First Sleep Test

[OwenTrantor]

Hi all,

I've just had the results from my first sleep test (Watch PAT + chest probe) and the results seem pretty alarming. I've always known that I snore loudly and had sleep apnea but these results seem pretty horrendous? I'd appreciate your thoughts!

Many thanks,
Owen

This study shows an AHI (number of apnoeas and hypopnoeas per hour in bed) of 102.8

events/hr. Many of the respiratory events were associated oxygen desaturation. The ODI
(oxygen desaturation index – number of drops in oxygen saturation >4% per hour in bed)
was 97.8 events/hr, with a mean SpO2 of 84% and a minimum SpO2 of 51%, there
was suggestion of hypoventilation. The mean pulse rate was 94bpm, with a maximum of
138bpm and a minimum of 46bpm.
Within the limits of this study the sleep architecture demonstrated increased light sleep.
Sleep efficiency was moderately good at 92.81%, with 11 wake episodes during the night.
Heavy snoring was evident during the study, with 50.4% of snoring reaching above 45dB,
and a mean snoring level of 47dB.
In conclusion, this is abnormal study in a symptomatic patient, supporting the diagnosis of
Severe OSA and possible hypoventilation. Current evidence suggests treatment is most
likely to be beneficial in people with moderate or severe OSA. A trial of continuous positive
airway pressure (CPAP) therapy may be appropriate. The patient should seek urgent review
by a specialist for further investigation and management.

   
   
   

[OwenTrantor]

Hi all,

Just to follow on from this, I've just ordered the Airsense 10 Autoset CPAP and the AirFit F20 CPAP Mask.

I'd appreciate any pointers towards initial settings to use with the machine.

Many thanks,

Owen

[Jay51]

Those results look pretty wild (all over the board).  Download OSCAR and upload some charts so everyone can see what is going on.

[Sleeprider]

Good choice of machines to treat your problem. It may come with default settings of 4-20, but I recommend you set minimum at 7.0, maximum 14.0 and EPR full-time at 3 and see how that works out. I'm not a big fan of full-face masks, and you sleep prone a lot. A FFM will not be good considering your sleeping position, and the FFM is bigger, heavier and moves more with pressure changes. Get an Airfit P10 nasal pillows. They are inexpensive, and if they work, you will never look back. The thing about good CPAP therapy with a nasal interface is that it enables proper nasal breathing, even if you think you're a mouth breather. I realize it's a bit of risk, but you may thank me or hate me later.

[OwenTrantor]

Hey all,

Thanks for your help so far! 

Interesting comments regarding the P10 Nasal Pillows! I'm a massive mouth breather so thought nasal options would be no use for me, but if you think that there's a chance that it might work I'll order that too!

[mesenteria]

Probably two or three out of every 10 CPAP users has a problem with mouth breathing when they are asleep.  Some quite a bit more than others, and those who simply cannot keep their lips closed sufficiently have to resort to either chin straps or to medical grade tapes.  I use tape, and so do many others who come to this forum even only somewhat frequently.

The tape sounds almost ridiculous as a solution to many, and it's understandable.  However, once you learn how to apply the tape, and which one works with your skin best (they're not all the same!!), you'll simply accept the tape as part of your treatment.  I do.

3M makes several good tapes.  I use the blue coloured, plastic tape described as 'strong hold'.  If you clean your mouth before adhering it in place, and then take up to a full minute to slowly peel it off your skin next morning (allowing the adhesive to part with your skin and not be left behind on it), you can actually re-use that strip several times.  I have gone up to five times, but only once. It's usually four.

There is a tape I haven't tried called Somnifix, if I have that recalled correctly.  Many use it here.

In a pinch, you could just use a length of the typical surgical tape found in inexpensive First Aid kits.

If you elect to try this, and I think it sounds like you'll have to, fold over 1/4" of one end of the tape on itself to serve as a quick-grab tab.  If you ever awaken and have to remove the tape in a hurry, that tab will be mighty hand.

Remember, clean around your mouth before applying for a good seal and if you penny-pinch.

[OwenTrantor]

Thanks so much everyone for the advice so far.

I've ordered the P10 Nasal Pillows and for now will try a chin strap. If I can't get the pillows to work I'll switch to the FFM.

I'll post my first night results once I have them.

I owe you all a beer!

Cheers,

Owen

[Jeff8356]

Owen,

Another option would be to try a hybrid mask like the F30 (although ResMed considers it an FFM). It goes under the nose and covers the mouth.
The Mrs. loves the P10, but it didn't work for me. Turned me into a mouth breather while asleep and I can't use tape (allergy), and a chin strap didn't work, so I settled on the F30 and haven't looked back since.

Whichever one works best for you is all that matters....

[Sleeprider]

Starting minimal and going from there will give you options you may not have realized. We're all about making this as comfortable and unobtrusive as possible. I guess we'll know is a couple days. Good luck!

[Dormeo]

Hey, I want a beer too! So here are some thoughts about how to breathe through your nose at night.

1. Tongue position. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar

3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar. But see whether the chin strap you order works for you. I hope it will.

4. Tape. Some people (including me) rely on tape to keep the lips from opening. (I can't rely entirely on the tongue thing.) When the lips open, all too often that eventually leads to a noisy and disruptive mouth leak. To see whether tape would be feasible for you, I recommend that you invest in a box of Somnifix strips. (Mesenteria remembers correctly.) They are very gentle on the skin but hold very well. Be sure to curl your lips inward per instructions before placing the strip. If these work for you, then you can experiment with lower-cost options.

5. Finally, if you have a stuffy nose, try using Flonase before bed (takes a week or two to kick in), and try nasal rinses like NeilMed. If your nose is still stuffy, try seeing an ENT if you can to see what is going on.