Lots of problems trying to tolerate CPAP

Hi

I'm new to this forum and new to CPAP.

I'm a doctor myself (Maxillofacial Surgeon) here in the U.K. but I need some advice.

Cutting a very long story short...

I have recently suffered multiple minor strokes secondary to severe, untreated hypertension which was probably already present in 20s (now just turned 55). My hypertension proved difficult to control. As part of the work-up, I underwent sleep studies that showed I have significant sleep apnoea (Sorry! English spelling!) and I was commenced on PAP about 4 weeks ago with a Philips Respironics device with the thought that my sleep apnoea was contributory to my hypertension.

I have been REALLY struggling to make this work for me. I really wanted and still want it to. Since my 20s I have suffered with symptoms such as headaches on waking but symptoms of day-time somnolence have never been a problem. They are now since I've been put on this machine!

I'm a bit overweight now especially since having to give up work about 6 months ago...but not clinically obese. And I already had some of the apnoea symptoms, according to my wife, when I was much slimmer...even with a BMI at the lower end of normal.

During the time that that I've had it (about 4 weeks), I have only actually managed to fall asleep with it on once! That only last for about 1.5 hours. In the whole of the rest of the time I have NEVER fallen asleep with it on and I either lie awake for hours trying to put up with the damn thing...or just rip it off in order to get some sleep!

I'm now actually exhausted and DO have symptoms of daytime somnolence!

It is just as well that I'm no longer able to work as a surgeon (the strokes have affected my fine motor control) because if not, I would now be finding it impossible to work.

I've had problems with masks but have now been given a nasal only (Dreamwear) mask which seems better. They programmed my machine down to a pressure where frankly it was probably of little efficacy at all anyway...and now back up again to the point that when the pressure automatically goes up I feel like a dry gale is being blown up my nose and it actually feels painful after a while!

I've now been given a humidifier to attach to the device (yet to use it).

Are there any other tips experienced users can give me please...I'm at my wits end! I really do want this to work both for myself and also because I feel a sense of embarrassment to my doctor because he's gone out of his way to help me as he's someone I've known since we were both very junior doctors! :(

Thanks in advance.

Lots of stuff here but to boil it down, you have medical conditions which would benefit from PAP therapy. The mask seems to be at the core of your issues with compliance. Since you make enough money to try different masks, I suggest that is a logical avenue for you to undertake. No matter how well meaning your sleep doctor or technicians are, they are not the ones with the mask on your face I had to try several masks before coming upon one that I was very comfortable with. Some masks tried were intolerable. I settled on an Amara View mask. Since you are not in the States, not sure which masks are available but I would find one that you can live with, doesn't make you uncomfortable and allows you to get some sleep. If your sleep doctor hasn't seen a patient struggle with masks and compliance, he has now so should welcome a bit of experience in this regard. Good luck and check in again when you are down the road with therapy a bit.