Sleep Apnea

I am going online to J.C. Penny's next as the inclining pillow is something that I will definitely use. I use to put one end of my bed up on bricks, pans (etc) but cannot handle this heavy pillow top mattress. I use a lot of pillows behind me but end up with a sore neck.

I am listening to each of you. I believe that my best hope is to ask for the full face mask and not the nasal pillows that I had previously chosen.

The diet is starting today. Goal is 20 lbs. and I will add a little walking to jump start the process. Iloveart
-----------------
Mike


posted by Chiptin
8 days ago
bttt


posted by Chiptin
8 days ago
I got the breath-right to work last night. Truly it seems to work however, I am now missing skin on the side of my nose. The adhesive is more than I can handle. I do feel more rested today and slept well I think. The Tech I talked to this morning tells me it is not nasal, but a throat problem so the breath-rights may have a minimal effect, but the machine will have a major effect.

The C-pap is coming with-in the next two days. They tell me that all apnea episodes are negative with the machine. Wow!!! I am going to work with this machine as I am committed to making it work for me.

I am setting my long term goal to include more exercise, careful diet, and doing what I can to lessen the impact of what I have contributed to my condition.

I told the tech that I had been online with masters of the c-pap and had good information.
To be forewarned it to be forearmed. I believe that I feel well-armed for my challenge due to all of you taking the time to help me. This is a very good site and I am so glad that I found you. Again, to all who responded, you were a breathe of fresh air and I do appreciate your time and effort.



posted by Iloveart
7 days ago
A little soap and water in the morning may help remove the Breathe rights strips without taking off skin. You may need to apply a moisturizer, such as aloe vera lotion to help speed healing.

If you don't use the Breathe right strips, it's always a good idea to keep some available when you have a cold or sinus infection. The strips will open up the nasal passages a little to help you breathe while using the machine.

Let me stress something here - It is extremely important that you keep any CPAP filters, masks, hosing, straps, etc. clean. Wash them regularly, especially those coming in contact with your nose/face. Bacteria can building up in the humidifier, hose(s) and mask very quickly.

Using the CPAP while you have a bad cold or sinus infection isn't fun. You may want your doctor to prescribe something like Rhinocourt spray to have available at the first side of infection. and/or a presciption for antibotics.


posted by Chiptin
7 days ago
Peterr' mentioed using an inclined support or wedge to help sleeping. First you need a wide enough one to accomodate your head and most of your back. What the inclined sleep position does for some of us, is keeps the tongue from relaxing too far back and blocking the airway.

This is dependent on a number of factors, tongue size/volume, sleep angle, sleep position (on back, or side), etc.

There are probably other factors, maybe sinus, that are affected by the incline.

Warning though: sleeping for a prolonged period of time in an inclined position, whether it's on a wedge, in an adjustable hospital bed, a Craftmatic bed or sleeping in a recliner; you risk compressing your spine in some manner, and possible misalignment of your hips.

More to come.


posted by Chiptin
7 days ago
bttt


posted by Chiptin
6 days ago
Inclined Sleeping Positions

This is from personal experience, and it was a very costly and painful lesson to learn. It may not be applicable to everyone, because of a variety of physical factors, but it pays to be knowledgeable and cautious.

Early on in my obstructive sleep apnea (OSA) lifetime, and it feels like a lifetime has passed, I learned that the more erect I slept (no wise cracks ladies), the better I could breathe while sleeping with an improved quality of sleep. Of course, it didn't always work out so well; not enough incline - head falling forward; cramps in the legs - from pressure on the recliner foot rest; cramps in the neck; dry mouth/throat from snoring, etc.

I first tried propping myself up in bed using various methods; all too uncomfortable, and ending up with a crimp in the neck, sliding down, rolling over, you name it. Not practical. Plus I wasn't up to shelling out hundreds of dollars for a hunk of foam you find in a medical supply store.

Next venture was sleeping in a big old recliner. After some aborted attempts, I finally seemed to get it right, most of the time. The leg cramps waking me at night were downright painful.

Ok, so this went on for a couple of months, sleeping alone out in the living room, putting up with the kids coming home from a late night out, or my step-son coming out for a late night snack in kitchen.

So, my wife and I finally decided to invest several thousands of dollars on two Craftmatic beds. You've probably seen the commercials, looks like fun, and practical. My wife spend a great deal of her time after work sitting on our bed correcting school papers and she prefers reading and watching TV propped up in bed. It was a marriage made in heaven, the idea of having adjustable beds, side by side. And she would have the remote adjustment option.

More to come.


posted by Chiptin
6 days ago
Got the machine yesterday and will give it a try tonight.
The lady told me that seldom do you adjust outright. it takes about six months to be able to sleep through the night.

Today was a very hard day for me. Got up at 4:00am and drove my 40 miles to work. I was sooo tired all day.
If this machine can help at all, I am going to give it my all.
That little machine in it's own case is $1200.00 plus the 3 hospital stays. Thank heavens for Medicare and insurance huh? Believe it will all be covered for those that want to know.
I have a feeling that I will do better at home as I can relax. If it needs to come off, I can make that quick decision until I can handle it for good. My plan is to make it work.


posted by Iloveart

Chiptin --- my husband and I also have two Craftmatic beds and he has the C-Pack. I just have the nasal oxygen. (A short note here -- I have sleep apnea and stop breathing a number of times during the night. My sleep study, however, showed that I got no REM sleep and that I was getting to much Nitrogen and not enough Oxygen at night. I CANNOT sleep with my mouth closed! I also need the oxygen at night for my heart or I have irregular palpitations.) At any rate - we got the Craftmatic beds. They do not make for a marriage made in heaven in our case --- we have them strapped together -- but they still come apart and just are not suitable for "romance"! I would love to have a regular bed back if only we both could breathe!!! MOM


posted by laughingspirits
5 days ago
Just to let you know, I now have the C-Pap but can't fall asleep with it on. I will keep trying. I have ordered the wedge incliner from Penny's and that is on the way.

I am not one to ever drink anything but will try a glass of wine before bed tonight. That should help right?


posted by Iloveart
5 days ago
I'm going to say that wine is probably not a good idea, besides you may have to get up to pass it.

You should discuss this with your doctor, a pulmonary specialist is he/she?

They might prescribe something like Ambien to help you nod off.

Don't expect this to be easy and give up. If you don't get enough sleep, then don't perform any chores, like driving, washing clothes, when you're so tired. You could seriously endanger your life.

Is it a problem with comfort? Fit? Air leaking out? does your CPAP have the RAMP-UP feature, where it starts at a low air pressure and goes up to a higher one?

I assume that the machine is a one pressure setting only (besides the possible ramp-up feature), that is your doctor or the sleep study tech told the Company you got the machine from to start it at a particular setting?

Is the pressure too little or feel like it's too much? If too much, consult with whoever determined the initial setting.


posted by Chiptin
5 days ago
This is the wedge peterr was talking about:

view link


posted by Chiptin

Not to throw a wet blanket on the wedge idea, but the angle of it may not be steep enough to alleviate your symptoms. It may lessen them somewhat? As I said above, I slept in a recliner at first.

Also, if you start increasing the slope of the wedge (sleeping on two or ?) you run the risk of possibly throwing your back, spine, hips out of place.

Something to think about before jumping into it. I will be ordering one for myself, it will probably help my situation some.


posted by Chiptin
5 days ago
Iloveart --- I agree with Chiptin ---- you really do not want to drink any alcohol before bed. It further depresses your breathing and that is not what you want! Sleeping pills do the same thing - which is why Dr. Sare so hesitant to prescribe them also. We seem to get caught in a catch 22 situation with that! Sleeping pills are being used, however, generally at a low dosage. MOM


posted by laughingspirits
5 days ago
Craftmatic bed cont'd

I slept in the Craftmatic for about 3 more months, or about five total sleeping in the more or less upright position.

