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First night with nasal mask/tape, check my charts please?
#21
RE: First night with nasal mask/tape, check my charts please?
(05-01-2023, 04:32 PM)Uphold9887 Wrote: So my oxygen concentration doesn't seem to be a concern at these levels?

I wouldn't be concerned with O2 staying at 90 or above or brief dips slightly below that.  Movements while you're sleeping can compromise the contact of finger o2 monitors and affect the readings, AND they lose accuracy below 90 anyway.  If the changes you've made both on your machine and in sleep aids are starting to move your numbers in the right direction - things are getting better, I'd suggest keeping things as they are.  If you reach a plateau and still think you need to make adjustments, then you can try some more adjustments.  Changes should be incremental - one thing at a time so you can isolate the effect and see if it was helpful.  You should probably assess over several nights, since there can be significant variability night to night.
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#22
RE: First night with nasal mask/tape, check my charts please?
(05-02-2023, 11:03 AM)Uphold9887 Wrote: After reviewing the clinician's menu, it seems I can only change min and max pressure, and the EPR value.  So I'm simply adjusting pressures upward again?  I left settings unchanged last night, and O2 sats were slighly improved (nothing below 90%), however still fairly fatigued.  I also dialed back on the melatonin and magnesium which I think may have helped somewhat.

Here's last nights data (with oximeter imported):

 

Too much melatonin can actually cause you to wake up in the middle of the night. I'd highly suggest sticking to the recommended dosages from studies. More is definitely not better. I'd start with 0.3mg melatonin and then increase that up to 1mg at most. I'd also consider some lifestyle interventions to naturally increase your melatonin production and be more tired at night. For example exercise, no blue or bright lights 1-2 hours before bed, not eating 3 hours before bed to see if you can be more naturally tired.

My subjective experience with too much melatonin is that i'd wake up in the middle of the night and i'd be excited and happy. I'm not a doctor FYI so take this with a grain of salt. Serotonin is a precursor for melatonin, which means serotonin is used to create melatonin in the body. In these types of interactions it is possible that supplementing melatonin can increase your serotonin as your body doesn't need to create it's own. Which seems to align with what i've experienced.


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#23
RE: First night with nasal mask/tape, check my charts please?
(05-02-2023, 03:34 PM)cdplatt Wrote: I wouldn't be concerned with O2 staying at 90 or above or brief dips slightly below that.  Movements while you're sleeping can compromise the contact of finger o2 monitors and affect the readings, AND they lose accuracy below 90 anyway.  If the changes you've made both on your machine and in sleep aids are starting to move your numbers in the right direction - things are getting better, I'd suggest keeping things as they are.  If you reach a plateau and still think you need to make adjustments, then you can try some more adjustments.  Changes should be incremental - one thing at a time so you can isolate the effect and see if it was helpful.  You should probably assess over several nights, since there can be significant variability night to night.

Thank you, yes I am going to slow down on the adjustments to the machine settings for now and see how i manage with decreasing melatonin significantly.  


(05-03-2023, 06:34 AM)jerop Wrote: Too much melatonin can actually cause you to wake up in the middle of the night. I'd highly suggest sticking to the recommended dosages from studies. More is definitely not better. I'd start with 0.3mg melatonin and then increase that up to 1mg at most. I'd also consider some lifestyle interventions to naturally increase your melatonin production and be more tired at night. For example exercise, no blue or bright lights 1-2 hours before bed, not eating 3 hours before bed to see if you can be more naturally tired.

My subjective experience with too much melatonin is that i'd wake up in the middle of the night and i'd be excited and happy. I'm not a doctor FYI so take this with a grain of salt. Serotonin is a precursor for melatonin, which means serotonin is used to create melatonin in the body. In these types of interactions it is possible that supplementing melatonin can increase your serotonin as your body doesn't need to create it's own. Which seems to align with what i've experienced.

Thank you, I did not know this about melatonin.  That's very interesting.  I do make efforts to limit screen time and not eat before bed, as well as avoiding caffeine in the afternoon/evening.  I have been off of work for an unrelated medical issue the last few weeks, and so my level of physical activity/exercise is much less than normal.  I think maybe this is also contributing to my difficulty sleeping at night.  Last couple of nights I've taken around 1-2mg melatonin and some magnesium for sleep aid, and I will have some herbal sleep aid supplements arriving this week,so when they come I will try to transition away from the melatonin entirely once again before I make any other adjustments to my machine.
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#24
RE: First night with nasal mask/tape, check my charts please?
Okay, after over a week of messing with this nasal mask and feeling awful every single day, I switched back to the FFM last night.  Melatonin intake is 1.5mg and unchanged for several days.  Brought pressure back down to 8-14.

