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Chronic Insomnia
#91
RE: Chronic Insomnia
I was wondering if I need to drop my max pressure back down to 13 where it was or leave it at 14? I had raised it myself about a week ago just to see if it might help with the apneas.
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#92
RE: Chronic Insomnia
more experienced members may have more specific suggestions but I think you're at the fine-tuning stage where you have to judge based on how you feel. you can always make incremental changes to see what shakes out. meanwhile, your ahi is lower and good at 9 & 14 so you might stick with that for a while. your machine wants to go higher still (but not as much as when you were at 13) so if you set your max higher, watch for ca, leaks and aerophagia. if you go lower, watch for more obstructive issues. personally, I'd experiment with even higher min pressure before max pressure if you can tolerate it, but before I messed with a good thing I'd stay with these settings for a week or more to see if you start to feel better.
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#93
RE: Chronic Insomnia
            Last night was a bad night. I used my chinstrap, taped my mouth and wore the SCC and I still had a plethora of OA's. Most of the OA's were in clusters with back to back events. What may have caused this? I know some of them are SWJ from me being awake around 12:20a.m. and 3:30a.m. but that is still a lot while I was a sleep. I am posting a screenshot from Feb. 10 when I had almost no events to last nights problems. I am just trying to learn the things I need to do to prevent me from having all these events.
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#94
RE: Chronic Insomnia
The obstructive clusters suggest your chin managed to drop into the collar or some obstructive mechanism was at work. You were at maximum pressure, so we really can't look to the PAP therapy to resolve this.
Sleeprider
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#95
RE: Chronic Insomnia
I will make sure I tighten the collar tighter tonight. The chart from Feb. 10 does show the collar works.
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#96
RE: Chronic Insomnia
if you're using the standard style chinstrap, try without it. typical chinstraps pull the chin back, increasing the potential for obstruction. a properly fitted and worn collar alone should help with both mouth leaks and clusters of oa. and, as I expect you are aware, pillow height should be minimized.

you were at your maximum set pressure of 14 but the vauto will go to 25. pressure won't overcome chin tucking but you can experiment with increasing your max ipap. I wouldn't recommend it though because your previous higher settings produced leaks and ca.

ahi in the last 2 charts I saw were below 5 and a hair over 1 so I'm thinking pap is doing it's job. besides the chin tucking, I wonder how much your meds are affecting both oa and ca, and how you feel. lifestyle factors too. how's your 'sleep hygiene'?
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#97
RE: Chronic Insomnia
I use the blue Pap Cap by Pur Sleep that seems to pull my jaw straight up. It is what I have used for years. I recently purchased the Knightsbridge double strap but have only used it once. I finally finished tapering off the Trazodone and have been off of them for 1 month now. I only use Ambien occasionally when I have a few bad nights in a row and need some sleep. I haven't taken one of them in about a week. So I think most of the problem now is my chin tucking and when the collar works my OA's go way down. I agree with Sleeprider and that last night my chin must had dropped inside the collar. And since I have started mouth taping my leaks have mostly gone away to let pap therapy do its job. Last night was the lowest leak rate I have had in months. I have been following a strict routine with sleep hygiene ever since my insomnia problem started last year. I normally quickly fall a sleep every night until I wake up several times during the night I guess to apnea events. The problem used to be that when I would wake up I would stay awake for a few hours. Now it seems that I normally can fall back a sleep a little faster than I use to.
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#98
RE: Chronic Insomnia
good that you're able to get back to sleep more easily now. that's progress at least.

frequent awakening is the pits. apnea and periodic limb movement used to wake me scores of times a night. now that I've got them under reasonable control, I still wake multiple times. like a lot of others, I seem to be sensitive to flow limitations, leaks - especially leaks - and pressure variations. maybe you are too. and while I like to think my sleep hygiene is good, there's probably room for improvement - if I was disciplined enough. it's the only other explanation for my waking my layman's mind can think of.

keep at it with the collar(s). they're a literal and figurative pain in the neck but they do the job.

btw, your profile shows pressure of 10-14 which looks like an apap setting. to clarify, I think your vauto is currently set to ps 4 over 9-14?
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#99
RE: Chronic Insomnia
Thanks. Good sleep is a very precious thing. Most people who have no problems with sleep do not understand what we go through each and every night. Some nights I feel like an astronaut putting his suit on for space travel. I sit there on the edge of my bed first putting tape across my mouth then putting my pap cap with chinstrap on then the mask over my face and finally putting the collar around my neck. But I guess we do the things we have to do. Thanks for reminding me about my profile settings. I will update it.
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RE: Chronic Insomnia
I am posting some screenshots from last night. It shows I had 12 OA's and I need to find out if they were maybe caused from chin tucking or not to see if I might need to adjust the collar a little tighter.


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