Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Switched from APAP to BIPAP
RE: Switched from APAP to BIPAP
I am most interested in the nasal mask test, as you note if feeling better without CPAP it may not be helping and a reason for that could be the FFM being a source of issue.
Post Reply Post Reply






Donate to Apnea Board  
RE: Switched from APAP to BIPAP
I will use the mask tonight. I did want to reply to a post you made around a month ago which makes me suspect the issue is breathing-related.

This is what you said:




"Amirkas as I mentioned before I believe those tidal volume swings are the periods where your sleep quality is poor. Flow rate and TV charts like that are not normally seen in members on here (believe I previously worded it as those periods being specific to your case).


It appears to be arousals that spike the change in flow rates and it seems you have continued arousals that keep your flow rate in flux. Like QAL commented you appear to be "awake" for much of these periods although if that was truly the case you should be aware of these periods of being awake. It makes me think it is more likely you are bouncing around in light sleep and not cognizant of what is going on but not getting good sleep. I was hoping your titration study you had done would comment on findings that would explain this but it didn't indicate an issue breathing or sleep in general which kind of surprised me since this occurs every night in your CPAP data. 

I don't think this is caused by breathing issues although there is potential for it. The one time we see somewhat similar flow/tidal volume rate fluctuations is in central apnea cases where there is periodic breathing because of the fluctuating respiratory drive. I have wondered if that is what goes on with you and it could explain why those periods seem more pronounced when you use higher PS. 

It may potentially correlate with sleep patterns but it often happens during your initial transition to sleep which would indicate it is NREM/light sleep and not rem sleep. If it correlated with a rem sleep period I would have more inclination to obstructive/restrictive issue, but being NREM/light sleep I think it closer fits a central apnea type effect like say sleep transition central apneas. Fyi central apneas rarely occur in REM sleep and your "apnea" (central or obstructive) almost always occur during these periods of poor sleep. I think a lot of them if not most of them are sleep wake junk but it is too hard to tell as there is no clear indicator as to what is causing that poor breathing/sleep. Because it seems like it may be central in nature is why I pushed to get you to try the lower pressures and PS which seems helpful so far (just not too low that the flow limitations become an issue).

The main breathing test that I have been curious to try to see if it improves these periods is the nasal mask test but that keeps getting put off due to nasal congestion issues so it seems you need to find more relief from nasal congestion before we can focus further on breathing."





According to my watchpat sleep study done half a year ago, my events seem to populate mostly during REM sleep. How accurate this is, I don't know, but it seems like an important piece of data. Coupled with my symptoms, I've been suspecting UARS more than standard OSA which I believe would cause those kinds of TV / MV graphs to occur (prolonged breathing effort?). I understand that UARS is a subtype of OSA, but its symptoms seem to differ in a couple of key areas.

I am investigating all other options related to my gut and inflammation to see if those can mitigate my symptoms. One thing to note is that my symptoms have gotten better, but there is still a lot of improvement that can be made.
Post Reply Post Reply
RE: Switched from APAP to BIPAP
So I tried using my nasal mask (N30i) for the first time last night, and while I still feel awful, here are the results on Auto mode with min EPAP 7, max IPAP 14, and PS 4. So far these results have a more consistent flow chart than essentially any flow chart with a FFM on it.

   
Post Reply Post Reply
RE: Switched from APAP to BIPAP
I've used the nasal mask again, and it caused major irritation to the bottom of my nose so I ultimately took the mask off. Still feeling fairly awful.

Are there any nasal masks anyone can recommend besides the n30i? 
I normally sleep with a partner who likes to cuddle, and she's sensitive to noise.
I also move around a fair amount in my sleep and sleep on my side. 


Here are the results from last night by the way:

   
Post Reply Post Reply






Donate to Apnea Board  
RE: Switched from APAP to BIPAP
It is hard to tell for sure but it does seem like these flow rate charts might be smoother than with the FFM. Still getting some of the ragged looking breathing but somewhat interestingly it seems to correlate with mouth leaks so may be related to mouth breathing like I was wondering about.

I really like the F20 because it is so quiet. Most nasal masks are louder and vent more although the N20i you tried is bad for both.

Lots of people like the P10 mask because it is small and light. It is less intrusive and less noisy than the N20i but similarly it can irritate nose until you get used to it (can take a while). An N20 is kind of similar to F20 but more noise/vent and probably would help with nose irritation. I had trouble getting it to seal well but might work for you. Getting used to a nasal mask can be tough especially if you already find the F20 quite comfortable.
Post Reply Post Reply
RE: Switched from APAP to BIPAP
When using therapy, my best mask brand was Fisher and Paykel. So far, I've got the full face Simplus and Vitera. On their New Zealand website, there's a new hybrid mask soon to be released there and later here. I think it's called Evora plus or something like that, it's not the standard Evora already out. I'd consider giving F&P a look to see if there's something suitable for you. My biggest like about these F&P masks is the RollFit bellows on the cushion to make leak control easy, not really upset with movement, and a bonus of high comfort with low strap tension requirement.
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.
Post Reply Post Reply
RE: Switched from APAP to BIPAP
Try the P10. It was very disruptive as my wife kept asking me awake to make sure I was still breathing since she couldn't hear me breathe as she could hear with other masks. That quite enough?
Post Reply Post Reply






Donate to Apnea Board  
RE: Switched from APAP to BIPAP
I'll definitely pick between the p10 and another mask. I wanted to ask if there were any nasal masks (not pillows) that also fit the criteria. Taped my mouth last night and I'm pretty sure I had a hard time breathing due to the mask fit. Had to take the mask off because of that.

Here are the results from last night by the way:

   
Post Reply Post Reply
RE: Switched from APAP to BIPAP
The N20 I mentioned is similar to F20 in style but only covers nose.
Post Reply Post Reply
RE: Switched from APAP to BIPAP
I ordered the Fisher and Paykel Eson 2 since I've heard many good things about it. In the meantime, I'll refrain from making additional posts till I get the mask.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Pressure] Help with dad's APAP to BPAP transition electric.sheep 5 104 10 hours ago
Last Post: Sleeprider
  [Treatment] Ontario Canada Resident--Prescription for APAP, or ASV machine? DaveL 13 297 12-05-2021, 05:11 PM
Last Post: DaveL
  when should I replace my Bipap machine ckingzzzs 2 122 12-01-2021, 12:34 PM
Last Post: Sleeprider
  Feeling even more tired with bipap skyuser37 11 451 11-21-2021, 12:05 PM
Last Post: Dormeo
  BiPAP ST to ASV - Optimizing fikus56 117 2,921 11-19-2021, 11:00 AM
Last Post: SarcasticDave94
  Still Having Centrals—even on APAP (Graphs Included) eddie19852004 15 377 11-10-2021, 09:35 AM
Last Post: SarcasticDave94
  Understanding APAP Pressure Ranges upsman 4 236 11-04-2021, 12:33 PM
Last Post: quiescence at last


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.