I had the bed tilted to resemble the recliner, with the leg portion up so the backs of my knees were on the hump and my feet pointed slightly down. I slept pretty well most nights like this. It was interesting getting in and out of bed, especially those late night potty breaks, but...

I started to develop lower back ache, my tail bone area and up it. Pain got so bad I put the bed down and tried sleeping on my favored right side. After a week or so, my right shoulder ached; so I slept on my left side, same thing happened to the left. Then I switched back and forth, until I couldn't sleep reclined, or on either side, I had to sleep on my back with the C-PAP machine again, my head tilted to one side or the other. At times my neck would start aching, and I would get severe headaches. I was a mess!

More to follow


posted by Chiptin
5 days ago

Mike, that is so scary to stop breathing and waken up gasping! I can't imagine how awful that must be. I am not surprised you can't sleep, when you have that apparatus attached to you. I can never sleep in hospitals when they have those drips attached as I need to toss and turn all night or can't sleep. Also I hate sleeping in a room with others in the room, and the hospital of course has several other people in the ward and the wards here are open to the public who walk past looking for their loved ones.
Thank you for sharing more about the apnea and the treatments for it. I am glad I don't have that as I sleep like a log UNTIL Grandfather gets up to do his nightly rounds with shouting. I can't ignore him as it's like having a toddler running around on his own, in all kinds of danger.
I am glad you found a way to make the wearing of the mask thing, more comfortable. One thing we need is SLEEP!!!! I just can't survive if Grandfather has been up two nights in a row, and I don't get any sleep during the day, so I don't know how you and the others must feel with your Apnea.
June



posted by mermaid777
5 days ago
Folks, I don't drink. I have no intention of having a really big glass of wine, more like an ounce. With your input, I will settle for two Tylenol to see if that relaxes me.

Funny-Today I went to a meeting of my new club. It is comprised of ladies-only for the Church. We had a light lunch and dessert, but prior to lunch, wine was introduced for all. I declined and spent twenty minutes explaining that I would fall asleep in the meeting should I even try such a thing. They were so insistent that I join them. I won out but I was the lone ranger for sure. For some reason this is a meaningful part of the meeting. Guess I'll have to learn to tolerate a glass of wine at my age? (think I will pass)

Chiptin: I am so sorry for your sad experience with your Craftmatic bed. I had the same experience with an old mattress that was past it's prime. A pillow-top mattress (and a luxury for me) solved all back, hip, and leg problems. They were resolved in a matter of weeks. I never cease to be amazed at the wonder of my mattress and it is now four years old. What a blessing. It may be time for you to go back to a wonderfully soft but solid mattress. Don't keep fighting with what you have. We really need those hips, back and legs.

I saw the wedged pillow and that is exactly what is coming my way. I noted on the website that they were low on stock, so order away while you still can.

My problem is with the c-pap is just adjustment to having the obstruction on my face. I plan to win the battle and to try each night until I am comfortable with the addition. I tried for an hour last night, took it off and slept 8 1/2 hours. I just need to relax and have not learned that skill with the mask yet. Who knows, tonight may be a winner.

You all are great and a wonderful support system. Thank each and every one you so much. I did note to the therapist, that I did have an online support system which is making the transition bearable.



posted by Iloveart
5 days ago
Sorry to take up a second reply but I did get Ambien in the hospital. My first and only sleeping pill in my life. I slept 6 hours at the hospital, 7 more when I got home, 8 that night and was still dozing the next day. It took three days to get out of my system.


posted by Iloveart
5 days ago
Back to Inclined Sleeping

My pain problems became so severe, chiropractic adjustment and massage therapy didn't make a dent. I ended up seeing spine care specialists, had more x-rays and MRI scans. They found my tailbone was out of alignment, my lower spine was compressed, both hips were out of place, and lastly (for the major issues), both shoulders were out of place.

Why? Do much pressure/weight on the lower spine and hips over too long a time. Think what happens to bed-ridden patients how they get bed sores and how their muscles deteriorate over time. Because I wasn't using my shoulder muscles to support me for nearly five months, and because I wasn't performing routine exercises (due to lack of sleep and pain) those muscles deteriorated. Then when I did lay on them they rounded out of place.

When all this happens, the muscles pull unnaturally on the spine nerves, creating all sorts of unbelievable pain and discomfort.

I went on short term disability for 5 1/2 months, during which time, I had physical therapy, occupational therapy, traction (had my neck stretched), chiropractic, and massage therapy. Besides sleeping on my back with the C-PAP. I also used our swimming pool as much as possible. The cold water helps sooth those flaming nerves. When I couldn't use the pool, I filled the bath tub with cold water and immersed myself.

I was finally able to return to work but with some hefty restriction for months.

We moved both Craftmatic beds out of our sight into the basement (they were never very comfortable), and got a king-size plush pillow top (the works). It's comfortable, but realy doesn't alleviate the OBS symptoms at all.

I've had to continue various forms of physical therapy from time to time. I've had chiropractic and massage therapy almost weekly ever since to help keep the alignment. I never know when something will move out of place.

All of this in the pursuit of a good nights sleep!

You may be asking yourself,. why didn't he sue the Craftmatic Co.? Honestly, it took months of me going through therapy and asking questions (very important), and I'm the one that pieced it together. When I presented my facts to the specialists they agreed. But see, i also slept in the recliner for nearly two months. so what could I do? Are there warning labels on these adjustable beds and recliners, I really don't know, but anyone who intends to use either for a long time, better check it out.

Everyone - Make darn sure you're all following your doctor(s) or therapist(s) recommendations/advice, Don't make significant changes unless you consult with them first. If you have questions of them, ask them, don't be put off. Meet with them as an informed patient; don't rely on them knowing everything about you. Something else may be affecting your sleep.

When you do a sleep study, the doctor/therapist/tec should have you preparing/keeping a daily sleep journal/diary to possibly identify other causes of sleeplessness. Be honest with it.

I'm not a doctor, all I can do is relate my experiences and suggest things based on those experiences. So never take my word for gospel (I'm not a priest or minister either).

More to come

Any questions you need help with? Please post a reply here, or PM me.

Mike


posted by Chiptin
4 days ago
Dear heavens: What you went through!!!
Months and months of physical pain. Although I have a tiny bit of knowledge of how painful some of this can be; I have never walked in your shoes.
I had a complaint this morning, but it doesn't seem too important now.
I do hope that you continue on the road to recovery. I hope your employment is not something that increases the wear and tear on your bones and muscles.
One thing I have found to be incredibly hard on the back and legs is driving.
My employment consisted of driving many miles within a county. (about 2500 per month) I worked 40 miles from home, and then spent hours in my car after I got to work for the last 25 years. The bucket seats wreaked havoc on the hips and especially right leg. (gas) Thankfully, since semi-retirement seven years ago, that has been whittled down by 75%. I still have problems if I go too often. There are so many variables that may impact on those poor old bones for sure.

I did sleep with the mask for about three hours last night. Progress, yes. I awoke with one closed sinus for about an hour. Is this something that others have experienced. Since mine is a throat problem, not a nose problem, wonder if the full mask would be better. The variable here is I cleaned with cleaning products yesterday which can create the identical nose problem.



posted by Iloveart
4 days ago
C-PAP & Humidity

Soon after I started using the C-PAP, I discovered a couple of things that needed to be changed IMMEDIATELY.

