When I first started researching sleep apnea and found this forum, I really found the reports from people just starting out to be very helpful.  So, I've decided to post my own first few nights.

Yesterday I went to my appointment with my DME to pick up my equipment.  Thanks to this and other sites, I was well armed with info and knew I wanted a robust enough CPAP machine that would let me collect and create reports on my usage data.  The Respiratory Therapist (RT) was very helpful, and issued me a brand new REMstar Pro2 model.  The prescription from my doctor specified "c-flex and humidifier" but neglected to specify HEATED humidifier.  Now, I don't know if I NEED a heated one, but from what I've read I may very well want it - and I'd rather have an unused feature, than not have it and be stuck without.  The DME agreed, and they took it upon themselves to call both my doctor and my insurance, and in fact got a new prescription faxed over to them so that I did get the heated humidifier.

Now it was time to pick out a mask.  I had tried a nasal mask at my CPAP trial and didn't care for how it felt on my face, and instead had successfully used a Swift with the nasal pillows.  I only sleep on my sides, so the swift isn't perfect since the air hose comes out one side of it.  I had read a lot of recommendations for the Breeze nasal pillow mask, and that was one of the options through the DME, so I had the RT fit one for me.  She said she's had a lot of patients use it successfully, but did warn me that some have issues with it when on their backs (the headgear shifts in that position and can cause the nosepiece to then leak).    The machine was programmed by her for 7cm H20 pressure, C-Flex setting of 3, and heated humidity set at 2.  Ramp feature was set for 15 minutes.

I took it home, and waiting (a little apprehensively, I'll admit), for bedtime.  I set it up on a small table next to the bed.

At 11pm it was time for bed.  I put it on, and fired it up.  My wife commented that it was pretty quiet - the machine itself is barely audible.  The mask seemed quite noisy to me while breathing, but she said it wasn't loud at all.  It wasn't terribly uncomfortable (but let's face it - there's nothing natural feeling about wearing something like that on your face), but breathing felt strange.  Not difficult, but just odd - I think what was happening was that I was THINKING too much about breathing, so instead of natural breaths they were much more forced.  After about 20-25 minutes of this I started to get a little frustrated.  I wouldn't call it an anxiety attack, but it might have bordered on one - just frustration with having to wear it.  I considered taking it off, but then calmed myself and reiterated that it WILL take some time to get used to it, and that using it WILL make me feel better.

After that, I relaxed.  At some point I drifted off to sleep.  And slept.  Multiple times during the night I woke up to roll over, as usually happens.  Normally, when I roll over, I hardly wake up.  Last night I found I was waking up a bit more completely when rolling over, primarily because I'd either have to adjust where the hose was, or the hose would rub/smack against the wooden headboard and make an unexpected noise.  I quickly drifted back to sleep, though.

At 4:30am I woke up and found it was taking a bit longer to get to sleep.  I decided to get up for a minute and use the bathroom (most nights I use the bathroom 2-4 times during the night, so making it to 4:30am is a good sign).   I'm used to getting up, stumbling half-asleep to the bathroom, stumbling back, and falling back to sleep pretty quickly.  I've always said that if I don't wake up "too completely" I can get back to sleep fast.  Unfortunately, taking off the mask, turning off the CPAP, then putting it back on, turning back on the CPAP, getting into bed with it on and readjusting the hose position, all woke me up pretty well. :)  So I laid in bed, with it on, for my final hour (I get up for work at 5:30am).  I drifted in and out of sleep during that time, and was asleep when the alarm went off.

I got up, and I feel I was much more alert/rested feeling.  It's hard to tell for sure, as I was really LOOKING for that feeling (i.e., it could just be psychological or adrenaline).   I seem to feel pretty darn good considering my sleep was broken up by my being unused to using the machine/mask.  My drive into work this morning was easier than it has been - no concerns that I was going to drift off at a stop light.  And, when I pulled into Tim Horton's for a coffee, I didn't have to fight the urge (or give into it, like I often do) to go with caffeine instead of decaf.  The real test will be how I feel as the day goes on - I have some good long boring meetings later that should really test it.

