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Intro and request for advice
#41
(02-23-2015, 07:52 PM)me50 Wrote: I am curious as to what chin strap you tried. I had a great chin strap and when I ordered a replacement the DME sent me a chin strap that hardly had any material to it and what material there was, was weak at best and there was no cup for my chin and no way was that chin strap going to do anything but cover up a little bit of my face. So, maybe you could stick with the pillows or nasal mask, which ever you prefer, and then get a better chin strap and see if that helps. I used a chin strap with a nasal mask for a month or so and then I didn't need to use it anymore because my mouth stayed shut when I was sleeping. YMMV

I am currently using a FFM, only because I cannot find a chin strap which successfully keeps my mouth closed during sleep. Since you seem to have success with some, could you possibly advise me which you would recommend please? I am desperate to find one, because I can manage my quite mild OSA with a dental device if I could only keep my mouth closed!
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#42
Eric, it's really not about keeping your mouth closed. In fact, a closed mouth can simply create a place for air to build up until your cheeks poke out in all directions and something pops.

So it's not about keeping your mouth closed.

What a successful chinstrap will help you do is keep your jaw from falling backwards when you go to sleep and your body relaxes. With it forward, your tongue can take it's proper place at the roof of your mouth which creates the air seal. A very effective air seal as a matter of fact. Once you're good at it, you can open your mouth and listen to all the funny noises even.

There is a technique involved with a chinstrap that needs to be used:

1. It's not about lots of force, but rather a gentle encouraging to keep the jaw forward. If you use a lot of force your jaw will tense up, your teeth will clinch, and during the night the whatsitcalled gland in between your jaw and your ear will begin to hurt like crazy go nutz. So gently encouragement. Not force.

2. About comfort: I don't like wearing a chinstrap. I do find that odd, because I don't mind wearing a mask. But chinstraps bother me. So for me, the best chinstrap is the very simple single strap things that are a minimalistic as possible. Lots of people do better with the ruby-reds, or equivalent that suck up your brains. But not me. I like something as small as possible. And I wear it under my P10 mask so that when I get up in the night I can remove my mask without fooling with the chinstrap.

3. The conventional wisdom is to wash them frequently. I try to wash mine at least once a month, when I also wash my socks. But don't make the mistake of putting an almost-dry chinstrap on when you go to bed. It's not a good thing.

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#43
Rg you crack me up. I can't remember the last time I washed my socks!

QAL
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#44
One quick follow up question for the experts here. Is there any value in getting a second opinion from a different doctor, or will they come to the same conclusion looking at the same data? My last three checkups have not resulted in any improvement in my condition or any changes in treatment. I am wondering if it is worth going back again for another checkup.
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#45
Hi Seabird.
Smile
I see from the posts you've been on the hose a few months now.
You should be adapting nicely.
Your numbers look pretty good. Only improvement I can think of is to
try 7-11 range. Usually a 4 point spread catches the dynamics a bit better. YMMV of course.
Still not getting rest though...hmmm...
When you do get any leaks does it make a significant amount of noise?
That has been causing me all kinds of grief.
Maybe try some sealing compound for your mask. Check for mouth leaks too.
Those can wake you up as well.
There's Skin Tac Wipes you can use on your sealing surface.
It puts a coating of rosin on your seal so it stays tacky.
I have been using that and Avery Glue Sticks. (non-toxic)
Getting a lot better naps that way with out the seals blowing out. Tongue
**
In any case do not quit!
The CPAP is going to be keeping you alive. It's preventing you from going into O2 desaturation
and that is a terrible wearing thing on your system.

Best of Luck!


"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#46
Thanks for the reply. My current API averages around 2. I don't really have significant leaks any more. I think I have finally taught myself to sleep with my mouth shut. I average around 8.5 hours/night.

I have actually been on CPAP almost a year now. I really don't feel any different from when I started. I'm still tired all the time. I can't take the doctor telling me "hang in there!" and more. I'm trying to figure out of someone else might be able to help me.
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#47
Sounds like you have things under control CPAP wise, Seabird.
Just keep up the good work!

Well-done

The machine is going to keep you alive at this rate. This is a good thing.
Something else might be disrupting your sleep though.
That is the mystery to solve!

Thinking-about

Best of luck! Hope you find the disruption.

Sleep-well
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#48
Yes, I am trying to figure out what the "something else" might be. So far I haven't been able to get to the bottom of that.

I'm still wondering if there is any value in seeking a second opinion.
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#49
Seabird,

two ideas for you:

1. post some recent data here and let the forum have a chop on it. It won't be medical advice of course, but maybe a fresh look at recent data will generate some new ideas, or at least a confirmation that your CPAP therapy is doing what it is supposed to do on that part of the puzzle.

2. Maybe the reason you are still tired is something other than sleep apnea. Usually people rule out lots of other stuff before exploring sleep apnea, but maybe it's time for you to rule out sleep apnea and look into other potential reasons you don't feel well.

If your CPAP therapy looks to be effective and you have been at it for a long time without feeling better, then maybe it's time to consult your family doc (not another sleep doc who will tell you it looks great and hang in there some more), and so explore what else might be going on.

You might have something going on that was hiding behind other stuff like sleep apnea or could not be addressed until sleep apnea was ruled out. Anyways, your family doc might be in the best position to review all the things you have considered up to now including the CPAP therapy and help you decide how to pursue what is still left of the puzzle.

** updated: afterthought... You seem keen on getting a second opinion of a different sleep doc. My earlier comments notwithstanding, trust your gut. If your intuition tells you that you need a different sleep doc to have a look then it's worth doing. It's one visit, bring all your data and see what happens. The peace of mind will be worth and you may have been perceiving something that you can't put into words. Trust your instincts. **


good luck,

Saldus Miegas

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#50
Hi, thanks for the reply. I am leaning toward getting a second opinion. Even if that doesn't get me anywhere at least I will have ruled that out.

As far as my data goes, nothing has really changed there. We have reviewed it on here and with my sleep doctor several times. Everything looks good from that perspective.

I think my sleep doctor would agree that the cause of my problems would be "something else". The issue is figuring out what that might be. My primary care doctor doesn't have any ideas, nor does my endocrinologist. I am "annoyingly healthy" (my term).

Sometimes I wish I could just give up and just be tired. That is really difficult for me because I keep thinking that there has to be some solution out there somewhere.
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