Well, here goes, first night of treatment

[Brummie Jon]

Hi

I have finally been issued with my CPAP, it is a Remstar Auto, M series, BiPAP, Aflex. My mask is a Respironics comfort gel nasal mask.

I have to get on with it to get my driving licence back before I lose my job. So non-compliance or "not getting on with it" are not options. I'll use hypnotherapy if I have to... lol.

The NHS down here in Kent are enlightened enough to realise that they get better compliance rates by issuing a better machine, so I'm hopeful that I shouldn't have too many problems....

My sleep technician was very helpful, explained that I should try the nasal mask first to "train" myself to breath through my nose properly. If after two weeks I can't get on with it, she'll post me a full face mask. She said that I shouldn't need a humidifier but would issue one for me if I had problems with drying up........ Can't say fairer than that.

Now I'm wondering what it feels like to sleep properly, I'm so used to living with constant tiredness and managing it by spending half my life in bed, I might not like being awake and twiddling my thumbs....... I intend to spend any "new" time in the Gym, lose some weight with a view to lose the mask.....

I'll post back and let you know how my first night goes.....

*JP*

[Tigers Fan]

Good luck!

Hi Brummie Jon

You did well with kit! especially the Remstar.

Good luck tonight! A positive attitude goes a very long way with PAP therapy. You might like to think about having some trial runs this afternoon or evening - get you used to the mask - on, off and using. Find out what leaks where and what fixes it for you, all before bedtime.

And then - zzzzzzzzzzzzzzzz

You can expect a real high in the morning after sleeping well for the first time in ?????? years?

Tigers Fan

[Brummie Jon]

I'm really tired now

Well

First night didn't go too bad but I am absolutely knackered..............

Mask fitted OK, I fell asleep quite quickly at about 11pm, there was something quite comforting about the rush of air and the gentle noise as I breathed in......... The machine would ease off as I breathed out (The A-flex I guess) making ibreathing seem natural in a strangely unnatural kind of way.........

I woke up a couple of times in the night (no more then usual), this time my mask was leaking, the ramp had eased off and now the pressure was up. I need to adjust the mask to seal at the the higher pressures but in the middle of the night, half asleep, I wasn't coherent enough to make adjustments, I don't want to wake myself up any more cos I have to leave early in the morning for my 3 hour journey to work.

I woke up at 5am, half an hour before I have been getting up lately, I took off the mask and immediately found it difficult to breath. My nose became blocked and I wondered if the constant pressure, which seemed almost to induce assisted breathing (my lungs were inflating more than usual), was actually a good thing to get used to. Anyhow, that was just a passing thought in the waking moments.

Left the house at 6, 25 mins walk, two trains and a taxi drive later I'm at work and feeling absolutely knackered. I'm not daunted, I know it will get better, I just wonder how long I can keep up with the 6-7 hour commute to work every day for the next few months.........

*JP*

[leswaller]

Keep pushing on, the first night is always traumatic, it will get better and you will feel a lot better after a few days

[Tigers Fan]

Why a few months?

Hi BJ

Why do you expect to be using public transport for the next few months. You have your machine now, a day or three to get used to it and you should be able to tell DVLA that you are compliant and not sleepy during the day.

Do you have the necessary forms to hand? Get them if you haven't, fill them out 'as if' ready for posting and the moment you feel ready - mail them with a 1st Class stamp. A few days later, you should be driving again.

Tigers Fan

[Brummie Jon]

I have already unlocked my REMstar features

Thanks all for the support....

I was disappointed this morning that I was unable to view my machines settings and overnight readings. I wanted to see how my first night went as far as my CPAP was concerned. So I learned to unlock the settings today, I have no intention of changing any pressure settings at this stage, just wanted to be able to look at the data.

OK, you may be able to tell me more but they seem quite good for a first night.

Ramp starts at 4 and goes to a max of 16 l/s
mask leak 48.8 lpm (sounds a lot to me)
1 session >4 hrs
AHI 8.3/h (pleased with that)

I'll need a months data to be confident that this is working but last nights indicators seem good....

I have tightened he mask slighty because it was quite loose, I was suprised at how well it sealed when I tried it last night but it couldn't cope with the higher pressures once I'd drifted off.

I have my DVLA forms filled in and ready to go but my doctor said that he wouldn't be able to "sign me off" to the DVLA until I saw him again (at least three months time). from what you are saying TF, the DVLA don't need my doctors "sign off"?......

Here's to a good nights kip, at least it's the weekend and I can have a long lie in.........

*JP*

[DevonBound]

Why Didn't I think of that...!

