Replies to This Discussion

Permalink Reply by Judy on December 21, 2009 at 8:55pm

Something which helped me were "think dreams". When I went to bed I concentrated on dreaming up some lovely story about something I would like to do but probably never will. Racing a horse over green meadows and gently rolling hills w/fresh running water in a brook and big beautiful shade trees on the side. Its an endurance race and we win!!! Showing one of my home bred Collies and winning Winners at its first show, Best of Winners at its second show, Best Opposite Sex at its 3rd show, Best of Breed at its fourth show, Group 4 at the 5th, Group 3 at the 6th, Group 2 at the 7th, Best in Group at the 8th and Best In Show at the 9th! Me handling all the way. (Except I always manage to fall asleep before I win the Endurance Race or we win Best In Show ....) *wicked grin* Whatever floats your boat. Maybe a trip to the Caribean is more your cuppa tea. Just do some fun, wishful thinking and turn it into a story and a dream.

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Permalink Reply by Pam McReynolds on December 22, 2009 at 2:30am

Great discussion! Answered some questions for me too. Thanks for starting this discussion Claudette.

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Permalink Reply by claudette paluch on December 22, 2009 at 6:17pm

Your welcome Pam...glad its helping....claudette

Pam McReynolds said:

Great discussion! Answered some questions for me too. Thanks for starting this discussion Claudette.

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Permalink Reply by claudette paluch on December 22, 2009 at 6:23pm

Judy, that sounds like a great idea to me...I love your examples..but if i start to do that I will get immersed in them and it would ,for me, keep me awake...I find that I have to clear my head of everything except how comfortable I feel and just try to relax.....and wait for sleep to carry me away... claudette

Judy said:

Something which helped me were "think dreams". When I went to bed I concentrated on dreaming up some lovely story about something I would like to do but probably never will. Racing a horse over green meadows and gently rolling hills w/fresh running water in a brook and big beautiful shade trees on the side. Its an endurance race and we win!!! Showing one of my home bred Collies and winning Winners at its first show, Best of Winners at its second show, Best Opposite Sex at its 3rd show, Best of Breed at its fourth show, Group 4 at the 5th, Group 3 at the 6th, Group 2 at the 7th, Best in Group at the 8th and Best In Show at the 9th! Me handling all the way. (Except I always manage to fall asleep before I win the Endurance Race or we win Best In Show ....) *wicked grin* Whatever floats your boat. Maybe a trip to the Caribean is more your cuppa tea. Just do some fun, wishful thinking and turn it into a story and a dream.

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Permalink Reply by claudette paluch on December 22, 2009 at 6:41pm

Thank you Jeff.

I did sleep better last nite...not great, but better....It will take a while for me to restructure some practices.

.Your advice was invaluable. I really have not attended to monitoring what I was doing much....I like structure but I wasnt implementing it with regard to sleep habits. Your reply was really great! I have not googled sleep hygiene yet....but I doubt that I will see more essential elements than you provided.

Another question I have tho,Is it ok to take naps?

Arethey to be avoided so as not to affect night time sleep or does it depend on length of nap, need, and proximity to
night time sleep,

I had been told once never to nap....doesnt seem like a good idea to me....

hearts need a little rest once in a while mid day as well as their owners

What do you think? thanks...claudette

claudette paluch said:

Jeff,

I cannot formulate a proper reply to you right now for your wonderful words and suggestions....except to tell you that I appreciate them so much.........Thank You!........Claudette

j n k said:

Claudette,

You have to train you brain and body to sleep by being consistent in what you expect. You start dimming the lights in the evening and giving clues to your body and brain that it is time to start winding down as the evening goes on. Then, by the time you get to bed, your brain is ready to sleep.

It is natural for your nervous system to dread sleep if it spent years learning that it had to gear up to startle you awake every few minutes just to keep you alive at night. It doesn't have to do that anymore. So you have to help it calm down as it unlearns that. Give it time. You can help it learn that by developing a set time for sleep and a set time for being awake.

