TL;dr – I want to like the machine, really (or at least I’d love the results that I see many people get), but I’m really having a hard time. Biggest problems are – still waking up choking / other symptoms with it, general discomfort / distress / noise
Actually I’d hoped (and so had my sleep doc) to get by without it, but not so far, and it seems like my last hope left for the short term since I’ve tried everything else.
Anyway, some relevant data, problems and things I’ve tried:
- 34 yo male, BMI of 30, definitely over optimal weight but not morbidly so
- Extreme fatigue (disabled most of the past 7 years), not sure how related to OSA etc, but definitely sleep deprived and classic OSA symptoms the past 9 months+
- AHI was like 7 or 8 in my test last October
- ResMed S9 Escape Auto (which only gives a few basic readings)
- APAP mode and pressure is like 9-14, settles around 10 while in use; EPR on 2 full-time
- F&P Eson nasal mask is the one I’ve done the best with
- Also have Rio II nasal pillows (had trouble keeping them in my nose, willing to try again); and AirFit N30i (nice and comfy but extremely loud)
So while trying to use the machine off and on over the last few months:
- 13 days used >= 4 hrs (might be over reported)
- 24 days used < 4 hrs BECAUSE I HATE IT no wait, because I’ve had trouble using it
- It reports low AHI when it’s run for several hours, usually below 5-6…. BUT……
- Sometimes the pressure changes suddenly and wakes me up
- Sometimes I get a leak and it wakes me up
- Sometimes it’s just too noisy and/or uncomfortable (I’m a pretty light sleeper)
- Sometimes it blows my mouth open and wakes me up (after drying my mouth out for a while)
- Sometimes I still wake up with choking and other symptoms even with CPAP. The other night this happened so badly I gave up in disgust.
On the best days it’s a struggle with the noise, not to mention all the things I have to fumble around with and attach to my head, etc. (by which time I am no longer sleepy). Which leads me to what I’ve tried so far:
- Just try to get used to wearing it, breathing with it, adjusting for no leaks, etc – some progress made, can probably use some more
- Fiddle with pressures per online guides – a little, but since I’m still not sleeping, not much help yet
- Chin strap – first one didn’t keep my mouth closed that well unless really tight, and pushes my jaw backward which seems to be bad for me per Dr.
- Chin strap 2 – goes under the jaw and pushes back much less, but is even less comfortable
- Mandibular advancement device – was hoping to use this alone, Sleep Dr. thought it might be the best option for me based on my anatomy. But hasn’t done it so far.
- Nasal surgery to reduce turbinates, straighten septum, reinforce collapsing nostrils (valves) – Dr hoped it would help CPAP effectiveness; not so far but it has helped daytime breathing
- Earplugs and/or ear buds with something to listen to – help, not all that comfortable
- Drugs – ambien helps me fall asleep if not sleepy (am hardly using that these days); antihistimines keep me drowsy, most days now I use 1/4 dose of diphenhydramine (Benadryl) which is the shortest duration I’ve found. — not sure if these are a great idea with CPAP / OSA though!
- Sleep hygiene practices, etc – they help but only so much
- Sleep mask for my eyes, and sometimes silicone nasal dilators (because my nostrils still collapse)
- Edited to add – side sleeping and raising the head of my bed up
Sorry for the long post, but anyone have any great ideas I could try?? Getting pretty desperate here. Thanks much!