One, was the ramp up pressure - too little pressure, causing me too much exertion to inhale until it rose to my Prescribed pressure. The Prescribed pressure is determined after your sleep study or studies are reviewed. My machine was then preset to that single pressure; I wasn't supposed to increase or decrease it myself. then ramp up feature was an Option, so I could turn it off and receive my preset pressure right away. which I did. Some people can't tolerate the higher pressure right away or it may take a longer time for them to adjust. Consult with your doctor if you feel you need more or less pressure. You should also be journaling a sleep diary for a month or more during this time period - be honest with it.

Two - I only had the machine, no humidity attachment; the insurance wouldn't pay for it. I'd wake with sore dry mouth throat and sinuses. i bought vaporizers, and compact humidifiers, all did little to help. i used the Breathe Right strips, no help.

I finally got the pulmonary specialist to order one from the company that supplied the machine. This "humidifier" was a passive air flow over water design/ It was about 1 1/2 inches thick, and about the size of the machine. An extra hose ran from the machine's output into this plastic water holder, then another hose came out of it to my mask. The machine sat on top of the plastic (pardon me) piece of crap.

The basic idea was that air flowing over the water would be moistened, thereby wetting your palate so to speak.

More to come


posted by Chiptin
4 days ago
C-PAP & Humidity (con't)

I first went on C-PAP about 8 years ago. At that time, insurance coverage varied greatly. Initially, the insurance company paid monthly rental fees, after about six months, they made an outright purchase and the machine was mine. So it cost them twice as much for it.

The passive water humidifer cost me a $100 for a piece of plastic. The water wasn't heated, though I found the colder the water was, the easier I could breathe. Of course the water warms up to room temp. I even put ice cubes in the container a couple of times.

There was a heated humidifer unit but it was hundreds of dollars out of my own pocket.

Oh...about the machine's cost, also back then, you had to keep your machine for ten (10) years before the insurance company would (at least for me) allow a new machine. that has changed not to only five (5) years. You can get a new or different mask and hose(s) every year. Contact your C-PAP supplier for the insurance rules regarding the different replacement parts.

The only way i could have gotten a new machine was if it broke, BUT, I first had to allow the company time to try to fix it. Can you imagine how long it might take to maybe fix it, hopefully they would give you a loaner while that happened?


posted by Chiptin
4 days ago
C-PAP & Humidity (con't)

This POC gave me more problems over its lifetime due keeping it filled every night, not just filling it, but to the proper height. High enough to get maximum moisturizing effect, but low enough not to have the water shoot out, thru the output hose and UP YOUR NOSE (literally with a rubber hose).

I still kept a humidifier running in the room to help.

In this thing, you could use tap water (for emergencies or short term), bottled drinking water, but distilled water is preferred, mainly to reduce bacteria buildup in the container. Believe me...this can occur almost instantaneously. It's like having a swimming pool, one moment it's clear and beautiful, the next, it's an ugly disgusting, slimy green color.

Well, this can happen to such a humidifier, NOT ONLY the passive type (thankfully, I believe most aren't offered anymore?) but to the heated ones too. so be careful with both.

Proper humidification is, I believe, of utmost consideration for your sleeping comfort, next to mask fit. After now using a heated type (more on that later), I highly recommend that type, and many C-PAPS now come with them as part of the unit.

more to come.


posted by Chiptin
4 days ago

I am fortunate to be eight years behind you pioneers that have
have run the gamut of problems and solutions for us.

I have all the above on my machine. Heated humidity, warming coils, etc. Your little container must be different than mine as it cannot be opened that I can see. It is one unit and with two small outlets for pouring in the water, etc. They even include a second container and a tiny funnel. I have a hard time cleaning it to get every drop of water out.
I have a two week window with the mask and can exchange it during this time, cost free. I can get a new mask every six months. It is supposed to be the best machine with the fewest problems. There is only a co-pay for the subsequent masks. Of course the difference is age and Medicare plus group insurance. I believe you are still just a youngster and not old enough for Medicare?
I just received the wedge incliner. I couldn't believe how quickly they sent it. The order is not more than two days old.
It is such a gentle incline that I do believe that it may not be problematic. I had notified the therapist that this was a plan.

I will call today and discuss the problem with the therapist of one side of my nose closing down. (which will immediately awaken me) I am sure that they will tell me to keep on trying as I may just be experiencing sinus problems from the wild swings in temps that we have been having.



posted by Iloveart
4 days ago
Hi..

Saw your "ad" for this group in Managers...grin.

I'm an RN who has had sleep apnea probably for years but was recently diagnosed about a year and a half ago via sleep study. CPAP was prescribed and has remained a nightmare.

Recently did an APAP study at home and over an 11 day period it showed actual sleep of 8 minutes for one night...and a whopping 109 minutes for one night...no wonder I'm exhausted! My usual was 22% sleep...which of course doesn't mean REM, just sleep as the auto-sensor on an APAP can only detect sleep, not the type. The APAP says my AHI is wonderful etc. but how can it be accurate when the sleep it's calculating that on is so little? I still need to take meds to keep me awake to drive.

I really don't see the need to continue with this...it's obviously not helping and yes, I'm aware of the studies. The respiratory therapist suggested BiPAP to my sleep doc but he thought that was ridiculous...I mean, look at these wonderful AHIs of 1!! Pffffffffft.

Kandra


posted by Kandra
4 days ago
Iloveart --- seems like you are doing all the right things - congratulations! Kandra - welcome to the group and we know how you feel ---!!! If only the answers to sleep apnea were easy and comfortable!!! We appreciate all the input we can get --- let us know how things progress for you! MOM


posted by laughingspirits
4 days ago
FYI

APAP = Auto PAP vs C for Continuous

More on APAP later

The apnea-hypopnea index (AHI) is an index of severity that combines apneas and hypopneas. Combining them both gives an overall severity of sleep apnea including sleep disruptions and desaturations (a low level of oxygen in the blood). The apnea-hypopnea index, like the apnea index and hypopnea index, is calculated by dividing the number of apneas and hypopneas by the number of hours of sleep.

From Wikipedia, the free encyclopedia


posted by Chiptin
4 days ago
Oy vey!!! I think I made this worse? Medical terms - love them or hate them, you really need to know the lingo. Impress your doctor or sleep therapist, making sure you kinda of know what they know, and they know you know something. Got that?

Hypopnea
From Wikipedia, the free encyclopedia

Hypopnea is a medical term for abnormally shallow breathing or slow respiratory rate. This differs from apnea in that there remains some flow of air.

Hypopnea comes from the Greek roots hypo- (meaning low, under, beneath, down, below normal) and pnoe (meaning breathing). Literally it means under-breathing.

(Clear as mud right?)

General information
In the diagnosis and treatment of sleep disorders, a hypopnea event is not considered to be clinically significant unless there is a 50% (or greater) reduction in flow and an associated 3% (or greater) desaturation in the person's O2 levels for 10 seconds or longer, or if it results in arousal or fragmentation of sleep.

The direct consequence of hypopnea (as well as apnea) is that the CO2 in the blood increases and the oxygen level in the patient’s blood decreases proportionate to the severity of the airway obstruction. This disruptive pattern of breathing generates disruptive sleep patterns, the consequences of which being that those individuals exhibit increased fatigability, lethargy, decreased ability to concentrate, increased irritability, and morning headaches. Basically, those individuals are extremely tired due to their inability to get a good night’s sleep.

