CPAP making things worse

[dchristie31966]

Hi, I am a new user to CPAP. I'm having so much trouble and am ready to just give up. I don't have issues so much with the mask, but I'm like an angry gnome at the audacity of insurance companies making people COMPLY with their dumb restrictions, along with the notion that I have to give up everything I enjoy if I attempt to do their stupid therapy. I call complete BS! I'm having more events with the machine than I had during my home sleep study. My nose is always congested, I see the ENT people this coming week. Maybe surgery will help with that. Short background, I have very mild COPD, but the issue isn't apneas, it's hypopneas which in turn cause my oxygen to drop to 78% which causes nocturnal hypoxemia. My original events is only 7.8%, now I'm having over 10 events per hour. I'm so dang frustrated. Should I wait and see if they do surgery on my nose to chuck the thing out the window or just give up entirely? I feel like since the sleep apnea is so mild that I'm literally torturing myself for something minimal and losing my mind while trying.

[robbob2112]

Hi and welcome,

A couple of things. Please fill out your machine profile and mask so we know what you have exactly. The cpap machine will help the hypopneas once on the right settings. If you have a copy of your sleep study and titration results, black out the personal information and post it as well. And list your current machine settings.

Next, download Oscar from the link in the sticky note and put your data into it. You will need a SD memory card to transfer the data from the machine to the computer. Assuming you have a resmed the card will be 2 to 32gb in size.

My original sleep study pegged me at 55 events per hour, 30 central events and the rest obstructive. Now I typically have only a couple of them per night.

Your COPD may complicate things a bit.

[LSAT]

What restrictions? The insurance company is only concerned that you use the machine they paid for. If you don't use it you have to return it or pay for it. I don't think that is unrealistic.

[Miss Emerita]

During your sleep study, do you know how much of the time your O2 levels were below 90?

Echoing others: it'd be great to have more information so we can be of better help to you!

[chunkyfrog]

One of the hardest things about treating a sleep disorder is dealing with our anger.
It is unfair to be afflicted with this condition. Cpap is the TREATMENT.
Insurance is the means without which so many of us would be forced to continue to suffer.
Cpap is good--insurance is a necessary evil. We do what we need to for normal life.
Most of us here have much fuller lives with cpap than we could have without it.
---And longer lives, as many will attest.
The cost and inconvenience will become a non-issue as you get used to cpap.
Like wearing glasses, or using a cane.

[Julie]

If you can manage not to sleep on your back, your hypopneas should lessen by a lot. Try it for a few nights and you might just be surprised.

[kteague]

About your nasal congestion, are you "always congested" when using cpap or always congested day and night? If only when using cpap, consider that if a mask hits at the wrong spot on the sides of the nose, it can feel like the worst congestion ever.

[Conrad]

Hi, I am a new user to CPAP. I'm having so much trouble and am ready to just give up. I don't have issues so much with the mask, but I'm like an angry gnome at the audacity of insurance companies making people COMPLY with their dumb restrictions, along with the notion that I have to give up everything I enjoy if I attempt to do their stupid therapy. I call complete BS! I'm having more events with the machine than I had during my home sleep study. My nose is always congested, I see the ENT people this coming week. Maybe surgery will help with that. Short background, I have very mild COPD, but the issue isn't apneas, it's hypopneas which in turn cause my oxygen to drop to 78% which causes nocturnal hypoxemia. My original events is only 7.8%, now I'm having over 10 events per hour. I'm so dang frustrated. Should I wait and see if they do surgery on my nose to chuck the thing out the window or just give up entirely? I feel like since the sleep apnea is so mild that I'm literally torturing myself for something minimal and losing my mind while trying.

If you don't like following the rules from the insurance company (audacity? hardly) feel free to send the machine back and DC your treatment. Or you can shell out the money from your own pocket and not have to follow any rules. Your choice.

"along with the notion that I have to give up everything I enjoy if I attempt to do their stupid therapy."

You have to give up everything that you enjoy? Like what, and why do you have to give it up? Their stupid therapy is attempting to give you a longer and healthier life. How stupid of them, right?

With that attitude of yours, CPAP therapy is never going to work. Either get your head around it or toss the machine back to the insurance company and be done with it.

[dchristie31966]

Thank you to those that replied. I have taken the time to upload machine specs (I think), will work on the sleep test results. Not super tech savvy but try to learn if I can.
Thought I would throw a little more information out as one person asked about sleeping differently. I had a double fusion of my lower lumbar spine in 2011 so sleeping on my sidees is extremely difficult. I even try propping pillows behind my back to get me to stay on my side, but I always end up on my back, which in turn turns me into a mouth breather. Maybe I need therapy to help me fix the way I sleep, I don't know. My really main concern is the nocturnal Hypoxemia. I had asked if oxygen wouldn't help but nobody ever got back to me from the pulmonologists office.

[ozij]

I'm glad you're back.
Your sleep study would really help us understand what's going on.

COPD is a problem with your lungs ability to function it's "chronic ostructive pulmonary disease"

Obstructive sleep apnea is a result of full or partial obstruction of your upper airway, and the CPAP's role it to keep that part of your airway open, the pressurized air acts as a kind stent.
Assuming you hypopneas are a result of upper airway obstruction - oxygen won't solve your problem.
Which is not to say whether oxygen is needed or not - only to say that your upper airway has to be clear of obstruction so the oxygen (supplemental or not) can get to your lungs.
A faster car will not help you go any faster if there's a traffic jam that keeps it from moving.

[Janknitz]

Somewhere in that understandable anger your are feeling (it's actually one of the stages of grieving for this newly diagnosed condition your are grappling with), it sounds like you are willing to work to make this better.

We can help.

You may be having more apneas with the machine than in your sleep study because it's not optimized for you (even if you had an in-lab titration which supposedly came up with magic numbers for your treatment).

You mention nasal congestion specifically, that may be a good place to start. Too little OR too much humidity with the machine can cause nasal congestion. Try a few things:
1. Address your nasal congestion before bed. Try a saline nasal spray to clear your nose.
2. Note what the humidity setting is on your machine. Try adjusting it one setting up or down, and give that a few nights to see if it makes any difference. If it's a little better but not fixed, up or down a notch more. If it's worse, head one notch at a time in the opposite direction. It can take some time to find the "sweet spot".
If you are using a decongestant like Afrin or an oral decongestant, be aware it has a rebound effect and can actually make congestion worse. It's not a good idea for anything but VERY short term (3 days or less, and I will NEVER touch decongestants again after a horrible experience with rebound).
NOTE that unless your nasal congestion is a constant thing day and night, surgery is not the answer to fixing it. And personally, I wouldn't want to do any surgery without trying non-surgical approaches first.

Meanwhile, if you can tell us your settings for pressure, humidity, and ramp, that would be helpful.