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Have you tried both replacing the hose and trying different settings on it? That sounds like pretty warm setting….and perhaps the hose is defective…did you use the same hose with your last machine?
I noted that Sierra (who, we all agree is decidedly awesome, BTW) mentioned a cervical collar. I should have included that one among the self help possibilities. One of my acquaintances is using all three in combo therapy: PAP, a MAD, plus a cervical collar. He reports that although he’s not a pretty sight at night, it DOES work well for him and his spouse is happy to not be awakened by his snoring…
Either side will help a lot, but if GERD is a problem, then sleeping on your left side is your better bet. But changing sleeping positions is NOT the easiest thing to do…preferred sleeping position is a very ingrained habit. And remember that the vacuum/negative pressures created during an apnea are quite capable of suctioning up acidic stomach juices, creating serious heartburn/acid reflux issues.
The appropriate dental device will depend on the nature of your airway narrowing, but the most common is a Mandibular Advancement Device (MAD). It consists of forms that go over both your upper and lower teeth with an adjustable hinge mechanism at the back that can be gradually ratcheted forward over time. The effect is to pull your lower jaw forward while you are sleeping to maintain an open airway. The trick is to avoid getting TMJ before you get relief from the SA. I tried a MAD for travel purposes, but ran into that problem. But I also know people for whom it has worked well-some as an adjunct to PAP and some as sole therapy for mild to moderate SA.
I don’t know where you are located, but here in the NE USA, it has been an exceptionally bad year for allergies. But the ineffectively treated SA is possibly the source of your headaches, because morning headaches are a classic SA symptom.
Here are several possibilities:
1) It is possible to combine two forms of therapy: E.g. PAP AND a dental device. Sometimes people requiring high pressures use that combination to stay within the range of the machines when their pressure demands seem to be rising. It can be a little tricky to avoid the mask impinging on the device in your mouth, but it is usually doable; the dental device will help open your airway and the pressure requirements will go down.
2) depending on the architecture of your airway, a palate expansion or other surgical procedure may help. But investigate and research surgical procedures and success rates very carefully. And seek out the best experts. Palate expansion works best when the airway is narrow left to right. Top to bottom constriction may require a different type of procedure. If your problem is a deviated septum, nasal surgery would be necessary. It helps to know where the obstruction(s) is/are occurring.
3) those ideas won’t help you in the very near term, or in time for your vacation, of course. So, the things you can immediately do yourself (assuming you aren’t already doing them) are: A) positional- sleep on your side-not your stomach or back; sew tennis ball pockets into the back of your PJ tops, if necessary or use pillows: B) deal with allergies or nasal congestion using OTC meds or simple nasal saline; those problems can increase pressure requirements; C) Get a chin strap to help keep your mouth closed, to avoid drying out mucus membranes because that may be contributing to the sore throat and remember to hydrate before sleeping; D) longer term, if overweight, lose the weight. Even a little will help. And investigate diet and exercise programs that help sleep.
I’ve seen a lot of negative reviews out there, too. It’s a little scary. There is an FDA Board involved in oversight of medical devices and given the proliferation of devices in the sleep field, we should make an effort to get one or more knowledgeable sleep patients on that Board.
Most people have a much higher AHI in REM than in nonREM sleep. The Average or overall AHI hides more than it reveals, sadly. I had an overall average of 19, considered moderate at the time, but during REM it was a very high 83, when I could even stay in REM which wasn’t often because I was desaturating below 60. when that happens, your body goes into alarm mode and you awake gasping with your heart pounding. That, in itself, is quite stressful and anxiety producing…..it “wires” your CNS. Being effectively repeatedly suffocated during most of the night is not just bad for your sleep, it is very stressful on your CV system and the hypoxemia is harmful to many of your organs and metabolic processes. The damage SA produces is underestimated by both the public and the policy-makers. The cardiologists “get it”, though.
There’s another reason to avoid sleeping meds. If you have sleep apnea, the only thing that keeps you alive is that you DO wake up to breathe.
BabaG: what was the nature of your insomnia? Inability to fall asleep? Or inability to stay asleep? Either way, can you describe in more detail?
Pre PAP treatment, I fell asleep BEFORE my head hit the pillow, but would awake like clock-work every night after 3.5 hours, unable to return to sleep. I had an AHI of 83 in REM and was desaturating below 60%, so couldn’t maintain REM. I was misdiagnosed with insomnia, but fortunately never took sleeping pills, or i probably wouldn’t be here writing this. It took me 30 years to get properly diagnosed and treated.
It might be useful to get another data point by checking your O2 levels while sleeping to determine whether you are desaturating. If so, you are likely experiencing apneas. You can do that yourself using an overnight recording oximeter. They are available online, and communicate via bluetooth with your smart phone.
If you aren’t having apneas, could you be experiencing hypnogogic jerks? And if you ARE having apneas, are they obstructives or centrals?
Can you get them to restate the diagnostic study in AHI, since that is the metric used by the licensing authority? And is this in the US?
