Replies to This Discussion

Permalink Reply by Oswald Abraham on September 28, 2010 at 9:19pm

Hi,

In reply to your last post, I have suffered with severe OSA for a few years. In addition to my OSA, I have upper airways passage problems like sinuses, and swollen turbinates. There are many more.

Like most patients I had a polysomnogram test done, and was rushed off to get a CPAP. I was never asked if I had upper airways passage problems, which I think are very crucial factors in snoring and sleep apnea. Sometimes solving these problems can prevent or reduce snoring and sleep apnea.

In my experience excessive sleep made me feel tired and left a drowsy feeing whole day, or insufficient REM sleep may be another factor for excessive unhealthy sleep. Normally, in every 7 to nine hours sleep, we have about 3 to five REM sleep periods. In my case I need 6 to seven hours sleep, and 2 or three REM sleep periods to wake up fresh every morning. Each REM sleep period is about 90 minutes to 110 minutes.

I made a decision not to use a CPAP, because I find it very claustrophobic and intrusive. I use an Inclined Lateral Positional Anti Snoring Pillow. I am quite comfortable with it. Most time people with OSA are left alone to make decisions about a live threatening condition like OSA, it can be very difficult. However, sometimes, that is just what we need to do. I hope you find a good solution.

Oswald

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Permalink Reply by Jenny Foerst on September 28, 2010 at 11:25pm

I was diagnosed with severe OSA a year ago and received very poor follow-up. I just went to a new sleep doctor last week and am having a new sleep study done this friday. The doctor thinks that since my thyroid disease was diagnosed and is being treated now that the pressure I need may well be lower now.

I would be willing to undergo any kind and multiple surgeries to cure my OSA, as two people from work and another friend have, but this doctor and an ENT I saw both cannot find a single anatomical reason that would be contributing to my OSA. I have a double deviated septum already operated on once. She said getting that fixed may reduce the severity, but nothing will "cure" me.

So, I guess I'm resolved to get better equipment at least. The medium mask they imposed at the first study leaked all night, so I can't help but wonder if that affected the pressure prescribed. I wonder if I can at least bring my smaller mask with me to use for this one.

I was surprised at how resistant the doctor was to my getting a decent machine like the S9. She said all they do is blow air and that I don't need it to do more than that. I told her I want something that records events, etc. Also, I think the S9 reduces noise transmission down the hose--right now I have to wear earplugs AND turn on music to get to sleep b/c of the whistling in my head.

I asked for an APAP, but she says they haven't been demonstrated to work like they are supposed to, so she won't prescribe one.

Any suggestions, comments? Help?

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Permalink Reply by 99 on September 29, 2010 at 3:20am

i want an apap and am willing to pay the difference
whos paying
do you want to get paid

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Permalink Reply by Banyon on September 29, 2010 at 6:27am

Jenny Foerst said:

I was surprised at how resistant the doctor was to my getting a decent machine like the S9. She said all they do is blow air and that I don't need it to do more than that. I told her I want something that records events, etc. Also, I think the S9 reduces noise transmission down the hose--right now I have to wear earplugs AND turn on music to get to sleep b/c of the whistling in my head.

I asked for an APAP, but she says they haven't been demonstrated to work like they are supposed to, so she won't prescribe one.

Any suggestions, comments? Help?

Get a new doctor who cares about patients and is not holding on to 20th century technology.

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Permalink Reply by Mary Z on September 29, 2010 at 12:00pm

This sounds like a case of "the doctor knows best" and is outdated and detrimental to our compliance with treatment. We are part of the Medical Team and our opinions should be heard and requests honored whenever possible. I would try to find a new sleep doctor who is more up to date as far as involving the patient in patient care. You gave logical reasons for wanting that particular machine and your involvement in your care encouraged.
Good luck, Keep us posted.

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Permalink Reply by Rev Aaron Fielder on September 29, 2010 at 4:24pm

It should be remembered that many of these "new" Doctors are only following the dictates of their 19th Century Medical School books. Sleep studies aren't really all that old, and as such, unless it is the specialty of a very interested Doctor, hasn't been taught in most medical schools except just as the barest outlines of procedures. Also, keep in mind the politics of the situation, as many of these Doctors are afraid to lose influence over their patients decisions. There is a lot of "Liability Fear" out there, especially since they have to sign their names (and careers) on the "Recommendation Rx!"
As I have experienced, a good "sleep study" can usually tell "what you are doing during the night" by observation, but not necessarily "why you are doing it!" i.e. "Is it physical, mental, spiritual ...or just a nightmare of all three?"