If you have gone through life changes and have emotions to work through, one of the best things you can do is to get enough in-bed time, where the rule is you aren't allowed to think about those things there to give yourself a break from it and heal. If need be, you set aside time early in the evening to sit in a chair away from your bed to think about things calmly. Then when you go to your bed, if those thoughts start to creep back, you laugh at your brain for doing that and lovingly remind it that it isn't allowed to think about it when you are horizontal, that you already thought about that stuff in the chair earlier. It is kind of like lovingly house-breaking a pet. You have to be strict with your brain or it will keep doing the same things. But you have to be gentle with it, too, so you don't discourage it or get it upset. It is an organ. It belongs to you. It is your job to train it. It pays off, because you don't have to go around cleaning up after it. :-)

Well, enough of my pop-psych babble. I hope you sleep well tonight, Claudette.

jeff

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Permalink Reply by claudette paluch on December 22, 2009 at 9:26pm

Jeff...

Thanks, I am smiling...yes, I do know now not to sleep without my machine...but I learned that the hard way...I really felt terrible when I have had to do that....which was on rare occasion. Now I would never let it happen again....ever...I really felt strange, groggy and ill when I woke up...at the time I had no choice.

I was wondering about naps because I was not sleeping thru the night and I was feeling so tired during the afternoon that I was falling asleep at the computer... since I received the VPAP....I am so glad that you gave me the information re sleeping. And, as I said, I had been told unequivocally not to nap.... I am in the process of making my sleep plan..

thank you........Claudette



j n k said:

I have read that if naps are taken, they should be taken early in the day, since, if you take them late in the day, you interfere with good sleep at night.

My take, as a fellow-patient, is that if you are in good shape physically, you might want to see how you feel staying awake all day then getting 8 hours of in-bed time every night and see if you can train your brain to sync up to a normal sleep-wake cycle. That being said, if you are dealing with things physically, mentally, and emotionally, I would say get sleep when you can. Just make it a goal to normalize your sleep habits to the extent you can once you are in a position to do so.

But never, never, ever sleep without the machine. You knew that, though.

jeff

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Permalink Reply by claudette paluch on December 23, 2009 at 5:37am

Good Morning Judy...

.I did find the literature for my respironics profile lite mask...the auto 25 names the mask as Ultra Mirage which I see from the user guide is a Res Med mask...I once had that mask but dont now...So what is the effect, if any, on the fact that the machine identifies a mask different from the one I am using?

Is there a way to change the name of the mask in the machine to the Profile Lite? Do I need to do that?

What is the "VPAP reported pressure" that you refer to?

I do have other questions re the graph but will wait to see what you say with regard to the above....

thank you Judy.............Claudette

Judy said:

First off, Claudette, if that Respironics ProfileLite is comfortable for you and you have a good Leak rate - stick w/it, do NOT change masks. Do you have the literature that came w/it? In that literature there will be a table type of chart. There will be table chart, probably on the back page that will have a caption like "Pressure vs Leak rate" most likely. Down the left side will be some numbers, probably 0 at the bottom on up to 60 at the top. On the bottom there will be numbers running from left to right, probably 10 to 20. And then a line running thru the chart lower on the left and higher towards the right. The numbers on the left are the "exhaust leak rate" or "allowed vent rate", the numbers along the bottom are various PAP pressures.

Pick your VPAP reported pressure (not set pressures, reported pressure) at the bottom and see at what number that line hits the exhaust leak rate.

For example, my Simplicity simple nasal cushion mask at 8 cms pressure hits the exhaust leak rate line at about 21 L/M.

Then look in your VPAP Auto 25's Users Guide. Somewhere in it there will be a list of Resmed Masks and their allowed vent rate (exhaust leak rate). Pick the Resmed mask w/the exhaust leak rate closest to your ProfileLite's exhaust leak rate at your pressure.

For example, the Resmed Swift nasal pillows mask has the exhaust leak rate closest to my Simplicity at 8 cms so I would set my Mask Selection to the Swift.

Most likely your DME provider has made this correct Mask Selection for you. and you don't have to bother w/this at all.

Claudette, do you have a set time that you have to get up each morning? I've found that I get my best sleep between 6 AM and 8:30 AM. Of course, few jobs allow you to sleep that late. But now that I am retired and can sleep any dibblety-darn hours I want I find I like going to bed about midnight to 1 AM and can often then sleep until 8 or 8:30 AM. Hubby is an early-to-bed, early-to-rise person. I find I really enjoy those few late night hours to myself. Why fight my natural sleep hours when I don't have to? I've always preferred a late bedtime as well as that 8:30 AM waking time as far back as I can remember.

AI = apnea index = the number of apneas you experienced PER HOUR that night - or averaged PER HOUR over the week, month, 6 months or year previous (once you've used your VPAP Auto 25 that long).

