Monday, 31 August 2009

CPAP diary (6)

This will probably be the last CPAP diary entry, just because tomorrow morning a new adventure begins. I may be reporting more CPAP stuff, but as something else displaces the novelty, I'll probably be perseverating on other things.

So I had my consult with the sleep people at RANA. This is the company that deals with the CPAP stuff. I've had my trial machine for about 3 weeks, and as I'm off to Toronto tomorrow (there it is), it was important to see if they could switch me to my permanent machine before I left. It can take up to 3 months to get steady data with which to program the machine.

So my new CPAP consultant, Audrey (it was Kendra) congratulated me on my compliance. I used it every night and for a couple of naps, and apparently that was astonishing. I guess most people have trouble adjusting to it. Me, I like playing spaceman as I drift off to sleep. My apnea episodes, which you may recall were occurring around 80/hour, have been greatly reduced. (I didn't get a specific number, but apparently it was also impressive. The difference, I mean.) I seem to need pressure of around 18 cmH2O, which is quite high. Audrey, interpreting the data collected by the smartcard in the trial machine, said that it seemed to work--reducing the apnea astonishingly, without a lot of leaks or me waking up or fiddling with the mask. I do wake up about 3-4 times per night and reset the machine (the machine has a "ramp" function, which starts at a low pressure (5 cmH2O) and ramps it up to whatever slowly--presumably as you fall asleep.

The new machine is bigger, and I'm told has a superior humidification system. But it doesn't automagically monitor and adjust the pressure. It just goes on and ramps up to the programmed 18 cmH20 and stays there. It also lacks the coolest feature of the trial machine--which would start automagically if you put the mask on and exhale sharply a couple of times. Way cool, but oh well.

I should use it tonight, but since I just have to pack it up at 4am, I'm going to have a go without it, and just hope I get some decent sleep before I have to get up. I'm also totally out of distilled water, and since you can only get distilled water in 4L bottles, I figure it's just as well I don`t leave an open bottle of distilled water to collect microorganisms just sitting around when I need as soon as I land in Toronto anyway.

Next entry: Toronto Diary (1)

Wednesday, 19 August 2009

CPAP diary (5)

I remember very clearly, once, I woke up totally refreshed. It was in Madison, WI, while I was a post-doc and basically being paid to do not a lot and get a lot of exercise and rest. I woke up one morning, and was just ... up. Awake. Ready to go. Not dozy, not yawning, not just wishing for five more minutes. And not needing it.

I'm not actually feeling this way now, but I'm definitely getting up easier. If the alarm goes off (being on "Research Leave" I have just been letting the machine do its work as much as possible), I maybe hit the snooze once or twice, but for the most part, I don't doze. I'm awake. I'm not really happy about getting up, preferring to snuggle up under the covers and play spaceman (no that' snot a euphemism for anything--remember that the mask covers my nose and mouth and makes neat hissing noises), and I'd definitely stay in bed if I had a choice. But if I set the alarm, it's because I have something to do, and generally speaking, I can now just get up and do it.

I'm not saying I'm refreshed. I'm not saying that I'm not fighting a depression-induced (I assume) desire to crawl back into bed a few hours later. But I get up. And get going.

Okay, 'going' may mean getting all the way to the living room to turn on the TV and the computer, and eventually making coffee and breakfast. But mornings have always been very, very hard for me. Except that one time in Madison. I'm much more a 'crack of noon' kind of guy.

Usually by the time the Daily Show comes on at 11 am (Comedy Network up here runs it and the Colbert show on a 12-hour delay) (they may run it earlier, but what are the odds I'm going to catch it) (I mean, I'm waking up easier, but not really working at getting up at a normal 'human' time of morning), I'm fed, caffeinated, caught up on e-mail and, more often than not lately, dressed.

It's so ... different.

Wednesday, 12 August 2009

CPAP diary (4)

Here's something interesting. FSVO interesting.

I've always gone to sleep on my back. I've always woken up on my back. And in between I've always been a thrasher. People don't like sleeping with me because a) I snore like a chainsaw and b) I thrash. People who have shared a bed with me have ended up with bruises. But I have always gone to sleep and woken up on my back.

With the machine now, I've been waking up on my side. Comfortably. I wonder if all those decades of snoring and thrashing and poor sleep was just me trying to keep my airway open.

