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Falling Asleep At The Wheel

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    #16
    Medicare pays for them if you have it. Bipaps are much more expensive than a CPAP. There are many used ones available.

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      #17
      I get a similar problem of becoming mesmerized and kind of in a trance rather than sleeping. I used to drive for hours without a break pre iinjury no problem even when I was tired.
      It is like I become hypnotized by the repetitiveness of it and I find myself lane drifting, never over the line but kind of incapable of stopping it. It seems to happen after about 50 minutes driving on the motorway. If I open the window, turn it into a Rock Concert but it all makes no difference I still drift in the lane.
      I stop for about 10 minutes park and roll the window down and call someone or just talk to myself for a couple of minuted then I can just get back on the road no problem. Then about 50 minutes later....

      It's very weird, can be morning,afternoon or evening makes no difference.

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        #18
        i fell asleep at the wheel too...one time too many...now i'm a quad...thankfully i only injured me...don't mess around...use alt trans until you find a cause and solution

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          #19
          Here's an update:

          Instead of the hospital sleep study, I was able to use equipment at home for three nights. The results showed I have mild to moderate sleep apnea and need auto titration, pressure varying from 5 to 20, depending on my breathing at the moment.

          I got the equipment ($1800 purchase) and used it two nights. I felt more energy, but still fell asleep driving. I got suspicious about the mask (just fits in the nostrils), and it turns out it doesn't work for me lying down (can't breathe with it connected, only when it's leaking) . I'm going back today to probably get a full face mask (nose and mouth), which will be harder to put on.

          I'll give another update soon...
          "Cherish your tears. If you can cry, you still have some humanity left, and you are reclaiming more of it." -- David Kelly


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            #20
            Man, I hope you get it figured out. It's good to hear the sleep apnea is only mild to moderate.

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              #21
              Originally posted by dnvrdave View Post
              I got the equipment ($1800 purchase) and used it two nights. I felt more energy, but still fell asleep driving. I got suspicious about the mask (just fits in the nostrils), and it turns out it doesn't work for me lying down (can't breathe with it connected, only when it's leaking) . I'm going back today to probably get a full face mask (nose and mouth), which will be harder to put on.
              I use a full face mask (mouth and nose) which helps if you breathe through your mouth a lot while sleeping.

              It can take up to 1-2 months to establish a new equilibrium for sleeping. Sleep apnea usually goes undiagnosed for years before folks address it (if at all) and it takes time for your body and mind to adjust after treatment and get the full effect of good consistent sleeping.

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                #22
                Ok, enough beating around the bush about sleep apnea. Since I'm a member and the president of the club, just joking. I do sleep with an nasal mask and do eval, order sleep studies, and treat sleep apnea in my clinical practice. Therefore, some thoughts on this evil disease that causes other secondary medical problems. Memory loss is classic symptom of OSA. Nocturia aka excessive urine output at night. This is a little funny and baffling for non-neurogenic bladder pts who are up and down peeing multiple times. I was routinely 1800-2000cc in bedside bag for years. Didn't have to wake up like the usual person and relieve myself. Mentioned it for years to Uro and he thought it a bit strange but no comment. Then 4-6 months post starting CPAP my night output down to 800-1200. Didn't change a thing except added CPAP. Here's the really strange thing about OSA on CPAP. Recent clinical trials indicate 57% treated pts on CPAP have persistent daytime sleepiness. The brain changes over time. From a clinical perspective, some folks take 1-3 months to perk-up and others need meds for excessive day time sleepiness. Google Eppworth Scale and take the test. A score of 10 or higher is suggestive of OSA/Hypersomnulence/Sleep Shift Work Disorder. No I don't work for Cephalon. Again OSA has many, many sneaky symptoms. Not all big folks have it and some very small folks have it. Look for it and treat before other things break (ie DM,HTN,CAD,CVA,Depression). Sorry about the digression, but OSA almost got me into big trouble with health issues and I look for it.PS make sure someone is closely watching auto-titrate data-NeuroNP

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                  #23
                  PS: Forgot to mention that many nasal mask users have better success if one uses a chin strap then applies the mask. Reduces leaks and awakenings. My wife tells me "it's the only time my mouth stops talking". Bedtime for me so I can fly to NC in AM. Strap on, plug in (mask and BSB) and Goodnite yes that too on-poor joke but true-NeuroNP

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                    #24
                    Thanks Nuero for the good advice. Glad to see you here. I have the new Respond S9 Bipap and like it a lot. The nasal mask they gave me has two staps; a "plastic" one that goes on top of the head. I thought the other went over the back of the head' perhaps it's suppossed to go underneath the chin. Will have to check it out.