Hypopnoeas can be either central (i.e., as part of a waxing and waning in breathing effort) or obstructive in origin. During an obstructive hypopnoea, in comparison to an obstructive apnoea, the airway is only partially closed. However, this closure is still enough to cause a physiological effect (i.e., an oxygen desaturation and/or an increase in breathing effort terminating in arousal).

A hypopnea index (HI) can be calculated by dividing the number of hypopneas by the number of hours of sleep. The apnea-hypopnea index (AHI) is an index of severity that combines apneas and hypopneas. Combining them both gives an overall severity of sleep apnea including sleep disruptions and desaturations (a low level of oxygen in the blood). The apnea-hypopnea index, like the apnea index and hypopnea index, is calculated by dividing the number of apneas and hypopneas by the number of hours of sleep. Another index that is used to measure sleep apnea is the respiratory disturbance index (RDI). The respiratory disturbance index is similar to the apnea-hypopnea index, however, it also includes respiratory events that do not technically meet the definitions of apneas or hypopneas, but do disrupt sleep.

Among the causes of hypopnea there are:

anatomical defects such as nasal septum deformation or congenital narrowness of nasal meati and the gullet,
overweight and obesity,
neuromuscular disease or any condition that entails weakened respiratory muscles
use of sedatives (sleeping pills, etc.),
alcohol abuse,
smoking,
aging,
and some others that are typical of snoring and sleep apnea.

The most common hypopnea symptom is excessive sleepiness, which results from constant sleep interruption. People with hypopnea often have loud, heavy snoring that is interrupted with choking sounds or loud snorts followed by periods of silence, because not enough air can flow into the lungs through the mouth and nose. The periods of silence can last 20 seconds or longer and can happen many times each hour, resulting in poor sleep and reduced levels of oxygen in the blood.

Other symptoms of hypopnea may include depression, forgetfulness, mood or behavior changes, trouble concentrating, loss of energy, nervousness, morning headaches. Not all people with hypopnea experience all of these symptoms and not everyone who has these symptoms has hypopnea.

Hypopnea is a disorder that results in excessive daytime sleepiness and compromised quality of life, including traffic accidents, diminished productivity in the work place and emotional problems.

Cardiovascular consequences of hypopnea include myocardial infarction, stroke, psychiatric problems, impotence, cognitive dysfunction, hypertension, coronary heart disease, and memory loss.

The most common treatment for hypopnea is continuous positive airway pressure (CPAP). CPAP is a treatment in which the patient wears a mask over the nose and/or mouth. An air blower forces air through the upper airway. The air pressure is adjusted so that it is just enough to avoid the upper airway tissues from collapsing during sleep but apnea episodes return when CPAP is stopped or it is used improperly. For people with neuromuscular disorders the most common treatment is the use of BIPAP or other non-invasive ventilation.

Mild hypopnea can often be treated by losing weight or by avoiding sleeping on one's back. Also quitting smoking, refusal from alcohol, sedatives and soporifics before sleep can be quite efficient. Certain physical exercises that strengthen gullet muscles also bring some results in hypopnea treatment.

Also there's an operative method, i.e. surgery. Upper airway surgery is site-specific. Depending on the cause of obstruction it focuses on the soft palate, the uvula, tonsils, adenoids or the tongue. There are also more complex surgeries that are performed with the adjustment of other bone structures - the mouth, nose and facial bones. Surgery is actually the last thing that doctors recommend to resort to in hypopnea treatment. But sometimes it is the only choice when other options don't work

Next posting on Apnea, good stuff though



posted by Chiptin
4 days ago
Apnea
From Wikipedia, the free encyclopedia

Apnea, apnoea, or apnœa (Greek απνοια, from α-, privative, πνεειν, to breathe) is a technical term for suspension of external breathing. During apnea there is no movement of the muscles of respiration and the volume of the lungs initially remains unchanged. Depending on the patency (openness) of the airways there may or may not be a flow of gas between the lungs and the environment; gas exchange within the lungs and cellular respiration is not affected. Apnea can be voluntarily achieved (i.e., "holding one's breath"), drug-induced (e.g., opiate toxicity), mechanically induced (e.g., strangulation), or it can occur as a consequence of neurological disease or trauma.

Under normal conditions, humans cannot store much oxygen in the body. Apnea of more than approximately one minute's duration therefore leads to severe lack of oxygen in the blood circulation. Permanent brain damage can occur after as little as three minutes and death will inevitably ensue after a few more minutes unless ventilation is restored. However, under special circumstances such as hypothermia, hyperbaric oxygenation, apneic oxygenation (see below), or extracorporeal membrane oxygenation, much longer periods of apnea may be tolerated without severe consequences.

Untrained humans cannot sustain voluntary apnea for more than one or two minutes. The reason for this is that the rate of breathing and the volume of each breath are tightly regulated to maintain constant values of CO2 tension and pH of the blood. In apnea, CO2 is not removed through the lungs and accumulates in the blood. The consequent rise in CO2 tension and drop in pH result in stimulation of the respiratory centre in the brain which eventually cannot be overcome voluntarily.

When a person is immersed in water, physiological changes due to the mammalian diving reflex enable somewhat longer tolerance of apnea even in untrained persons. Tolerance can in addition be trained. The ancient technique of free-diving requires breath-holding, and world-class free-divers can indeed hold their breath underwater up to depths of 214 metres and for more than nine minutes. An apneist, in this context, is someone who can hold their breath for a long time.

Many people have discovered, on their own, that voluntary hyperventilation before beginning voluntary apnea allows them to hold their breath for a longer period. Some of these people incorrectly attribute this effect to increased oxygen in the blood, not realizing that it is actually due to a decrease in CO2 in the blood and lungs. Blood leaving the lungs is normally fully saturated with oxygen, so hyperventilation of normal air cannot increase the amount of oxygen available. Lowering the CO2 concentration increases the time before the respiratory center becomes stimulated, as described above.

This error has led some people to use hyperventilation as a means to increase their diving time, not realizing that there is a danger that their body may exhaust its oxygen while underwater, before they feel any urge to breathe, and that they can suddenly lose consciousness — a shallow water blackout — as a result. If a person loses consciousness underwater, especially in fresh water, there is a considerable danger that they will drown. An alert diving partner would be in the best position to rescue such a person.

Because the exchange of gases between the blood and airspace of the lungs is independent of the movement of gas to and from the lungs, enough oxygen can be delivered to the circulation even if a person is apneic. This phenomenon (apneic oxygenation) is explained as follows:

With the onset of apnea, an underpressure develops in the airspace of the lungs, because more oxygen is absorbed than CO2 is released. With the airways closed or obstructed, this will lead to a gradual collapse of the lungs. However, if the airways are patent (open), any gas supplied to the upper airways will follow the pressure gradient and flow into the lungs to replace the oxygen consumed. If pure oxygen is supplied, this process will serve to replenish the oxygen stores in the lungs. The uptake of oxygen into the blood will then remain at the usual level and the normal functioning of the organs will not be affected.

However, no CO2 is removed during apnea. The partial pressure of CO2 in the airspace of the lungs will quickly equilibrate with that of the blood. As the blood is loaded with CO2 from the metabolism, more and more CO2 will accumulate and eventually displace oxygen and other gases from the airspace. CO2 will also accumulate in the tissues of the body, resulting in respiratory acidosis.

Under ideal conditions (i.e., if pure oxygen is breathed before onset of apnea to remove all nitrogen from the lungs, and pure oxygen is insufflated), apneic oxygenation could theoretically be sufficient to provide enough oxygen for survival of more than one hour's duration in a healthy adult. However, accumulation of carbon dioxide (described above) would remain the limiting factor.

