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Switched from APAP to BIPAP
RE: Switched from APAP to BIPAP
I used Afrin last night along with a breathe-right strip and mouth tape and had a somewhat successful trial with the F&P Eson 2. I woke up in a much better mood than the night before and seemed to have improved sleep quality (Although I am very certain there's much more room for improvement.) I did end up taking off the mask due to nasal irritation and some congestion later on in the night (my partner covered my mouth at one point due to mouth leakage.)

Here are the results from last night: 

   


I am getting another prescription for fluticasone propionate since I don't have time to go to an ENT doctor before travelling but will discuss Dymista use eventually. 

Any other suggestions for settings/masks would be appreciated.
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RE: Switched from APAP to BIPAP
That data still shows fluctuating TV/MV but overall the flow rate chart looks better and more consistent (no real periods of lower flow rate). You now have to wait a few days before can try Afrin again, it would be kind of interesting to see a test of Afrin and your FFM to see if flow rate is the same or if it has periods of flower flow rate again. If similar it would mean nasal congestion is likely to be what is restricting the flow rate, if it has periods of low flow rate than it supports a nasal mask being more effective in your case.

Getting used to nasal masks is tough and it will be even tougher with a nasal congestion issue as mouth breathing is a natural response to congestion. Unfortunately nasal congestion is one of the main causes PAP users have to use a FFM but if you are a case where a FFM negates effective treatment then that makes it really tough.

I think you need to continue to focus on figuring out what is causing the nasal congestion and treating it. Medication wise Dymista is the best but it isn't a cure, just a band aid. Something is causing your nasal congestion but you might have to jump through hoops to find out what it is. In my case I have now confirmed that both dairy and gluten cause congestion (just confirmed gluten about a month ago after trying to reintroduce it after 6 months gluten free). I think literally any food sensitivity can cause congestion issues and unfortunately there are no tests other than elimination diets to try and find culprits. For some reason mainstream medical doesn't even really even mention the possibility of this but after my personal experience and research finding other people having similar results I have become a strong believer.
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RE: Switched from APAP to BIPAP
I just found something really cool.

The Royal Prince Albert Hospital in Sydney Australia is a leading teaching hospital tied to the University of Sydney.

They have a book on food intolerances and an elimination diet guide for helping find and learn how to live with intolerances. They list some common intolerances that I wasn't previously aware of (salicylates, amines, glutamates). This link gives a few pages of background on some common food intolerances and idea of their elimination diet. I believe you have to purchase full version from them if interested in learning more.

Anyways just glad to have finally find a high quality medical source discussing these issues.

Link to few pages

wholechildonline.com
https://www.wholechildonline.com › ...PDF
Elimination Diet Handbook - Whole Child Pediatrics

Link to hospital page

https://www.slhd.nsw.gov.au/rpa/allergy/...books.html
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RE: Switched from APAP to BIPAP
(12-11-2021, 01:25 PM)Geer1 Wrote: I just found something really cool.
 
Thanks Geer1 that looks very useful indeed and I am sure this will help many of us here.

Pity it is hidden deep inside this thread.

I have ordered the books and they are on the way!

The test will be to see if I have the discipline, consistency and ability to listen to sound advice. Let's see. 

As with all physiological changes it may take quite some time for the body to adapt and reset its homeostatic mechanisms, but I will do my best.

Thank you for sharing. Thanks
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RE: Switched from APAP to BIPAP
AmierKas, fluticasone propionate including brand Flonase is sold over the counter in the U.S. without prescription.
Sleeprider
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RE: Switched from APAP to BIPAP
I've used Flonase in the past and there's no side effects that I could recall. Certainly not at all like Afrin. For an over the counter medicine, Flonase works very well.
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: Switched from APAP to BIPAP
Costco sells Kirkland brand generic Flonase in a 5 pack for a very reasonable price.
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RE: Switched from APAP to BIPAP
I finally used the nasal mask yesterday with fairly clear sinuses after using Flonase for 4 straight days. However, it feels like I've slept a lot less than I should've because I feel tired today, but in a slightly different way (describing it qualitatively is difficult, but facial pressure and muscle weakness are much more prominent than usual). I've also noticed that my eye-twitching was worse than usual today, which normally happens when I'm more tired than usual.