Hi Brummie Jon,

Good to hear you are finally on treatment, as the other chaps have said it will get easier - you sound like the type of guy that will persevere and will undoubtedly get the best from your treatment.....you will now start to experience a whole new world of problems which most members; and may I say my own unsuspecting personal Guru 'Tigers Fan' have all experienced before in some fashion......

Not sure if I am the only one ( I suspect not!) that as soon as I get home from work each day, can't wait to see if the figures on my APAP have updated themselves.....I know sad isn't it! but I am a business analyst and stats are my OCD!

Slight splash of realism here though - few days to get your licence back - I don't think so! get used to at least 8 weeks of the long commute. The DVLA literally are a law unto themselves.....
After rushing through all of my appointments, with some very understanding Lab Techs and consultants - my consultants dictated a letter on Monday and e-mailed it to the DVLA same day, from which an immediate read response was received, I called the DVLA 15mins later where they claimed not to have received it and that it would take 72hrs to log onto their system.....72hrs Later (Today) I called them and it was now on the system and is now with the Doctors to read through and make a decision. "How long will this take" I ask optimistically - to which the reply comes it can take up to 15 days!!....WHAT!..... this 7 weeks after my licence was revoked....you see, it seems in my case they wanted me to be compliant for at least 30 days....

Don't get me wrong, I am now and always was (after the initial Red Mist!) very light hearted about the whole ordeal - but I do detest this age we seem to be in, I think it's called 'Technology' or laziness, why can't they pick up the phone and speak to each, have we lost the art of communication? says me talking to a screen and a keyboard .

Good luck with night No.2 and keep talking to us!
DevonBound

Oh - ps: Tigers Fan, I think I might need to start talking to you about 'Rain Out' a whole new experience!

[Tigers Fan]

Might I remind you?

Hi BJ and DevonBound

May I remind you that ten minutes is included in "up to fifteen days"? I'll admit I wasn't counting but my memory is that it was a fairly quick response from DVLA to my submission.

Now, I gotta ask! Why are you guys relying on your medics to tell the DVLA that you are fit to drive? What do your medics know that you haven't told them about what the DVLA need to know?

In Mr Stefan's "Driving Advice" in "Sleep Apnoea", GrumpyBiker points the way to go - oh! and says it took two weeks.

Point is - your licence has nothing to do with your Sleep Clinic so communicate directly with our good friends (he says provocatively ) at DVLA. At the least, you cut out someone else's opinion.

"I am not sleepy during the day" is all they need to hear. They trust you but have big fines in case of wicked people!

Tigers Fan

PS DevonBound - I suggest rain out needs it's own new thread so we don't hijack BJ's

[Brummie Jon]

second night, better but not perfect

Hi

My second night was better than the first, I managed to sleep about 6 hours straight. Adjusting the mask a little tighter definately did the job and kept a seal under higher pressures whether I was on my back or either side. I woke up at about 7am with a completely blocked nose. I took off the mask and sprayed some beconase up my nose (I use it for my ashma) and within half an hour my nose was clear again. I resumed CPAP and got another couple of hours kip. Obviously the nose mask is drying me up, I'll persevere with it over the next week but if the drying up continues, I'll have to ask for a humidifier. I want to avoid using a humidifier if I can because it seems to bring with it all sorts of other issues that I'd prefer to avoid having to deal with. I'd prefer to keep things as simple as possible.

Now to answer the question about why I think I need to involve my "medics" in my reapplication of my driving licence, the simple answer is, because I have been advised by both my doctor and the DVLA that the "medic" will need to "sign off" the fact that my treatment is working and that I am compliant to the DVLA before I am reissued with my licence. Personally, I agree with the approach. Otherwise I could just lie to the DVLA that a) I am actually having CPAP therapy at all and that b) I am no longer tired during the day. If licences are given back that easily, because I say I'm OK now.....it makes a complete mockery of the whole system and verifies my earlier rant about evidence based decision making (or the lack of it).

The DVLA have given me a declaration form to sign, giving permission (under the Data Protection Act) to have access to my medical records. The DVLA tell me that their medical board only meet once a month to discuss applications but wouldn't tell me when, rendering the timing of decisions a matter of luck for the applicant. I'm not convinced that your simplified veiw of how it all works is correct, maybe, when you reapplied for your licence you had a particularly lazy DVLA employee. There is no consistency of approach, also reiterated in these forums. I am considering making a complaint to the Parliamentary Ombudsman about this lack of consistency (cheaper than lodging my appeal, which BTW, is going ahead).

TF, thanks for your input but you seem to think that just because you and GB got your licences back easily that everyone elso will. You seem to infer that those who lose thier licences for a long time do so through their own fault for not doing their "homework" properly. I think that luck, ones post code and DVLA inconsistencies play a bigger part in it than you seem to accept.

*JP*

[Tigers Fan]

You are right, again!

