4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
Hi everyone,
I'd appreciate any ideas or insight/advice about an issue I've been having in transitioning from nasal N20 to full face F20. I thought it would improve, but it seems to have worsened my apnea.
I definitely feel like I'm getting more air and have fewer snores, but have had some terrible episodes of OA and feel like a bus hit me in the morning.
A few nights ago, I had about an hour of severe OA and flow limit, - about 15 episodes, some of which lasted about 40 seconds or more. I actually had a dream that I was sprinting and couldn't run fast enough. Screenshot below of the hour when I had a problem and a zoom in on one episode that lasted 51 seconds (!). Oscar data says fixed 11.4cmH20 but pressure was apap 11-13.6 at the screenshot time.
I never had this issue with the nasal mask (or even before CPAP therapy) and was wondering what the problem might be.
Any insights would be appreciated- thanks!
Michael
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
You are having some of positional apnea. You can see positional apnea where either H or Oa events are clustered together. There are not a huge amount but getting rid of as many as you can will lower your AHI.
Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
(09-15-2023, 11:33 PM)staceyburke Wrote: You are having some of positional apnea. You can see positional apnea where either H or Oa events are clustered together. There are not a huge amount but getting rid of as many as you can will lower your AHI.
Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
Hi Stacey
Yeah I tried sleeping on my back because both of my shoulders are shot and it sometimes hurts to sleep on my side. I had hoped the full face could help with that as I have some issues with palatal prolapse (separate topic)
I'll try the cervical collar and see what happens. I have one and will try it again this evening.
By the way- I slept on my back sometimes with the nasal mask and never had this issue. That's what's really puzzling me.
Cheers
Michael
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
You're screen printout still indicates you were using a nasal mask. Did you change the mask type in the option settings when you switched to the full face mask? Why did you switch from the nasal mask?
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
I had it set to FFM until I had the issue and woke up. For the following session, I then switched back to my nasal mask and I think oscar is showing that because it's the last mask I used that night.
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
"By the way- I slept on my back sometimes with the nasal mask and never had this issue. That's what's really puzzling me."
Cheers
Michael
Hi Michael,
There is no problem with sleeping on your back if you are making sure that you are not allowing your head to tilt forward into your chest. This is called "chin tucking", which causes "Positional Apnea."
Look at your Obstructives and Hypopnea. They are clumped together. It really has little to do with the mask change, or sleeping on your back, but how you are allowing your head to tilt forward. Note: "chin tucking" can occur with side sleeping too.
Read and compare the graphs to your graphs. Yours isn't as bad, but it does need corrected. More pressure won't blast through "clumps" of apnea.
Positional Apnea
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
Thanks Opal, for this little nugget. Most useful.
RE: 4 months in, horrible OA after changing from nasal N20 to full face F20- PLEASE HELP
Also, by and large, using a full face mask usually gives you less effective treatment than the nasal mask and much less than with the nasal pillows for the same pressure setting. So, the full face mask use may dictate an increased therapy pressure to make up for that. If you did not change the pressure, you would likely have more obstructive apneas and snores with the full face mask over the nasal varieties.
QAL
Dedicated to QALity sleep.
