[CPAP] Recent CPAP Struggles

[gold3n]

Good day everyone!

After spending quite a few years lurking on this forum and gaining some useful information it is now time for me to seek some advice. Thank you to all past posts and post responses for highly experienced folks. You have helped more people than you may realize. 

Nearly a decade ago I was diagnosed with severe Sleep Apnea with a home study of about 40 AHI in my late teens, obstructive apnea, I have large tonsils, poor nasal cavities and am a HEAVY mouth breather. Due to being young, naive and not having a great experience at the sleep clinic I decided to stop treatment. Now that I am older, 29 and heavier I started suffering from day-time fatigue. I still had my Resmed S9 which was my late grandfathers, I opted to start therapy again and do my best to treat it myself. This worked great for quite some time! I averaged an AHI of 1-3 and felt okay, not perfect but okay. But recently I stopped vaping concentrated THC and my AHI score and Central Apnea events have got out of hand and its really taking a toll. I am now averaging 3-5 AHI with last night being 10. This is still classified as mild, but I must say, I sincerely do not feel good at all and contribute it to my CPAP. Which is why I am posting this which puts me way out of my comfort zone. 

Most of the time I had a good AHI score and felt okay when I used a full faced mask. However, after several masks I never was able to find one that fit right and didn't leak. The only way I was able to get them to not leak was if I had them quite tight, this gave me neck problems and at best some red marks that lasted a good portion of the day that I was self conscious about. I also had troubles with dry mouth even with my humidifier as I'm sure I was mouth breathing the entire time, I wasn't able to adjust the humidifier to rectify this after numerous attempts. 

I recently switched to nasal pillows. What a fantastic product! But my heavy mouth breathing made this difficult to use. One solution I have been doing is mouth taping, even though it is not recommended it worked great for me, until recently as I touched into above. Since quitting THC I have been waking up feeling light headed, less conscious/spacey throughout the day, swollen lympnodes aka double chin area, increased anxiety and a strange build up of phlegm in the back of my throat . I do understand some of this is likely from me quitting THC, but my AHI has been higher and CA events up to 20 seconds which has me a bit freaked out. I understand the ultimate recommendation/advice is go to another Sleep Clinic and seek professional help. But please indulge in my stubbornness and provide some advice or insight so I can hopefully rectify this myself and or optimize my CPAP to help get me through what I predict is a bit of withdrawals. It would be much appreciated. 

Attachment #1: Highest AHI and worst night I have ever had last night.

Attachment #2: Two Nights ago. AHI of 5.5. Nearly all events were CA and were grouped.

Attachment #3: Zoom in of my CA events from the night above.

Any other information you need for any possible advice I can provide right away. Thank you very much and I appreciate your time.

[Jay51]

Welcome to ApneaBoard.  The first major problem I see is leaks.  If you can somehow get these leaks under control, your therapy could be a lot better.  

The 2nd has to do with EPR.  You have it on full time at 1.  Increasing EPR can reduce flow limitations, but it can also increase CA's.  Hopefully most of your CA's are do to leaks and getting used to pap therapy - they should reduce the more you use it.  

3rd - you kind of have a cluster of OA's in one of your charts.  This can be caused by chin tucking.  You can try lowering your pillow height, sleeping on your side instead of back, and maybe even getting a soft cervical collar (your decision).  

Here is a link to help with leaks.  Mask Primer