Here are the results for interpretation though:

   
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RE: Switched from APAP to BIPAP
Hi, AmirKas
_ apologies for my non native English, first.
_ I have learned some much with people here in Apneaboard, and I am so grateful.
_ After a long while without posting here, however following the forum sporadically, your case has called my attention and touched me. That because it looks has to do with my current residual issues during REM sleep. I modestly think your strange TV curves, would be correspondent to REM stages, when I compare to mine. Luckily, we might find a similar solution, benefitial for both of us;
_ I am 69, male; very very anxious person. Since 7, I have Restless Legs, and since 17, today, I know, I started having poor sleep due to respiratory efforts during REM, very likely, as well as with PLMS/RLS, arousal/awakening/waking me up hundreds times during the night. That lasted entire middle school, college, and 39 years of sucessuful profissional career, suffering a lot with poor sleep (almost all day, waked up in the morning worse than when I went to bed). Very hard times. Benzo's (maximum dose of 0.6 Clonazepam equivalent) saved my career and, I think, my life. Surprisingly I end up all those years without any significant healph problems, except, of course, very poor sleep. Retired in 2015, I finally, had time to dig in this problem;
_ in 2017, august, for the first time, a dam MD asked me to go for my first PSG1 (two pictures attached downhere); since then, it was three more; last one some two months ago, which pretty much replicated the PSG1. Very soon, I took charge of my therapy. First, I lost about 1 year, blindly, with a brick CPAP, then, some 1 month more lost with a useless APAP for my flow limitations. Some 2.8 years ago, lights started come in with OSCAR and with the BiPAP auto curve. 
_ In January, 2020, I finally got my tailored parameters (by using the Resmed protocol for S-mode) with the BiPAP, as well as my great deception: since this time I have always zero in p95% collun, and < 0.1 (zero most of the time, likewise) in maximum flow limitation collumn. Yet, I started observing I could not go smooth through my my REM stages (I think I know very well where these stages are in my waveforms, very similar to yours, based on my aspects of FR, TV, MV, RR variability, and so on, audio recording of some my nights, and calibrations with my PSG's outcomes);
_ I also, maybe like you, have bad anguishing dreams/almost nightmares, easily remembered almost all nights, when my stages are interrupted, right coiciding with peak on those bad dreams;
_ Summarizing, for while, my residual drawbacks on RLS and UARS, keep being too many arousals, awakenings, and interrupted (very often) REM stages, even with no any flaggeed FL, or just minor flow restrictions (say, 20%). Without BiPAP, things become hell quickly,  though. Without 0.4 mg of Clonazepam (see graph attached), I usually could go betweeen earth and heaven, and, definitively adding the 0.4 mg, I am pretty much always in heavens;
_ Main questions: what causes these arousasl/awakenings during REM? bad dreams come first and provoke them? a very sensitive simpathetic too  much used all those 47 years?...still don't k now, reason  why I have decided to go back posting here.;
_ Recent consults with my ENT he asked me my last PSG (replication of the first one), pretty much; as well brain mapping wave analyses done, nothing significant there;
_  He also asked me for a tomography, which indicated some cysts and polyps somewhere in nosetrills, for which I could go or not for a surgery. I have a great doubt on this currently; I saw your surgery looked not produced some good results. That because I am doing very well with FFM air fit f20, no congestion at all, no mouth breathing, etc.

all the best and good luck

P.S: Those pictures below I took for something post in a RLS Forum. Please let me know if want see some more details of my waveforms, etc. Not much time left for today, and anxious to see your, Geer1's and others opinions in my case. Many thanks


Attached Files
.pdf   REM pattern and Clonazepam_de-2021.pdf (Size: 876.17 KB / Downloads: 12)
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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RE: Switched from APAP to BIPAP
.....Just to let you all know this long post, right above, was intented to put in perspective something on my case that could eventually have some analogy and help on AmirKas'. I am aware of hijacking issues, etc. I am going probaly open further and more complete discussions on my REM drawbacks in my single thread in this Forum.
Good luck
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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