For some, being diagnosed with sleep apnea evokes fear, stress and anger. If you have a significant other it’s important to include them, and make them part of your new diagnosis.  Their life is also impacted by your diagnosis, and the more comfortable and accepting they are with sleep apnea, the more likely you are to succeed with treatment.  Some people often report being embarrassed at having to sleep with a mask and CPAP unit.  Having that important conversation with your partner about sleep apnea and how it adversely impacts your health will hopefully strengthen the commitment to treatment–not only from you but from your partner.

If possible, having your spouse or significant other come to your doctor’s appointment is a good idea.  Having an extra set of ears can help process the information that you receive from the doctor, as well as make them feel part of the situation.  Additionally, there may be questions that your partner has that are important to them and meeting with the doctor is a good time to get both of your issues out and addressed.  If your partner can’t make it to the appointment with you, ask the doctor’s office to provide you with general handouts on sleep apnea so that you can share these once you get home.

Spouses and/or significant others offer support in many different ways so please include them in this journey because you are not alone.

Safe travels!

Katia

1. Mask leak
2. Weight gain
3. Age
4. The need for pressure adjustments or a titration study

Any one or combination of these factors above can cause and or contribute to snoring while on PAP treatment.  Make sure that your mask fits well and that you are changing out the mask cushions on a regular basis. 

Weight gain and age are also likely responsible for snoring issues that weren’t there before or were previously being managed by your PAP treatment.  This may indicate that your pressures need adjustment and for some of you, this may mean a titration study.  A  CPAP titration study is a sleep study that is performed while you sleep at the sleep lab with your CPAP or the lab’s CPAP equipment.  While you sleep,  a sleep techinician monitors your sleep apnea and titrates (adjusts) the CPAP unit to make sure that the unit is eliminating your sleep apnea obstructions.  However, if you are using an Auto Titrating Unit and you recently completed a sleep study, your sleep doctor or clinician can make adjustments to your APAP unit to help with snoring issues.

Make sure you let your doctor and or clinician know if you are snoring…

Safe travels!

Katia

Do you ever wake up with painful bloating after PAP(Positive Airway Pressure) treatment?

For many of you on PAP treatment, waking up with a small amount of gas is normal.  However, if you are waking up with persistent -painful bloating that interferes with your normal day, this should be addressed and eliminated as quickly as possible.  Bloating due to swallowing excessive amounts of air is called aerophagia.  According some research, aerophagia may be related or more prevalent in people who suffer from GERD (gastroesophageal reflux disease).  ( Watson and Mystkowski paper on CPAP Related- Aerophagia).

Here are a few techniques to try to reduce or eliminate  aerophagia:

Head Position

First and foremost try changing your sleep position.  Make sure that your head is tilted back in order to ensure that your trachea is open.  You might want to reduce the amount of pillows you sleep with or purchase a wedge pillow that automatically places your head and neck into this position.  Some research also suggests elevating the head of the bed may help as well.  You may need to try both positions and see if either one of these suggestions helps your case.

CPAP Pressure

Speak with your doctor or DME provider about lowering your pressures.  If you have an APAP- changing it to CPAP and reducing the pressure or narrowing the APAP pressures as well as lowering the pressures overall can help.  If your CPAP/APAP has an EPR (Expiratory Pressure Relief) option then have your clinician set it the highest level of exhalation relief.

When I work with a driver who is suffering from aerophagia, reducing the pressures for a period of time sometimes does the trick.  Once the discomfort has been reduced or eliminated then I slowly work to increase the pressure to the optimal titrated level.

Bilevel Unit

In some cases, if lowering the PAP pressures is only slightly effective, switching a driver to a bilevel unit can usually resolve the issue.  A Bilevel unit is a more sophisticated unit that has a separate exhalation pressure that can be reduced to help with aerophagia.

Also:

Avoid eating too soon prior to bedtime

Avoid caffeine and nicotine

It’s important to let your Doctor and DME provider-clinician know of your symptoms so that they can help you.

Safe Travels!

Katia

Who inspires you?  Perhaps a famous person or maybe a beloved family member? For some it may be nature or a favorite author- poet.   Most recently for me it was a driver who shared with me a poem he had written years ago.   I thought I would share it on this blog because it touched  my heart, and I hope it touches you in some way too.  I continue to be honored to work with so many great truck drivers.  Thank-you again for opening up and letting me into your lives.