                    I know the machine has literally been a life saver for me. It took a while, but the nights I sleep thru unless there is a leak in the nasal pillow.

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                      #25
                      i was having the carbon monoxides for over a year, at least that is what i called them, at home seated i would start going out and if there was a fire i couldn't get up, it was happening while driving too, it still may, i rarely drive very far, 15 minutes max.
                      i bought one of those sugar testers and i was down around 56 ,2 hours after a big break fast, with oatmeal and fruit. once when this happened driving, got to a rest stop and got a candy bar and was fixed. ever since i started the testosterone, it stopped, the opiods messed up my endocrinology, my prolactin was out of ranges for years, but no one did anything, except order the brain mri, but they didnt do anything to treat the out of range until my internist sent me to a endocrinoloist
                      cauda equina

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                        #26
                        Originally posted by dnvrdave View Post
                        For the past 8 years or so, I've had a problem nodding off when I drive (my van, not my wheelchair). I, of course, figured out to pull over and take a nap before crashing, but I've had lots of close calls. It happens in the morning on my way to work as well as on my way home in the afternoon (not at night).

                        I know this happens to lots of other drivers, but I wonder if there is a higher occurrence in SCI folks. Do any of you experience it?

                        I don't know the cause. It's not related to how rested I am or whether I take caffeine or sugar, which I usually don't.

                        My latest theory is that it is somehow related to wearing a chest belt and a possible lack of oxygen. It starts about 15-20 minutes into my drive. I drive from the wheelchair, and only need a chest belt for driving.

                        When I pull over, I always sleep for 1-10 minutes and then feel completely rejuvenated, and I'm good for the rest of the trip.

                        As an aside, I also feel very tired at work right after lunch for about two hours. I've had my blood sugar checked, but it is fine. If I can get a 10 minute nap at work during that time, it energizes me for the rest of the day, including the drive home. But in my new job, a nap is not possible now.
                        This is how I became a c4-c5 complete quad 30 + years ago. Now I can't sleep in anything that is moving.
                        ^^(A)^^

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                          #27
                          When I tried the full face mask, my RT set the pressure to 10 and I couldn't exhale, so she said I needed Bi_pap. I tried it 2 nights ago, and woke not being able to breathe, in or out, so now I am back to CPAP, which actually seems to work ok. My score after a week of using CPAP was 6.3, and it's supposed to be <2! So I will see if it goes down after a month or so of using it.

                          And hopefully, I'll actually stop falling asleep driving within that month!

                          I'd like to know how many quads require BiPap rather than CPap. I might start a survey here...
                          "Cherish your tears. If you can cry, you still have some humanity left, and you are reclaiming more of it." -- David Kelly


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                            #28
                            I'm a t6/7 para and use the Bipap. Just got the new S9 and can't believe the difference from my old machine.

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                              #29
                              RE: Falling asleep at the wheel

                              I tried BiPap with my last study two years ago and hated it. Crazy thing seemed to cut me off when not finished exhaling. From my clinical perspective BiPap works best for folks with central apnea such as head injury, opiates/sedatives, or lung disease pts (i.e. Asthma, COPD). This big toad's pressure requirements for CPAP is 17.5 to 19 depending on my weight. Although my build is not excessive at 245lbs, that's what it takes. Here's a great example of my pursuit of cheap. I need a new chin strap. Old one stretched out and despite wife sewing more velcro it still slipped each night. So tried no strap for past week and re-checked AHI (apnea hyponea index) last night. Almost seized because it read 4.6 and with mask/strap it's always 0.8 to 1.8 ALWAYS! Wife reported hearing no funky noise with me off strap too. Yes, I re-ordered a new Respironics Premium strap from CPAP.com today. Didn't want to see what was going to happen at end of 2 or 3rd week like "falling asleep at the wheel"-NeuroNP

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                                #30
                                If you can sleep with the darn thing, it is great- and they have come a long way in face masks and machines but more work to do. I know if they can make my new dishwasher so quiet you can barely hear it I know they can make this machine quieter.IF not ear plugs are the answer.
                                I am sure they will be sleak and beautiful soon!
                                Remember, -
                                sleep apnea can cause hypertension and contribute to heart disease . -Obesity leads to sleep apnea and sleep apnea or lack of good quality sleep contributes to obesity????
                                There is still alot of research to be done.
                                BIPAP should work for both, and mixed and you should be studied and tested with your face mask/equipment if there are any issues.
                                A very new interesting subject!
                                CWO
                                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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