Banyon said:

Jenny Foerst said:

I was surprised at how resistant the doctor was to my getting a decent machine like the S9. She said all they do is blow air and that I don't need it to do more than that. I told her I want something that records events, etc. Also, I think the S9 reduces noise transmission down the hose--right now I have to wear earplugs AND turn on music to get to sleep b/c of the whistling in my head.

I asked for an APAP, but she says they haven't been demonstrated to work like they are supposed to, so she won't prescribe one.

Any suggestions, comments? Help?

Get a new doctor who cares about patients and is not holding on to 20th century technology.

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Permalink Reply by James Skinner on September 29, 2010 at 4:25pm

A couple thoughts:

1. Its is possible that CPAP is giving you centrals and that is the reason that you could not get the RDI down?
2. The lump in your throat sounds like GERD to me. A common side effect of apnea.
3. Its imperative that your nose work well to use CPAP and to lessen apnea. Get that fixed ASAP

Is there any way that you can post your sleep studies so that we can take a look at them? I wouldn't give up on CPAP just yet. A dental device might be an option too but you would need to get your nose working better first.

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Permalink Reply by 99 on September 29, 2010 at 5:33pm

be careful that the machine is not swapped after your 4 week trial unless it is with another autoset machine with humidifer


Donna B. said:

I got my machine today (Tuesday) an Autoset II w/heated humidifier for a 4 week trial (and it does record the data) and an F.P. Opus nasal mask (same one I had for my sleep study) My technician let me try it out for 15 minutes this morning, it's funny, I sat in the chair and closed my eyes, could feel myself falling asleep. It only took a few minutes after being plugged in to get used to the pressure.I don't find the mask uncomfortable at all and had no trouble sleeping with it at the overnight.

Mary Z said:

I don't think this necessarily holds true all the time, 99. The pressure needed might be such that a person would be more comfortable with a BiPAP, or APAP after titration.

99 said:

the apap is to try before they give you a cpap, note the difference
the apap is for titration for the cpap to be set at

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Permalink Reply by Jay Polatnick on September 30, 2010 at 9:14am

Thank you for sharing this experience. Ironically, it was very similiar to my first experience with a CPAP machine and mask. I felt more clearheaded, but had difficulty tolerating some of the pressure settings. I'm just talking as a layman and positing the theory that ANY increase in oxygen intake can have a positive effect on one's health. Wishing you the best and will look out for your future responses.

Regards,

Jay P.

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Permalink Reply by Sarah Gorman on September 30, 2010 at 5:44pm

You should be given a trial on an APAP.
Some people need varying pressure levels, not a constant one, to prevent apneas.
If you are one of those, you may be able to eliminate the apneas by going to an APAP.

APAPs are a little more expensive than the CPAPs but I'm on my second APAP
and love it! Good Luck!

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Permalink Reply by Donna B. on October 3, 2010 at 9:29am

@xxx, My APAP is a 4 week trial, if they find that this APAP is not doing the job then what other xPAP choices do I have ? I am having a bit of trouble with the pressure being set at 11. I wake up about 2 hours after getting to sleep gasping for air. I also am having trouble with the air filling up my mouth and having to release it. I don't recall this being a problem during my study. Any thoughts on why this is happening ?

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xxx said:

be careful that the machine is not swapped after your 4 week trial unless it is with another autoset machine with humidifer


Donna B. said:

I got my machine today (Tuesday) an Autoset II w/heated humidifier for a 4 week trial (and it does record the data) and an F.P. Opus nasal mask (same one I had for my sleep study) My technician let me try it out for 15 minutes this morning, it's funny, I sat in the chair and closed my eyes, could feel myself falling asleep. It only took a few minutes after being plugged in to get used to the pressure.I don't find the mask uncomfortable at all and had no trouble sleeping with it at the overnight.

Mary Z said:

I don't think this necessarily holds true all the time, 99. The pressure needed might be such that a person would be more comfortable with a BiPAP, or APAP after titration.

99 said:

the apap is to try before they give you a cpap, note the difference
the apap is for titration for the cpap to be set at

• ▶ Reply

Permalink Reply by 99 on October 3, 2010 at 11:33am

after a cpap there is an apap
after an apap there is a bi pap
try and stick with the apap.
you are new to all this so do not dispair and stay the cource, it may be bumby at the moment but i am confident that that things will smooth out for you

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