Starting My Sleep Apnea Journey
I have been tired for years. It isn't just the kind of tired at the end of the day. It is an over the top exhaustion that is there from the moment that I get up to the time that I go to bed. I never seemed to catch up on my sleep.
Then I would wake up out of a sound sleep with my eyes wide open. This would happen several times a night. I would find myself staring at the clock by my bed stand. Sometimes I would get up because I was wide awake and felt like I needed to move around for a while.
So, at a yearly physical, I spoke to my doctor about all of this. She was concerned about it, so my journey with sleep apnea began.
Who Has Sleep Apnea? Do You?
What Is Sleep Apnea?
Sleep apnea is a serious sleep disorder where your breathing often starts and stops while you sleep. Obstructive sleep apnea is the more common form of the disorder where the throat muscles relax. Central sleep apnea is where your brain does not send the right signals to the muscles that control breathing. Complex sleep apnea occurs when both obstructive and central sleep apnea are both present.
Loud snoring is the most common symptom that you might think of when it comes to sleep apnea, Other symptoms can include gasping for air while sleeping, dry mouth, morning headache, insomnia, and daytime sleepiness.
There are basically two main types of sleep apnea-central sleep apnea and obstructive sleep apnea
Obstructive Sleep Apnea
Obstructive sleep apnea is the most common form of this problem. It actually causes you to stop breathing while you sleep. If you have sleep apnea, your airway becomes blocked repeatedly during sleep. The amount of air reaching your lungs is limited. When this happens, you may snore loudly or make choking noises. Your brain and body become oxygen deprived and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.
In many cases, an apnea, or a short pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in the back of the throat vibrate as you breathe.
Central Sleep Apnea
Central sleep apnea is not as common as obstructive sleep apnea. Central sleep apnea is caused by the brain failing to send signals to the muscles associated with breathing.
Central sleep apnea may occur as a result of other conditions, including metabolic diseases, trauma, brain tumors, heart failure, or stroke. The symptoms of central sleep apnea are similar to those of obstructive sleep apnea, although people with central sleep apnea usually do not display the same level of snoring as patients with obstructive sleep apnea.
Common Systems Of Sleep Apnea
Here are some of the symptoms related to sleep apnea. If you have one or more of these, you probably should check with your physican or health care provider to see if you need to be tested.
- Loud or frequent snoring
- Silent pauses in breathing
- Choking or gasping sounds
- Daytime sleepiness or fatigue
- Unrefreshing or restless sleep
- Morning headaches
- Waking frequently during the night to go to the bathroom
- Difficulty concentrating
- Memory loss
- Decreased sexual desire
- Difficulty maintaining an erection
Risk Factors For Sleep Apnes
The biggest risk for sleep apnea is excess weight. But thin people have sleep apnea too. Even when I did shed 40 pounds, my sleep apnea continued.
- Excess weight: Your risk for sleep apnea is higher if you are overweight (with a body mass index of 25 or more) or obese (with a body mass index of 30 or higher).
- Large neck size: Your risk for sleep apnea is higher if you have a neck size of 17 inches or more for men, or 16 inches or more for women. A large neck has more soft tissue that can block your airway during sleep.
- Middle age: Sleep apnea can occur at any age. However, it is more common between young adulthood and middle age.
- Male gender: Sleep apnea is more common in men than in women. For women, the risk of sleep apnea increases with menopause.
- Hypertension: High blood pressure is common in people who have sleep apnea.
- Sedation: Medication or alcohol can interfere with the ability to awaken from sleep and can lengthen periods of apnea.
- Airway abnormalities: Examples are a deviated septum or nasal polyps.
- Family history: You have a higher risk of sleep apnea if a family member also has it. Inherited traits that increase the risk for sleep apnea include obesity and physical features such as a recessed jaw. Other common family factors—such as physical activity and eating habits—may play a role.
- Use of alcohol, sedatives, or tranquilizers: Since tend to relax the muscles in your throat.
- Smoking: Smokers are three times more likely to develop OSAS. Smoking also leads to inflammation and irritated airways.
- Nasal Congestion: Either because of your anatomy or allergies, you are more at risk for developing OSAS.
More Sleep Apnea Information
- Sleep Apnea: Types, Common Causes, Risk Factors, Effects on Health
Learn more from WebMD about sleep apnea, a disruptive and potentially dangerous sleep disorder.
- Sleep Apnea Information for Individuals | Sleepapnea.org
If you have sleep apnea or think you do, this is a good information source for all kinds of questions about your situation
- Sleep Apnea | National Sleep Foundation
Sleep Apnea is a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep. Learn how to cope with this sleep-related breathing disorder.