DRIVING THRU TEARS

YOU THINK ABOUT THIS

HUNDREDS OF MILES FROM HOME

I’M ON THE PHONE

MY LITTLE GIRL’S VOICE SAYS

BUT, DADDY IT’S CHRISTMAS

WHY CAN’T YOU BE HOME

FRIDAY NIGHT

MY SON JUST MADE THE WINNING TOUCH DOWN

FOR THE STATE CHAMPIONSHIP

BUT I WON’T KNOW TILL TOMORROW

YOU’RE THE ONLY ONE IN THE AREA

IT’S A HOT LOAD

YOU GOT TO GO

WILL GET YOU HOME NEXT WEEKEND

FOR SURE

SO YOUR ANNIVERSARY

JUST HAS TO WAIT

A CAMPER PULLING A FISHING BOAT

PASSES ME

MY SON WILL NEVER KNOW

HOW MUCH I LOVED

THOSE WEEKENDS WITH DAD

IT’S AUTUMN

THE LEAVES HAVE CHANGED

AND THEY’RE SPECTACULAR

THE MOST BEAUTIFUL EVER

STILL DOES NOT COME CLOSE

TO MY LADY AT HOME

SO THE NEXT TIME YOU’RE

RUNNING LATE AND DRIVING HOME

FOR THAT SCHOOL PLAY

A BIRTHDAY PARTY

OR THAT SPECIAL DINNER

WITH THE WIFE

TAKE A MOMENT

AND LOOK UP AT ME.

NOW, YOU KNOW

WHY

I’M DRIVING THROUGH TEARS

BY

ROLLIN P. JAMES

 How many of you think in terms of the glass being half full or half empty?

Research shows that many of us are pre-programmed to think or react to things in certain ways and the way that we approach life can significantly impact our emotions. (WebMD)

Cognitive-Behavioral Therapy puts forth the idea that our thoughts influence our feelings and behaviors, rather than external things like people or situations.  So in essence, we can change our behavior by changing our thoughts.  If you listen real carefully to your mind- you will begin to hear the internal dialogue that is constantly running in the background.  Most of us have become so accustomed to this dialogue that we rarely give it a second thought- many of us don’t even realize that we have an internal dialogue.  Just stop for a moment and listen to what you are telling yourself on a daily basis.

Are you your biggest cheerleader? Does your internal dialogue go something like this, “Yes- I can do this… because I’m a winner!” or are you more of a naysayer, “I can’t do this, it’s just not in the cards for me- why try, I’m only going to fail”!  Two very different approaches to life right?  Who do you think is happier or more successful in life?

When it comes to successful CPAP treatment, there is a large element of positive thinking involved.  Of course, CPAP treatment is hard and yes it takes a lot of getting used to- but how successful do you think you will be if you tell yourself “I just can’t do this!”????  So my suggestion to you naysayers out there is …. YES YOU CAN DO THIS… OF COURSE YOU CAN DO THIS and you keep on telling yourself this over and over and over again 100 times a day each and every day while you are adjusting to all of the components of treatment.  Not only does your job depend on it, but your HEALTH depends on it- your kids, wife, grandchildren, girlfriend, boyfriend are all counting on you to be healthy and take good care of yourself.

Start to apply this positive thinking to other aspects of your life, such as weight loss.  Start telling yourself that YOU ARE GOING TO LOSE WEIGHT… YOU CAN DO IT.  Again, weight loss isn’t easy, but if you tell yourself you can’t do it- or it’s just too hard to lose weight, then chances are you won’t.

I think you get the point- pretty simple right?  Think again- it’s not always easy to shift how you’ve always approached something.  It takes a lot of work and it’s not always easy- but it can be done.

REMEMBER:  YOUR THOUGHTS influence  YOUR BEHAVIOR… Listen to your internal dialogue and start to develop your own positive mantra.  YES I CAN DO THIS… OF COURSE I CAN DO THIS!

Unleash the power within you….

Safe travels,

Katia

For those of you lucky enough to be home for the holidays, I hope that you are surrounded by those you care about~ whether they be family, neighbors, friends or your loyal pet…  For those of you working through the Thanksgiving holiday- I hope that you will be safe in your travels…

Some important CPAP treatment points to remember everyday but especially during the holiday festivities:

1)If you are spending the night or long weekend away from your home, remember to take your CPAP with you

2) Some of you will be sharing and toasting to the holiday with alcohol.  Remember that alcohol relaxes the muscles in the back of your throat- thus having the ability of making your sleep apnea worse.  It is very important that you use your CPAP treatment (every night) but especially after drinking.  You may be inclined to not use it- please make it a point to use your CPAP over the holidays.

