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Looking for some help - almost 5 years and not feeling a lot better
RE: Looking for some help - almost 5 years and not feeling a lot better
Thanks for the sentiment. Either my untreated status passes or the docs will. I'm kidding maybe.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
A better night. Finally broke the 11 day slow upward AHI + UF2 trend. Not an awesome night, but much better than yesterday. For this I am grateful. Feel a bit more refreshed and energetic.

Tried an experiment for the evening and ditched my pillow. My foam pillow is not very high, at 4 inches (10 cm) but thought it might contribute to pitching my chin down and causing positional apnea. Surprisingly, it wasn't that uncomfortable. I'd like a little more cushioning, but having no pillow isn't bad at all. Will check around the house to see if I can commandeer a thinner pillow.

Last night AHI: 0.83, previous nights 1.56, 1.40, 1.20, 0.74, 0.71
Last night UF2: 0.36, previous nights 0.60, 0.23, 0.33, 0.50, 0.59
VT = 340, RR = 15.20

IPAP only bumped the limit for about a total of 4 minutes for the entire evening, so that seems good. I'll let these settings "simmer" a while and report back.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Sounds like a move in the right direction. I use a down pillow that gives very comfortable cushioning without a lot of elevation.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Alas, I had posted at the bottom of the AHI curve.  Things are better now.  But I found out something that might affect others.

Apparently, the spice thyme, which I love, affects my sleep.  I had some soup which had thyme in it at dinner and had a terrible nights sleep.  Previously I had made a turkey dish which had a lot of fresh thyme.  I remember having a bad nights sleep after eating the turkey, but thought it might be something else.  5 days ago, I defrosted some of the turkey.  And made turkey sandwiches for lunch, three days in a row...  (What was I thinking!)  My AHI climbed for the three days, (almost logarithmically) each night worse than the next.  Ran out of turkey, thank goodness, as I was getting sick of it.  By the 3rd day had a splitting all day migraine headache.  One day later, AHI dropped in half!  Feeling much better.

Have to rule out thyme in my diet now.  Can't have zaatar either, it keeps me up, yes, zaatar has thyme in it.  I love that stuff.

I used to have a "cast iron stomach".  Still can eat spicy foods, but apparently not thyme.

So, keep good notes with your sleep records.  OSCAR has a nice "Notes" area.  Take advantage of it.  Review your notes every once in a while.  You might find something interesting, I did.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Sorry to be a broken record.  But something isn't right.  I can't seem to get back on track again since replacing my VAuto.  This one doesn't seem to be as effective, for whatever reason.  Sometimes it feels like it is less sensitive to flow restrictions than the earlier one.  All I know is I feel worse than before.  

I'm using a low cervical pillow, you can google Sormag memory foam pillow, an F10 FFM, and a foam cervical collar.  Only way to get my pillow lower, is to dump the pillow, or use a loose feather pillow.

I tried boosting both the EPAP min and IPAP max to PS 4.2 over 9.4-15.0, hoping that I could reduce the hypopneas.  After a couple of days, my centrals declined back to 0.12, which is good.  But my Hypopneas aren't apparently responding very well.  I also have a higher UF2.  Last night was: CAI=0.12, OAI=0, HAI=0.96, UF2=0.72.  The hypopneas are about what they were before the change.  


I am also getting a lot of palatal prolapse.  Had over 45 minutes last night.  Having problems with getting the F10 to seal.  The straps are loose enough to occasionally fart, depending on head position, so I can't go much looser.  The cushion is new.  Fortunately, I have learned to lower the position of the mask, so it seals better near my eyes.  Baggy eyes are a bit better.  The mask does tend to ride upward, so I put in a velcro strap under my chin to prevent this.  The velcro strap mostly works.  

3 days ago, I tried my Simplus mask again, and I developed a sore by the seal by my lower jaw.  For some reason it was wet inside the mask, and the seal rubbed against my jaw.  I'm putting on some sort of Rx cream to help it heal.  So tightening either FFM moves my jaw backwards - probably aggravating the prolapse.  I'm willing to try a nasal mask, I need to fix this.  This bad sleep stuff is really destroying my quality of life.  It's like being a yoyo, up, down, up, down.  Except it's more poorer sleep, rather than refreshing.  And that poorer sleep makes all the rest of your life harder.

My headaches are increased.  I have run out of ideas on how to make this situation better.  Help!  