- Sleep apnea - Symptoms and causes - Mayo Clinic
Snoring loudly could be an indication of sleep apnea, a disorder in which breathing stops and starts repeatedly during sleep.
How To Get Tested For Sleep Apnea
If your physician feels after a consultation and examination, that there is a possibility you may have sleep apnea disorder, he/she will order a sleep study for further evaluation.
Home sleep study tests are available and are one of the easiest ways to get your sleep apnea diagnosis. These tests measure your heart rate, blood oxygen level, airflow and breathing patterns.
This was the test that my physician ordered for me. It was a simple two night test. The test machine was sent to me. The directions were simple to follow, I attached one line around my chest, one piece wrapped around my index finger and one had a line that went in my nose like an oxygen line. All the lines attached to a recorder that wrapped around my arm with velcro. While it was a bit ackward, the test was not bad at all.
Once I finished the two days, the equipment was sent back to the company for analysis. My doctor received the information within a couple of days. The whole process was very fast.
The other test for sleep apnea is called nocturnal polysomnography. It is generally done in a sleep center. You are hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.It gives more information than the home sleep test does. Some folks find it difficult to sleep in that enviornment.
The Effects Of Sleep Apnea
How Does A CPAP Work
Treatment Options For Sleep Apnea
After your sleep apnea test, your physician will work with you to decide the best course of treatment depending on what type of sleep apnea you have as well as how serious your apnea is.
Some mild apneas can benefit if you are able to lose some weight. Though my apnea was not considered mild, I am working on that aspect of my health to make it better. It never hurts to lose a few pounds.
The most common form of treatment is the Continuous Positive Airway pressure or CPAP. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing apnea and snoring.
A mask is worn over the face and nose, just over the nose, or with a nose cushion. Some folks find the masks restrictive and difficult to use. It might take you a few different masks till you find the one that is right for you. Always talk to your physician before you stop using your CPAP machine.
You need to use the machine at least 6 hours to be effective,
If using a CPAP machine continues to be a problem for you, you might be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping (auto-CPAP). Units that supply bilevel positive airway pressure (BPAP) also are available. These provide more pressure when you inhale and less when you exhale.
Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances might be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.
For me, the CPAP machine has been working and I have noticed that I am getting better less disturbed sleep most nights.
Weight management may help your sleep apnea. There is no guarantee that it will go away. But it would certainly help your overall health
Finding The Right Mask-Crucial Part Of Your Therapy
So, when you start your therapy set up with your supplier/ provider, it is very important to understand options regarding the different types of masks that are available. Finding the right mask that will be comfortable for you is an important step in staying compliant and using your therapy to its best advantage.
Everyone has a different prospective on how the different types of masks will work best for them. For example, since I am a little claustrophobic, I knew the full face mask which covers the mouth and nose would not be a workable option for me.
I chose the mask that just covers the nose, which is workable for me for now. This is a mask that covers the entire nose, including the bridge of the nose, but not the mouth.
There are other mask options that just cover the nose. There are two types available one has little "pillows" that go into the nostril and the other simply covers the nose itself.
When you are setting up your therapy, try several different masks and decide which one is most comfortable for you.
Every manufacturer has it's own line of masks. The best mask for you is the one that is comfortable and one that you will use. It may be a little trial and error till you find the best mask for your sleep.
Suggested Supply Replacement Schedule
- Clean your mask, tubing and headgear once a week. Put this .time in your schedule so that you don’t forget to do it. Follow your manufacturere's directions how to clean your unit
- Adjust your mask straps and headgear until you get the fit right. You also can try using a special bed pillow that is shaped for a CPAP mask and tubing.
- If your machine has a filter, make sure that it is clean. Replace the filter following your manufacturers directions
There are a few accessories to your CPAP unit that will help make your experience better.These accessories can be obtained through your provider or online.
Consider investing in a mask liner. Mask liners absorb oils from the face, helping increasing CPAP comfort, and can improve the seal. There are many different kinds of mask liners you can use to cut down on red marks and pressure sores if, after multiple mask fittings and trials, you can't seem to avoid them.
CPAP pillows can help CPAP users achieve more comfort if they are typical side sleepers, as the pillow design provides allowance for the headgear and mask parts that might otherwise protrude into the pillow once the sleeper turns to the right or left side.
Tubing lifts keep your CPAP tubing out of the way may be a priority for you, especially if you have limited space along the sides of your bed, frequent "visitors" (pets and children), or a sleepmate. These products help stow unused lengths of hose out of the way while you sleep.
