Posted by M3LFL on December 04, 2002 at 18:48:20:

In Reply to: general/surgical advice posted by M3LFL on December 02, 2002 at 16:06:23:

First of all, thanks for all the replies and info. One suggestion was to move this to the Non-CPAP forums which I will do after I provide this answer and we tie off this thread of discussion. Second here are some details and answers I didn't originally provide that several of you asked about, and one or two I thought to mention on my own. One of which is that I am a little overweight and I'm trying to lose the 25 or so pounds I put on over the last year or so and maybe even an extra 10 or 15. The thing is that I'm relatively muscular and proportioned so I don't think it's an issue of a lot of extra fatty tissue in my neck closing off my airway... but at the same time my neck size has increased over the years and is currently between 17 & 18 inches, so maybe it's more of a factor than it would appear. That's all about me that would make a difference so here are the answers to the details of what CPAP equipment and accessories I've been using.

During the second half of the sleep study when the CPAP worked it was with (as far as I could tell without knowing then what I know now) a standard CPAP machine with no humidifier and a regular type of nose mask. Then for take home use I was supplied a Res-Med CPAP machine (not sure of the model) with a ramp feature that I did use, a passive humidifier, and a headgear setup that was with nasal pillows rather than a nose mask. I had difficulty with that too (which I'll go into in a second) and was switched to a BiPAP also with a ramp feature, but this one had a heated humidifier which helped some issues with dryness so it was better, but I still had problems with that setup. So, then my Dr added a chin strap and the prescription for Ambien to try and get me over my initial problems and to help me fall and stay asleep while using the machine.

Here's my take on how things have gone and the troubles I've had. The deviated septum that I didn't know I had means that the limited airflow I get nasally causes me to mouth breathe once every so many breaths so I can fill my lungs and catch up (or I yawn causing the same effect). I notice this pattern of breathing even when I'm awake. This was why I asked about the one post I read on the site about a guy that had a random or alternating breathing pattern with a bunch of shallow breaths and then a large one 'cause that seems to be what I do.

So, even if I do fall asleep while the machine is ramping up, once it gets to full pressure at 16 and then I try to mouth-breathe the forced air obviously shoots out of my mouth once I open it and I wake up. Most of the time though I lay there for an hour or more without falling asleep in the first place and eventually get so frustrated that I take it off so I can get at least SOME sleep even if it's not restful.

The only other thing I've thought of was that a regular nose mask like I tried in the sleep study might be better for me than the nasal pillows for not restricting air flow, but the medical equipment company rep I've been dealing with said that the pillows provide better flow and less possibility of leaks so I should stick with them.

I know the surguries (even after both) would never cure me and get below 5 episodes, and I'd be lucky to get down to 15 or so and just have mild apnea, but they might make CPAP more tolerable (ie - lower pressure) for me. However, the more I read the more I see that the surgeries aren't permanent. Eventually the improvements would go away and I'd have to have the pressure adjusted upward again and I might end up back where I started.

So, any more comments or thoughts now that I've provided some of the missing puzzle pieces?

Thanks, and sorry this got so long...

M.

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