BS: sleep apnea treatment

Subject: BS: sleep apnea treatment
From: keberoxu
Date: 18 Apr 22 - 05:13 PM

It's a new era for me: just brought home my very first device ever
for breathing in my sleep. It's an APAP in my case.
The first store I stopped at, after getting off the turnpike,
did not have distilled water, having run out, they told me.
So will hit other locations/stores between now and bedtime.

The sleep study -- which I was able to do in the privacy of home,
with a home kit that sent data to the hospital --
determined that I have "serious" sleep apnea but, at least,
it isn't the sort where the brain goes on the blink. Just the "obstructive" kind.

I spent most if not all of one full hour with a respiratory therapist at a home-health-supplies supplier place, a sort of franchise.
This sleep apnea stuff is big bucks now, a full-on business deal.
Coordinating all of these moving parts has been interesting.
I am a resident patient at a long-term clinic for mental health treatment.
The clinic's medical office lined me up with
the "sleep disorders center" at the big county hospital campus,
and that was the source for the sleep study.
I never did see a physician face to face.
I worked the whole time with a nurse practitioner;
when the data from the sleep study was analyzed, summarized, and reviewed,
a physician whom I never met signed off on the report.
I want a copy of that report, have to ask for it again
because my first request got, erm, overlooked.

Then that nurse-practitioner at the sleep disorders center explained
that a prescription is in order, insurance requires it so;
and that what came next would be a waiting period while
insurance and the doctors and the pharmacy that does respiratory stuff
did a little arm-wrestling about cost and stuff,
and waited for the order to be filled.
All this told to me at the last appointment on the hospital campus.
I reminded them, since I'm in treatment myself,
to contact me through the mental health clinic.

So I get a message from the clinic's medical office.
They relay this message from someone, about how much the insurance will cover,
how much I have to pay, and then they tell me to return the call.
And it turns out that this isn't the pharmacy named by the hospital.
It's a franchised supplier which has somehow gotten into the act
and they are going to sell this thing to me on a rent-to-own basis;
and in order for me to see them in person and collect the device,
I have to drive to the next county to their nearest office.

Which I just finished doing today.
So I have the machine which has the little humidifier chamber built in.
I have that tube/hose, and a nasal mask that they described as "pillow",
I said, does that mean you are selling me a pillow?
No, they explained, that's how they describe the part that goes into your nostrils -- it's "pillowed" ...
for your information, I have an extra-small-size nose.
That's the size of the nasal pillow, extra-small.
As opposed to small, medium, or large and what have you.

I do hope this works. It's been a long day and I feel very cross indeed.

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 18 Apr 22 - 05:17 PM

Losing 80lbs of body-fat cured my Sleep-Apnœa, and my snoring. ;-)

Subject: RE: BS: sleep apnea treatment
From: Stilly River Sage
Date: 18 Apr 22 - 07:25 PM

I make my own distilled water these days. I have a steam juicer, it's like a triple-decker boiler. The bottom has the water, the middle is the pot that catches juices (steam moves through a volcano-shaped central spout). The top is the colander that fruit or vegetables are put in. Instead of putting anything in the top I fill the bottom with water, put rest of the pot in place, then put the lid on upside down so it's a shallow dish. Fill that with ice cubes and the steam hits that lid and drips as distilled water into the catchment pan. (That pan has a hose for decanting liquids). It's a complicated description of this pot. They're expensive enough that you can probably buy about 75 - 100 gallons of distilled water for the price.

If you don't already own one there are other ways to make it at home. Depending on how much time you have, etc. It doesn't take long, and you may not want to bother in general, but this will work in a pinch when you're out of water and don't want to run to the store.

Here's another article how from Wikihow.

Subject: RE: BS: sleep apnea treatment
From: Steve Shaw
Date: 18 Apr 22 - 07:58 PM

Yep. As with BWM, lose weight. It's a cure. I speak from experience.

Subject: RE: BS: sleep apnea treatment
From: Rapparee
Date: 18 Apr 22 - 08:55 PM

I was given a BiPAP machine (a fancy CPAP) by the Veterans' Administration. Mine is a ResMed Air Sense 10 and seems to have been made in Australia. I also have a special pillow. If you get the pillow, get a second pillowcase for it so you can wash them on alternate weeks.

