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snuzyQ

snuzyQ
Joined May 2015
Bio

dx OSA Oct/2012. Husband and I are CPAP "duelies" for 6 years now. Respironics system one and Swift FX for her nasal pillows. Husband has ResMed AirSense 10.

SF East Bay Area, California

snuzyQ
Joined May 2015
Bio

dx OSA Oct/2012. Husband and I are CPAP "duelies" for 6 years now. Respironics system one and Swift FX for her nasal pillows. Husband has ResMed AirSense 10.

SF East Bay Area, California

Hi Rick and welcome to the forum.

Are you using the ResMed Airsense 10 Auto CPAP? What are your current settings? Are you using the ramp feature? What settings were recommended/prescribed by your clinician?

Do you have a copy of your sleep study results? In this report should be a figure for AHI (Apnea Hypopnea Index). Any level over five is indicative of obstructive sleep apnea (OSA). If your number is 30 or greater than 30, your level of OSA is considered to be severe. CPAP is the first, most effective and least invasive of all the treatments for OSA. CPAP or XPAP is the gold standard for treatment of sleep apnea.

Sleep Apnea is related to a number of different medical conditions, but it happens even to those who are in pretty good shape and without any lung problems. There are studies that demonstrate genetic tendencies, as sleep apnea tends to run in families. Because my husband and I have OSA, our children are 98.7% likely to develop OSA sometime during their lifetimes. My brother and my sister both have OSA. I suspect my father had it as he snored so thunderously, but not everyone who snores has OSA. We'll never know for sure because he never had a sleep study done. OSA tends to worsen with age and with changing conditions (lack of fitness and weight gain). Having a sleep study done and finding out that you have obstructive sleep apnea is a great gift...because now you can do something about it. And it's worth getting the best treatment for it because untreated OSA will likely lead to an entire host of health ills (diabetes, high blood pressure, car accidents, high cholesterol and atherosclerosis, stroke, kidney disease, CHF - even cancer and early death). My husband's father, who also snored thunderously, developed all of these ills along with all the diabetic complications. But he also was never sleep tested, though we encouraged him to get a study done. The thought of being hooked up to a machine made him never want to know. It was really too bad. We tried to show him that CPAP is just a different way of sleeping and once acclimated to it, you never give it another thought. And that's usually because you just feel so much better when the apnea is adequately treated...much less sleepy and fatigued during the day. Our pleas fell on deaf ears. He died 5 years ago. My father died 10 years ago.

So...let's get your therapy up and running. Your difficulty breathing out against pressure most likely is related to your treatment pressures and settings. This is a common complaint of patients who are using fixed, rather than auto CPAP and/or who are not using ramp for comfort. Please answer the above questions and we'll try to help you more directly.

As you have already found, our brains are very good and quick at making associations. The associations that your brain has made in this case are: mask = insomnia, and, no mask = relaxation and sleep.

Your job now is to get your brain to make a new association which will negate the old associations. This new association should be; mask = relaxation and sleep. Now troubleshoot...what can you do to make this new association happen? If this were me, I think I would handle it this way: I would put on my mask while still up and awake (but nearing bedtime) and read a book (something I find very pleasant). I would read until my eyes began to get tired and I started to feel sleepy. Then I would have a "chat" (silent thinking) with myself: "Wow...I'm feeling really sleepy with my mask on...I don't want to fall asleep in this chair/sofa/recliner...I think I'll go to bed now and hook up (with my machine)". Once in bed and hooked up, with my machine on I would continue the "chat". "My mask is on and my machine is going and I'm feeling very sleepy. It's safe for me to go to sleep now. I'm so thankful for this mask and machine for how it makes me feel so rested in the morning. I will always sleep with my mask on...this is my lifeline...what a blessing. CPAP is my best friend ever.....I'm feeling really relaxed now...It's OK to go to sleep this way...I like this." I would keep the conversation going until sleep sweeps me under and my very last conscious thoughts are something, anything, positive about my CPAP treatment.

If I found myself wide awake after this restful "talk", then, without judgement in any way, I would just get up out of bed and out of the bedroom (with mask in hand), go get a cup of soothing tea and linger over it, put the mask back on and grab my book once again. The book must not be a wild adventure story...just something fun and relaxing. Then, after putting my mask back on, I would read until my eyes got heavy again. Then back to bed. Repeat this as many times as you need to until you finally fall asleep with your mask on and your machine running. Your desire/need for sleep will overcome you...with your mask on.

Repeat this process each night until your brain transitions with the new association: mask = sleep, comfort, relaxation, sweetness, a good refreshing night, etc.

Never, ever, fall asleep without your mask on and your machine running. It isn't safe for you to do that anymore. Tell yourself that over and over again. Believe it...because it's true.

Our brains are amazing tools and are quite malleable. You may be surprised at how fast your brain picks up again on this way of sleeping. The keys in working with it are patience and persistence. You must outlast your brain. You can do this!

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.