Sierra

There is a website started by a pharmacist that was concerned about the use of sleeping pills especially in the elderly. It apparently significantly increases the risk of falling and breaking a hip etc... There are a lot of good tips there including the use of the CBTi process.

https://mysleepwell.ca/

Good advice!

David. thank you for that account of your experience. Mine is not totally different but diabetes got me first and along with that came high blood pressure and cholesterol. Fortunately I got good treatment and brought those issues back into control, as well as my weight. My apnea came later and I have to admit that I was really not having any sleep issues, but I was annoying my wife with snoring. She had gotten a CPAP much earlier than me, and was on my case to get one. She tested at about 73 or so for AHI and the CPAP did amazing things for her. She now averages less than 0.5 for AHI. When I broke down and got tested I came in at 37 or so. I did not take well to the CPAP and the first or second night I was considering opening the window (second story house) and throwing the whole thing out the window. I did not fortunately as at that point it was a loaner machine... In any case I finally worked things out and made friends with the CPAP. I don't do as well as my wife as I have central apnea issues, but I am still managing to stay under 1.0 for AHI.

Your message is a valuable one. When I think about it now I was ignoring the symptoms of diabetes and had it for a long time before diagnosis. It was kind of strange how I figured it out. I was out of town with my son who was in a hockey tournament. One of the kids on the team got hurt and I ended up taking them to a rural hospital. They had to call a doctor in to check him out (it turned out he had a ruptured spleen), and while I was waiting I read a pamphlet that was on the rack. It was about symptoms of diabetes. I realized at that point I checked all the boxes. I saw a doctor when we got back to the city and sure enough my BG was off the chart.

That was 23 years ago now, and thanks to insulin and a few drugs my BG, BP, cholesterol are well under control. The CPAP is still probably the most invasive treatment, but it works! We should be thankful for technology. Many others before us did not have it...

If the Dreamstation is like the ResMed you will have lost all the detailed data. ResMed machines only send high level summary data over the air to the cloud. However, you can start collecting data now by inserting a SD card. If it is like a ResMed all you need is a 4 GB or up to 32 GB SDHC. The machine should format it when you insert it. You may have a old SD card around from a camera or GPS.

"The following machines have been tested and are supported by OSCAR v1.4.0: DreamStation 2

DreamStation 2 CPAP (410X150C, 410H11C, 410T11C) - see note 3 below DreamStation 2 Advanced CPAP (420X150C, 420H11C, 420T11C) DreamStation 2 Auto CPAP (510H11C, 510T11C) DreamStation 2 Auto CPAP Advanced (520X110C, 520X130C, 520X150C, 520H11C, 520T11C) DreamStation 2 Auto CPAP Advanced with P-Flex (521X120C, 521X140C)"

Here is a video on where it is located if it is a supported model.

https://www.youtube.com/watch?v=VkBkhGYZSHk

It is also possible that the supplier of the CPAP has removed the card. It is a dirty trick, but some do it.

You may want to try using OSCAR to provide more detail on what is going on during your CPAP use. There may be room for improvements to the setup.

I am afraid I would be very skeptical about the effectiveness of EPAP. It only increases pressure on exhale, and I suspect by not very much as there is no indication of the pressure. My experience is that apnea events are more likely to occur in the inhale portion of each breath. In fact most CPAP machines reduce pressure on exhale without any impact on apnea frequency, and in some cases reduce the number of hypopnea events.

The second issue with an EPAP is that it does not monitor the effectiveness of the device by giving you an AHI score each night. You can even use some freeware called OSCAR to give you much more detailed daily report. My AHI at diagnosis was 34 which is in the severe range. With my CPAP I now average 0.85 for AHI. My wife does even better at 0.5 for AHI.

I use a very minimalist mask after unsuccessfully trying a number of other types. Each person has their preferences but I like the ResMed AirFit P10 Nasal Pillow. This mask is also very quiet and does not disturb the other person. My wife uses a bit different mask called the F&P Brevida. It is a bit larger, but is easier to adjust for fit.

Your best bet would be to try the CPAP again. Successful use usually depends on finding a mask type that works for you. What mask did you use last time and what were the issues?

My wife uses a mouth appliance for TMJ and uses it while using a CPAP and has no issues.

Here is a link to the posts made by @SleepDent in the past few years. You may want to check them out to see if any are of help.

https://myapnea.org/members/SleepDent/posts

There is a dentist that checks in here now and then. Hopefully he will see your post and give you a response. I have no experience in that type of approach.