And guess what?  I feel *so much* better in terms of my fatigue and brain fog.  My jaw, of course, is noticeably worse today.  So I guess, i get to choose between trying to avoid making my jaw worse, and feeling like a braindead sloth every day.  Great choice.  Not like I need my jaw to eat, or anything....*sigh*

Of course, because nothing with CPAP actually makes any sense (to me), my stats are noticeably worse last night using the FFM:

           

Oximeter dropped as low as 86% for a brief period.  18 drops over 4%, 41 drops over 3%.  25 minutes with my pulse under 50/min.
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#25
RE: First night with nasal mask/tape, check my charts please?
And here, for comparison's sake, is the previous night where i used the nasal mask/tape.   

           

Pressures had been upped to 11 min 14max and it seemed to make no difference in how i feel.  Oximeter died around 5am, but for the most part all the stats *appear* to be better....its just i feel awful.  Fatigue, yawning, brain fog all day.

What do i do here?   is there any hope of finding some settings for the nasal mask that will actually let me feel *good*?? Feeling hopeless but I dont want to give up on this...this choice between jaw pain and feeling like a normal rested human can't be my only two options....
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#26
RE: First night with nasal mask/tape, check my charts please?
When you switched back to the full face mask you apparently neglected to change the settings on the machine to indicate you were using the full face mask.  Both nights are showing nasal mask in the stats on the lower left side.  That may have influenced the therapy results using the FFM.

Looking at both nights, despite the reported low AHI number on your nasal night, the O2 desaturations remained high - 15.2 per hour.  There should not be that much difference between your AHI and ODI.  Your ODI was still high on the comfortable night with the FFM.  If those numbers are accurate, it's a bit mystifying.  You may want to check back with a sleep clinic for an explanation if you confirm that your pulse oximeter is reporting accurately.   In the Viatom app dashboard there is a perfusion index number.  It should be above .4%.  If it isn't, you won't be getting accurate O2 readings.  

Personally, if I had to choose between groggy/fatigue and worsening TMJ, there would be no contest.  I'd go for groggy.  Having pain every time you chew, not being able to open your mouth all the way, have a jaw lock open or closed, eating only soft foods - for months - is depressing - though it's great for weight control.
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#27
RE: First night with nasal mask/tape, check my charts please?
(05-10-2023, 12:37 PM)cdplatt Wrote: When you switched back to the full face mask you apparently neglected to change the settings on the machine to indicate you were using the full face mask.  Both nights are showing nasal mask in the stats on the lower left side.  That may have influenced the therapy results using the FFM.

Looking at both nights, despite the reported low AHI number on your nasal night, the O2 desaturations remained high - 15.2 per hour.  There should not be that much difference between your AHI and ODI.  Your ODI was still high on the comfortable night with the FFM.  If those numbers are accurate, it's a bit mystifying.  You may want to check back with a sleep clinic for an explanation if you confirm that your pulse oximeter is reporting accurately.   In the Viatom app dashboard there is a perfusion index number.  It should be above .4%.  If it isn't, you won't be getting accurate O2 readings.  

Personally, if I had to choose between groggy/fatigue and worsening TMJ, there would be no contest.  I'd go for groggy.  Having pain every time you chew, not being able to open your mouth all the way, have a jaw lock open or closed, eating only soft foods - for months - is depressing - though it's great for weight control.

Thank you for your response.  However, I *did* change tthe machine settings to reflect my full face mask.  Somehow my SD cards got messed up when they sent my regular machine in for repair and i tried to use my old SD card in the new machine.  Now, for some reason, OSCAR doesn't show the right settings on the left hand side (and gives the warning in red).  Very annoying but not really my primary problem right now.  Not sure how to go about fixing that.

Unfortunately in the ViHealth app dashboard, I cannot find a perfusion index number.  I have been somewhat suspicious of the accuracy of the oximeter... Not sure if there are alternatives I can find that would be more accurate?  Availability is minimal in Canada.

I have made another appointment with my sleep doctor and I guess I will try to discuss things with him.  I'm not optimistic he will have any meaningful suggestions, but, I guess I can try.  I know that during sleep tests they will not allow me to tape my mouth while using the nasal mask, so I wont be able to make that comparison to see if I'm getting enough oxygen during those periods.


This grogginess and fatigue is extremely debilitating to me.  I already deal with a multitude of mental health issues, which are significantly exacerbated by feeling this way.  When I have a good rest day, I feel so much better mentally.  Not to mention the brain fog,fatigue and forgetfulness is holding me back in terms of being able to make positive life changes with respect to a career and education.  Its a really difficult choice to choose between one or the other.  Right now I'm not ready to give up, I hope there are more possibilities out there to help me resolve this dilemma.

Hoping some others may have some ideas and can chime in as well?
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