Some strange flow rate curves

[DJCpap]

Hello, I recently increased minimum pressure to 9 and got some strange flow rate curves, though overall my apneas decreased. Just wondering about my insp / exp rates as well.  Please see attached. Any help would be greatly appreciated.

Woke up many times though. Also, having issues with mouth leakage despite using Somnifix. Air also puffs out my cheeks. Woke a couple of times with terrible dry mouth and sore throat. I used a chin strap before but that did not work too well and it also pushed my jaw back quite a bit.

[Ratchick]

Re: Mouth leaks and chipmunk cheeks - I feel you. It's worse with pillows but I even get some chipmunk cheeks with a FFM too.

It is something that you can sometimes "train" your tongue to sit in the right position over time (I'm sure someone can link to a post about that that describes it better than I can if needed). In my case, it's because my jaw drops when I fall properly asleep. I can get away with a particular chin strap that both helps prevent my jaw drop and also is snug over my cheeks too, but honestly, I've found a soft cervical collar is way better. So that's also an option, too.

With the odd flow rates, is this all night? Or just a few periods during the night? My flow rate goes to crap during REM sleep and my resp rate triples sometimes, so some of it might be to do with that, but hopefully, some of the others who are better at recognising different things can give you more info.

[DJCpap]

Thank you, Ratchick. Last night I used a headband and Somnifix. I had less leaks and chipmunk cheeks, but it was uncomfortable. 
I have been trying for a year and a half to get a solid 8 hours of sleep, but I wake up so much through the night despite decent numbers. 
Can you recommend a good cervical collar? 
Things go very haywire in REM for me too, so I bet that is where the strange breathing happens.

[Ratchick]

Unfortunately, I'm in the UK, so whatever I suggest is probably not on the US stores, but genuinely, I just buy a cheap (less than £10) soft neck collar, which is basically just foam covered in a tube of cotton and has velcro on both ends. I'm sure there are some reviews if you go down to the Other Product Reviews board. The important part is to measure yourself correctly, but all the info you need is in the board's Wiki.  I did a quick search on tongue positioning, and OpalRose describes the basic method here. But there are a lot of threads that might have more information too. Trying to train your tongue to stay in that spot will help a lot with the chipmunk cheeks too. I'm still working on it, but between the collar and that, I'm mostly okay. I don't wake up with a sudden POP like I'm a puffer fish anyway! 

Question: After this long, is there a reason you haven't perhaps tried a full face mask instead? That wouldn't fix your jaw dropping but the mouth leaks wouldn't matter because of the mask. I have to admit I find an FFM more comfortable than pillows and a chinstrap and tape.

[DJCpap]

Thank you! I will try a collar. 
I am using a nasal cushion now. I started with a full face mask and I swallowed so much air. I still swallow air, but not too much. Also, I have a lot of dental issues and I know that the air flowing in the mouth doesn't help when your teeth are bad. Maybe I should try it again. I know I definitely have some nose breathing issues. I really appreciate your help! I have had some scary chipmunk cheek panic arousals from not breathing. 

Another topic...do you use an overnight pulse oximeter? I was thinking of getting one because I think I may have some desaturations during REM.

[SarcasticDave94]

I've never used a collar yet, but there's been several members that found success with the Corflex Ultra Cervical Collar. From what I recall, it's said the order process is easy and sizing is pretty accurate too.

Here's a review link from Aludj

http://www.apneaboard.com/forums/Thread-...tra+collar

[DJCpap]

Thanks, SarcasticDave! I am gonna try it.

[Ratchick]

I do, yes, because I have truly awful desats (yey for central apnea :/). My personal choice is Viatom/Wellue because I think the ring sensor that they use is way more secure and comfy, but you can always go with one of the Contec versions. The wiki shows which ones will work with OSCAR.

[DJCpap]

Thank you, Ratchick. I just ordered the Wellue SleepU model, only because of my budget. Hopefully there will not be too great a difference.
On days when I take a nap without CPAP, I know my oxygen desats quite a bit because when I wake up, I feel drugged and out of it. I put on a finger pulse oximeter and it says 90% (this after moving around to find it). I just want to make sure it is not dipping too much on CPAP because I do have restless nights even on CPAP.
I really appreciate your help!

[Ratchick]

That's great, that will work well and it's nice being able to look at the data side by side with the CPAP data too.

You should try to start using your machine for all naps too, really, especially if they're obviously making you feel so garbage afterwards. That post-sleep headache and confusion was the worst. Even though my (central) apnea is still woefully undertreated right now, the fact that it's enough to stop most of those is just... bliss. It's what's kept me doing it religiously every day.

I would definitely suggest wearing the pulse ox during the day at some point, just to get some baseline reports of what your oxygen levels and pulse are like while you're awake, so you can get a good comparison. For me, the difference right now is blatantly obvious, even someone who has never looked at that kind of chart before could probably guess the point at which I fell asleep. LOL But hopefully your levels while on the CPAP will be as close to normal as possible.