6 ms·

Welcome to my sleep-apnea life. The CPAP is only partially effective due to (surprise, surprise) a new allergy to... well, everything airborne, seemingly, inclu

Welcome to my sleep-apnea life. The CPAP is only partially effective due to (surprise, surprise) a new allergy to... well, everything airborne, seemingly, including house dust... and even though Allegra does a decent job, sometimes I unconsciously take the thing off in my sleep, and proceed to have a much shittier sleep: http://i.imgur.com/f9oHjqQ.png http://i.imgur.com/f9oHjqQ.png

trjordan 11y ago
That's crazy. My restlessness graphs don't look much different than yours -- is the sleep apnea what's waking you up after 5-6 hours?
- rconti 11y ago
  Seriously. I sleep like a baby and often show 30+ times restless.
- lectrick 11y ago
  I'm... not sure. Sometimes I have trouble falling asleep (insomnia), although SOME of that can probably be attributed to late-night device usage (I use Flux, but the iPhone won't have "time-based screen yellowing" until the next iOS release.) My girlfriend, who sleeps in the same bed as me, also gets up around 6, and sometimes that wakes me (not most of the time, fortunately).
- DenisM 11y ago
  If you wake up after 5 or 6 hours well-rested, that's all you needed. If you feel like shit when you awake, and yet can't go back to sleep to catch up on the deficit, then you may have some variety of mood-affective disorder. The excess adrenaline makes and keeps you awake as soon as you rested a little bit in the first 5-6 hours. It also makes you dehydrated, and longer-term it forms a vicious cycle due to accumulated sleep deficit. This condition requires attention of a medical professional, which I am not.
DenisM 11y ago
Do you have the latest CPAP machine? The latest generation is a dramatic improvement over the older generations, especially with the exhale relief, this yields less discomfort and more compliance. I can't recommend it enough.
- lumpypua 11y ago
  Any particular suggestions? I need to go shopping soon.
  - DenisM 11y ago
    I swear by my Resmed AutoSet S10. They have too many S10 models, so be sure to get the AutoSet (or higher), as it dials the pressure up and down. I'm kicking myself for sticking with an older S8 model for far too long, all the misery I endured was entirely unnecessary! Proper pressure is the key to compliance. This machine has auto-set, so the minimal required pressure is used; it has better algorithms for it (compared to S8); and it has exhale relief (it drops the pressure when you start exhaling). It's easier to exhale, thus reducing the overall pressure. An additional way to reduce the pressure is a neck pillow. I use one with a silly name of Dr Dakota. Aside from keeping your chin from falling down, it keeps your neck straight, and so it opens up the airways. It's a big deal if you have bad posture, like I do. This was a dramatic improvement for me. Further, reducing the pressure will reduce leaks, and thus reduce pressure further, as the machine won't need to compensate as much. A virtuous cycle, if there ever was one. And lastly, reducing the pressure allowed me to use a nasal pillow mask, which is very comfy, easy to maintain, and has the lowest leaks of all designs I have tried. I can't use it at high pressure due to mouth leaks, but I can handle it at the low pressure, and due to mostly zero leaks now ... the pressure goes down even more. Combining all of these, I brought my leaks to zero (like, 90%th percentile), and AHI to less than one, like 0.6 is in there most of the time. That's only one event per the 90-minute sleep cycle. Good luck!
    - lumpypua 11y ago
      Thanks for the extensive answer! I did an at-home CPAP trial after a sleep and they gave me some POS machine and I hated it. Unfortunately getting anything more fancy is going to require jumping through insurance hoops. rolleyes Pretty new to this whole thing. My posture definitely makes a big difference, I'm at 9 AHI sleeping on my side but 50+ on my back untreated. I'm gonna duct tape pillows to myself or something. Glad you found something that works for you!
shas3 11y ago
There is research that shows that at least with outcomes measured by BP, CPAP and mandibular devices are almost as good: http://jama.jamanetwork.com/article.aspx?articleid=2473494 http://jama.jamanetwork.com/article.aspx?articleid=2473494
- lectrick 11y ago
  That's fine for BP, but what about elevated cortisol levels as a result of repeated breath cessation? In my case a MAD was not helpful, unfortunately
PhasmaFelis 11y ago
I don't know if this helps, but most people have to try a few different CPAP masks before they find one that's really comfortable for them. This is pretty much the normal usage pattern, and most insurance that covers CPAP at all also cover multiple masks, so I don't know why doctors don't push it more. For the record, there should not be any air hissing out around the edges of your mask. If there is, you either need to get a different mask or at least adjust the straps on your current one. My experience is that full-face masks absolutely don't work with a beard; a nasal pillow mask works much better, but I do need to keep my mustache trimmed short or it chafes a bit. Also, I don't know much about the allergy angle, but you're theoretically supposed to change the air filter regularly; there might be filter options designed for allergy sufferers.
- lectrick 11y ago
  Nasal pillow mask is (relatively) the bomb IMHO. Don't even try anything else, you will be disappointed. Good point about the air filter; I need to get a new one
  - PhasmaFelis 11y ago
    You might also try being rigorous about regular cleaning, if you don't already. In theory you're supposed to thoroughly clean the hose, mask, and reservoir daily. I'm lucky if I manage it every other month, and it works fine for me, but I don't have any major allergies.