An APAP is above my grade of machine. FWIW, my AHI index was 129.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 18 Apr 22 - 10:51 PM

Thanks, Rapparee. It's like talking to a relative.
Estranged from my family, I have no blood relatives to share my journey with, so my Mudcat relatives are keeping me company.

Just looked over the whole kit and caboodle, and again,
it's different than that nurse-practitioner said it would be,
that's going to be like a broken record for me, that statement.

The mask comes from ResMed and it's a "for her" mask. Fits well. Nasal.
The machine itself says it is a CPAP, not an APAP or a BiPAP.
Nurse-practitioner said it would be from Resmed. It isn't.
It is by Resvent, from Shanghai, China by way of Hamburg, Germany.
The model is called an iBreeze.
I've already plugged everything in and it sits on the night table.

Bought a gallon of distilled water at the nearest supermarket.
So now I pour in the water and close up the chamber;
get the mask pillowed properly over my extra-small nostrils;
turn out the light, get in bed,
and hit the START button. And it starts. I hope.
Has to run for a minimum of four hours per night.

Talley-ho and away we go,
see you [tomorrow morning] in a brand new show . . .

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 19 Apr 22 - 02:38 AM

Yep. Weight loss did it for me too. 10 years of untreated apnea 7 years of cpap. Now, 50lb less with 20 to go, no problem.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 19 Apr 22 - 10:15 AM

Running the CPAP device last night,
I lasted for three hours before
taking off the mask and turning the machine off.
There is still water left in the humidifier chamber,
and I left it so, in place, for tonight's sleep.

The mask will take some getting used to.
It feels odd to have something squashed into my nose, pillow or no pillow.
The air circulation was unobtrusive in itself.
More being distracted and annoyed by the sensation of the nasal mask.

So will keep going with this every night and getting accustomed to the treatment over time.

Subject: RE: BS: sleep apnea treatment
From: Stilly River Sage
Date: 19 Apr 22 - 10:45 AM

Is it very noisy?

I have a friend who carries around one of those expensive oxygen generators and we usually put a power strip in the closet so she can put it in there to run and have her tubes run through the crack in the doorway around to the bed. That knocks a few decibels off of the operation.

Subject: RE: BS: sleep apnea treatment
From: Sandra in Sydney
Date: 19 Apr 22 - 10:57 AM

I was diagnosed c.2006 but have never used a machine. At the time my physios were working on turning mouth breathers like me into nose breathers, & recommended a small piece of micropore tape vertically across one side of the mouth to keep it closed when sleeping. At the time I was also suffering from reflux, so could also breathe out of the other side of my mouth if I woke with an attack.

I fold a little hem each end of the tape to make it easier to remove.

by-the-by, 2 of my folkie singer & musician friends built the prototype of Resmed's original machine at Sydney University way back in the early 80s. ResMed story

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 19 Apr 22 - 11:19 AM

I took to the full cpap mask like a duck to water and I was in hospital for an unrelated condition when I first got it! Noise was never an issue unless the mask came loose and Mrs G said even then it was far quieter than my snoring :-)

Subject: RE: BS: sleep apnea treatment
From: leeneia
Date: 19 Apr 22 - 12:31 PM

I'm happy for you, Dave,and keb, I hope the machine works for you. Better sleep can make a wonderful difference in your life.

My sleep used to be bothered by a deviated septum, which kept me from rolling over every 20 minutes, which sleeping people are supposed to do. I used to wake up feeling miserable, (not having moved all night), and I was only in my 40's. Got it fixed, and now I wake up feeling warm and snuggly.

Subject: RE: BS: sleep apnea treatment
From: MaJoC the Filk
Date: 19 Apr 22 - 01:50 PM

Dave the Gnome: I'm surprised Mrs G hasn't tried the old trick my Management used to stop me snoring: a hoof in the kidneys at three in the morning turneth aside snores. She didn't take long to train me to be incapable of sleeping on my back. At least that's what she told me in the morning.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 19 Apr 22 - 07:11 PM

About to turn in for the night again.
Stilly, my breathing is louder than the device itself.
I'm sure the old-fashioned ones were a lot to contend with,
but this model and technology are really very quiet.