Chin supports can come in handy for those using nasal pillows or nasal masks who tend to breathe through their mouths on occasion.
Nasal gel pads bring comfort along the bridge of the nose can be achieved by using a nasal gel pad inserted where contact with the skin results in discomfort.
More CPAP Tips
- Improve CPAP Comfort with These 10 Tips - 1800 CPAP Blog and Sleep Apnea News
CPAP discomfort keeping you up at night? Improve CPAP comfort and find out mask tips and tricks for a better night's sleep and overall apnea compliance.
- CPAP Cleaning Tips: A Step-By-Step Maintenance Guide
Follow these five simple steps to clean your CPAP machine at least once a week. You do not need an expensive cleaner or sanitizer to do this!
Medicare And Insurance Certification
Your physician and the supplier will work with Medicare and your insurance to make sure that the equipment that you need for your sleep apnea is covered once you get a confirmed diagnosis.
Most insurance including Medicare and Medicaid cover the CPAP or BIPAP mahine as a durable medical device.Once you have been diagnosed with sleep apnea, and your physician orders your equipment, your provider will work with you to explain how your insurance will cover your equipment. In some cases you will be required to use a specific supplier in your network.
You will initially get the machine and one set up of supplies to get your started. Co-payments and deductables may apply, depending on your policy
In most cases the machine is rented for a certain period of time specified by your insurance carrier. After that time, you will own the machine. And your supplier will supply you with replacements on your hoses, masks and filters.
Most insurance companies follow the Medicare guidelines for renting and paying for the equipment. They start as a rental for between 3-13 months before you own it.
3- 4 month rental and then own (PPO)
10 month rental then own (most HMO and some PPO)
13 month rent and then own (Medicare and other government insurance)
The other requirement to keep this machine is that you have to prove that you are using the machine on a regular basis, For Medicare patients like me, that means that I had to prove that I was using the machine at least 4 hours a day for a 22 day period out of 30 days. Since most equipment have modems and chips, it is easy to certify that information. Once you meet the requirement, you have an appointment with your doctor who certifies that you have.
The reason that you go through the certification is simple. Your insurance carrier does not want to pay for something that you do not use. I have certified and completed the process, it was easy.
The bottom line is once you get your diagnosis , you will be provided information on how and when your insurance carrier will cover the equipment and supplies, You will be also informed of any costs that might be your responsibility.
Phillips Recall Information
In June 2021 Phillips recalled certain of it's cpap, bipap and mechanical ventilators. The problem was in the foam surrounding the motor to keep the motor from being too loud.
This affected the United States only. They advised that you discontinue use of your Cpap unit right away and consult your physician reagrding the best alternative for continued therapy. Other countries will be added later on.
Ventilator patients were told to continue to use the ventilator, but speak to their doctors right away,
There is a registration process to register any and all machines affected. The phone registration number is 877-907-7508.
Machines Affected By The Recall
- Trilogy Evo
- Trilogy Evo OBM
- Trilogy EV30
- Trilogy 202
- BiPAP A40 EFL
- BiPAP A40 Pro
- DreamStation 2
- Omnilab (original based on Harmony 2)
- Dorma 100, Dorma 200, & REMStar SE
- All oxygen concentrators, respiratory drug delivery products, airway clearance products.
- Philips is recommending that customers and patients halt use of ozone-related cleaning products, and adhere to their device Instructions for Use for approved cleaning methods.
More Phillips Recall Information
- Philips PAP device recall: Guidance for patients | AASM
The American Academy of Sleep Medicine provides important safety information for patients about the Philips recall of certain PAP devices.
- Philips provides update on recall notification - News | Philips
Philips issues recall notification to mitigate potential health risks related to the sound abatement foam component in certain sleep and respiratory care devices.
- Sleep and respiratory care update | Philips
Sleep and respiratory care updates
My Update On Recalled Phillips CPAP Units
Of course having the Phillips Dream Station, I am on the recall. That means that I had to stop using my unit and decide what to do. I called all the local vendors in my area. For the most part, they either Did not have units r were not willing to help.
So I wound up buying a unit online. Now when you buy a unit online, they do not deal with Medicare, so everything is out of pocket. Most do have payment plans. I found the unit I wanted and made the purchase. It will be at least a week before the vendor that I selected will have any in. Most vendors as of the end of June have waiting lists.
Phillips has said that they will repair, replace with a reconditioned machine or replace with a new machine. They also state that the process could take up to a year. Really?
I have now been off my machine for two weeks and it has affected my well being for sure.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Linda F Correa