Howdy everyone. Doing a quick check-in since it’s been a bit. I’ve been doing some “playing around” to try to understand how things really impact my breathing/sleeping. I’ve never quite managed to find that sweet spot that I hit the first weekend with full alertness and feeling like I have a lot of energy. But I’ve also never relapsed into the pre-PAP fatigue with headaches. So, I’m definitely better than I was, but I still have something to strive for.
Here’s some info on the playing around, as well as some commentary on how altitude has been impacting my process:
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Min pressure: I’ve settled on 9 as my minimum, but am feeling like I would be happier at 10 due to my slight air-starvation reaction as I’m falling asleep each night. The only thing that’s stopping me is that I still have some aerophagia issues and I don’t want to exacerbate them.
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For Her vs. normal Auto: I’m comparing the two settings. The For Her setting provides better control of events (AHI’s in the 0.5 range), but it’s reaction timing to CA’s seems to wake me up just as I’m changing sleep stages in the early morning hours, and severely disrupts my REM cycles. The normal Auto mode provides much worse event control (AHI up to 5), but it doesn’t wake me up as it treats, so my oxygen is slightly lower, but my sleep is more consistent. I haven’t decided which one I’ll end up choosing – I need more evidence to make the final choice.
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Nasal pillows vs. FFM: I wanted a FFM backup for allergy season and because I’m having some significant mouth leaks, but I completely failed with it. I went through the whole mask fitting process on the wiki and felt like it was seated well and slept fine, but my AHI was over 10 for multiple nights when using it. (I dropped the EPR one of the nights to prevent CA, but still ended up with a boatload of them along with new OSA and Hypopneas, too. And my SpO2 was worse than without CPAP.) I’ve concluded that a FFM is actually worse for my particular situation, since I’m really an O2 issue not a classic apnea case.
- Mouth leaks: I tried taping my mouth and it slightly reduced my mouth leaks, but not as much as I would have expected. I did it on my business trip because the topic freaked my husband out and I didn’t want to mess with his brain too much.
Since I returned home, I haven’t taped, and my leaks have gotten bigger. I’m thinking that I need to commit to the taping for a bit and see if I can get it under control. My results are definitely worse when my mouth drops open.
Here’s a couple of recent charts – nothing exciting. Pretty much a consistent treatment at this point with a few O2 drops and a few events that don’t seem to be directly connected to the O2 drops.
Comments on altitude:
I had a 2-week business trip to Utah, which is just over half of my home altitude, and did some comparisons of how my Sp02 was impacted. I ended up sleeping without treatment on the night before my early flight home, since the machine was packed up and I was being lazy. It was a rough night, but it provided some good comparison data.
It looks to me like the PAP can cover for ~4000ft of altitude, so it brings my treated Utah readings into alignment with my untreated sea level readings, and aligns my treated home readings with untreated nights at 4000ft. I may be interpreting it wrong, but it's interesting data to consider, anyway.
General note on this comparison chart is that I sleep more soundly with treatment, regardless of my O2 levels. The night at sea level was taken before I had a machine, and you can see that my O2 was good, but I tossed and turned and was generally uncomfortable anyway. Same with all the non-treatment nights. For the nights with PAP, I slept well even if my O2 was dropping. If I woke up between sleep cycles, I fell right back to sleep after rolling over. So I may not have my O2 fully above 90% yet, but I am definitely seeing improvements.