The nurse-practitioner took one approach which soothed me.
She talked with me in terms of,
let's get you sleeping properly, getting a healthier condition for resting and breathing and so on,
and then consider what a difference it makes to your waking life,
when you are better rested and not exhausted and fatigued all the time.

Then, and only then, we can worry about weight loss
and eliminating obesity (yes, I do have that diagnosis).
Which to me sounds like a kind way to talk about it.

Subject: RE: BS: sleep apnea treatment
From: Rapparee
Date: 19 Apr 22 - 09:03 PM

APAP and BiPAP are CPAP machines on steroids. It's all in the programming.

Subject: RE: BS: sleep apnea treatment
From: Joe Offer
Date: 20 Apr 22 - 04:12 AM

I have a ResMed Airsense 10 CPAP machine, It's noiseless, and works quite well. Rap, I wonder how your AirSense 10 is a BiPAP machine. What's the difference?
It's not perfect, but it seems to help.

-Joe-

Subject: RE: BS: sleep apnea treatment
From: Steve Shaw
Date: 20 Apr 22 - 04:37 AM

I can't think that I would sleep properly with a big mask over my face. A few years ago I suffered from suddenly waking at night in a panic, needing to gasp for breath, always after sleeping on my back. The same thing happened if I had a daytime nap in an upright sitting position. After I lost a lot of weight these attacks completely stopped. I understand that apnoea can occur without waking, but Mrs Steve has not observed any interruptions in my sleep-breathing for years. None of this is intended to be medical advice. It's just my narrative, that's all. With me, it appeared to be one hundred percent related to being significantly overweight.

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 20 Apr 22 - 06:26 AM

"I can't think that I would sleep properly with a big mask over my face. A few years ago I suffered from suddenly waking at night in a panic, needing to gasp for breath, always after sleeping on my back. The same thing happened if I had a daytime nap in an upright sitting position. After I lost a lot of weight these attacks completely stopped. I understand that apnoea can occur without waking, but Mrs Steve has not observed any interruptions in my sleep-breathing for years. None of this is intended to be medical advice. It's just my narrative, that's all. With me, it appeared to be one hundred percent related to being significantly overweight."

I completely agree, Steve, The idea of attaching myself to a machine with pipes and a mask just to achieve a normal night's sleep sounds dreadful to me. I might be misunderstanding, but resorting to breathing-machines and masks, what I would consider a 'last resort', seems to be regarded as a 'normal' thing to do by our US buddies?

I used to snore like a train, and frequently woke up panting, out of breath, with my heart racing. Mrs. Backwoodsperson woke me up on numerous occasions because my breathing had stopped. Other medical conditions back in 2005/6 meant that I lost over 80lbs in weight, I've managed to keep around 60 lbs of that off for the past fifteen years, and I haven't suffered apnea or snored since that time.

Obviously, we have no way of knowing whether other apnea sufferers here have a weight-problem but, if any do, I would strongly recommend investigating losing weight as a far better, healthier way to deal with apnea. Personally, breathing-machines and masks would be an absolute last resort, only to be undertaken after all else failed.

The Standard Disclaimers apply - IMHO, YMMV, yadda yadda.

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 20 Apr 22 - 07:51 AM

They work very well, John. Not dreadful in the slightest. In my case the apnea was weight releated and, having tried and failed to lose weight many times, it made a massive difference. Lack of sleep causes all sorts of mental health problems which in my case manefested as over eathing and drinking too much and that led to being physicaly unable to excercise much. I was on a CPAP maching for 5 years and my mental well being improved so much that I managed to lose 4 stone and now easily hike up big hills that I used to struggle with, cycle 10 miles or more 2 or 3 times a week and am a regular at the gym. Keberoxu mentioned elsewhere about having mental health issues and on this thread has already said -

The nurse-practitioner took one approach which soothed me.
She talked with me in terms of,
let's get you sleeping properly, getting a healthier condition for resting and breathing and so on,
and then consider what a difference it makes to your waking life,
when you are better rested and not exhausted and fatigued all the time.