3) Many of you are trying to lose or manage your weight and the holidays don’t have to be a deal breaker with your diet.  Key word to remember is portion control.  Have a little bit of everything, but limit your portions and don’t get seconds.

4) Consider taking a family walk after your Thanksgiving meal… it’s a great way to walk off some calories and spend some time outdoors with your loved ones or Fido…

Above all~ enjoy your day with whomever you decide to spend it with….

Happy Thanksgiving from the PPD Team…

Safe travels!

Katia

Once you have been diagnosed with sleep apnea and provided with a CPAP (Continuous Positive Airway Pressure) unit, it can take anywhere from a few nights to a few months to adjust to wearing the CPAP. Many people become discouraged fairly soon after starting CPAP treatment and give up on the treatment altogether.  Most truck drivers don’t have that option because for many  truck drivers, treatment of sleep apnea is not optional.

What you can do to help with your adjustment to CPAP:

1. Try not to get discouraged when you initially start CPAP treatment- most people take a while to get adjusted to wearing a mask and having pressure flowing down your airway. Be patient with yourself.
2. Set small obtainable goals – most people have a hard time reaching the desired 4 hours or more per night, so break it down.  If you struggle with CPAP treatment- try using it for 1-2 hours over a period of time and then slowly start to increase your usage.
3. Practice makes perfect.  In order to increase your usage and improve your adjustment to CPAP- try using it when/if you take a nap or while you are reading a book/watching TV and sitting quietly.  The more acclimated you become to CPAP, the easier it is to adjust long-term.
4. Communicate your CPAP treatment issues to the clinician assigned to help-coach you with your compliance.  Things like pressure and mask issues must be dealt with early on in order to give you the best possible chance at adjusting to CPAP.
5. Make sure you are using humidification with your CPAP.  By far the most complaints I receive with CPAP intolerance are related to lack of humidification.
6. Replace your mask inserts often- usually monthly if you are using your CPAP every night- an old cushion will affect how well your mask fits and seals to your face.
7. Join a virtual- on line sleep apnea support group.  These forums are usually filled with a lot of information and personal stories of how other people overcame their own CPAP treatment struggles. For example: www.sleepapnea support.org is a great site for sleep apnea information and support.
8. Above all, don’t give up hope- keep working on your CPAP issues- many people take 3 steps forward and 2 steps backward for a while until they have worked through their treatment issues.  Call your DME provider or support center for ongoing support and help…

Hang in there!!!!

Because your own personal CPAP journey can be so valuable to other newly diagnosed drivers- won’t you consider sharing your story with us?  How long did it take you to become adjusted to CPAP treatment?  What suggestions might you have for others reading this blog?  Please share your story….

Safe Travels- Katia

Fall is in full swing, and Winter is right around the corner… and for some, has already reared its chilly head in some parts of the country.

Some important things to remember with regard to the cooler temperatures and your CPAP treatment, especially for those of you who are sleeping in your trucks:

• The cooler and dryer the ambient temperature is, the more humidification you may need to help combat dryness or congestion issues.
• If you increase your humidifier dial, remember that if you start to get condensation in your hose and or mask (rain out), then you need to either decrease the humidifier dial and or call for a hose cover.  In the meantime, you can place the hose under the covers and your body warmth will help with the condensation.  You can also make your own hose cover by sewing a few white tube socks together and sliding them over the hose.
• Some of you may not normally use a humidifier, and that may have worked for you in the warmer-humid months, however, if you start to have any of the following symptoms: dryness in throat-mouth and nose, bloody nose, sinus headache, congestion, runny nose etc. then you may need to add some humidity to your CPAP treatment for increased comfort.
• Many of you are using bunk heaters in the Fall and Winter months… please keep your hose away from the heater… also, it’s a good idea to keep a spare hose in your truck in the event it is damaged by the heater or by any other means.
• Make sure your SD card or data card are protected from extreme temperatures.  Try insulating the card so that it is not exposed to the cold temperatures in your truck.  The cards are sensitive to extreme temperatures and data may get erased if the SD/data card has been exposed to cold or hot temperatures.
• Some of you may experience some power issues in your truck as you turn your humidification dial up above 3.  If you are using a newer CPAP unit with the DC converter -you should be ok going above 3 on the humidifier dial, however, those of you with older CPAP units, may need to stay below 3 due to power issues. New ResMed and Respironics units are ok but –I am not sure about other manufacturer’s units and how they impact the power in a truck with increased humidification.