Apneic oxygenation is more than a physiologic curiosity. It can be employed to provide a sufficient amount of oxygen in thoracic surgery when apnea cannot be avoided, and during manipulations of the airways such as bronchoscopy, intubation, and surgery of the upper airways. However, because of the limitations described above, apneic oxygenation is inferior to extracorporal circulation using a heart-lung machine and is therefore used only in emergencies and for short procedures.

(Ah...this you'll love to hear)

Apnea test

An apnea test can be used to determine whether or not someone is brain dead—if they are unable to breathe unaided (that is, with no life support systems) for a certain amount of time, then the apnea test is considered to be positive and brain death is confirmed.

(Got all that)

I'm going to include one more item here about REM which was brought up. At the end of this reply is a link to the Wikipedia, the free encyclopedia for more info on Sleep Apnea. REMEMBER - This website may contain unsubstantiated information, just keep that in mind.

REM

Normal sleep/wakefulness in adults has distinct stages numbered 1 to 4, REM sleep, non-REM sleep NREM and consciousness. The deeper stages (3 to 4) of REM sleep are required for the physically restorative effects of sleep, and in pre-adolescents are the focus of release for human growth hormone. Stages 2 and REM, which combined are 70% of an average person's total sleep time, are more associated with mental recovery and maintenance. During REM sleep in particular, muscle tone of the throat and neck, as well as the vast majority of all skeletal muscles, is almost completely attenuated, allowing the tongue and soft palate/oropharynx to relax, and in the case of sleep apnea, to impede the flow of air to a degree ranging from light snoring to complete collapse. In the cases where airflow is reduced to a degree where blood oxygen levels fall, or the physical exertion to breathe is too great, neurological mechanisms trigger a sudden interruption of sleep, called a neurological arousal. These arousals may or may not result in complete awakening, but can have a significant negative effect on the restorative quality of sleep. In significant cases of obstructive sleep apnea, one consequence is sleep deprivation due to the repetitive disruption and recovery of sleep activity. This sleep interruption in stages 3 and 4 (also collectively called slow-wave sleep), can interfere with normal growth patterns, healing, and immune response, especially in children and young adults.

For more info view link and selected other topics.


posted by Chiptin
4 days ago

APAP - Which I've been using now for 2 1/2 months. Much better.

Automatic Positive Airway Pressure abbreviated APAP, is the most advanced form of treatment for sleep apnea. An APAP machine incorporates pressure sensors and a computer which continuously monitors the patient's breathing performance. It adjusts pressure continuously, increasing it when the user is attempting to breathe but cannot, and decreasing it when the pressure is higher than necessary.

From Wikipedia, the free encyclopedia

Good old Wikipedia, if I could phrase it better, I would.

Let's see...in October 2007 I went to see my pulmonary specialist due to the increased lack of sleep. He ordered an APAP study done. I had to pick up a machine like the one mentioned above. It came equipped with a type of recording card that stored my breathing history/usage for a month. After a month, I sent the card to the supplier, they downloaded it and sent my doctor a report. From that he was able to determine what pressure setting I required. This was great, I didn't have to go to the hospital for an over night sleep study.

Only thing was, when I picked up the APAP, the technician rep told me that insurance plans had changed and I could now get a new machine after only five years. AND, if I liked this machine, all the doctor had to do was prescribe it for me, and it was mine.

Of course I did this. It came with a built-in heated humidifier which my my life a whole lot easier and healthier.

To: Iloveart

My machine is a Respironics REMstarAuto M Series, what is yours?

It has a small lid that opens up and I pull out the water container. It has a metal strip on the underside, two holes for air input/output. On the opposite end of these two holes is a plastic clamp which can be slide to the left(?) and it opens to two pieces for easy cleaning. This clamp is a bit hard to slide over though. I would think your should open as well.

To All Readers:

If you want to be more aware of my posting updates, feel free to become my Friend, then you'll see my posting updates on your MY Eons page, unless you have a lot of active Friend members, then it updates quite fast.

Mike


posted by Chiptin
4 days ago
My machine is a Sleep Style 600, humidified system. I believe is is made by Fisher and Paykel healthcare.

I can find nothing where I can open it. It appears compact and not attainable other than through the two little chutes on the inside. That is where you fill it and flush it. This is a difficult thing to accomplish when cleaning.

I have slept with it for a total of three hours and spent a least an hour cleaning it on a daily basis. It is a nuisance and I am sure that it will get easier.
I am not finding it in anyway easy to maintain. The hose, chamber, nose pillows and connections are cleaned daily regardless of the length of time in use.
The chamber gives me the most problems as I can never get it completely dried and using soapy water to clean it makes me think I am still subject to breathing soap residue at night. Not a happy thought. Am I doing something wrong? I will contact the people in charge on Monday again.



posted by Iloveart
4 days ago
Just for tonight,
I am taking two Tylenol and leaving the machine off.
I am so tired and need to sleep. Hopefully the wedge incliner will allow for a more comfortable night and I will try the machine again tomorrow. Maybe the chamber will have dried out by then. : ))


posted by Iloveart
4 days ago
thanks for the welcome, laughingspirits :)

Chiptin: was nice of you to post all that info for everyone else! :) I'm sure there are other medical people here but if I can answer any questions, please let me know...I manage another group (NOT an ad!) and sometimes am able to answer people's medical questions or point them in the correct direction :)

Regarding the machine you're using Chiptin..I used that one for my APAP trial. My usual is the Respironics Remstar Pro. I noticed with the other one though that the humidifier was always bone dry the next day and I had the heat setting dialed in at around 1.5

I've had to send my machine back for repairs...for the second time so now I have a "loaner"..same machine as my usual one. The other I used for the APAP trial can be set for either APAP or CPAP.

My APAP trial only lasted 2 weeks, not a month...and as I mentioned, I don't see how it can be accurate when my sleep was 8 - 107 minutes. Of course my numbers (AHI etc. which you thoughtfully explained! :) look stellar...so why do I need to take medicine to even drive? I'm so exhausted I just can't stand it at times...

I'm a mouth breather so tried a full facial mask..didn't work. I've tried the chin strap..doesn't work. No matter how tight I put it, can still open the 'ol mouth...maybe that's telling me something...lol!

Oh, insurance allows me to change mask/tubing every 3 months.

K.


posted by Kandra
4 days ago
Did sleep last night but I am still tired this am. No sinus problems though. Back is better.
I am going to have to re-arrange my sleeping hours to a earlier bedtime
I am just too tired after a really long day (18 hours) to want to fight another second. I cannot begin the new hours until Sunday.
I know this will make a difference and that is where I need to start.
When I volunteer, I don't get home until 10:00, putting bedtime at midnight or later. Too late for someone that doesn't get quality sleep anyway.
Part of the frustration is my fault as I am too tired to fight as I should.
Chiptin: The incliner is too low for not using a pillow too. Add a pillow and the point of pressure is on one hip. Not a good thing.
I will begin again Sunday evening to master the C-pap.
I will be 69 next month and have lived all my life believing that I am normal. I usually love new experiences and find them as a challenge. I know that I will master this one too, it just may take me a little longer.



posted by Iloveart
3 days ago
i had a feeling that the wedge might not help entirely or at all; depending on the severity of the obstruction. I ordered two of them on Friday, not that I'm going to use both; the other is for my wife when she's reading, correcting papers, or watching TV in bed. Yes, she'll have to use at least one pillow besides, but she won't be sleeping with it all night.

