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

[Treatment] 28 days into CPAP - OSCAR feedback please!
28 days into CPAP - OSCAR feedback please!
Wave Hiya from Arizona,

I'm 28 days into CPAP therapy and need help optimizing treatment. 

44yr old male, 5ft'9in / 167 lbs

My presenting complaint @ sleep study: 
- tired most days w/ brain fog (for a few years)
- ever-hungry for one or two more hours of sleep, but rarely able to resume sleep after the ~ 6 hour mark.

Lo and behold, the one-night (split) polysomnography yielded an OSA diagnosis with an AHI of 26 (worst on back, then left side, lowest on right side - AHI 10). 

Provider said I had significant disruptions in sleep stages during first 2 hours baseline: my N1 was good but I lingered longer in N2 and N3 and never progressed into REM at all, due to apnea. Disruptions lowered my oxygen to 78% at times (total time below 88% was 2.4 min). 

Lots of movement in limbs during baseline 2 hours. Then, AFTER CPAP added - (nasal pillows), next few hours were API 2.0 and complete resolution of limb movements, heart rate and EKG variability was normal, and I entered REM for 15% of the remaining sleep time on nasal pillows pressure=7.

Got my Airsense 10 shortly after the sleep study and have used it nightly for 28 days with varying subjective results. Mouth-opening has been a problem for me. Chin strap didn't work. Mouth tape mitigates the disruptive sounds of mouth-opening, but when the back of my tongue or jaw relax in the slightest, the lip seal isn't enough to keep me asleep; I sense the air accumulating and exiting my mouth (softly, through the porous tape, but enough to arouse). This, combined with a night or two of "rainout" in the hose, caused me to go into the clinic and try a mask with greater coverage than the Airlift P10's. 

The respiratory therapist gave me a Fisher & Paykel Evora Full Face Mask (cradles under the nose, with mouth coverage)--similar to F30. 

I've had mixed quality nights on this mask, mainly due to strap-adjustments and such. I finally have a knack for fitting it properly now. 

There was condensation in the mask last night, which hopefully resolves tonight w/ the addition of a warming hose (I keep my room very cool).

I'm open to all general feedback. But my specific questions are:

1. OSCAR SEPT 15 ATTACHED: Last night (Sept 15) - I increased my pressure from 7.0 to 7.6, hoping to lower my API's which have varied from 3 to 11 (generally under 6). I've inferred that the second half of my nights typically have higher API's than the first half. I know this because when I wake up to pee at the midpoint of night (less often now, since CPAP), my API is one thing, and by morning it's twice what I saw, or even more than twice, meaning the second half of the night must've been considerably higher to push up the average by double. 

I went to bed last night with my Airlift P10 pillows and couldn't fall asleep. 90 minutes elapsed. So I switched to my face mask and from that point slept 6 hours.

I noticed the machine displayed an AHI of 11-12 at the 90 minute mark on the pillows. But I hadn't fallen asleep yet (to my knowledge). 

What went WRONG with the first portion of my sleep/non-sleep (nasal pillows)? 

Maybe the extra coffee at Noon (bad!) delayed sleep onset? I normally don't have trouble with onset. 

What is that cluster of clear airway events as I was trying (but unable to) fall asleep?

What went RIGHT last night with the second portion of my sleep (face mask)? That part felt restful! I would like more good segments like this.

Note: when I switched out the pillows after 90 minutes of no sleep, I took a second low-dose Lorazepam (0.50mg). I normally only take one before bed.

Tonight, I hope the slight increase in pressure I made to 7.6 + more familiarization with the new mask + the warming hose (starting tonight)--will allow this restful six hours to be replicated, and elongated.

2. OSCAR SEPT 14 ATTACHED: Night before last (Sept 14) - this represents a typical night with the Airlift P10 during the first ~28 days of my CPAP journey. First half of the night is OK, both AHI-wise and subjectively, but when I fall back asleep for "round two" my sleep is plagued with more events and wake-ups (from what I perceive as numerous jaw relaxation episodes that cause noise or sensation-based wake-ups). What do you see in the data? Does it support my perception?

Thank you very much!

Attached Files Thumbnail(s)
Post Reply Post Reply

Donate to Apnea Board  

Possibly Related Threads...
Thread Author Replies Views Last Post
  OSCAR Results - Would love feedback and support! anyadee23 3 84 10-05-2022, 05:46 PM
Last Post: Crimson Nape
  Failed Cpap and Bipap, would love some help with Oscar info! Ryanns 2 226 09-01-2022, 10:39 PM
Last Post: clownbell
Sad [Symptoms] Still Tired on CPAP - Suggestions Based on OSCAR Data? happyhurry 1 264 08-27-2022, 08:40 PM
Last Post: Melman
Smile No sleep with APAP after 5 days, any advice? Darkpunchedstars 12 833 08-02-2022, 01:16 PM
Last Post: joepublic23
  AHI still high with CPAP. OSCAR data included. jakeroviks 0 231 07-18-2022, 07:39 PM
Last Post: jakeroviks
  OSCAR Data 1st 9 days of AirSense 11 FirstNoele 2 244 07-10-2022, 02:54 PM
Last Post: FirstNoele
Question First Night CPAP Oscar Data - Please Advise! alwaysdragging 1 434 05-23-2022, 09:50 PM
Last Post: Bobbob

New Posts   Today's Posts

About Apnea Board

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