[Pressure] Still feeling frustrated/confused after years...

[Mossify]

Hi all. Lost my first post uploading OSCAR data. Perfect example of how Sleep Apnea seems to make everything harder. 

Coming back to Apneaboard in 2024. In 2023, I got diagnosed with Severe-Inattentive ADHD, currently on 54mg Concerta, but still very brainfoggy, still not very functional. Bogged down by chronic pain/fatigue still, can't function. Still stuck in medical gaslighting loop no matter what I do.

At wit's end, feels like being stuck in Limbo when you're doing due diligence but nothing helps.

I can't furnish details (mask, etc. right now). Too tilted.

SLEEP HQ (past 30 days): https://sleephq.com/public/59cfccc9-935f...5eb6a10d10

OSCAR attached below.

Hope y'all are decently ok in 2024. Take care.

[OpalRose]

Mossify,

Looks like your OSCAR image didn't post.  Follow these instructions:

http://www.apneaboard.com/wiki/index.php...pnea_Board

[Mossify]

Thanks for the heads-up. Hope this is acceptable.

Full:    

Daily Reading:     

Device Setting:     

I keep getting told that everything is "as managed as can be", but still feeling like there's things I'm missing.
For e.g. nailing down mouth leaks - I'm already dutifully doing it with medical tape.

15cmh20 was what the Hospital titration study said, no min. value, BC I literally couldn't get to sleep. Deeply traumatic experience. Still feel like it didn't give me much more information to work with. The private sleeptech I've retained insists that we should just go ahead with it, even though I feel like it still gives me aerophagia. Coming up to a month of trying 15cmh2o, still haven't gotten used to it. This day was particularly problematic, BC I feel like I've more nocturnal arousals, not less. 

I've tried to dutifully follow the "give it a week to settle in" rule here, but it's frustrating BC I feel like I'm stuck at the "can't narrow things down stage" - & medical advice seems deeply contradictory. 

Any assistance would be appreciated.

[paulag1955]

Do you know if your initial sleep study indicated that you have clear airway/central events?

[OpalRose]

Mossify,
Your sleep tech was on the right track with suggesting a straight pressure, but since you're dealing with Aerophagia, let's try a lower pressure.  

The procedure for eliminating Aerophagia (the swallowing of air) is to start with a lower pressure and "slowly" work your way up.

Lower your pressure to 12cm.  Use EPR 2.  Try this for 2-3 days.
If no Aerophagia, raise your pressure to 12.4.  Try for a couple days.
If no Aerophagia, continue to raise pressure > 12.6.

Continue this pattern as long as it's comfortable.  If at any time, you're still having problems, then back off by .2 pressure.  This is time consuming, but you should be able to narrow the pressure where you still receive good therapy with no Aerophagia.

Now.... you also need to address the "Positional Apnea" (clumps of Obstructives).
You are either "chin tucking"  or sleeping in a position that is cutting of your air.
Use one thinner, but supportive bed pillow compared to fluffy pillows which could tilt your head into your chest.

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[paulag1955]

And be aware that chin tucking can happen even if you're sleeping on your side.

[Mossify]

Yes, but they're the same 'low' numbers that I have now, so I'm not sure what actually is the extent of Central Events that I'm having.

[OpalRose]

Lower the EPR to 1 and see if that helps with the CA's.

The suggestion to lower your pressure to 12 and titrate up slowly was to help with the Aerophagia. You are currently using a pressure at 15, which may be too high.

[CPAPfriend]

Pillows mask is not working under the current conditions. You're opening your mouth all night, which is likely waking you up and MAY be due to not getting enough air. Overall, your data looks terrible, and there's likely lots of room for improvement. It would be interesting to see your flowrate zoomed-in, because in general it looks quite strange to me from this scale. It's quite all-over-the-place, and the expiratory peaks are very inconsistent. The OAs seem quite clustered, suggesting that they could be due to positional apnea, as mentioned above.

Keep your head up

[Mossify]

Thanks for the advice, will try to act on it.

I'm already using a pretty thin pillow, that's another reason why I don't understand why the blockages are happening. Some have suggested sleeping on a folded towel... that seems to be the last recourse to that. Do I sleep on my back still? BC I can't sleep on my side, with a thin pillow, the pressure is uncomfortable.