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Please help--1yr+ treatment issues
#1
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Please help--1yr+ treatment issues
New forum user here, looking for some assistance if at all possible. 34 year old male.

I began treatment after seeking medical help approx 2 years ago for extreme and debilitating fatigue 95% of the time.  Waking up with headaches and feeling like my eyes were constantly heavy, brain fog, etc.

Sleep study was completed after some initial difficulty, and if memory serves, they observed over 150 breathing interruptions per hour and oxygen levels going into the 70's during the study.  I was diagnosed with severe sleep apnea.

I was supplied with a Resmed Autoset 10 for Her model with Rx pressure of 5-15.  I struggled for months to find a mask that was tolerable.  I seem to be a mouth breather at night mostly. 

The first mask that I used for an extended period of time was the AirFit F20.  After a while with this, I noticed some significant symptom improvements-- fewer headaches, much less fatigue, more alertness and energy.  However, the mask would routinely leak loudly through the night and wake me up. I also began having some serious jaw pain from the mask strapping that continues to plague me to this day. I am scheduled for an MRI on my jaw next week as I can't eat without pain and/or clicking anymore.

I have since moved to an F&P Simplus for the last several months.  It rarely wakes me up at night, however I'm noticing over these last several months that my symptoms are feeling like they are gradually returning to pre-treatment levels.  Looking at my events on the machine, it seems I am usually in the 3-5 range.  Talking to the respiratory therapy clinic, they claim my machine is reportedly working very well and controlling my events as expected.  But I continue to feel worse.  If i had to guess, I feel like the vent on this mask (while quieter) is resulting in less actual pressure to my airway?  I have no idea but I am becoming desperate to get to the bottom of whats going on because my symptoms are truly debilitating.

I realised that my machine has no SD card to download my own reports, so I have installed one today and will begin downloading the data into OSCAR after reading how to do so on these forum.  Will the newly installed SD card download past data? Or only future data from today on? Until then, I would wonder if anyone here might have any input or advice on other steps I could take?

Possibly relevant context?-- I was prescribed lowest possible dose of synthroid years ago for extremely mild hypothyroidism, and my thyroid levels continue to be monitored via blood work, and apparently are within normal ranges

Thank you
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#2
RE: Please help--1yr+ treatment issues
When you install the SD card, your machine will write summary information about past therapy. This includes hours of use, AHI, settings etc. Your detailed therapy information is only written to the SD card when it is inserted during use. So you will have a summary of your past therapy, but will be able to post detailed charts beginning from today provided you keep the card in the machine during use.

It may help to see your sleep study results. Canada has a habit of diagnosing all sleep disordered breathing as obstructive sleep apnea and not treating central apnea if present, so we would like to double-check the test. Apparently more complex forms of disordered breathing do not exist in Canada. I'm not aware of synthroid side-effects that should influence therapy. We will learn a lot from your Oscar detailed results when you have them available to post. Welcome to Apnea Board.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#3
RE: Please help--1yr+ treatment issues
Thank you for your prompt response.

Should I wait for a week of detailed results to be saved to the SD card before downloading, or should I post what I have available immediately?

Should I also request the sleep study results from the clinic?  I am not sure if I will be able to locate my sleep study results records here at home.

Lastly, I am noticing that my face mask has begun to leave quite noticeable red marks around the outline of where the silicone meets my face.  Its particularly apparent where the mask meets my upper cheeks and around the nose.  Do you have any tips to reduce this?  Fair caucasian skin.  I have tried reducing the tightness of the mask but when I do I get considerable mask leaks, and strangely enough it seems when the mask is looser it aggravates my jaw pain issues.
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#4
RE: Please help--1yr+ treatment issues
Edit--resolved
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#5
RE: Please help--1yr+ treatment issues
Attempting to post sleep study results again now that I have 4 forum posts...


[Image: photo-2022-12-15-09-56-24.jpg]

[Image: photo-2022-12-15-09-56-26.jpg]

[Image: sleep-study1-obfuscated.png]
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#6
RE: Please help--1yr+ treatment issues
The sleep study was helpful to see and it's interesting how your apnea was in 4-5 big clusters and mostly in supine position. From what I can tell this is entirely OA and H events. If you can post a daily details chart, a single night of data will tell us most of what we need to know to help optimize your therapy. Instructions on organizing and posting charts/images are in my signature links.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#7
RE: Please help--1yr+ treatment issues
Here is data from a recent night.  Hopefully I uploaded this properly, let me know if you need to see anything else.  I chose not to use last night's data as the hose disconnected from my mask for over an hour before I woke up!

Do you also have any recommendations for how to reduce red marks on my face from the silicone of the mask?  They are quite noticeable and rather embarrassing!

Thanks for all your assistance.


Attached Files Thumbnail(s)
   
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#8
RE: Please help--1yr+ treatment issues
Welcome Uphold,
skin irritation can be mostly resolved by having a fabric pad or cushion cover.
when using the fabric cover the flexure and movement of the silicon is somewhat reduced, and way less irritating, disruptive, and tickly.
it also can allow light leakage in addition to all the other designed leakage out of mask vents. This is much better than sudden leakage when mask lets out a rip and flutters. The slight but constant leakage also causes a cooling sensation that also soothes adjacent skin.

QAL
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#9
RE: Please help--1yr+ treatment issues
Your most recent graph shows that the 6.0 minimum pressure is really not making your Autoset very happy. I'd like you to try minimum pressure 8.0, Autoset standard mode (not for-her). The maximum pressure is fine, but flow-limitation is pushing pressure higher to nearly 10.0 as an average. I just think 8-10 pressure with EPR 3 looks pretty good.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#10
RE: Please help--1yr+ treatment issues
(12-16-2022, 08:01 PM)quiescence at last Wrote: Welcome Uphold,
skin irritation can be mostly resolved by having a fabric pad or cushion cover.
when using the fabric cover the flexure and movement of the silicon is somewhat reduced, and way less irritating, disruptive, and tickly.
it also can allow light leakage in addition to all the other designed leakage out of mask vents.  This is much better than sudden leakage when mask lets out a rip and flutters. The slight but constant leakage also causes a cooling sensation that also soothes adjacent skin.

QAL

Do you have a recommendation for a preferred cover?  I have found a ton on amazon, but not sure if theres any particular type or style I should be seeking out. Thank you

(12-16-2022, 08:12 PM)Sleeprider Wrote: Your most recent graph shows that the 6.0 minimum pressure is really not making your Autoset very happy.  I'd like you to try minimum pressure 8.0, Autoset standard mode (not for-her).  The maximum pressure is fine, but flow-limitation is pushing pressure higher to nearly 10.0 as an average.  I just think 8-10 pressure with EPR 3 looks pretty good.

I will have to research how to change the settings myself and see if I can do that.  I'm not sure what you mean by EPR 3?  Is that a setting I need to change also?

How long should I evaluate these changes?  Should I post graphs here after a couple of nights?

Thank you
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