Then, and only then, we can worry about weight loss
and eliminating obesity (yes, I do have that diagnosis).

CPAP machines are easy to use, do not involve any medication, are proven to be effective and can lead to a quality of life that some people could not otherwise achieve. Far from a last resort.

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 20 Apr 22 - 08:17 AM

That’s a good point, Dave, and I wouldn’t argue with you. My post wasn’t intended as criticism of anyone for using breathing-machines, I was just giving my own experience and saying that I would prefer to use a mask and breathing machine only after else had failed.

Apologies for calling them ‘breathing machines’, but all those abbreviations/mnemonics dotted around the thread mean SFA to me! ;-)

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 20 Apr 22 - 10:17 AM

OK. thanks John. Maybe I was being oversensitive. Being obese for a number of years never really caused me any image hastle but I do know people who have been driven to tears and worse by throwaway comments like "I would strongly recommend investigating losing weight as a far better, healthier way to deal with apnea". Do you not think they have tried already? As to whether CPAP (Continuous positive airway pressure - Easy to find!) is regarded as normal in the US, I have no idea. It should be regarded as a normal course of action everywhere as far as I am concerned and suggesting it is abnormal and should only be used as a last resort helps no-one come to terms with it :-(

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 20 Apr 22 - 10:39 AM

Still not arguing with you, Dave - what I said was my own personal preference, and I fully understand and accept that others disagree with me. No problem.

Incidentally, I too was obese for many years - 5’ 7” tall and 17-1/2 stones in weight - and often subjected to unpleasant, insulting comments about my weight, so my comments about weight-loss were made from a position of empathy and understanding, not criticism. But there is no doubt that obesity and sleep-apnœia are related and, in your case, Steve’s, and mine, weight-loss provided relief from the condition without the need for mechanical intervention. That surely has to be a good thing, and worth recounting for the benefit of others?

BTW, my weight-loss was as a result of a medical condition, treatment for which precluded eating fats and carbs to a great degree, not because of my own will-power, so I don’t make any claim to being especially virtuous, the opposite in fact - if it hadn’t been for sickness, I would probably still be as overweight as before.

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 20 Apr 22 - 11:25 AM

I am am not arguing either, John. Just explaining why I am right :-)

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 20 Apr 22 - 11:32 AM

Stilly, I have to correct my answer to your question.
As long as the CPAP machine is sending the flow of air straight into the face mask, with a tight seal to the nosepiece, then the machine operates nearly silently.

This changes if I pull the mask off my nose while the machine is still turned on. There is a sudden burst of noise from the hose/tube with the airflow, and that goes on being very noisy while the air is released into space. It is remarkable how much quieter the whole operation works when all the air is moving neatly through the mask into the nasal passages.

When I kept my appointment with the respiratory therapist (salesperson?) early this week, to learn how to work the CPAP machine, I remember how much she made of the strict requirements for patients who are employed full-time as truck drivers, as we call them in the USA (we don't say "lorry"). That was sobering to hear: to think of how long-distance driving with a truckload of freight is hazardous at the best of times, and downright problematic if the driver doesn't get enough sleep -- sleep deprivation, falling asleep at the wheel -- and between the insurance coverage and the industry which employs the drivers, the question of sleep deprivation and sleep apnea is one that people grapple with in real life. If I heard her right, the therapist was talking about portable CPAP machines that the driver uses IN THE DRIVER'S SEAT OF THE VEHICLE. While driving, not while sleeping. Maybe I heard that wrong?!

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 20 Apr 22 - 11:52 AM

”I am am not arguing either, John. Just explaining why I am right :-)”

That’s two of us then Dave! ;-) :-)

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 20 Apr 22 - 12:21 PM

The other advantage of a CPAP machine is that the constant pressure helps in any situation where obstruction prevents normal breathing in situations other than sleep. Maybe truckers have waking obstruction due to being seated for so long? Just a thought!

