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AHI low, what else could be making me sleepy?
#11
RE: AHI low, what else could be making me sleepy?
if you mouth breath in a full face mask that doesn't leak, you'll get dry mouth but therapy won't be compromised. you can try xylimelts for dry mouth.

if you can't manage mouth leaks with strap, collar, tape, you won't fare well with nasal or nasal pillow masks.

my lip leaks caused by pressure are sufficiently reduced with a collar to enable me to use nasal pillows, a lifesaver because I haven't found another mask or tape to work with my beard & typical chin straps cause more problems than they resolve for me.
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#12
RE: AHI low, what else could be making me sleepy?
Sleeprider can explain it much better than I.  Yes raise the min 1 and see if you can cut down on mouth breathing.  There are several ways.  tape, full face mask, collar... I have a link to the collar at the bottom.  None is a great alternative but you need to find what works for you.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#13
RE: AHI low, what else could be making me sleepy?
Yes, they do seem to look like the mouthbreathing/snoring charts shown in the wiki.  I'm going to look into purchasing the resmed and will try higher pressure for the time being.  Thank you so much!
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#14
RE: AHI low, what else could be making me sleepy?
If you plan on buying try Supplier #2 on the supplier list at the top of the site. I bought mine from them. It was used. Used less than1 month, great machine and great company. I think the s10 Auto set was about 380.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#15
RE: AHI low, what else could be making me sleepy?
Do they ask for a prescription by any chance?  I messaged my sleep center asking for a copy of mine but I highly doubt they will get back to me.

All good food for thought.  I think I'll go back to the full mask for the time being and raise the pressure.  It's strange how your AHI can drop but you actually don't feel any better.
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#16
RE: AHI low, what else could be making me sleepy?
Actually just ordered it through them.  Thank you for the tip!
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#17
RE: AHI low, what else could be making me sleepy?
I did not need a prescription. Yes it takes a lot of changing to get it right but my Dr only looked to see if I was compliant (4 hour a night) and less than 5 events an hour. They listened to my complaints but did nothing. 

Even after you get things dialed in it takes awhile before you get back after years go sleep deprivation. But I think you are on the way.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#18
RE: AHI low, what else could be making me sleepy?
I've found the same in other areas of healthcare as well.  If you don't advocate for yourself and do research you can end up being no better off than when you started.  That's why I appreciate what you guys have told me today so much.  God knows how many months forward each of you helped move me today.  It's so nice to not have to go it alone and be able to talk to others who are in the same boat and more knowledgeable.
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#19
RE: AHI low, what else could be making me sleepy?
Sleeprider, I was thinking about what you were saying:

Quote:"I will bet if you zoom in closely on your flow rate, you are going to see the characteristic flat tops on the flow wave."

I went back and compared my full face mask with my nasal mask.  It looks like the full face mask has very obvious flat tops but the nasal mask is more rounded.  So, now I'm not sure if I should opt for going back to the full mask or sticking with the nasal mask.  Dont-know

The thumbnail on the left is the nasal mask, thumbnail on the right is the full face mask.


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#20
RE: AHI low, what else could be making me sleepy?
Both examples are flow limited but the first one (left nasal mask) is pretty extreme.  What we see here is the inspiration starts and reaches an early peak, then flow reduces ahead of expiration.  This is the classic "chair shape" wave form  To see it even better, you can right-click next to the Flow Rate label and pull up the context menu.  Select Y-Axis and Add Dotted Line at zero.  Everything above the line is inspiration, below the line is expiration.  You can also override the scale of the y-axis so that the scale is the same in every image. Note that the two images you posted are difficult to compare for that reason (auto scale).

Back to this image. You start to inhale, but your airway actually closes like a crimped hose just as you get going. It's like drinking a delicious thick milkshake through a straw so thin, that won't let you pull it into your mouth.  This inspiratory effort to overcome flow limitation is exhausting, even though your doctor won't even consider it to be important because it is not an event.  It limits the amount of air you can get in, or it takes longer and more effort to get a full breath. Pressure support in a bilevel, adds pressure to "inject" air at just the right time and rate to make respiration normal again, making all of this effortless. Using a set range of +100 to -100 makes the scale the same in all graphs.

Not sure what you ordered from Supplier #2. The Autoset is good, the Vauto is much better.  The difference is the Autoset can give you up to 3-cm of pressure support as EPR, while the Vauto has unlimited pressure support as well as inspiration timing and sensitivity controls.  The Vauto is a true bilevel, and while more expensive, is worth the extra expense...about $200.  You will improve with either one compared to the Philips, but you can see what I use.

[Image: attachment.php?aid=27662]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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