"I got my APAP machine 7 days ago. I thought I would be going through he** for months trying to get used to the thing. I wore my nasal mask for a few hours before I went to be the first night just to get used to the feel. I went to sleep that night and never woke up until the alarm went off at 5am the next morning. For the last 7 nights I put my mask, my machine comes on, I go to sleep and then it ramps up, I guess. I never wake up. The pressure never bothers me during the night. I never wake up and find my mask across the room. I don't have any air leaks around my mask and I had .6 events per hour last night, which is high for me. I feel awake and good during the day. I don't have to take naps in my car during lunch time. I don't feel like I'm not going to make it through the day at 8 o'clock in the morning. I don't come home from work and go right to sleep any more." - PersistentCobaltBlueNewt1334

"This discussion is extremely important-- its understandable how frustrating it is when despite following all medical advice, including wearing CPAP nightly, you still feel poorly. I am assuming by "crappy" you mean you are not feeling refreshed after a night's sleep and are feeling tired or sleepy during the day--is that what you mean? There are a few straight forward responses, but indeed this problem sometimes does not have an evident quick fix. As mentioned, when feeling sleepy or tired despite using CPAP the entire or most of your sleep period, you should speak with your sleep specialist to ensure you are indeed getting the optimal pressure and not losing pressure due to mask leak. Sometimes the machine's output is not precise enough to determine whether you really are getting the pressure you need and a follow up formal sleep study is needed. A second sleep problem--such as periodic limb movements-which can disrupt sleep-might be considered. A repeat sleep study might be needed to assess this. You and your doctor should ensure that you are getting the right number of hours of sleep per night (generally 7 to 8 for adults, but this could vary person by person) and following a consistent sleep schedule is important: no amount of CPAP will help if you are only getting a few hours of sleep per night! Sometimes medications have side effects that include fatigue and sleepiness and you and your doctor may want to review your medications, as well as to make sure there are no other medical issues that may be contributing to fatigure or sleepiness. Undiagnosed depression is sometimes a contributor to continued sleepiness or fatigue. Obesity has been associated with sleepiness and fatigue and weight loss and diet/exercise can be helpful in improving alertness and vigor. Finally, it is estimated that as many as 10% of patients with sleep apnea have some degree of continued sleepiness/fatigue despite what seems to be optimal treatment of their sleep disorder. It has been speculated that these patients may have had untreated sleep apnea for a long time and some of the brain areas controlling alertness may have been affected. In this small group of patients, there may be benefit to careful use of prescription medications that have alerting actions while continuing CPAP--taking such medication needs to be a very carefully considered decision by the patient and his and her doctor, and will require close monitoring by the patient's doctor. An excellent review of the problem of continued sleepiness despite CPAP therapy can be found at: http://www.medscape.com/viewarticle/812910. This might be something you want to print out and discuss with your doctor. But dont give up--as noted above, there are many things that need to be explored to find which of the factors, when addressed, will help you the most. I would like MyApnea.Org to consider future research on this problem. If this problem affects 10% of patients, then with our current membership of almost 5000 people, there are at least 500 sufferers in our community. Let me know your thoughts." - Susan Redline

"http://www.cpaptalk.com/our-collective-cpap-wisdom/checking-CPAP-machine-settings.html You should really work with your sleep doctor about this but here is what I found. Good luck. A pressure that is too high for you may be indicated by uncomfortable therapy, large mask leaks, mouth breathing, dry mouth and throat even with heated humidification, aerophagia (swallowing air), an AHI above the normal 5 or below events per hour, and still feeling tired or sleepy during the day. Some people have concerns that too high a pressure setting may lead to pressure-induced central apneas (the brain not telling the body to breathe) unless the PAP machine algorithm (operating rules) prevent runaways as in Respironics machines. Pressure settings above 15 cm/H2O are considered high for some people; for others, 18, 19, 20 cm/H2O is high." - StarSleeper

"Do you have a copy of your sleep study results? In this report should be a figure for AHI (Apnea Hypopnea Index). Any level over five is indicative of obstructive sleep apnea (OSA). If your number is 30 or greater than 30, your level of OSA is considered to be severe. CPAP is the first, most effective and least invasive of all the treatments for OSA. CPAP or XPAP is the gold standard for treatment of sleep apnea. Sleep Apnea is related to a number of different medical conditions, but it happens even to those who are in pretty good shape and without any lung problems. There are studies that demonstrate genetic tendencies, as sleep apnea tends to run in families. Because my husband and I have OSA, our children are 98.7% likely to develop OSA sometime during their lifetimes. My brother and my sister both have OSA. I suspect my father had it as he snored so thunderously, but not everyone who snores has OSA. We'll never know for sure because he never had a sleep study done. OSA tends to worsen with age and with changing conditions (lack of fitness and weight gain). Having a sleep study done and finding out that you have obstructive sleep apnea is a great gift...because now you can do something about it. And it's worth getting the best treatment for it because untreated OSA will likely lead to an entire host of health ills (diabetes, high blood pressure, car accidents, high cholesterol and atherosclerosis, stroke, kidney disease, CHF - even cancer and early death). My husband's father, who also snored thunderously, developed all of these ills along with all the diabetic complications. But he also was never sleep tested, though we encouraged him to get a study done. The thought of being hooked up to a machine made him never want to know. It was really too bad. We tried to show him that CPAP is just a different way of sleeping and once acclimated to it, you never give it another thought. And that's usually because you just feel so much better when the apnea is adequately treated...much less sleepy and fatigued during the day. Our pleas fell on deaf ears. He died 5 years ago. My father died 10 years ago." - snuzyQ

"Condensation in the hose is a common problem with the humidifier. The solution is to reduce the temperature difference between the humidifier heater and the cooler hose. You can Google tips for doing this. I don't clean my CPAP daily but I probably would if water was condensing in the hose." - StarSleeper "Manufacturers recommend cleaning the hose and mask once per week with the right soap. The bottom line is no anti-microbial soap. The best I have found is Johnson Baby shampoo. I agree with this regimen, going longer has irritation side effects." - Will

"I cannot say if there is a problem with purified water versus distilled water. Both are basically water that has been treated in one manner or the other to remove impurities. We generally recommend distilled water because CPAP manufacturers make the recommendation for distilled water in their documentation. In the absence of distilled water, I have seen recommendations for purified bottled water." - DanM