On my REMstarAuto, the humidity is set on about 3.5; I had it set as high as 5. More refreshing but too much condensation may buildup and you can get a snoot full of water.

Every night I refill the water container, and about every other night, I at least give it a good rinsing. With the old passive one, I got lazy at times and just kept adding water. Too much to disconnect, a hassle; then boom it developed bacteria and I had a sinus infection. Sometimes real nasty, and was on antibiotics for a month. Then it was scrubbing the water container nightly, refilling with distilled water every night. Wasn't worth being lazy a couple of times (actually more).

As for trying to stay awake during the day, one of the first drugs prescribed was Provigil, 200mg tablets, 1/2 - 2 tablets to be taken as needed. Didn't do a thing for me.

What helped me immensely, but at a price (I don't mean money) was Ritalin. Yes, the same drug used for ADHD is used for treating drowsiness. It comes in generic version, and a time released one. I WAS taking this, popping a couple every couple of hours when at work. It worked but my brain and body often felt disconnected, kind of a zombie feeling. It's been a while since using Ritalin, but my brain functioned fairly well , but my body was sluggish. It was little weird, and the fact that I work with high voltage and high speed moving parts (I test CAT scanners) was always dangerous; still is.

Ask your doctor about a generic Ritalin to try.

Here's the info from From Wikipedia, the free encyclopedia

Methylphenidate (MPH) is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder, or ADHD. It is also one of the primary drugs used to treat the daytime drowsiness symptoms of narcolepsy and chronic fatigue syndrome. The drug is seeing early use to treat cancer-related fatigue [1]. Brand names of drugs that contain methylphenidate include Ritalin (Ritalina, Rilatine, Ritalin LA (Long Acting)), Attenta, Concerta (a sustained release tablet), Metadate, Methylin, Penid, and Rubifen. Focalin is a preparation containing only dextro-methylphenidate, rather than the usual racemic dextro- and levo-methylphenidate mixture of other formulations. A newer way of taking methylphenidate is by using a transdermal patch (under the brand name Daytrana), similar to those used for hormone replacement therapy and nicotine release.

Read more here view link


posted by Chiptin
3 days ago
I would never not follow directions for cleaning and safety. My friend's daughter-in-law ended up in a hospital with bacterial pneumonia and was there for over ten days due to the c-pap and bacteria. That should be a wake up call for anyone who fails to follow the directions. She still uses the machine.

I am going to try the machine again tonight. I have a clear receptacle after it dried over night. My best best is to interchange the two that I was given. This would allow one to dry.

I am pretty sure that I am an ADD adult. I am anti-medication if possible but embrace needed medications when perscribed. I have two meds for alllegies, and one for cholesterol.

Having worked with meth people, I am a little worried about any persciption that starts out with Meth in it's name. I did read the link. I did appreciate it's safety record, but nowhere did it mention gerontology. Pedicatrics only. I just need to get use to the machine. That will help.



posted by Iloveart
3 days ago
p.s. I am going to try the wedge again tonight. I had a sore back to begin with yesterday and was overly tired. (I know better than to attempt to move furniture around) I chose to sleep unobstructed for just last night. I am past those problems today and looking forward to starting again. I would rate the wedge as very good for reading and relaxing. Keep the added pillows soft. Mine are not.



posted by Iloveart
3 days ago
Autonomic nervous system stimulants
Drugs such as atomoxetine (Strattera®), which stimulate the autonomic nervous system, appear to have positive effects in some people with Chronic Fatigue Syndrome (CFS) symptoms. Amphetamines and amphetamine analogs may help some patients. For example, methylphenidate (Ritalin®) has been found to be significantly better than placebo in relieving fatigue and concentration disturbances in a minority of CFS patients but more research is needed into the long term effects.[221] Modafinil (Provigil®), a medication designed to aid in maintaining wakefulness, has had some positive effect on individuals with CFS, but has not been properly studied. A small study suggested that long-term treatment with modafinil may not be beneficial for CFS patients.



posted by Chiptin
3 days ago
WE were discussing sleep aids and I remembered this from earlier postings.

(Rozerem is a highly refined form of Melatonin, which is produced naturally by your body. Melatonin can be purchased OTC but start off using one 3mg tablet to begin with, now more than several at a time. If you fail to fall asleep after taking or wake up soon after, you may feel very groggy for a while, same is true taking some OTC sleeping pills.)

You can try the Melatonin to see if it helps calm you down and aid in falling asleep.


posted by Chiptin
3 days ago
Chiptin: You have been such a support system that you deserve to hear this first-----I slept with the C-Pap most of the night. I went to bed earlier, was relaxed, and had no problems. I added the inclner which worked wonderfully and I feel refreshed this morning. I already have tended to the cleaning of the machine and it is ready for use tonight. It just takes getting use to. If I can do it at almost 69 years old, then all of you out there can adjust too. Thanks, to all who have helped me to make this transition and especially that well organize Chiptin. Annie


posted by Iloveart
3 days ago
Annie, that's wonderful news to hear, not just for me, but all of those who suffer from sleep apnea, or just plain insomnia.

With everything going on in my life yesterday (septic system backup) I completely forgot to take my antidepressant and Ambien tablets before going to bed. So when Nature made a slight call at 2am, I woke up and realized what I forgot to take. After taking care of all business, settled back down for several hours more sleep. I'm not totally refreshed but doable.

Thanks Annie for the great news.

Mike


posted by Chiptin
3 days ago
Wow, everyone! After workin all nite this has been a lot
to take in (ok some of it I skipped over until I can think more
clearly).

Thus far, no machines on this end. About 10 yrs ago I had a
sleep study done (due to ex's concerns over my stopping breathing).
He was correct but at the time, neurologist said not enough apnea
episodes to warrant treatment (which he indicated would be prescription). At the time was raising three school age children, and working midnights (which I do now, as well). Got ver little sleep, so of course, every chance during study I could zapped right out. Went directly to REM sleep each time. I was sleep deprived; less so now cuz kids are older.

Funny read article about how working midnights literally is bad for your health in more ways than one; but not a day person - more afternoons but too busy.

My question is do you think sleep studies warrant being repeated?? Some of the lethargy & depressive type symptoms I can attribute somewhat to lack of sleep - but that's an entirely new subject. Just wondering if, like other conditions, apnea is one that should be monitored down the road.

Thanks 4 the opportunity to ask. :)


posted by dispatchdebbie
2 days ago
Debbie, good question on whether you should have you sleep apnea monitored from time to time.

Definitely, BUT you probably don't need a full over-night study done to accomplish this.

One thing mentioned recently was the use of the A-PAP machine, not just auto but with the capability to insert the recording card for downloading and review.

Any of this would have to be prescribed by your attending specialist (for insurance purposes mainly).

But that doesn't mean you should rely on him/her to order a study done. If you're experiencing changes in your health, weight gain or loss, another illness develops, a change in lifestyle, that appear to be having an effect on your sleep quality, YOU AS THE PATIENT, should inform your doctor about it. Don't wait until your next six month appointment.

Weight gain can significantly and adversely affect your breathing; your doctor may advise or such weight loss therapy, and/or be checking to see if your air pressure is still enough to keep the airway open.

If you've developed any sinus or bronchitis, pneumonia, flu conditions; all of these could affect your sleep quality. Even the common cold or a slight runny nose.

Also keep in mind - any time you're going in for surgery, and there's the chance of you being put under, or even having a local apathetic, INFORM ALL NURSES & DOCTORS of your sleep apnea condition. They can then make adjustments for your breathing, or at least be aware of any breathing problem that might develop.


posted by Chiptin
2 days ago

After I was diagnosed with moderate to severe OBS, the doctor placed me on CPAP. I hated it, couldn't tolerate having it on, etc. AT the first opportunity, on the pulmonary specialist's referral, I saw an ENT or Ear, Nose & Throat Specialist for a surgery option called UP3.