As we make the transition to the colder climates, I hope the above suggestions help you remain as comfortable as possible with your CPAP treatment.

Above all be SAFE and stay warm….

Safe travels!

Katia

Has anyone ever heard of the Hat Trick- or is anyone currently using it?  I came across this “trick” a few years ago and thought it might be a good idea to bring it back to the surface as I think it is a creative solution to a common problem… masks fit issues.

Here is how it works- if your mask straps move around during treatment- especially if you are bald or prone to sweating  a lot, you might want to try putting on a baseball cap over your mask straps.  It helps keep the straps from moving on your head- thereby keeping them in place so they are less likely to come off and interrupt your sleep.  It also may help and keep you from pulling your mask off during the night.

I’ve heard of one case where a driver was so desperate to keep his mask on at night that he used an ace bandage to secure the mask to his face.  When one of our clinicians suggested he use the hat trick… voila… no more problems and goodbye ace bandage.

We are always striving to bring you helpful solutions and or problem solving techniques to help you with your CPAP treatment challenges.  The sleep community is vast and there is so much information out there… if you have heard of or tried anything that has helped you- please write to us about it…

Also- if you have ever used the hat trick- let us know how it worked for you…

Safe travels!

Katia

Send Data or SD card by regular US mail- if you can, certify the envelope  to ensure that it is received by PPD. Keep in mind that it can take 7-10 days for the card to arrive to PPD.

-          If sending by mail, please be sure to place your Data/SD card in the protective folder provided to you in the carrying case of the CPAP unit.  This will help protect the card. If you are only sending the card and no other paperwork, you will need a 44 cent stamp. Otherwise you may want to place 2 stamps unless you know the weight and stamp requirement of your envelope.

-          If you have an upcoming DOT physical, please write a note requesting a DOT letter.

-          Make sure your name and driver # are visible on the protective folder.

If your compliance information is time sensitive and requires immediate attention please consider the following options:

-          UPS/FED EX or USPS Express mail options for: Overnight, 2^nd day air and 3^rd day select or ground services.  These packages can be tracked and normally arrive to their destinations without problems.

-          Please be sure to place your Data/SD card in the protective folder provided to you in the carrying case of the CPAP unit.  This will help protect the card.

-          If you have an upcoming DOT physical, please write a note requesting a DOT letter. Keep in mind that PPD cannot send your DOT letter and paperwork directly to your DOT doctor without a Release of Information Form.

-          Make sure your name and driver # are visible on the protective folder.

If you have a computer and your CPAP unit uses the newer SD card compliance tracking technology, then the best option is to email your compliance data to PPD.  This is the cheapest and fastest way to send your compliance data.  Please follow the instructions for emailing your SD card:

1) Remove SD card from the back of your CPAP unit (SD card is located in the upper right hand corner in the back of your CPAP unit.  You will need to push on the card and it will pop out for removal).

2)  Make sure that your PC or Lap top have a built in SD card drive.  If you have an older computer model that does not come with a built in SD drive, you can purchase an SD card adaptor that fits in to the USB port.

3) Insert the SD card into the computer or USB port adapter.  Make sure the arrow on the SD card is pointing toward the computer.

4) Wait for the dialogue box to open and click on “VIEW FILES”

5) You will see 5 files with the following names:

• Datalog
• Indentification.crc
• Indentification.tgt
• STR.crc
• STR.tgt

6) You will only need to work with 4 of those 5 files which are the following:

• Indentification.crc
• Indentification.tgt
• STR.crc
• STR.tgt

7) Transfer these 4 files one by one to your desktop ( click and drag  each file to your desktop)

Once you have completed step #7 go to your email and compose a new email to the following email address: compliance@ppdsleep.com

9) Please include:  your Name, Driver Number and Contact Phone Number in the SUBJECT line of the email

10) If you have an upcoming DOT physical and need your compliance information and DOT letter, please include that information.  PPD can email you your DOT letter and necessary paperwork.  If you prefer to receive your DOT letter by regular mail please include your preference in the email note.  Keep in mind that PPD cannot send your DOT letter and paperwork directly to your DOT doctor without a Release of Information Form.

11) Now you will need to attach the 4 files from your desktop into your email.  You can either click on attach file or you can drag each file one by one to your email

12) Press Send

13) You are done

If you have any questions or need assistance with emailing your SD card, please call PPD and someone will guide you through step by step.

Telephone Number: 713-520-5864/ Toll Free#: 1-866-370-3102.

Safe Travels,

PPD Team