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Mouth tape causing OSA ?
#11
RE: Mouth tape causing OSA ?
Hi Dormeo

OK! good point, thanks for nudging me in that direction...
Good exercise in trying to make sense of this.

Now attached as Sorted by EPR.pdf.

.pdf   Sorted by EPR.pdf (Size: 53.69 KB / Downloads: 9)

Pretty rough data but I think I do see a trend:

Best AHI and good OSA with EPR = 0, but because Average and Median EPAPs are higher.

EPR =3 has lowest Median EPAP of 6.58, but also lowest Average EPAP when I had no OSA, and lowest average EPAP when I did have OSAs.

If I understand that correctly my start settings may too low for when I want to go EPR = 3 ?

Also attached is last night's chart.
   

My subjective Quality of Sleep score was good: 15.5 / 20, always happy when I awake refreshed before the alarm clock. No headache, grogginess, palpitations etc, just the leaks and dry mouth which I will deal with later.

If I am correct then looking at last night's Oscar chart, if I want to go to EPR = 3 I need to up the start pressure from 9.6 upwards, but how much? Do I go up slowly by 0.2 at a time or just whack it up by  1cm H20 ? Is there a consensus/guideline on this or just trial and error?
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#12
RE: Mouth tape causing OSA ?
I think it'd be quite reasonable to try raising your minimum pressure. By how much really depends on what is comfortable for you. I'm going to bet if you go to 10 you won't really notice the difference, given the pressures you tolerate well during the night. So give that a try for one night; if it is OK, then try going up to 10.4. If that is OK, then I would say leave it there for a week or two to gather some more data.

But I do want to stress that you are very much in "How do you feel" territory. Your numbers are very good.
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#13
RE: Mouth tape causing OSA ?
Thanks heaps Dormeo, will follow your advice and review in a week or so.
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#14
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RE: Mouth tape causing OSA ?
Hi again:
As promised here is some feedback:

As suggested I went to EPR = 3
Also, as suggested I increased min to 10 all good, then 10.4 but woke up with headache "palpitations/pounding heart" so went back to min 9.6 max 11.6

Still bothered by massive leaks...

So on the 23rd tried Somnifix but landed up with very dry mouth, and very large leaks.
(these are clearly mouth leaks because N30i and P30i give very little leaks from the cushion.)

So as suggested in earlier posts (with Collar around neck and prayer or two) I started mouth taping.

Immediately noticed very low leaks: 0, 0, 8.4, 8.4, 7.2 and 13.2.
Very gratifying, and grateful for the advice in this forum.
   
But I did notice some Apneas creeping in again and some CA's:


I will post some questions about this on a separate thread:
SevereApnea help needed with CA's please

   
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#15
RE: Mouth tape causing OSA ?
Nice to see you out of large-leak territory! I wouldn't worry about those CAs, if I were you. It is common to see a few more when pressure is higher, and it is common for there to be a lot of fluctuation in CAs from one night to the next. ("Consistently inconsistent," as they say on the forum.)

If you're curious, you can zoom in on them and see whether they are preceded by breaths with an increased flow rate, indicating a little arousal. That's how almost all of my CAs happen: a little arousal, during which the deeper breathing causes my O2 to rise and CO2 to drop, then a pause in my breathing (the CA) while the CO2 rises again, then the resumption of breathing in response to the CO2.

As your body adjusts, it is likely the CAs will diminish.

How are you feeling during the day?
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#16
RE: Mouth tape causing OSA ?
(04-18-2020, 05:46 AM)Sleep2Snore Wrote: I have not looked at your charts, but I could guess that you are tucking your chin into your chest, the air can't get down and pressure increases giving you sore ears and even eyes!  Try a neck brace cushion to keep your head from going forward.  If you have a chin strap you can then still use it or drop it and rely on the neck cushion to keep your mouth closed, though I found I still had to use the chin strap.  There is only so much you can do to stop are escaping out your mouth as it will come out between your lips.  Personally I don't bother much with leaks these days, I just let the machine increase the flow, but that leads to a bigger leak   It is a viscous circle.  Mouth taping will work, but be careful what tape you use as it does cross the lips.

Apologies for piggy backing, but would you please tell which chin strap and collar you use.

Thank you
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#17
RE: Mouth tape causing OSA ?
Hi Mike

Collar:
At the moment I just an el cheapo from the local pharmacy, around AUD19.
Size Medium. Only tight enough so it supports the chin.
Have tried the small and the large, the correct size for you will depend on your own build.
Its purpose is to stop clusters of events due to chin tucking.

Chin strap:
I have tried many, none of them work for me anyway.
The best one was the Seatek neoprene Medium: they come in two flavours: "chin" strap and "chin and Mouth" strap.
This latter is wider and fits over the mouth: this, for me, anyway is the secret.
Because it fits over the mouth, it dampens the audible mouth leaks, sort of like a silencer.

However, it interferes with the Mask headgear, is not comfortable because it squashes up my face and, I feel, adds to facial swelling in the morning.

The only one I have  not tried yet is the one sold in the USA Knightsbridge double chin strap.: I was not able to get AU payment to go through so have not pursued this in the Covid era. If I was to try another one that is the one I would try.
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#18
RE: Mouth tape causing OSA ?
Thank you for the info. I found a cheapo neck brace on eBay that I may try. I’ve been looking at the PR Premium Chinstrap, but who knows. I don’t like any of them.

Thanks
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