The following I found on Yahoo! Answers, and the question was answered by a person known as CaliDoc (a doctor in California) this is the link to the page view link but the text is as follows:

What is a UP3 or UPPP?

Uvulopalatopharyngoplasty is surgery for obstructive sleep apnea (OSA). I work directly with one of the original pioneers of this surgery. It is effective at reducing severe OSA (not eliminating it) and can eliminate mild/moderate OSA. The surgery is about 50-70% effective, depending on who you talk to, and is not very effective (or perhaps totally ineffective) in the obese population (body mass index greater than 30). The surgery itself involves tonsillectomy (if they are still present), removal of the uvula (the punching bag in the back of the throat), removal of part of the soft palate, and suture re-suspension of the cut surface to open the oral airway (throat) more. Other items that will make the surgery less effective include an enlarged tongue, short lower jaw, and deviated nasal septum.

In most cases, it is prudent to try continuous positive airway pressure (CPAP) first. This is a non-invasive machine that helps OSA in most users, and is the mainstay of treatment in the obese (aside from diet or gastric bypass).

The surgery itself is relatively short, usually requires overnight observation, and has a very painful recovery period. Most patients who have the surgery in our clinic will lose 15-20lbs in the postoperative 3-4 weeks from the pain. This part is serious business because many patients if not properly warned, will say they regretted the surgery by this point.

In the case of life-threatening OSA and inability to use CPAP, some patients require tracheostomy. These are fairly extreme cases, and almost always are morbidly obese.

Please don't take offense at any of my comments regarding issues of patient obesity, etc, this information is based upon a body of scientific literature and the disorder of OSA affects a disproportionate number of people in this group.
1 year ago
End of article

Yes, I did have the surgery; a week before that year's Christmas. I had my tonsillectomy done when I was a kid in the 60's, but had the rest done. It was still quite pain and uncomfortable. I did manage to lose about 20 lbs, but gained it back later.

The surgery was effective, but for only about a year. Weight fluctuations and just the fact that your throat tissues relax after the surgery, and for other reason, brought back the symptoms, so back on CPAP.

Could it help you? Consult with your doctors, also get second opinions.



posted by Chiptin
2 days ago
I do Debbie:
Your tests were some time ago. I do know that my apnea progressed over the years. New machines, new tests, and you may come away with a different diagnoses.
I too worked evenings, cared for children, attended college during the day and was literally exhausted, (I was in my forties) but I always put one foot in front of the other and continued on. Years down the road and I have more problems than before. I did NOT like the study much and had to do three of them, but maybe this will be sucessful for me. I am in the beginning stages of the diagnoses but the people here have written a book that should be published on sleep apnea. So many good replies.


posted by Iloveart
2 days ago
I mentioned how I underwent UP3 surgery a number of years ago, and it was ineffectual after a year's time.

Now, on this January 29, 2008 I will be undergoing a surgical treatment called glossectomy or lingualplasty (depending on my needs).

In severe obstructive sleep apnea syndrome following UPPP failure, lingualplasty (more aggressive removal of tongue tissue) demonstrated a 70% short-term success in reducing respiratory disturbance index (RDI) to less than 20 events per hour. Early complication rates approached 25% and included bleeding, severe odynophagia (pain when swallowing), tongue edema (swelling), and taste changes. The rate of major long-term complications was low. Lingualplasty appears to be indicated in patients with disproportionate tongue base size and/or macroglossia (excessive size of the tongue).

See view link

Both midline glossectomy and lingualplasty cause direct trauma to the pharynx. They are often applied in patients with more severe disease. Perioperative airway support is crucial. Tracheotomy or continuous positive airway pressure (CPAP) is mandatory.

The will be followed up, same surgical time, by a tongue advancement surgery called Limited Mandibular Osteotomy & Genioglossus Advancement. The anterior wall of the lower throat is primarily composed of the tongue. The position and collapsibility of the tongue is determined primarily by a muscle called the genioglossus muscle. By advancing the insertion of the genioglossus muscle the tongue can be changed. The addition of skeletal procedures for patients with blockage in the lower throat appears to improve success rate compared to Uvulopalatopharyngoplasty (UPPP) alone.

See view link

My surgery will be performed by: Dr. B. Tucker Woodson, MD, Professor and Director of the Medical College & Froedtert Sleep Disorders Program

The tongue surgery is one where the tongue is pulled forward and held in place by a plastic (?) line inserted thru the underside of the chin, and anchored in the tongue muscle. The tongue and line is advanced forward and tied at the chin.

More to come...



posted by Chiptin
2 days ago
thanks for all the info.......I'll have to remember to bring it up when I see doc again (which will be soon for med chk); I always forget about it really since it's been so long! No offense taken about anything at all. I'm not thin skinned and geez, this is the greatest group! It's like havin ur own doc here to educate!!

thanks again and the best to you in you next procedure!


posted by dispatchdebbie
1 day ago
Good Grief: I can't believe all that you have gone through and even more, what is planned for you. You are a brave soul for sure. Your apnea must be of the highest level ever. No wonder you are in the expert level on this.

On a really milder note, does anyone have problems keeping the apparatus on their faces? I do have strap adjustments available but the little straps seem to slip away while I am sleeping. Perhaps it is the softness of my hair, my conditioner, or something, but I find myself during the past two nights, of having the apparatus peacefully lying beside me. It must come off during the night as I don't take it off. (at least I don't remember taking it off) The straps slip off my head so easily.
It does not seem to fit as closely as it should. Perhaps I'll run over to the medical supply house and have them adjust it for me today.


posted by Iloveart
1 day ago
This is the best compendium of information on sleep apnea and related treatments that I've ever seen!


posted by NoHiddenMeaning
1 day ago
Annie, you need to have the straps secure, and that usually means a little tight, otherwise you'll have air leakage.

Are you using the chin strap to hold the mouth closed? When this is attached to the head gear strapping, usually by Velcro, it helps hold it on your noggin.

I'm going to need the nurses here for a medical term definition. For me, the straps cause hard mole-like growths to appear on my head, and the side of my face. Doctor says it from the pressure and movement of the straps on the skin. I may be more susceptible to this occurring than others. When I used the chin strap and had my beard, the rubbing caused itchy, scratchy buildup from the strap rubbing the beard hair against my chin skin. Took a couple of weeks for it to clear up after removing the beard.

What are these growths (on the skin) called?

My doctors have told me twice, but I forgot the term. One doctor just said to cut or shave them off. I have done this with several of them, but if the straps continue to be positioned over the area, they come right back.

So it may be a good idea to try to reposition your various straps from time to time. And they too need to be washed and cleaned thoroughly.

Yes, my surgery next Tuesday will be a two-step one involving several hours. I will try to chronicle the experience for you, depends on how I'm feeling. I may not be on-line for several days next week, so I'd appreciate it if members would keep updating and asking questions, and maybe providing answers.


posted by Chiptin
1 day ago
I do not have a chin strap with the just the nose pillows. I do believe that while I listened closely to the care and cleaning of the machine and hoses, I did not pay attention to which way the straps lie on the face. It just does not seem to fit. I am taking them with me and asking the therapist to demonstrate the way they position on my face. That seems to be the best solution.