I had some strapmarks from the Breeze on the upper sides of my head - I think for most people those marks would be hidden by hair.  I'm a bit follically-challenged (I figure you only get so much testosterone, and if you want to waste yours growing hair, then hey, good luck to you.  :)  )  My nose is in better shape then I expected - I figured it might be a bit sore from the nasal pillows, at least until it "toughens up" some.  Seems fine this morning - just a slight odd feeling, but nothing painful or like a sore may be forming.

My first-night comments/observations:

1) I think it went really REALLY well for a first night.  Thank God I didn't give in when frustrated early on and just remove the mask.

2) I need to evaluate my setup, regarding the hose.  I think I need to route it up over the headboard, so that it's not so much getting into my way on the pillow when I roll over.  Also, that ribbing on the hose is noisy when it rubs against the sharp edge of the headboard.  I think one of those cloth covers would do wonders for reducing that noise, and help remove that, "what's this hard thing my hand just bumped into" startlement.  I may need a longer hose, though.  My DME said my insurance will pay for a new hose every month - and suggested if I can wait one month, I get a second 6' hose and she can supply me with an adapter to connect two hoses together.  I may just pop for a 10' hose from an internet site.

3) I think a lot of my concerns/issues will go away with time.  After a few weeks or months of using it, I'm hoping that familiarity allows me to roll over without waking up as much, quickly put on/take off the mask for bathroom trips, etc.   Does it ever become second nature?

Wow long post - I hope someone bothers to read it to the end. :)  I must have more energy, look at all that typing I did before 8:30am!



Last edited by FJC on Thu Oct 13, 2005 6:25 am; edited 1 time in total
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--Frank (FJC)

Frank,

Wow, great description!

Sounds like you have a good DME which answers your questions and works with you nicely.  That is great!
I doubt you were imagining the extra energy this morning.  I struggled with the machine and the mask for a very long time, but I felt relief from the very first day using it.  Not everyone does, but it does happen to many people.  

I don't use the nasal pillows, so I don't know what that's like.  And I too switch from side to side, but have managed to deal with the hose alright.  If you can rig something that works, that's great!

And you were wise to fight your frustration to take off the mask early on.  The longer you can keep it on, the better, even if you still end up taking it off later.   To be honest, I have been known to cheat, and not use it some nights.  But I found in the beginning that was not wise.  I found that it was better to try and sleep with it even if only a couple of hours than to skip an entire night.  As you said, your body has to get used to having this contraption on your head and to breathing a little differently.  So it's best to try rather than skip entirely.  If you skip, it only takes longer to get use to, I found.  But don't be surprised if you find you've ripped that thing off in the middle of the night in your sleep, not remembering doing so.  That happens alot to many people, in the beginning.

Sounds like you had a pretty good first night, considering all that you have to get used to.

Keep us posted on how things progress.  I sure love reading about it.
I found writing about it in the beginning to be really helpful.  It helps you to think about how it's working for you, if there's any relief or if there are problems, etc.  So keep writing, if you wish.  It helps us all to learn what others experience.


Linda

Give it time.  My first night was good but a few probs...each succeding night was better with fewer problems.  I was told early by the good folks here that a positive attitues was very important.

I just cant get over how much better I feel.  This therapy is by far the best thing that has happened to me in years.

It took 10 weeks from appt with my primary care doct to referral to pulmanary doc to scheduling the sleep study to follow up and meeting with DMG and gettin my machine but it was all worth it.

Good luck to you.

...and thanks to all who helped me this forum is great


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Thomas Vaughan

Congratulations, Frank!!!!  You will get to the point that everything will be second nature.  I loop my hose over the top of my headboard and that made a big difference.  The first night is always the hardest.  Each night should get increasingly easier.  I have been on CPAP for 10 months now and can't imagine sleeping without it.  I, too, felt incredibly better after just my first night.