And, by the way, when I use my ProBasics Zzz-Mask full face mask, its allowed exhaust leak rate also happens to fall w/in the Resmed Swift nasal pillows allowed leak rate at my reported pressure so I use the Swift Mask Selection for the Zzz-Mask too - AND - I've gotten a 0.0 reported leak rate on several occasions so it is possible w/o a Resmed mask to get a 0.0 leak rate ON OCCASION. But, as jnk has said, as long as my leak rate is under 0.4 L/s I don't care, I'm happier than a pig in a pile of dung as leak IS a problem for me w/my Simplicity even w/a chin strap.

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Permalink Reply by Judy on December 23, 2009 at 10:02am

First off, get out your ProfileLite mask literature. W/o knowing the allowed vent rate at your pressure from that literature I have no idea if the Mask Selection is correct or not.

Respironics may have an online allowed vent rate chart for all of their masks but I don't know if they do or not and I sure don't know the URL if they do. Ooops, just checked my Respironics Simplicity literature and Respironics calls it the Exhaust Leak Rate and the chart heading says Pressure vs Leak Rate.

VPAP Reported Pressure is the Pressure that shows up in your Results or Review menu list when you check your data on the LCD screen before noon.

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Permalink Reply by Judy on December 23, 2009 at 10:11am

Ha! Found it! Respironics also calls it the "Intentional Leak Rate".

http://sleepapnea.respironics.com/PDF/LeakRate.pdf

*sigh* I HATE the hyperlink "thingie" here!!! Sometimes it works for me, other times it doesn't. Those who want the link will just have to cut and paste it.

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Permalink Reply by claudette paluch on December 23, 2009 at 7:11pm

Thanks for all this information Judy! I dont understand much of all this.....

.Do you think that my machine should identify the correct mask that I am using by name? I dont have an "ultra mirage" mask...which is the name identified in my machine. There was some confusion when I received the machine and they may not have had time to change it if it requires changing...or because it is a respironics mask, perhaps they have no way to enter that....I will check on that....I have alot of questions...

Thank you for the link...My profile lite literature says nothing about "exhaust rate" or " intentional leak rate"....They may have updated the literature...I am going to check on that also. The chart title is "Pressure vs. Leak Rate" tho. But quite frankly, I still dont understand the whole concept....I think I need to do some reading....so as not to sound so obtuse....

I will let you know what I find out...if anything....

Thanks so much............Claudette

Judy said:

Ha! Found it! Respironics also calls it the "Intentional Leak Rate".

http://sleepapnea.respironics.com/PDF/LeakRate.pdf

*sigh* I HATE the hyperlink "thingie" here!!! Sometimes it works for me, other times it doesn't. Those who want the link will just have to cut and paste it.

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Permalink Reply by Judy on December 23, 2009 at 8:50pm

The Resmeds only have Mask Selections for their own Resmed masks. When using a non-Resmed mask you have to check the allowed vent rate, whatever they want to call it, against the various Resmed mask allowed vent rates and then use the Mask Selection for the Resmed mask that most closely matches the non-Resmed mask you are using. I'm sure your DME provider knows this and set your Mask Selection accordingly. I shouldn't have brought this subject up as at this point it is just confusing you.

But as long as I did I might just as well post the link to the Resmed mask allowed vent rates too.

http://www.resmed.com/assets/documents/service_support/pressure_flo...

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Permalink Reply by claudette paluch on December 23, 2009 at 11:19pm

Thank you very much for all that information...I have copied it and the information on the Resmed site you kindly provided a link to. I have to take some time to read about it all. I am still taking baby steps...I have appointments set up with my providers in a few weeks and I can check with them as what was set re the mask.....and go from there.................Thanks again...........Claudette


Judy said:

The Resmeds only have Mask Selections for their own Resmed masks. When using a non-Resmed mask you have to check the allowed vent rate, whatever they want to call it, against the various Resmed mask allowed vent rates and then use the Mask Selection for the Resmed mask that most closely matches the non-Resmed mask you are using. I'm sure your DME provider knows this and set your Mask Selection accordingly. I shouldn't have brought this subject up as at this point it is just confusing you.

But as long as I did I might just as well post the link to the Resmed mask allowed vent rates too.

http://www.resmed.com/assets/documents/service_support/pressure_flo...

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