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I've been tired most of my adult life. I am not the classic sleep apnea patient. I am 55, atheletic, a triathelete, only ~ 10 lbs over weight (but it doesn't look it). I am a veterinarian and use to work 70-80 hours / week. Now ~ 45. I don't sleep at night. I am up every hr. to 1.5 hrs either tossing and turning or urniating. I go to the bathroom on average 3-4 times / night. I feel when I'm sleeping I am half awake, but I actively (very actively) dream. I never wake up refreshed. I had a study done at a sleep ctr. and was diagnosed with sleep apnea - mild. The doctor said I seldom hit REM sleep. I was prescribed a CPAP machine and struggled with it for 2 months getting even much less sleep than in the past. I have stopped using it. I was using the nasal pillows head gear. I sleep best most nights on the sofa. I haven't sleep with my wife in years because I am alway up and down. When I sleep I sleep first on one side then when I get up to urinate or just awaken, I then sleep at the other end of the sofa. It has affected my back. I toss all night in a traditional bed, but much less on a sofa. I don't know what to do. My memory is so poor now it's a laughing matter at work and a point to tease on and I'm the owner of the business! I am half the person I use to be. I use to be unstoppable. Now I fear I am going to die an early death because of my lack of sleep. I've already gone throught kidney cancer and am down to one kidney.

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After ~ an hour or so my nose burns and I find my self waking up uncomfortable. I also find it confining (unable to move around) I can't get comfortable. I'm notw up after trying to sleep with it again.

j n k said:
What specific problems with using the CPAP can we help you with? We try to be as helpful as we can with coming up with ideas to solve problems with making CPAP work.
I noticed you said that you use the nasal pillows. I get the same nose burning sensation with those. I recommend trying different mask. I found out that I like the ResMed Quattro mouth and nose mask. It's the most comfortable to me and my nose does not burn as with the nasal pillows.
Using the CPAP is not an easy thing to do. I am grateful to this forum for teaching me to sleep with my CPAP. It is what jnk and Jason said, trying every combination of mask, machine, humidity, sleep pillow, positioning of the CPAP next to your bed and any other trick you can think of like wearing the mask while you are awake to get used to it.

It takes commitment and asking for help. Both my husband and I have sleep apnea. I have tried 3 different masks before I found the Headrest which works well for my face and nose shape. My husband has gone through 4 different masks and still switches occasionally between the Headrest and the full face mask.

I found it was hard for me at the beginning because my CPAP did not have the EPR setting so I found it nearly impossible to breathe until the machine was up to my recommended pressure. Switching to an APAP has been great for me.

Hang in there, you are in the right place for answers....
I have posted a document below that needs to be in the hands of patients before they review PSG results with the doctor. But you need to step back to it. Give us some comments.

Questions to ask about your PSG and Titration Study

1. Did I have any central apneas? How many?

2. Were there any comorbidities? What were they?

3. Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?

3. Did I exhibit Positional Sleep Apnea (PSA)? Was my apnea more severe in one sleeping position as compared to others? Is my pressure requirement higher in one position as compared to others? (Often sleep apnea is more severe when sleeping on the back.)

4. Is there anything else unusual about the results?

5. How will I know my therapy is preventing apneas?

6. I am determined to own a data-capable machine and software to monitor apneas, hypopneas and mask leak. This will allow me to call your office with specific questions if I have problems with the therapy. Will you help me with the appropriate prescription?

In addition to the questions:

1. Get a copy of your PSG. It is your legal right to have one.

2. Get a copy of your CPAP prescription.

3. Make sure the prescription calls for a humidifier with the machine.


BTW, Your nocturia is a sign that the therapy is not working properly and you are still having many breathing events. I have some things in mind that may be an easy fix, but give us some comments about the questions on the document.

Also let me note that the model for the classic patient is wrong. There are plenty of slim, even athletic, people who have sleep apnea. They tend not to get diagnosed because the medical professionals are ignorantly using the wrong model.
Thank you everyone! I've was getting very discouraged any you've fired me up again to go the distance. I will review the questionaire with my doctor and go forward with the data.

Thanks again!

JAM

Rooster said:
I have posted a document below that needs to be in the hands of patients before they review PSG results with the doctor. But you need to step back to it. Give us some comments.

Questions to ask about your PSG and Titration Study

1. Did I have any central apneas? How many?

2. Were there any comorbidities? What were they?

3. Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?

3. Did I exhibit Positional Sleep Apnea (PSA)? Was my apnea more severe in one sleeping position as compared to others? Is my pressure requirement higher in one position as compared to others? (Often sleep apnea is more severe when sleeping on the back.)