Way to go!!!!

Thanks for all the comments!  I've changed the topic to say "nightS" instead of "night", I'll keep adding some comments here.

My day yesterday was quite good at work.  I attended a few boring meetings, and not ONCE did I feel like I was going to nod off.  This is quite a difference from the past six months or so, where at every meeting I'd do that fight-fight-fight-headnod-ACK!-Did-anyone-see??  routine.  

Then, at 2pm, I hit a wall - it was amazing how it felt, it was like the fog rolled right in on my brain, and I was exhausted.  The rest of yesterday felt like a normal no-CPAP day.  Any comments on that?  I'm assuming that it's a combination of having gotten quality, but not quantity, of sleep the night before - and maybe also this "sleep debt" I've heard about.  I suppose if you took a normal no-sleep-problems person, then said, "Here, wear this mask that's blowing air up your nose tonight," and they had a semi-fitful night trying to get used to it, they'd be a bit more tired than usual the next day. :)

One interesting thing - my blood pressure has been high for a bit, and two different drugs haven't helped.  On my latest drug (lisinipril? something like that), it is averaging right aroudn 145 over 85-95 when I check it during the evening.  Last night, after only one night on CPAP, my reading was 128 over 80.  Not a significant sample since it's just one reading from one night, but a good sign.

So anyway...

THE SECOND NIGHT

Last night went better than the first.  I was surprised when I went to fill up the humifier that it appeared to have hardly used any water at all - I'm talking the water level was maybe an eighth of an inch lower than the fill line.  After checking things I realized I must have never turned the heat on the night before (I think I thought it would be on automatically).  So apparently I didn't really have heated humidifed air the first night.  

I tried running the hose a bit differently, such as over the headboard, but it's just not long enough.  I'm going to order a longer hose after I return from my long weekend trip (15 year anniversary, and even ditching the kids - grandparents coming to house-sit, woohoo).  A good friend of mine who read my comments about the first night found some nice tie-wrap adhesive-backed mounting things, I may order some and use those to route the hose.  For last night, though, I adjusted where the machine is on the table, and routed the hose so that it was sort of trapped between the headboard and top of my pillow, coming out in about the middle.

I turned it on properly, put on the mask, turned on the pressure (still didn't try the RAMP feature - I keep thinking I'd just lay in bed trying to detect it ramping up), and went to bed.  10:30pm last night, a bit earlier than the night before.

I honestly think I fell asleep in about 10 minutes last night.  And really slept well - I can vaguely recall waking up once or twice when rolling over and having to mess with the hose, but not to the degree I did on the first night.  I also recall at one point feeling like there was a small leak from one of the nasal pillows (not a loud leak, but if I opened my eyes, I could feel air blowing up at my right eye).  I adjusted them and it seemed better, and I fell back asleep.

The first night I woke up at 4:30am.  Well, similarly, this morning I woke up at 4:23am.  Something didn't seem right with the mask, so I fiddled with it, but still couldn't seem to get it just right.  Finally I decided to get up and use the bathroom (though I didn't really feel like I needed to).  When I returned I put the mask back on and started up the machine, and now it felt fine again.  Perhaps I just needed a minute break there. :)  I wasn't sure if I was going to be able to fall back asleep, but since the alarm woke me at 5:30am I must have.

Got up, and just like yesterday I feel much more alert.   I'm sure I got more sleep overall than the first night.  Let's see if today I get past 2pm before hitting that "wall of fog."


_________________
--Frank (FJC)

Quote:

Got up, and just like yesterday I feel much more alert.   I'm sure I got more sleep overall than the first night.  Let's see if today I get past 2pm before hitting that "wall of fog."

I had the exact same experience.  I noticed that I "hit the wall of fog" later and later.  After the thrid day, I was free.  Good luck Frank.


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Thomas Vaughan