Kbarnes - Therapy Assistance

[jdougc]

super7pilot  ,expect some drool at first and a time or two .
https://www.youtube.com/watch?v=1u_S1ADwVmA

[Kbarnes]

So im new here i just made a post asking for help with still feeling tired after cpap useage and the other users was kind enough to give me recommendations an overview of oscar red flags and a good video about it. Ive watched a number of videos now and while i understand what the graphs mean for the most part now i dont know how to find out if i have a "good"score in the various measurements. If someone could take a glance at my oscar graphs for the past 2 days i would appreciate as even though my ahi is supposed to be low enough to be normal i still wake up feeling like death. Thank you

[ejbpesca]

Hello.  I am not an expert but I do have a few years of experience with OSCAR and 18 with APAP therapy.  I notice these things about your reports:


1.  The pressure stays quite a bit over your minimum pressure setting of 8 and stays below the maximum setting of 20.  8 and 20 are the common settings my DMEs (who provide my gear) set for my machines.  I then change them to better suit my apnea as I have no help from a doctor or the DME.  I have gotten help on this forum.  Someone will reply soon with more expertise than I and possibly suggest pressure settings.

2. The CA flags are Clear Airway apneas that may reduce as you become accustomed to your APAP therapy.  How long have you been using your AirSense 10?

3. You have 0 Obstructive Apneas on 5/28.  That's as good as that gets.

4. Flow Limitations are up higher than many want to see them.  You already have EPR at 3 which is often suggested to help with Flow Limitations.  I have them for reasons other than what PAP therapy can help and they disturb my sleep.

You will often read that <5.00 AHI is the standard for good therapy.  Many, like myself, disagree.  It is 1.00 and under when I feel less tired during the day.  Even with good PAP therapy, many things can cause unrestful sleep.

[ejbpesca]

I use an F40 ResMed mask after 17 years with Full Face Jet Pilot style masks.  The F40 has made a big and good difference for me.  It inflates my nose like described from pillow masks while I nose breathe then when I mouth breath it acts as a Full Face mask maintaining pressure.  I cannot use a pillows or nasal mask due to mouth breathing.  All the suggestions to stop mouth breathing failed for me, but have worked for others.

I have been getting some very low AHI scores lately by making some adjustments to my AirSense 10 and using the F40 hybrid mask.  If pillows do not work out for you the F40 is an option.

For years I would get a good day once every few weeks.  I have been getting many more from the F40 mask and after making some adjustments to my machine.

[Kbarnes]

Thank you for your insight. I will look into what you pointed out. I have been using my cpap for well over a year now. I have made a real effort to have good sleep hygiene as well to no avail. I will also seemingly randomly have issues with swallowing air and waking feeling bloated on top of feeling tired which is what made me reluctant to raise the min pressure any higher though i could be wrong about that line of thought. Thank you again im flailing here

[super7pilot]

jdougc, Where did you find the SomnoSeal insert? I didn't see it at Amazon.

[Kbarnes]

Suctions your tounge forward?!

[ejbpesca]

I had to bring my min pressure down from where it needs to be to stop swallowing air.  It is a problem for me.  You machine is doing a pretty good job of getting the pressure up and keeping it where it needs to be.  If mine were that stable I may have left it at 8-20.  My Max pressure was spiking causing many Large Leaks so I lowered it.

Swallowing air is called aerophagia.  It is a problem that can ruin my sleep, wake me, and exacerbate my acid reflux causing acid pain.  It is another reason for my minimum. pressure is lower than it should be by 1.2 cm. My min is up from 8 and my max is now from 20 to prevent leaks and aerophagia.

There are mask options some may suggest here.  I am using the F40 and have gotten high improvement from it.

Others with more expertise here may reply soon.

[Kbarnes]

ahi went up slightly and Hypopneas and central apneas suddenly going up. All of the sudden CPAP stop working for me and started giving me terrible brain fog and  feeling terrible when I wake up. Several days in a row. I tried turning epr up by 1 and that seem to make it worse. My osa is always .2 or under usually 0. I've been sleeping without my CPAP for the last few days and while I feel tired it's nowhere near as bad as whatever my CPAP is doing to me. The only difference I can think of would be the change in weather as it's been getting warmer outside. If anybody knows what's going on from experience I would appreciate some help. Thank you

[jdougc]

Kbarnes, please don't start new threads as we need to see your history. Sorry to hear you are having trouble.
Are you cleaning the exhaust ports on your mask, they can get clogged over time

Can you post a copy of your sleep report with your personal info redacted?
Are you on any medications that may affect your breathing or your sleep?
Do you have any health issues that may affect your breathing or your sleep?
Any changes in your medications or health issues lately?

Please post a few Oscar charts and post a few zoomed in charts of your wake ups.