Had a rough morning yesterday, but after staying up until almost 3 in the morning, I didn't have too much trouble getting to sleep (I guess if you're not really going to sleep until 3 in the morning, it helps not to go to bed and nine and toss and turn for six hours). Woke up a couple of times, on my side, but didn't have too much trouble getting back to sleep. It took about 45 minutes to decide I was awake--9:45 to 10:30 or so--but then I hopped out of bed and have been okay for about 45 minutes. Which is a huge improvement over yesterday.

Lying low today, taking it easy, and trying to just keep on keepin' on.

Monday, 10 August 2009

CPAP diary (3)

Nothing new to report, and after this I'm not going to bother unless there is. The only thing that started to bug me last night that was new is that the silicone 'gasket' thingy that mediates the seal around the mask to my face, if that's the right way to put it, is just a little narrower than my big fat mouth, which means that there's some capillary action happening (or it feels like it is) out of the corner of my mouth and around that side of the seal.

The 'blowing out' of the seal under higher pressures was a little better last night. Once again, I didn't have an easy time getting to sleep, nor did I get the uninterrupted sleep we're all hoping for. On the other hand, the waking up refreshed, or at least more refreshed than usual, or at least feeling less like just turning over and going back to sleep, is still continuing. And despite considerable boredom (had a haircut this afternoon, and have basically been sitting here trying to come up with something useful to do for a couple of hours) I'm not really inclined to have a nap.

So in all, things may be getting better. Flat six all around, I'd say.

Sunday, 9 August 2009

CPAP diary (2)

Well, I did end up taking a nap yesterday. A long one. Even by my standards. So sleep was not easily forthcoming when I finally went to bed. I ended up reading until about 3am before I felt like I could even try to drift off. Which is ironic since the novel I was reading had a scene where the protagonist/narrator reads a Sue Grafton novel until he can't keep his eyes open anymore.

Haven't read Sue Grafton since I or J, in case anyone is interested.

Woke up a few times during the night. Fewer mask problems this time, although when the pressures gets sort of high there's still more leakage than I'm happy with. Also the noise of the air whistling through the vents, which is pretty quiet at 5 cmH20, is actually kind of annoying, except it masks the resonance of the air moving through the hose, which is sort of annoying when you're trying to breathe regularly and clear your mind. But it's great for playing spaceman.

Sleepwise is a five again, but awakewise is probably a six. I've been up for a couple of hours now and don't feel like I really want to go straight back to bed, which is a leg up on yesterday. Doing a couple of loads of laundry this morning (well, it's noon now), which is making me feel very productive.

Saturday, 8 August 2009

CPAP diary (1)

Don't worry, I won't be doing this forever. I just thought I'd log the experience, if only so I have a record to tell the technician.

Playing spaceman with my full-face mask was fun, but when the time came I learned lesson 1: you have to adjust the mask while you're lying down. Because doing it while you're upright and playing spaceman doesn't really get it adjusted correctly.

Took longer to get to sleep than I expected, even longer than usual, but I don't know why. Should have read for a while, although the mask means I have to hold things a little further from my face than I usually would, and seeing at that distance turns out to not involve so much binocular vision. In other words, I have to work at getting a unified field of vision in the middle. Next time, may do the reading and such without the mask, and then put the mask on at lights out. But I was still playing spacemand.

Woke up several times, with the mask puffing air all over my face. Pressure had zoomed up to at least 15 (cmH2O) and was blowing the mask off. I don' t know what woke me up--it was probably the apnea actually, since with all the leaking I'm not sure the machine was doing its job (which is to pump enough pressure into my airway to keep it from collapsing closed while I sleep). Reset the machine, tightened down the mask, and tried to go back to sleep.

Woke up, eventually, on my right side, which is par for the course, machine going at 13.5, mouth dry as a bone (although the nasal passages and throat seem okay) and actually sort of refreshed. I don't know how much of that is psychological, but there it is. I have a silicon pad-shaped dent in my forehead and I think I should start using the toner-clarifier in the morning, to sooth the 'mask-face'. We'll see tomorrow.

On a scale of 1-10, I'd say 5. As usual. Woke up sort of refreshed and certainly more alert than usual, but now, an hour or so later, I'm not sure I'm not going for a nap later. Had the usual trouble getting to sleep, and woke up several times during the night, and didn't exactly have an easy time getting back to sleep. Best sleep late in the morning as usual. So 5.

I'm not expecting 10s anytime soon, but I'm hoping in the 3 weeks or so before I see the specialist again (and head off to TO) I hope to be up to 7 fairly consistently.