I'll post some graphs, but first I have to go pruning, I'm near my limit for attachment.  Be back later today.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Boy! You are having a bad time. I'm sorry to hear that it has gone downhill for you. While the firmware and electronics are the same, I believe that a combination of mechanical components and their variability could be a difference between machines. My thought is based on the fact that mechanical devices have allowable tolerances. As far as the pressures and responses, have you compared your old data to your current for any insights? For masks, you might try Resmed F30. It is a hybrid that has a nasal pillow with a mouth cover. It is designed to be set as an FFM on the Resmed.

Good luck!
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Masks, I have found I like the Vitera better than Simplus. Mine tends to be more easily adjusted to near leak free except at the nasal bridge on a few occasions. Oddly I think it's the Simplus that has wider adjustment range on the over the head strap. I've got more time on the Vitera as I found it better for me. The back of head webbing is more comfortable to me. It takes side and back sleeping and the transitions between while maintaining seal very well.

Pad-A-Cheek makes mask padding if you find that necessary; they are Supplier #31 and have strap covers and mask cushion coverings.

Attachment and running out of room: delete any older attachments and see if that helps. Also check that the file size is lower per attachment. Reduction per image editor may be necessary at times just to allow posting, but you can try lowering pixel count and similar edits to shave off extra file size to allow a few more attachments after old ones are purged out. I'd consider purging any but the most recent month or thereabouts.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
@SarcasticDave94, the Simplus makes me feel breathless at times (in the middle of the night).  Can't explain it.  It fits better than the F10, but I have worse nights with it.  Maybe it's due to the larger volume of the mask compared to the F10.  The Simplus feels better on me, but I have yet to get a good night's sleep with it on...  3 days ago, not only did I get a sore from it on my lower jaw, but the bridge of my nose was cut somehow.  I've never had that happen with the F10, or any other mask that I can remember.  I want to like it, but it's not liking me.

Not ignoring the Vitera, but it seems to have the same mask volume, although probably better sealing.

Is there any hope to me trying a nasal mask?  I am desperate enough to cut off my mustache of 50 years to try one and tape my mouth if necessary.  I have to get out of this cycle of prolapse (and dental damage) from these FFMs.  Wretched masks are putting pressure on my lower teeth, moving them inward.  

I will read the wiki on mask fitting again, maybe I'm doing it totally wrong (again).  Are there any high probability of success nasal masks that would fit and be comfortable?  Last time I tried a nasal mask it never sealed correctly.  To make it work, I had to keep on tightening the mask.  So much so that my nose was like porky pig in the morning.  (and sore!)  If I recall correctly, the nose piece have different sized nozzles that partially entered the nose.

Feeling discouraged.  Need some hope, and maybe some suggestions.  Is finding a good mask that fits a random process?  Is there some way to load the dice in my favor?
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RE: Looking for some help - almost 5 years and not feeling a lot better
It seems to me that your masks aren't right fitting in some way. They shouldn't need to be tight or that indicates ill-fitting. Pillows masks do have the bits very slightly into the nostrils but not by much. Older prong style is a very different story.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
@CrimsonNape wrote:  Boy! You are having a bad time. I'm sorry to hear that it has gone downhill for you. While the firmware and electronics are the same, I believe that a combination of mechanical components and their variability could be a difference between machines. My thought is based on the fact that mechanical devices have allowable tolerances. As far as the pressures and responses, have you compared your old data to your current for any insights? For masks, you might try Resmed F30. It is a hybrid that has a nasal pillow with a mouth cover. It is designed to be set as an FFM on the Resmed.

It's not been fun.  Every time I think it is going to be ok, something goes haywire.  Can't seem to keep a string of decent nights.

Trying not to be skeptical, but the F30 design seems like there are two interfaces to worry about fit.  Nose & mouth.  Can you have a mustache with an F30?  I've had a mustache for 50 years, and not particularly anxious to shave it off.  I wouldn't recognize myself in the mirror!  Seriously, I'd shave it in a heartbeat if I could get better nights of sleep.  

Of the nasal types, there's the N30i and the P30i.  They seem to have the same headset.  I really don't understand what the difference is between the two.  It's the nasal interface, but I have yet to see clear pictures of the bits that touch your nose.  The Resmed site has low contrast pictures so it's hard to make out on my monitor.  I think I tried the kind that look like individual nostril plugs.  Are those called pillows?  Is there a way to get a sampler pack of both kinds?
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