Brain Fog - seeking guidance in optimizing my therapy

[mesenteria]

At this point, looking only at your upper and lower settings, and at the flow chart and events, it looks like you might see some improvement by upping both by a full cm of H20.  Personally, if I were seeing what I see in your charts, I'd go 1.5 cm on each and try that for a couple of days.

[deocder]

I'm just learning about aerophagia as I've started experiencing the symptoms in the past few months.  I've lost some weight so perhaps it's related to that.  I do not feel like I'm sleeping well.  I wake several times a night and feel bloated.  Sitting up results in burping and it comes out the other end once I get up and start moving around.  From reading other posts it looks like I should add some pressure relief EPR?  Posting a couple of charts of some 'worse than others' days.

   
   

[deocder]

I brought pressure support down to 3 and cant say that I had any less aerophagia.  I really don't know what I'm doing.  There's certainly an issue with large leaks.  Perhaps the large leaks are just dumping air into my stomach? 

   
   

This chart is interesting.  I overlaid my weight loss and it roughly correlates to where snore reduced and large leak increased.  There were no machine setting changes during this time period.
   

[eriks]

Hi there, I am reading this thread with interest because I am having similar experiences as you. From the start of my therapy, in 2013, several things have tried but none of them really helped. I still need 10 hours of sleep and even then I don't really feel or function very well. I now do have better spells though (which I didn't have before I started the treatment). The most improvement was which each nose procedure, where part of the internal mucous membrane is removed. The procedure does have some side effects though (which I was told about only after the procedure).

My therapist says AHI < 5 is acceptable (which is following procedure here in NL), so they won't take any effort.

So once in a while I will start experimenting myself, like now (see my "insufficient deep sleep" thread).

I am seeing in your "old" graphs a "mountain landscape" style for actual applied pressure, just like mine. In the new graph it seems to be gone, so I'd say that's a vast improvement.

The only thing I really want to add is that, to my experience, a change doesn't make you sleep better or feel better overnight. It really takes some time for the effects to show. Don't give up. Good for you that you managed to get a new, better CPAP device, I probably won't be able to.

[deocder]

Still struggling with aerophagia and large leaks.  The leaks may be positional as I move around a lot, always looking for the most comfortable sleep position, and often ending up on my stomach.  Regarding the aerophagia, I'm thinking it's time to adjust pressure settings since I've not noticed any improvement since adjusting the pressure support from 4.0 to 2.0 in December.  I'm just unsure of what to change it to.  Any suggestions?  

Here are the last three nights:

   
   
   

[Sleeprider]

If you are looking for settings to try, then I think you can try dropping EPAP min to 9.0 and use PS 3 with maximum pressure 15, and see how that suits you. Your apnea is pretty well resolved, and it will be interesting to see if the lower EPAP starting point lets more obstructive activity in. Flow limits are already low, so while PS 3 will take the 95% closer to zero, it should be more of a comfort item. I really think improvement in your sleep comfort may be contingent on a better bed, although I have no idea what your're using.

I was working for a few days at our summer cottage to repair plumbing and other tasks, and was sleeping in our old conventional mattress. It's a good one, but I kept waking up in the night with pain in my hips and legs. Getting back home and in our over-priced memory foam mattress that is going on 9-years old now was a real relief and slept through the night. I don't experience your sleep, so only you can judge if a change might help. I know you try doing a lot of prone sleeping, so an articulating bed or mattress improvements that may even allow elevation of the hips, might be just the thing.

[deocder]

If you are looking for settings to try, then I think you can try dropping EPAP min to 9.0 and use PS 3 with maximum pressure 15, and see how that suits you.  Your apnea is pretty well resolved, and it will be interesting to see if the lower EPAP starting point lets more obstructive activity in. Flow limits are already low, so while PS 3 will take the 95% closer to zero, it should be more of a comfort item.  I really think improvement in your sleep comfort may be contingent on a better bed, although I have no idea what your're using.  

I was working for a few days at our summer cottage to repair plumbing and other tasks, and was sleeping in our old conventional mattress. It's a good one, but I kept waking up in the night with pain in my hips and legs.  Getting back home and in our over-priced memory foam mattress that is going on 9-years old now was a real relief and slept through the night.  I don't experience your sleep, so only you can judge if a change might help. I know you try doing a lot of prone sleeping, so an articulating bed or mattress improvements that may even allow elevation of the hips, might be just the thing.

Thank you for your response, Sleeprider.  I made the settings suggested and have given it a week of testing.  I'm still getting aerophagia, maybe somewhat less than before.  Regarding the leaks, I assume they are happening when I move to a prone position.

I'm currently in the process of finding a new bed which is a daunting task in and of itself.  

Here are a few charts from this past week:

   
   
   

[fikus56]

Regarding the leaks - i have to use a tight chin strap and mouth tape otherwise I’ll have leaks with nasal pillows.

[Abletree]

Thanks deocder and all. I have been battling brain fog/fatigue and aerophagia as well. Like you, it looks like I will soon be moving from an AS10 to a Vauto.

Along with the sleep issues, I have been trying to address all other health matters - labs/exercise/weight/stress/sleep hygiene etc

I will be very interested to see how you progress

Good luck!

[deocder]

It has been a couple of years and I'm returning to post some recent challenges to my sleep.  The struggles that are occurring are in the morning hours when I seem to wake up about every hour.  It feels rather disruptive as at the time I wonder if it's time to wake up so when I look at the time and it's 2:30 am or 3:30 am, etc. it's a frustration.  I'm able to fall back asleep but 20-30 minutes or an hour later I am awake again.  Having a look at my charts I can see several OA's that could be contributing.  I believe there is a need to adjust my machine but am not sure which direction to go, hence my post.  I know that I have some issues with leaks and I'm fairly certain it's because one of my sleep positions is on my stomach.  I've pulled screenshots from areas of the chart that were not in leak zones.