4. Is there anything else unusual about the results?

5. How will I know my therapy is preventing apneas?

6. I am determined to own a data-capable machine and software to monitor apneas, hypopneas and mask leak. This will allow me to call your office with specific questions if I have problems with the therapy. Will you help me with the appropriate prescription?

In addition to the questions:

1. Get a copy of your PSG. It is your legal right to have one.

2. Get a copy of your CPAP prescription.

3. Make sure the prescription calls for a humidifier with the machine.


BTW, Your nocturia is a sign that the therapy is not working properly and you are still having many breathing events. I have some things in mind that may be an easy fix, but give us some comments about the questions on the document.

Also let me note that the model for the classic patient is wrong. There are plenty of slim, even athletic, people who have sleep apnea. They tend not to get diagnosed because the medical professionals are ignorantly using the wrong model.
very encoaraging questions some may be difficult to answer after the event of a PSG and so it may be in order to ask the RT prior to the PSG to look out for these things so that a proper answer will be given you

Rooster said:
I have posted a document below that needs to be in the hands of patients before they review PSG results with the doctor. But you need to step back to it. Give us some comments.

Questions to ask about your PSG and Titration Study

1. Did I have any central apneas? How many?

2. Were there any comorbidities? What were they?

3. Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?

3. Did I exhibit Positional Sleep Apnea (PSA)? Was my apnea more severe in one sleeping position as compared to others? Is my pressure requirement higher in one position as compared to others? (Often sleep apnea is more severe when sleeping on the back.)

4. Is there anything else unusual about the results?

5. How will I know my therapy is preventing apneas?

6. I am determined to own a data-capable machine and software to monitor apneas, hypopneas and mask leak. This will allow me to call your office with specific questions if I have problems with the therapy. Will you help me with the appropriate prescription?

In addition to the questions:

1. Get a copy of your PSG. It is your legal right to have one.

2. Get a copy of your CPAP prescription.

3. Make sure the prescription calls for a humidifier with the machine.


BTW, Your nocturia is a sign that the therapy is not working properly and you are still having many breathing events. I have some things in mind that may be an easy fix, but give us some comments about the questions on the document.

Also let me note that the model for the classic patient is wrong. There are plenty of slim, even athletic, people who have sleep apnea. They tend not to get diagnosed because the medical professionals are ignorantly using the wrong model.
James A. Miele said, "I will review the questionaire with my doctor and go forward with the data.."

One thing you can look into before the doctor visit is mouthbreathing. Do you awaken sometimes with a very dry mouth? Have you ever awakened and noticed air rushing from your mouth? Has a bed partner observed mouthbreathing or snoring? All of these are signs of mouthbreathing.

You are using a nasal mask. If you mouthbreathe, the pressure can be lost and the therapy is ineffective. This is a very common problem and from reading the forums it seems common to prescribe nasal masks to patients who mouthbreathed during their PSG. The solution to mouthbreathing is a full face mask (FFM) which covers both the nose and mouth.

On another point, let's assume you have a good doctor who is a good listener, patient, and is working for your best interests. That is a good assumption to make, however, the medical field for humans is unlike veterinary medicine. The market is much more highly regulated and the intrusive hand of government is everywhere. Government pays (Medicare, Medicaid, etc.) for about 50% of all costs and much of the rest is paid for by highly regulated insurance companies. This creates something very different from the great, straightforward, patient-focused service provided by veterinarians to patients who are not restricted by government payments or insurance. So you need to be prepared to be assertive if your doctor is want to take the time to answer your questions fully and give you good assistance. See also http://www.sleepguide.com/forum/topics/the-sad-state-of-sleep
For nasal pillow burning, you can use Ayr saline nasal gel, and play with the strap tightness. I use it as tight as I can tolerate, same with the chinstrap, my wife took 2 tucks in it. But that's because I washed in hot water.(no-no) Good luck, keep us informed.
Good luck James. Let us know how it goes. It can be a tough road, but it is one well worth traveling. I hear you on your symptoms. My Dad and Grandpa both had bad sleep apnea and both were thin guys. I have it too, but you could write me off as I have it because I am overweight...but I know when I do get my weight down, I will still have it because it is something I have inherited from Dad and Gramps. We are using a screening tool at work to help spot people with undiagnosed sleep apnea prior to surgery. Unfortunately the screening tool is only based on BMI. Even the medical professionals just can't get it right. So hang in there....hopefully you'll get back to sleeping with your wife and wake up feeling refreshed and with a full functioning memory....you are almost there! I actually got my creativity back after successful treatment --- totally unexpected, I wasn't even aware it was gone! I love the suggestions people are giving you......the right mix is in there somewhere....keep trying, don't give up and let us all know how you are doing!

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