Hi BJ

But then - maybe not. GB and I didn't ever lose our licences. Just as so many others haven't, either.

My analysis is that the DVLA apply the same rules on the way 'in' as on the way 'out'. You tell them you are sleepy and you tell them that you are not, accordingly, they take away and they giveth back, unless you do both within the time limits they set.

Mind, when threatened with Court action, I expect they have to be very particular and get everything right. I can see that the opinion of one whose signature is acceptable to the Passport Office would be convincing to the DVLA, so it would seem you are bound to go on doffing your cap.

DVLA aside, I'm delighted to hear your second night was an improvement - but give yourself some time, it takes a few nights to get the hang of it. Longer for some Forum members, unfortunately.

Tigers Fan

[Brummie Jon]

advice from this forums blog

TF

Even this forum says...........

( see........ http://blog.cpap.co.uk/2007/06 )

"The Driver and Vehicle Licensing Agency (DVLA) says people with sleep apnoea must not drive unless they have satisfactory control of their symptoms which is confirmed by medical experts."

A different line to the one you're taking, even the advice on this forum can't be consistent...........

BJ

[Tigers Fan]

You are right, yet again!

Hi BJ

You're the man! Right again! and still walking!

Except, all you nned do is fill out their forms, sign the declaration, return it to them and after a few days they tell you it's OK for you to drive. Not just my experience, it's reported by others.

But you take them to Court, BJ, you are right and have Right on your side!

The message I want to leave for any newbies passing this way is that you don't have to lose your driving licence - you don't tell the DVLA anything until you have a confirmed diagnosis of OSA. At that point you apply to them for declaration forms and simultaneously get a real move on about getting yourself on to PAP therapy. The papers arrive, you must return them within 28 days (GB tells us, I didn't notice). If you can tell them that you are not sleepy during the day, they tell you to carry on driving. If you are still sleepy during the day, presumably by not being on PAP therapy rather than staying out all night partying, they take your licence off you till you are on PAP therapy/not sleepy.

Or you can do it the hard way, call them names, threaten to take them to Court - and they take your licence off you till you jump through hoops, cross the t's and dot the i's and then keep you waiting a bit longer just to make sure you get the point.

BJ - I really hope you get a good night's sleep.

Tigers Fan

[leswaller]

Tigers Fan is spot on, you can either do it the hard way or the easy way. Does it really matter if you dont like their technique, it is the end result that counts

[Tigers Fan]

DVLA and Forum Consistency

TF


"The Driver and Vehicle Licensing Agency (DVLA) says people with sleep apnoea must not drive unless they have satisfactory control of their symptoms which is confirmed by medical experts."

A different line to the one you're taking, even the advice on this forum can't be consistent...........

BJ

Let's hypothesize,BJ .........

As far as the DVLA are concerned there are two types of medical experts: There are DVLA experts (ours) and other experts (your Doctor).

You rely on your Doctor to tell DVLA what you told him, " I am not sleepy during the day anymore because I am compliant on CPAP." Your Doctor tells their medical expert, who assesses the evidence (your statement with Dr's signature) and agrees you are compliant and therefore fit to drive.

I (and others) make a declaration direct to DVLA, " I am not sleepy during the day anymore because I am compliant on CPAP." Their medical expert assesses the evidence (my statement and the filled out questionaire with my signature) and agrees that I am compliant and therefore fit to drive.

Seems to me that the advice on this forum is consistent.

Seems to me that the DVLA act consistently.

Seems to me that you think you are the only man in the entire army who is in step .

And that, as the Elder says in my favourite movie, is all I have to say.

Tigers Fan

[dezellis]

Hi,
If you voluntarily surrendered your licence and did not wait until it actually been revoked due to medical reasons then see below taken from the DVLA website. See the However, whilst medical enquiries are being made you are allowed to drive so long as you comply with the criteria all included below.

If you decide to return to driving after voluntary surrender.

If in the future, following surrender, you apply for the restoration of your driving licence, medical enquiries will need to be made. However, whilst these enquiries are being carried out the law provides cover to drive under Section 88 of the Road Traffic Act, 1988. This means that as soon as your application is received at DVLA (following voluntary surrender) you may resume driving provided you meet the following criteria:

a valid application is held at the DVLA
you have not or would not be refused or revoked a licence for medical reasons and you are able to meet the medical standards of fitness to drive. These standards are set down in "At a glance guide to the current standards of fitness to drive". All medical practitioners have access to this publication, therefore if you are in any doubt about your ability to meet these standards, you should check with you doctor before you resume driving
you must have held a GB or Northern Ireland licence issued since 1 January 1976 or another exchangeable licence
you keep to any special conditions which may apply to you, and to your licence
you are not disqualified from driving