We here are pulling for you and you are in our prayers. You have a great attitude and knowledge beyond the layman. This surgery does not sound easy and discomfort may be your partner for a while. Hopefully, this will be the end of your struggle. I am not sure how they will manage without you, but hopefully, you will be back very soon.



posted by Iloveart
1 day ago
Just recently I found out about the American Sleep Apnea Association (ASAA). The ASAA is a non-profit organization dedicated to reducing injury, disability, and death from sleep apnea and to enhancing the well-being of those affected by this common disorder. See view link

They have a tremendous amount of information on their website, informational forums on various topics, and also live chat at night.

They also have regional support groups that you can contact called A.W.A.K.E.

As this posting continues, I also want group members to take advantage of other internet resources. I can't read everything nor know it all; that wasn't the intent of this posting and all of its replies.

The more you know the better informed you are. Can't find the info or support you need here, then actively seek it elsewhere.

The primarily reason for this group posting is to make members more aware of the possibilities and the help available to them.

Take the next step and use it.

Mike



posted by Chiptin
about 23 hours ago
what does bttt mean?


posted by Iloveart
about 22 hours ago
bttt is just a term managers and moderators, and people like me, insert as a reply to get the posting to the top of the posting list without actually replying. OK?

This is something I found on on www.apneasupport.org that I felt was of immediate interest. Ref: view link

Long story short - 75 days on CPAP at pressure of 17 and not improving/feeling worse as time went by - I changed mask, I tried balls sewn to the back of shirt (So I couldn't lay on my back), I became frustrated to tears because I was not improving and some days I felt worse than ever.

I finally saw the sleep doctor and he tells, as I understand it, high pressure keeps me from properly exhaling, so I'm not getting oxygen - without CPAP, I'm not inhaling, with CPAP, I'm not exhaling, I need BiPAP- it pushes in when inhaling, stops pushing when exhaling.

I'm going for the study tonight - hopefully with a successful outcome.

Since these people don't communicate any kind of information very well, I'm wondering if anyone can give me an idea as what to expect?

Thanks,

reply: It will not be any different for you than when you had your original titration. Good luck! I sleep so much better now that I am on BiPAP

reply: Thanks, I neglected to mention/ask - can I bring and use my own mask?

I need a full face mask and I traded in my darth vader contraption for a mask that covers my mouth and has nasal pillows - I think it's called a hybrid - it's so much more comfortable.

(Members: take note of the mask type used above, I haven't seen this before. Also, a pressure of 17 is very high, My highest was a 15 at my heaviest weight. When my weight decreased it felt like my head was being blown apart. More appropriate for me was 11-12 pressure)

reply: You can ask your sleep clinic ahead of time or just take it with you. I was told to bring my own mask so I did and wore it. The RT said if there was a problem with my mask during my titration they would put me in another mask. I did not have any problem and slept like a baby.

final reply: Thanks Iking, I'll bring my mask along and see what happens.

At my age, very little gets me bothered, but I'm as excited about this study as a kid on Christmas Eve.

I hope this works out.

Thanks again.

(As I said go to the apneasupport.org site to learn more. I will try to pick our significant issues to post here. If anyone finds similare information, feel free to post it here as a reply. Please list source as a reference. thanks.)



posted by Chiptin
about 22 hours ago
Here's some more follow-up on Bi-PAP. See view link
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"Hello, does anyone know the difference between BI-PAP and CPAP with C-FLEX? I am currently using a regular Remstar CPAP machine and find it very uncomfortable on exhaling. Do I have to get a new prescription to get a BI-PAP machine?"

reply: CPAP is one continuous pressure. BiPAP is two different pressure settings, a higher pressure for inhale with a lower pressure for exhale. You will find more information about this on the manufacturer's website. Your sleep doc will need to write a new prescription for a BiPAP machine. You will want to be certain you get a full data capable machine, not a machine that just reports that you are compliant. Since your doc already has you in a Respironics he may want to keep you with the same manufacturer. If you find that to be the case the BiPAP you want to get is the Remstar BiPAP Auto M Series w/humidifier and data card. Be certain the DME turns on the AHI and leak settings for you as they tend not to do that and in my case wasn't even aware that the information was available for me to monitor on my machine; he thought it was only accessible when the info was downloaded.

reply: Hi tonyv,

What is your pressure setting?

C-Flex will allow the exhalation pressure to be decreased of by 1, 2, or 3cm from your inhalation pressure setting. For example: inhale of 10cm, exhale of 7cm.

A bi-PAP, as explained by lking above, will allow for even larger decreases in the exhalation pressure. For example: inhale of 15cm, exhale of 8cm. Bi-PAPs are therefore are especially helpful for those people who have high pressure settings.

Guest MJ

Edited to add: bi-PAPs may also be helpful to people who have other medical conditions, for example, GERD.

reply: GuestMJ is correct. In addition to my BiPAP settings of 13/8 my C-Flex is set at 3, which my DME says is the setting for the least resistance


posted by Chiptin
about 21 hours ago
There are a number of websites that sell/lease(?) various types of CPAP machines (APAP, BiPAP, etc) and all of the equipment you would need.

However, I would not buy machines (maybe with doctor's permission and insurance company ok) and any face mask (unless it's a direct replacement) unless your doctor and/or sleep therapist is familiar with the product(s). Even if they cost substantially less. They should be present when you try them out, and to adjust the air pressure.

This is something (the air pressure) you should NOT be fooling with yourself.

NEVER buy and try any of these on your own; you could potentially suffer injury or DEATH. YES, DEATH, I could have died as a result of my mask failing (it wasn't bought off the internet) and filling me (my abdomen) with air - I couldn't breath!

I did buy some replacement hoses. Although much cheaper, they were stiffer and not as easy to slip on or off the machine or mask output/input.

In some cases you get what you pay for!

Are these on-line companies reputable? I hope so, but be aware of knock-offs, off-brands, cheaper materials, etc.

Don't put your health and/or life in danger.


posted by Chiptin
about 12 hours ago
I can't imagine someone with a 75 air pressure. Mine is 2.5 and I do ramp it down to 1.5 when I first go to sleep. I am managing to sleep with it about four hours at a time and I do believe that that will increase as I continue to adjust to it. My therapist tells me that most persons will be a full time in about six months, some sooner, some later. I am still having some problems in getting the mask to feel comfortable and fit snuggly to my face. I did take it down to the medical supply shop, and have it adjusted but still, it just does not feel right. Perhaps, I just am not trusting that it won't smother me yet. Yesterday, I felt less sleepy, but today, I have had a couple of episodes. I do feel some better, but then expectations are that I will, and I am trying to comply. I thought my apnea was considered severe, but I don't hold a candle to some of you.


posted by Iloveart
about 11 hours ago
I feel the need to lighten this posting up a little.

When your CPAP wakes you up at night and you go to the bathroom...

One night at about 3AM my wife had just finished using the bathroom and was about to return to bed when she heard a little noise. It was a suspiciously rodent like sound that seemed to be right in the bathroom with her. She of course froze and listened attentively for any further sign of invaders. After a moment, satisfied that she was alone, she took a step for the door. Rodent scratchy sounds again! She froze, not breathing . . . Silence. Her heart beat fast as she once again tried to retreat from the bathroom.
This time the noise was accompanied by something touching the back of her leg! That was, of course, too much to bear. She literally flew the 8 feet to the bed, clearing the foot board by a couple feet, to land screaming by my side. This is not a pleasant way to wake up. Scrambling into consciousness, now scared half to death myself, I managed to get the light on.
The culprit was right there in plain sight, a trail of toilet paper neatly marked the path from bed to bathroom


posted by Chiptin
about 11 hours ago