trjordan 11y ago

That's crazy. My restlessness graphs don't look much different than yours -- is the sleep apnea what's waking you up after 5-6 hours?

rconti 11y ago
Seriously. I sleep like a baby and often show 30+ times restless.
lectrick 11y ago
I'm... not sure. Sometimes I have trouble falling asleep (insomnia), although SOME of that can probably be attributed to late-night device usage (I use Flux, but the iPhone won't have "time-based screen yellowing" until the next iOS release.) My girlfriend, who sleeps in the same bed as me, also gets up around 6, and sometimes that wakes me (not most of the time, fortunately).
DenisM 11y ago
If you wake up after 5 or 6 hours well-rested, that's all you needed. If you feel like shit when you awake, and yet can't go back to sleep to catch up on the deficit, then you may have some variety of mood-affective disorder. The excess adrenaline makes and keeps you awake as soon as you rested a little bit in the first 5-6 hours. It also makes you dehydrated, and longer-term it forms a vicious cycle due to accumulated sleep deficit. This condition requires attention of a medical professional, which I am not.

DenisM 11y ago

Do you have the latest CPAP machine? The latest generation is a dramatic improvement over the older generations, especially with the exhale relief, this yields less discomfort and more compliance. I can't recommend it enough.

lumpypua 11y ago
Any particular suggestions? I need to go shopping soon.
- DenisM 11y ago
  I swear by my Resmed AutoSet S10. They have too many S10 models, so be sure to get the AutoSet (or higher), as it dials the pressure up and down. I'm kicking myself for sticking with an older S8 model for far too long, all the misery I endured was entirely unnecessary! Proper pressure is the key to compliance. This machine has auto-set, so the minimal required pressure is used; it has better algorithms for it (compared to S8); and it has exhale relief (it drops the pressure when you start exhaling). It's easier to exhale, thus reducing the overall pressure. An additional way to reduce the pressure is a neck pillow. I use one with a silly name of Dr Dakota. Aside from keeping your chin from falling down, it keeps your neck straight, and so it opens up the airways. It's a big deal if you have bad posture, like I do. This was a dramatic improvement for me. Further, reducing the pressure will reduce leaks, and thus reduce pressure further, as the machine won't need to compensate as much. A virtuous cycle, if there ever was one. And lastly, reducing the pressure allowed me to use a nasal pillow mask, which is very comfy, easy to maintain, and has the lowest leaks of all designs I have tried. I can't use it at high pressure due to mouth leaks, but I can handle it at the low pressure, and due to mostly zero leaks now ... the pressure goes down even more. Combining all of these, I brought my leaks to zero (like, 90%th percentile), and AHI to less than one, like 0.6 is in there most of the time. That's only one event per the 90-minute sleep cycle. Good luck!
  - lumpypua 11y ago
    Thanks for the extensive answer! I did an at-home CPAP trial after a sleep and they gave me some POS machine and I hated it. Unfortunately getting anything more fancy is going to require jumping through insurance hoops. rolleyes Pretty new to this whole thing. My posture definitely makes a big difference, I'm at 9 AHI sleeping on my side but 50+ on my back untreated. I'm gonna duct tape pillows to myself or something. Glad you found something that works for you!

shas3 11y ago

There is research that shows that at least with outcomes measured by BP, CPAP and mandibular devices are almost as good: http://jama.jamanetwork.com/article.aspx?articleid=2473494 http://jama.jamanetwork.com/article.aspx?articleid=2473494

lectrick 11y ago
That's fine for BP, but what about elevated cortisol levels as a result of repeated breath cessation? In my case a MAD was not helpful, unfortunately

PhasmaFelis 11y ago

I don't know if this helps, but most people have to try a few different CPAP masks before they find one that's really comfortable for them. This is pretty much the normal usage pattern, and most insurance that covers CPAP at all also cover multiple masks, so I don't know why doctors don't push it more. For the record, there should not be any air hissing out around the edges of your mask. If there is, you either need to get a different mask or at least adjust the straps on your current one. My experience is that full-face masks absolutely don't work with a beard; a nasal pillow mask works much better, but I do need to keep my mustache trimmed short or it chafes a bit. Also, I don't know much about the allergy angle, but you're theoretically supposed to change the air filter regularly; there might be filter options designed for allergy sufferers.

lectrick 11y ago
Nasal pillow mask is (relatively) the bomb IMHO. Don't even try anything else, you will be disappointed. Good point about the air filter; I need to get a new one
- PhasmaFelis 11y ago
  You might also try being rigorous about regular cleaning, if you don't already. In theory you're supposed to thoroughly clean the hose, mask, and reservoir daily. I'm lucky if I manage it every other month, and it works fine for me, but I don't have any major allergies.