Do you have sleep apnea and use a CPAP machine, or do you know someone who does? Help a CPAP newbie who's having a rough ride by answering a few questions and/or giving advice.
In advance, please excuse me for the length of this; I'm asking a number of questions, which is why this goes on for a bit.
My first question
on Ask MeFi was about CPAP (continuous positive airway pressure) shortly after being diagnosed with sleep apnea. I very much did not want to undergo CPAP therapy, and my life underwent some traumatic twists and turns, making it easy to push the therapy to the back burner. Recently, however, my doctor has made it clear I need to go back on it, and so after work on Monday, Walgreens Home Care dropped off a Respironics REMstar plus
(with humidifier) and a medium ResMed Ultra Mirage Full Face Mask
, which I've used for two nights.
First, both nights, I've woken up at least three times during the night, and, moreover, woken up fully conscious and alert. (This only happened rarely in pre-CPAP times.) In order to get back to sleep, I end up needing to essentially go from full consciousness to completely asleep each time, just as I would when I first lay down for the evening. Ideally, I'd love to be able to close my eyes with the CPAP machine on and wake up to the alarm in the morning, and get the full effects of an uninterrupted night's sleep, but that's not happened so far, and I'm quite concerned it won't. Although I have felt the positive effects of CPAP therapy despite the interruptions (I awoke yesterday not feeling as if I'd drunk a million cups of coffee, but nevertheless energetic; the effect is dampened somewhat today - not quite as good, perhaps light fatigue -- but my usual sensation of heavy fatigue seems absent), this nevertheless is a definite hit to my comfort, energy, etc., and I'm wondering when it's going to pass. (As a side question, my pillows seem to be sliding around a lot more than they used to; I'm less able to find a comfortable spot with my head and the pillow.)
Second, equal in severity and possibly related, I'm not sure how to prevent air leaks while remaining comfortable. I've familiarized myself with where and how to adjust the mask, but it seems like any slight change in position causes an air leak to occur, unless I cinch the mask extremely tight to my face. The training video depicts a man adjusting the mask and then being able to turn from side to side without readjusting; with me, even if I rest my head on my hand, it seems to alter my face enough that a leak manifests and I have to cinch the straps and/or adjust. This can alter my sleep; if I adjust myself to get comfortable to fall asleep, I suddenly have to start fiddling with the mask (in the dark) in order to end the leak. I should note that since I've breathed through my mouth for nearly my entire life, the nasal pillows or nasal mask is almost certainly not the route for me. (It was a big problem during my CPAP titration.) Is it a sign that the mask is too small? Too large? And is it acceptable for a leak to exist only during the exhale? I noticed last night that sometimes a "leak" seemed to appear only when I would exhale; if I put my finger near that spot when I was inhaling or not breathing, I detected no vent air coming out.
Third, and also nearly equal in severity, my nose has swiftly and quite severely broken out. Pardon the grossness (I'm not enthused about talking about this, either), but it went from (presumably) normal skin pre-CPAP, to a cluster of whiteheads after Monday night (although, admittedly, I only saw the whiteheads after applying moisturizer to the area), to an unpleasant state of affairs after last night. I get the sense that this is due not to the physical pressure of the mask on the bridge of my nose, but due to air pressure conditions inside the mask; I may be wrong, but where I'm breaking out seems to be not so much on the actual bridge of the nose where the mask is riding, but directly beneath it. When I Googled about this, one commenter advised a questioner that their skin would toughen up within a week's time. Is this the case, or can I expect the condition to just worsen?
Fourth, what is the easiest, simplest, most low-impact way of taking care of my equipment? I'm not very household-conscious or gung-ho about cleaning. The person dropping off the equipment did go through it with me, but I'd nevertheless appreciate your own experiences as to how you wash your equipment and how frequently.
Fifth, when I wake up a few hours before I would normally awake (say, around 4:00 am), it almost feels as if I am breathing normally and without the CPAP at all. Is this normal, i.e., my breathing having grown accustomed to the CPAP by that point? Or is it a mechanical thing, such as the machine "backing off" after a certain period of time? Or is it indicative of a seal problem?
Finally, and still quite importantly, I'm finding myself concerned that the CPAP machine will be a real blow against my attractiveness as a sexual and romantic partner for a woman. I understand that women do have an ability to look past things, but certainly there is also a surface assessment; I'm concerned that the idea of sleeping next to a man with CPAP equipment on his face is such a turn-off that I'll have great difficulty with romantic and sexual relationships in the future. Now, if you already loved the man in question, that would be one state of affairs - for example, if your husband or boyfriend was set up with CPAP after you began dating him, then the romance and the feelings were established first. But has anyone dealt with a situation where the CPAP was established prior to the relationship, and you had to deal with, at some point in the relationship, discussing the apnea and getting the partner acclimated to the idea of sleeping next to someone with equipment on their face?
- Waking up alert and conscious;
- Preventing air leaks during casual movement;
- Swift and severe acne outbreak on nose;
- Taking care of equipment;
- Feeling as if breathing is 'normal' after several hours of sleep; and
- Sexual/romantic attractiveness.