Not long after I got my device I caught severe flu and was laid up in bed for a few days. It certainly helped me then. I believe they have been extensively used for covid patients too.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 21 Apr 22 - 09:03 PM

Backwoodsman, of course, maintains his apnea-free weight
with a lot of help from Baxter the Border Terrier, I am certain.

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 22 Apr 22 - 01:24 AM

Indeed I do , Keb - although now we’re both into our dotage our daily mileage has reduced from 5 or 6 miles down to 2 or 3. ;-)

Subject: RE: BS: sleep apnea treatment
From: Steve Shaw
Date: 22 Apr 22 - 07:54 AM

Dave and John reminded me of one of the immortal sayings of the great Brian Clough: "If I had an argument with a player, we would sit down for 20 minutes, talk about it, and then decide I was right.". :-)

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 22 Apr 22 - 07:55 AM

Steve - :-D

Subject: RE: BS: sleep apnea treatment
From: Backwoodsman
Date: 22 Apr 22 - 08:52 AM

LOL! You know me so well!

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 23 Apr 22 - 06:55 PM

The mask made for problems this first week.
I had trouble adjusting the fit.
The nosepiece fit my nose nicely enough, for a tight seal.
But the mask frame pinched my cheekbones and made my face sore.
Finally worked out how to adjust the frame and the band,
and now it doesn't pinch like it did.
May take a while for the bruising to settle down, though, still hurts.

Gradual and slight changes to the quality of respiration and sleep.
Dream sleep is better, I was badly deprived in that area.
I'll take it ... hope things feel better soon.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 03 May 22 - 03:39 PM

Another week in the life. Actually another month now that it's the month of May.
Good news:
sleeping better, more accustomed to machine routine, feeling better.
Other news:
my medical insurance is dead in the water because a premium payment was too late;
and my weekly COVID-19 test came back "inconclusive", which is a first for me after all these many months.
So the nurses' station at the clinic here just processed an antigen test for me, with the results "negative", just today.
Tomorrow I must go for another PSA test.
In between I wear a mask and social-distance.

It's funny that I would get my first "inconclusive" test results
at exactly the moment that I am feeling better for the first time in several months.

Subject: RE: BS: sleep apnea treatment
From: Joe Offer
Date: 05 May 22 - 06:34 AM

Keberoxu, what mask are you using, and which CPAP machine?
-Joe-

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 08 May 22 - 09:46 PM

Post of 22 April answers your question, Joe.

Subject: RE: BS: sleep apnea treatment
From: Dave the Gnome
Date: 11 May 22 - 03:46 AM

It was 18 April, Keb. I think you were looking at the year :-)

Same make as I had but mine was a full unisex one in medium.

"The mask comes from ResMed and it's a "for her" mask. Fits well. Nasal.
The machine itself says it is a CPAP, not an APAP or a BiPAP.
Nurse-practitioner said it would be from Resmed. It isn't.
It is by Resvent, from Shanghai, China by way of Hamburg, Germany.
The model is called an iBreeze."

Subject: RE: BS: sleep apnea treatment
From: Joe Offer
Date: 11 May 22 - 04:00 PM

Keberoxu, I am asking for the make and model of your CPAP machine and mask. I found a partial answer, but not on April 22.

Subject: RE: BS: sleep apnea treatment
From: keberoxu
Date: 11 May 22 - 09:02 PM

My bad, Joe. Gnomefriend, you're right, the post is 18 April.

This is the closest I can show you to the device which is covered by my Blue Cross/Blue Shield insurance.

The pictures, however, show a mask linked up to that hose/tube,
but in fact the device does not come with a mask of its own,
it just comes with the hose, at least that is how it was sold to me.

As for the mask, it came from ResMed and
this is very close to what it looks like. I was told it was a "for her" mask; but at this website I can't find a 'for her' product. Anyway.

Subject: RE: BS: sleep apnea treatment
From: Rapparee
Date: 11 May 22 - 09:39 PM

I need to place a correction: My machine is an Air Curve 10, not an Air Sense.

I think the biggest difference in the BiPAP and CPAP machines is in the programming.