help, way too many leaks last night

[retired_guy]

Been gone all day so I haven't been able to check up on you Clem. Thanks for posting your stuff. I believe you are on the right track doing what you are doing. I would like to see your OA's come down a little, and I think raising your pressures a tiny bit at a time might help. But it's also true that you need to give a little time for your body to get used to what you're doing now before you continue on. The problem with additional changes is it could result in your CA's deciding to go higher, and that would be counterproductive. So for tonight, I would suggest you leave everything alone. I would also suggest, if you're not doing it yet, put something under your mattress or at least under your pillow to bring your head up a little. (Maybe a cat? Or one of those banana splits?) It would be best if you sleep on your side for now as well.

I'm not opposed to you increasing the range, and that means both the bottom and the top, perhaps as much as to 8/13, but I think you need to wait a day or so.

[Clementine]

Do you have some indication that the masks is getting moved around and that is what is causing the leaks? Do the leaks wake you up and do you find the mask has moved out of position?

If the answer to these questions is no, then I would suspect (once again) that you may be mouth leaking especially if you did not wake up and readjust your mask to end those leaks.

Best Regards,

PaytonA

Yeah, I have a lot of indications that I'm moving and therefore the mask is moving out of position. It often wakes me up. Hubby tells me I'm travelling all over that bed, LOL, and I always have done so. How he gets any sleep, I dunno.

So, I've been spending most nights in my daughter's bed while she's away at college, as I get used to this machine. An occasional night in the recliner.

RG, yes, I use THREE pillows; last night I also used a ... cannot think what it's called ... something to prop me up when reading. Used that under my 3 pillows. So, I'm pretty elevated at night. Started that years ago when I could not breathe and would wake up almost choking. And started sleeping on my side years and years ago. That was when the apnea started.

Thanks to EVERYONE here for all of the info and support. I need to send out some big hugs to y'all. (((hugs))) And some banana splits -- but not near bedtime. LOL

[retired_guy]

Speaking of your girl child, how's she doing at college now?

[PaytonA]

While you have been sleeping in your daughter's bed, have leaks awakened you?

[Clementine]

Yes, the leaks do awaken me. Not all of the time but a lot of the time. I woke up several times last night.

Daughter is doing well in college so far. She is a freshman. She's only about an hour from home, so that's nice. She is attempting to get used to dorm life and having a roommate and eating college food. LOL She is in the honors dorm and some of her classes are in the building that is attached to her dorm with a skywalk. Sooo nice! I was not an honors student and not nearly so lucky . . .

[Clementine]

just for fun, posting last night's charts:


So, here's something I've been thinking about:
since my IPAP number is running consistently up there near the top number I've set (13); pretty much all night it's up there by the 13, does that indicate that I need to raise the IPAP even more? In other words, should my IPAP number NOT be running that close to the max number?
(not sure I expressed my question that well -- let me know if I need to clarify)

[retired_guy]

You could raise the range a bit. But just a little bit. Maybe not more than 1/2 a point?

You're leaks were a little out of line last night weren't they? Mine were as well, so maybe it's something in the air. My ahi came in at .33 which is the highest it's been in awhile, so I figure it has to do with the leaks more than anything else. I also think that's the case with your night last night.

I know lots of times I tell you your leaks are no big thing, and usually they are not. But last night they were a little higher than they should be for a predominant part of the night.

So continue to work on that.

In my case the problem was two-fold: One, my chinstrap sort of came off without me knowing it. Two, the smallest puppy decided she wanted to sleep on my chest all night. I'll work on the chinstrap issue.

Just continue to evaluate your situation and what has changed. I believe for instance you went to a smaller pillow size because you felt like it fit you better? Might want to rethink that.

[Clementine]

well, okay. I have the large mask; I just don't like to think that I have a large nose. I have used the large mask some nights and it does feel comfy in that it allows even more air through. But it was slippin' all over the place. It didn't seem to feel like it had sealed at all. And I tried the lanolin -- and that, IMO, makes it more slippery. I don't know.

I will try it again.

So many variables! And I agree that only one variable should be changed at a time, and one should wait and watch. It's so hard to wait and watch. But then one gets more info about what's working or working better that way. Sometimes I'm just not that patient.

LOL about the puppy. My pup wants to sleep right next to me, as in - glued to my side. She only sleeps in bed occasionally, though, thank goodness. She is like a little heater next to me, and I don't need that. I have my own internal heater that flares up on a regular basis.

Okay, that sounds bad; don't go there. Just meant that I have hot flashes a lot. LOL

[Clementine]

<sigh> here's last night:

[retired_guy]

Darn it Clem, what are we going to do with you? Ok, you raised the range just a little. But the leakage got worse too. Did you go back to the large pillows last night?

Your AHI graph does not appear to be influenced by your leakage. The AHI climbs in the night at times when the leak rate is good, which would seem to indicate you are sound asleep for that period. But if you were to raise the range much, which you may need to do to knock down the OA's, then the leak chart will will go through the roof. So what to do?

I was encouraged to see your CA's came down in spite of your range going up. So that's a good thing. That suggests you could raise the range a bit more without a major problem.

I still think the problem is with the pressure support. It still seems to me like there is too much room between the epap and the ipap, and you're topping out too soon. That suggests you should raise the whole thing by another point, but I really want some others that are more familiar with this machine, like Vaugh for instance, to weigh in on this first. I also still think the right thing for you might be a fixed cpap of around 14 for awhile until you get everything (leaks for instance) calmed down.

Maybe it's time to reach out to the sleep doc? I don't remember if you have one of those worth shooting or not.