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Still Having Trouble with Sleeping
#1
Still Having Trouble with Sleeping
HI, All,

Not sure whether to start a new post or what so for now I'm replying to my original thread. (OK decided now to do a new one.)

I'm still pretty miserable at night. I did switch recently to a nasal mask, first time I've tried that. Kinda worried about mouth breathing. Anyway, it's the Dreamwear under-the-nose mask. Pretty minimalistic, which I definitely do like. 

i feel like it's the same thing always waking me up on and off all night long--I just feel like I can't get a good, deep breath. I'm really struggling. Before I'm actually asleep and while still reading, I sometimes just need a big ol' yawn. So I have to temporarily divert the air away from my nose so I can get the really deep yawn that I crave. 

The other thing, just like with my previous mask, f30i, is that sometimes i think the madk is suctioning over my nose holes and blocking my breathing! 

Once the breathing issue wakes me up a certain number of times, I just want to SLEEP and so I take it off. i'm pretty tired in the mornings 

This mask just came Friday and I had the best results by far with it that night, so that is the data I am showing. That and last night's. I made it through 3 hours last night! Wooooohooooo!!!  

I'm not used to looking at this Oscar info. Anyone see anything "off" or have any suggestions for improving my sleep? 

Thanks for any help.  Trying to hang in there!!  --Cat
APAP ResMed 10, pressure currently at 8-12 at one of your suggestions. 


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#2
RE: Still Having Trouble with Sleeping
I'm sorry to hear about your continued struggles with sleep despite trying the Dreamwear Under Nasal Mask. Make sure the mask fits to avoid breathing problems and discomfort. If you experience leaks or feel the need to take a deep breath, consider adjusting your mask's fit and pressure settings. I hope you'll be fine
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#3
RE: Still Having Trouble with Sleeping
If you're worried about mouth breathing, you could try a soft-cervical collar or a chinstrap (knightsbridge) to keep your mouth shut, or something less intense like tape.

Yes, some masks will 'flap' over your nostrils and partially or entirely block the passage of air. Poor product design in those cases. Pillows and some FFMs avoid this.

Your events are still quite elevated, despite being on therapy, with a pretty even split between centrals and obstructives. There are a few periods throughout the night that look like positional apnea, where you might be rolling into a specific position, such as on your back or tucking your chin, which is causing a cluster of events. The centrals may be due to using PAP, which is common for many patients at the start of treatment, and the case would be strengthened if you did not have centrals on your sleep study.

You could try slowly bringing EPR down. It's not always clear when patients describe their breathing complaints, but I'm under the impression that these feelings you're describing are due to too much ventilation, as opposed to not enough, as evidenced by the CAs punctuated throughout your usage.
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#4
RE: Still Having Trouble with Sleeping
On one of the 2 nights (Jan 27th) You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.


Because the other night you did not have positional apnea this may only be a one off but you should keep looking for it in the charts.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Still Having Trouble with Sleeping
Hi and thank you. I did not have centrals in my sleep study. I feel it's more that I can't get *enough* air with any of the masks on, rather than the other way around.
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#6
RE: Still Having Trouble with Sleeping
I read recently that feeling like you aren't getting enough air indicates too low of pressure. With EPR 3 your EPAP starts at 5, which is pretty low, so you might want to increase your minimum pressure and see if it helps.
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#7
RE: Still Having Trouble with Sleeping
One thing to consider is the way EPR works. It is a differential between inspiration pressure and expiration pressure. Our bodies determine that we are ventilating properly when two conditions are met: 1. there is no CO2 in the bloodstream, and 2. there is air in the lungs. If you replace oxygen with an inert gas, both conditions will remain to be met and you may have no idea you are in trouble until you asphyxiate. I bring this up because of condition number 2 and EPR's effect of decreasing pressure on exhale. It may be that you are sensitive to the feeling that your lungs are being emptied too much by the pressure drop when you exhale and feel the need to fill up again with air. I know I find EPR very unnatural and I suspect that's part of why. When I woke up this morning I had to double check to see that the machine was still on because the constant pressure just felt like breathing regular air. EPR could be altering that sensation of air in, air out and making you feel like you need to take deeper breaths.

$.02
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
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#8
RE: Still Having Trouble with Sleeping
You are bumping up against your high-pressure setting of 12. I suggest that you raise it to 14 and see if you feel better.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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