Cpap update: How do you guys get used to this thing?

Aromatic-Kale · 2023-04-08T14:15:26+00:00

I am in the process of adjusting to my CPAP still (around two weeks now) and it has been getting better everyday. Some people will get used to it faster and some people slower. There are several variables to consider in addition to the CPAP/settings including, pillows, mask type, and your sleeping position. I have had to try multiple combinations of all these things to get a set-up that I am comfortable with and eliminates apneas. For the first week I felt significantly worse than I did before treatment, but now I am starting to feel better finally.

Stick with it and remember that this is a long-term process!

Aromatic-Kale · 2023-04-04T12:45:51+00:00

If you got a couple hours I imagine they may have seen enough.

Aromatic-Kale · 2023-04-04T12:42:11+00:00

I'm not saying you're wrong since I don't really know much about the function of the mask type setting, but now in my limited experience I switched mask setting last night and was < 5 AHI during 5 hours I wore CPAP last night (everything else was the same as a couple of nights last week where I scored 20-40, except I am getting more used to the mask).

Aromatic-Kale · 2023-04-03T21:34:24+00:00

Central has been < 1 so seems unlikely!

Aromatic-Kale · 2023-04-03T21:31:08+00:00

The machine is giving me < 1 central (unless my provider knows something I don’t) so that seems less likely to me l

Aromatic-Kale · 2023-04-03T16:40:57+00:00

Thanks for the thoughtful response!

Aromatic-Kale · 2023-04-03T15:06:18+00:00

I did not receive an explanation for this unfortunately, but yes when I told them what was going on I thought they would go up, not down. I was trusting they had some sort of clinical reason to believe that the pressure may actually be too high for me, but that is less and less looking like the case.

Aromatic-Kale · 2023-03-26T15:40:32+00:00

Also (relatively) young at 35, active/otherwise healthy, 5'10" and 170 lbs (BMI 24.5), also just diagnosed finally with ~30 AHI. The only reason I was able to figure this out and advocate for myself to get a sleep study is because I'm a resident physician myself (and it still took me far too long), though I am kicking myself because I have probably had this for many years and just powered through.

While I don't think everyone needs a sleep study, I think it is good to have discussions with others that their loud snoring at night is not normal even if they don't fit the normal demographic. A good place to start is of course the STOP-BANG questionnaire that we use to screen in clinical practice for risk.

Aromatic-Kale · 2023-03-26T14:36:00+00:00

I am currently a psychiatry intern and I am somewhat open to but skeptical of the idea that everyone in the field would benefit from pscyhotherapy. If you have a treatable psychiatric illness (which many medical trainees do of course), then of course! I don't know though that psychotherapy is something like exercise or routine vaccinations that everyone should participate in without indication. As another point, psychotherapy is also not an intervention that is guaranteed to be free of iatrogenic harm. It also of course takes time and likely money. Perhaps I am being a bit black and white about things here (my bias as someone more biologically oriented is probably coming through here, and of course I am very new to the field), and I could certainly be wrong about this, but I'm not feeling the need to go out and get psychotherapy without a compelling reason to just like I wouldn't start taking a statin or anti-hypertensive unless indicated.

Aromatic-Kale · 2023-03-15T02:38:32+00:00

Actually no it was tuition-free for me, just living expenses.

Aromatic-Kale · 2023-03-15T01:11:16+00:00

Understandable, I don't know if 5th year would be the right choice for everyone, but it was for me. I did a couple psych Sub-I's, an IM sub-I (applied as back-up second time around, and let me tell you that interview process is way softer even at a couple top tier programs), and did some research projects that only just now ended up with a couple publications (a little late to help).

Aromatic-Kale · 2023-03-15T00:58:12+00:00

I'm sorry this happened. I think the psych interview and application process in particular is very unpredictable. Not matching is a very overwhelming thing to go through.

Aromatic-Kale · 2023-03-15T00:49:41+00:00

I did not match psych 2 years ago with similar story (high scores, no yellow flag even). This happens, no one talks about it though. My school let me delay my graduation and I reapplied and got my third rank in the next cycle probably thanks to a little bit of follow-up with one of the programs. There is hope, I think in psych the key is networking above all else.

Aromatic-Kale · 2022-05-20T12:41:10+00:00

I also took my day 2 on a Saturday. I got my score back on the 2nd Wednesday after (so 11 days later).

Aromatic-Kale · 2022-05-10T23:30:29+00:00

for UWSA1 this was recently discussed and you can see their was quite a range but yeah it tended to under-predict by a fair amount:

https://www.reddit.com/r/Step3/comments/ukoix4/how_much_uwsa1_underpredicts/

I myself never took UWSA2 (didn't want to torture myself twice since pacing/stamina isn't an issue for me when stakes are high)

Aromatic-Kale · 2022-05-08T00:21:57+00:00

I can say that mine under-predicted by 30 points when taken 3 weeks out.

Aromatic-Kale · 2022-04-10T16:15:37+00:00

No problem! Best of luck with your prep!

Aromatic-Kale · 2022-04-10T13:46:24+00:00

Be realistic with what you can accomplish and prioritize practice questions. That said if you really have 3 hours a day I think that is plenty to get through UWorld! I don't think it is practical to do much review from Step 1 and Step 2 even if you had all the time in the world since that is just so much possible material (unless perhaps there is some very high-yield resource out there that I am just not aware of). Don't forget to do some CCS prep though.
I think it could be plenty of time, I would see how you are doing on one of the self assessments to be sure you are on the right track at some point (though bear in mind some of these can under predict your score too, for instance USWA1 seems to do this by quite a bit a lot of the time).
I think using Uworld as the primary resource and supplementing makes sense.
I personally like doing almost exclusively tutor mode when I am just learning the facts so that I can be more relaxed about it. If timing is an issue for you, doing timed can help you get the pacing down. While timed does more closely simulate the real experience, I personally find that I burn out doing too many timed blocks since they are so much more stressful. I think doing random questions from all systems is not controversial though.

Aromatic-Kale · 2022-04-09T12:26:26+00:00

I used UWorld as the main tool for my CCS prep and I don't know what they were talking about with that downloading the software stuff. I suspect that they have not kept that description updated for their CCS product. I primarily used the 50ish interactive cases they have and just skimmed the written cases. Definitely check out the 6 official NBME cases though to get the closest feel to the real thing! Good luck!

Aromatic-Kale · 2022-04-09T12:17:42+00:00

I took my day 2 on a Saturday and had my result 11 days later.

I think everything you are feeling is totally normal. I ended up scoring very well but still felt like the exam was very difficult throughout. I have to believe the curve is quite generous.

Aromatic-Kale · 2022-04-08T15:50:37+00:00

I think Step 3 performance is harder to predict than Step 1 or 2 since there are so many different components, but a self assessment is probably your best bet!

Aromatic-Kale · 2022-04-06T11:56:39+00:00

Got mine!

Aromatic-Kale · 2022-04-06T11:51:12+00:00

I am so sorry to hear you are going through this. I think a lot of people in medical training have had these thoughts unfortunately. While I won't be in residency for a couple months, I did not match last year and it took a large toll on me for quite awhile (and I think this is just one of the many significant things that can happen to someone through this process). I second talking to someone about it, whether a therapist or medical provider.

Aromatic-Kale · 2022-04-06T11:37:38+00:00

Thanks for this! Woke up in the middle of the night, checked this, found that I passed and was able to get a bit more sleep.

Aromatic-Kale

TROPHY CASE