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Obstructive apneas before falling asleep
#1
Obstructive apneas before falling asleep
Hello everyone,
I am a new member and have been on ACPAP therapy for about 20 days.
Sorry for my bad English, but I'm Italian and I use google translate.
I have a lot of difficulty getting used to the mask. I first tried an F&P Simplus mask that was provided to me for titration.
Now I am testing the Airfit F30i and it seems to me that it is doing better.
Initially I could not sleep for more than 30 consecutive minutes by waking up with a dry mouth (mouth breathing). I started using a gel and now I have reached about 2 consecutive hours and 3 times a night. I hope to be able to improve these results.

My problem is that I have a lot of obstructive apneas before falling asleep or soon after. This does not happen in the first sleep period, but only in the following ones.
During sleep, apneas are infrequent or absent.
I had started with a pressure of min 11 max 14.20
I tried to increase the minimum to 12.40 and the maximum to 14.60 to reach a higher pressure before falling asleep but the result does not change.
Can someone help me?


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#2
RE: Obstructive apneas before falling asleep
ditch the F30i mask and get a F&P Vitera... gotta have less leaks. Leaks mean less therapy.
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#3
RE: Obstructive apneas before falling asleep
Welcome to the forum.
Increase your min pressure to 13 ( I expect to raise it further to 14)
Increase your Max pressure to 20 (this is to give you room for pressure adjustments and your pressure is not increasing out of control)

Leave EPR = 3 fulltime, that is helping a lot.
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#4
RE: Obstructive apneas before falling asleep
These are the 3 periods you mean, correct?
23:36-23:45
2:15-2:35
4:20-4:40

Do you believe that you are awake or asleep? 

The machine reports many leaks during these periods. If you are awake, can you tell us what is going on with the leaks? What do you hear? Is it loud or soft? If it is loud, does it sound like a motorcycle engine or a trombone?

Your mask may be the wrong size for you. You may have it on too loose or too tight. Every person's face is different, and so what will be a good mask for you will be because of your own unique shape and size.

You may be doing something that causes one of the magnets to pop off.

When you are awake, then the apneas and hypopneas mean completely different things than when you are asleep. When awake, they could mean talking, or that you are holding your breath while you adjust the mask trying to get it to stop leaking.

Using the machine is still very new to you, and so there are things that you are going to have to learn from your own experiments.

If the mask you have is the right size and shape then you need to adjust it better to eliminate the leaks. But if it's just wrong for you then you will need to experiment to find a better mask for you.
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#5
RE: Obstructive apneas before falling asleep
Thanks Cathyf.
Yes, the three periods you mentioned are the minutes before I fall asleep and I'm probably trying to fix the mask.
I think the mask is the right size: in fact, when I fall asleep the apneas disappear almost completely.
I'll see if I can get used to it, otherwise I'll change my mask.

(05-10-2021, 07:47 AM)Gideon Wrote: Welcome to the forum.
Increase your min pressure to 13 ( I expect to raise it further to 14)
Increase your Max pressure to 20 (this is to give you room for pressure adjustments and your pressure is not increasing out of control)

Leave EPR = 3 fulltime, that is helping a lot.

I thank you for the answer.
As I replied to Cathyf, the apneas indicated in Oscar occur when I am still awake or just before falling asleep: when I fall asleep they are very few.


If so, should I still increase the maximum pressure to 20 and the minimum to 13-14 if I am still almost awake?
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#6
RE: Obstructive apneas before falling asleep
swallowing, coughing, turning over, can throw a OA flag. It's important to be in the transition to drifting off when you climb into bed.

If you're not sleepy as you climb into bed, prepare yourself. I eat a light snack, drink chamomile lavender tea, and take melatonin, 3 mg.

Don't know your meds you're on, so check to see if you can take melatonin. Diabetic? High blood pressure? etc....
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#7
RE: Obstructive apneas before falling asleep
You could go either way. My thought was that the higher initial pressure may be more comfortable allowing you less time to actually fall asleep.
The max 20 wouldn't hurt you either way since you are not trying ti plow through your set max pressure. If you do we simply turn it back down.
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#8
RE: Obstructive apneas before falling asleep
Your chart has the signature clustering of chin-tucking. We have a couple wiki articles that can help you understand:
Positional Apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar http://www.apneaboard.com/wiki/index.php...cal_Collar 

For some reason, your clusters of obstruction occur early in sleep onset. then goes away. It could be your pillow is too tall, you have other issues with the mask, but it is positional chin-tucking.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#9
RE: Obstructive apneas before falling asleep
Hello everybody
I followed your advice and in the last few nights I did some tests and I am very satisfied with the result.
In particular:
1- I raised the minimum pressure to 13.40 and maximum to 15.00, as suggested by Gideon
2- I used a lower pillow, as suggested by Sleeprider
3- I realized that apneas in the pre-sleep phase only occur in the supine position: now I fall asleep and sleep on the side
4- I'm getting used to breathing through my nose and I'm solving the problem of dry mouth

I got used to the AirFit F30i mask and I find it much more comfortable than the F&P simplus I tried, especially due to the lack of the tube in front of the face and the free nose.

The only problem that remains is that I sleep for about 1 / 1.5 hours and then wake up.
I cannot take melatonin as suggested by Sleepinwell because I have borderline blood sugar.
I'll ask my doctor for a sleeping pill ...

Thanks again everyone


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