AWAKE MEETING
By Nancy Fortner
The fifteen people trickled into the meeting room, some singly and some in pairs. Many were a bit hesitant, as if unsure of what to expect. They ranged in age from the late thirties to a couple in their seventies. Most were Caucasian, but African Americans were the next largest group. There was also a Hispanic man and an Asian man. Both sexes were represented fairly equally. There was also a large range of body types, from slender to very obese.
Geoffrey Hux, the Technical Coordinator of the Sleep Disorders Center, greeted all at Doctors’ Hospital in Pinole, California. He gave them two sign-in sheets; one from the hospital and one from Cliff, the representative from Home Med Equip, the company which was sponsoring this sleep apnea support meeting. Also present at the meeting was a nurse named Nancy who was a respiratory therapist at Doctors’ Hospital.
This was my second visit to the AWAKE sleep apnea support meeting. The acronym stands for Alert, Well, And Keeping Energetic. I had gotten several good tips at the last meeting, including being introduced to the Breeze nasal pillows mask which I am now using. My husband accompanied me, although I am the only one of us with sleep apnea. Several other patients brought their spouses to this meeting.
Geoff urged people to take some of the refreshments provided, then introduced Cliff. Unlike other sleep apnea support group speakers, Cliff did not spend a lot of time promoting his company’s products. Instead he emphasized patient service, and referred us to Home Med-Equip's Site, the new web site his company had created as an information resource for people with sleep apnea. He had a display of several types of C-PAP masks fastened to glass heads.
At the end of Cliff’s brief presentation, Geoff led the group into a general discussion. There was a much talk about the benefits to a patient of trying out several types of masks, and the problems with getting insurance companies to pay for more than one mask. Some home care providers supply several masks at their own expense, so the patient will be able to find the mask that best suits him or her. The best mask for one person is not necessarily the best mask for another. Differing facial anatomy, skin types, and the temperament of the patient are some of the factors that make mask selection an individual affair. Cliff said that new types of masks are being developed all the time, but the prices of masks are rising.
I had heard at the previous meeting that some people taped their mouths shut to keep them from opening while sleeping with a CPAP. I tried this, since mouth breathing has long been a problem with me. The tape did not work out at all well! I could not cough, talk, or take a sip from my sports bottle during the night. When I posted about this problem on the Sleep Disorders Forum at about.com, I was referred to Chin-up.com, a site that sells u-shaped pieces of tape that hold up the bottom lip without covering the mouth. I had been using them for several months, and have been pretty satisfied with their ease of use and their efficiency. I showed a strip to the group, then demonstrated how it is worn. I passed around a sample card with two Chin-up Strips and the information sheet supplied in each box. Several people took down the information about how to get them.
One woman asked how to handle a problem with the vent on her mask. Her C-PAP is set at a pressure of 18, and the air cold shoots out so violently from the exhaust vent in her mask that her husband had started has started sleeping in another room. She wanted to know how she could get him back. An elderly couple said they had solved that problem by propping a small firm pillow upright between the two pillows they sleep on. This prevents the cold air from chilling the bed partner.
At this point the meeting spontaneously broke into subgroups of two or three. Everyone was earnestly discussing their particular C-PAP problems, and telling others about the problems they had solved.
Eventually the group came together again, and discussed a common problem; keeping the mouth shut while sleeping. Geoff said that some people were able to train themselves to breathe only through their noses. Other people had success with chin straps to hold the mouth closed. One elderly gentleman had apparently been getting virtually no benefit from his C-PAP because his mouth always dropped open when he fell asleep. He would wake with his mouth so dry that his tongue and gums and cheeks would stick together as if they had been smeared with glue. Geoff arranged for him to get a chin strap, and he also took an information sheet on Chin-up Strips. He would probably have to shave his beard if he were going to use them.
