. Medicare requirements are complex, but hopefully your physician can help you navigate the process. Have you been able to find out exactly what Medicare requires in order to justify payment for your treatment?

Sounds great, LOVE2Sleep! Please let us know how things work out for you.

I Verne7. Glad to hear you've been able to lower your mask leak and obtain a better seal. Have you tried tightening your headgear just slightly to see if it keeps the mask from becoming dislodged? Just curious... Thanks!

Hi LOVE2Sleep. Wiredgeorge makes a good point about calling the medical supply provider that provided your equipment. You may need a different type or size of mask. When headgear is adjusted too tightly, it can sometimes cause leaks or impede airflow in nasal pillows because the soft material of the pillows can collapse. A properly fitted mask should generally be snug but comfortable. Please let us know how it works out for you!

Hello. I think you would likely need to contact sleep physicians in your area to see if any of the physicians are using EERS (Enhanced Expiratory Rebreathing Space). The sleepeducation.org website has a link, "Find a Sleep Center" that may be helpful.