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MountainGoat

MountainGoat
Joined Jan 2019
Bio

I'm 50, male, married and have two boys. I'm a CPA working at a remote gold mine in Papua New Guinea. The mine is at about 7,200 feet above sea level.

Brisbane, Queensland, Australia (home) and Middle of Nowhere, Morobe Province, Papua New Guinea (work)

MountainGoat
Joined Jan 2019
Bio

I'm 50, male, married and have two boys. I'm a CPA working at a remote gold mine in Papua New Guinea. The mine is at about 7,200 feet above sea level.

Brisbane, Queensland, Australia (home) and Middle of Nowhere, Morobe Province, Papua New Guinea (work)

I've suffered with seasonal hay fever, allergies and sinusitis all my life and have sensitive skin also, including nose and face. To complicate things further, the ENT said I have very small nasal passages, so much so that when he did the nasal endoscopy, he couldn't get the camera through the right nostril and had to use the left. We spoke about CPAP and using a nasal mask. His advice was to use steroid nasal spray every night. Apparently the dose is so low that it doesn't have any systemic effect and can be used permanently.

When the time came to buy a mask, I opted for the Resmed N30i. It doesn't have anything that go into your nose, it just seals against the underside of your nose and have openings corresponding to the nostrils. The starter pack is supplied with three different sized pillows, so finding one that fits your nose is important. The air pressure inflates the pillow and I find it seals quite well. I'm a side sleeper and find the mask reasonably comfortable overall and will probably be even more comfortable for a back sleeper. The air connection is at the top and swivels in both directions, so it isn't in the way of your arms when you turn around while sleeping. I tuck the hose between the pillow and the headboard and haven't found it to be restrictive or get in the way.

I found that at higher pressures, I ended up breathing through my mouth but tucking a pillow tightly under my chin helped for that and I so far don't find it to be a major issue.

Depending on the pressure you have to use, it may not work for you though.

Habit forming is a very good way of putting it. Bad habits, and I have many of those, are unfortunately also habit forming.

The body is very adaptable and will always rather adapt than die. Changing for the better fortunately can use that same mechanism. As an example, I was treated for very high blood pressure in 2016 and because the treatment was so effective, it dropped my blood pressure quickly, although it still was slightly above normal. However, that quick change was enough to make me feel dizzy every time I got up. My blood pressure is now lower than that and I feel fine.

I think this is the mechanism for real change, but it works in both the good and bad direction, depending on what is happening in your body.

The way I understood it is that your body will become used to the higher level of oxygen and undo the changes its made to cope with the lower oxygen saturation caused by OSA.

The OP's experiences are interesting. If her sleep issues didn't cause O2 desaturation, there isn't an obvious reason for the body to have adapted either by changing breathing patterns or making more red blood cells. However, I find the same thing when my red blood cell count is as high as it currently is. Very pink hands and red lips, especially when back at sea level.

I have to add that I was in the same position with buying a CPAP v having another sleep study, which is what the pulmonologist wanted. The cost of that, plus the titration was almost as much as the CPAP, so decided to rather buy the machine as my elevated haemoglobin and haematocrit definitely pointed to an issue with O2 desaturation.

So far, I think it was the right decision.

Hi All,

I started another thread about what experiences people's had with objective medical tests like blood tests to show an improvement possibly due to CPAP, but as a further introduction, reposting my intro from that post here.

I was referred for a sleep study as I suffer from type 2 diabetes, hypothyroidism, hypertension, obesity (31 BMI), polycythaemia and elevated haematocrit, high triglycerides and low HDL cholesterol as well as low testosterone. The doctor who referred me felt that the only way all of these can come together is due to OSA and that treating this will resolve a lot of these issues.

During the sleep study done in May 2017, I was diagnosed with severe obstructive sleep apnea, AHI 31.5. Due to the quality of the sleep study, which by the looks of it from other's comments here are pretty standard, I wasn't convinced that CPAP was really indicated. My reason for this was that the study found only 2.9 events per hour of obstructive apnea when on my back (NREM) and zero for other positions, including during REM sleep, for an average of 1.1 NREM and 0 REM. The hypopnea events though was a lot higher at 31.9 NREM and 26.7 REM. The thing is, I don't sleep on my back and the NREM OA events of 2.9/hr was actually while I was awake, waiting for day to break.

After subsequent visits to an ENT and a pulmonologist, both recommending CPAP, I decided to take the plunge. Interestingly enough, and admittedly after only three nights of use, the machine reflects similar findings to the sleep study with an average of 0.43 obstructive and 0.73 hypopnea events. However, the clear airway events are 4.57 average, pushing the AHI up to 5.73. The sleep study didn't recognise any of the hypopnea events as central apnea but again understand that often happens with sleep studies.

I started using a ResMed AirSense 10 Autoset with N30i nasal mask three nights ago, but have done a lot of reading on machines, masks, OSA etc. before the time and found this forum to be a fantastic resource. We're currently still fine tuning the settings on the machine, so hopefully the central apnea events can be reduced while maintaining the obstructive and hypopnea events at a low level.

What makes life more complicated for me is that I work at an altitude of 2,200 meter (~7,200 foot) above sea level for up to 16 days at a time, with a break of 7 to 10 days at sea level. This also has an effect on my polycythaemia and elevated haematocrit, as the wonderfully adaptable body adjust for the lower level of oxygen by creating more red blood cells.