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3xod1a Therapy Thread
#1
3xod1a Therapy Thread
Hi, new user here. I've used APAP and BiPAP on and off over the course of two years and decided to give it a try again. I will try to upload a screenshot of my PAP data from last night in this post for feedback. Tried to provide as much context in this post to see if I'm on the right track, although I might've overdone it.


Background: 
-my non-titrated study scored me with a 13 AHI and 26 RDI. 

-The second study was titrated and they brought me down to an AHI of 6, the range of pressures employed being 10-13 cm H20 and 6-10 cm H20 for IPAP and EPAP respectively. 

-I was dissuaded from continuing treatment because despite playing around with the settings the lab recommended for a month, I was still waking up 3 times a night on average (with most awakenings taking place during the latter half of allotted sleep time), resulting in the same degree of fatigue and brain fog. 

-I'm 145 lbs and 6'2", so weight isn't an issue

-I've consulted with a urologist (because I have to use the restroom each time I wake up), 2 cognitive behavioral therapists, and my general physician to rule out any other cause. The only other possible cause is maybe depression. But after several sessions, and noting that my general mood the day before doesn't affect the number of awakenings I experience, I suspect that my depression/low mood is a symptom and not the cause. 

Realizing that I never used this forum inspired me to give pap therapy another try, with greater consistency and feedback. There are other online forums I've used, but I think I only posted my OSCAR data once or twice on those. Also because I would like to get PAP working as confirmation that sleep apnea is causing my symptoms, which would make more comfortable with pursuing surgery. I've been contemplating double jaw surgery after consulting with multiple reputable surgeons over the past year who all think I would benefit from the procedure. But the thought of having to spending that much money, that much time recovering, and not knowing for sure if double jaw surgery would address my symptoms is not a very appealing decision. 

Settings: IPAP:10 EPAP:6. Will be dialing back IPAP by 1 tonight. I can comfortably fall sleep with these settings and higher, but I don't know how well my body is tolerating the pressures while asleep. Hoping that's why the therapy's effects haven't kicked in yet

Collar: I also just bought a coreflex collar that arrived today, which is longer and firmer than the 3M brand collar I used previously. While I don't see clusters of events on my OSCAR charts, my bad posture and tendency to sleep on my side makes me think that I'm experiencing chin tucking to some extent. In none of the recordings of me sleeping have I caught myself sleeping on my back for long periods of time. 

Mask: I've been using a medium F20 mask. Despite the wiki suggesting that I shouldn't make the mask too tight, I feel as though I need to really tighten the lower straps to prevent leaks. If I don't, my mask leaks from the bottom as I bring my chin towards my chest, or if my pillow pulls it. Now that I'm using a decent collar that actually supports my chin and am doing away with the pillow, maybe I shouldn't worry about it. But it seems like it would be a major design flaw if a mask that I had a proper fitment would still leak as a result of somewhat lowering my chin, or my pillow slightly pulling it from the side. Washing the cushion and my face doesn't address the leak issue for me. Linked is a photo of where my straps are currently set: https://imgur.com/a/pdXcGQj


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#2
RE: 3xod1a Therapy Thread
Also, here is my PAP titration study if anyone is curious. Way more events were flagged here, and they seem to be clustered enough to suggest I might be tucking my chin


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#3
RE: 3xod1a Therapy Thread
I hear you. When I fall asleep and get super relaxed, my jaw pops open which causes leaks and dry mouth. I attribute jaw opening to muscle relaxation, as I am not a mouth breather during the day. For me, the solution was mouth taping. If you fear the need to vomit or have serious acid reflux, maybe taping is not right for you. Otherwise, give taping a try. I use 3M medpore cloth tape, 2" wide which can be obtained on the site that started out selling books and now sells just about everything. The medpore tape is NOT tough on the skin when you remove it (some tapes remove a layer of skin). As a plus, the medpore tape is not expensive.
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#4
RE: 3xod1a Therapy Thread
Thanks for the input. I actually tried 3m micropore tape already. Definitely will be a consideration if I opt for a nasal mask again though
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