Sudden increase in AHI

[LarryRapp]

THANK YOU!  I just tried to see if there were any leaks in the hose (by submerging the thing in water plugging one end and blowing in it) and it was fine.  Then I tried loosening the mask and turning it on and off.  The mask was smiley!  Wow!  I guess maybe the mask was too tight.  Well, I'll try that tonight.

This is on top of another problem - I can't sleep nights.  This started about a month ago.  Sometimes I can get some sleep but mpstly I just drag my butt through the day.  Maybe if I fix the leak I'll also fix the sleep problem.  Boy, getting old is not much fun.

[mesenteria]

"Is your IPAP really 30?"

the resmed asv can display above 30 max ipap (I've had mine up to 34) to enable max epap and max pressure support to be set as high as possible for each of those 2 settings individually, but it will not produce more than 25 cmw.

Thanks, sheepless.  I'll try to keep that in my filing system for future reference.

[mesenteria]

THANK YOU!  I just tried to see if there were any leaks in the hose (by submerging the thing in water plugging one end and blowing in it) and it was fine.  Then I tried loosening the mask and turning it on and off.  The mask was smiley!  Wow!  I guess maybe the mask was too tight.  Well, I'll try that tonight.

This is on top of another problem - I can't sleep nights.  This started about a month ago.  Sometimes I can get some sleep but mpstly I just drag my butt through the day.  Maybe if I fix the leak I'll also fix the sleep problem.  Boy, getting old is not much fun.

We don't assume much around here, and we won't presume much about you.  But, could your 'sleep hygiene' bear some tweaking?  Do you spend hours at your computer screen, or surfing and swiping right/left on a tablet until just before bedtime?  That will make your mind active, and the blue light interferes with the production of sleep hormones.

Have you tried a 10 mg tablet of melatonin two or three times a week?  Take one just before turning-in, and it might help.

Daily exercise is very beneficial and conducive to good sleep.  It needn't be more than 20-30 minutes of walking, ideally some of it quite brisk.

Avoid all sources of caffeine after 3:00 in the afternoon.

If you have been napping, maybe don't.  It won't be fun, but if you can continue to drag yourself through the afternoon and go to bed at the usual time, you might do much better at nighttime sleeping.

Don't fall asleep in your easy chair while watching TV in the evening...if that's something that is typical, or becoming so.

Do you have to rise to void during the night?  Sleep apnea can exacerbate this annoyance, but so can drinking fluids of any kind after supper.  Going to bed slightly dehydrated might help, although I can't say I fully recommend it to anyone.  Health experts say to drink plenty of fluids, as my aged father does, but he has to get up three times each night.  Sorry...not for me at all.  I wanna sleep, thanks very much, and that's exactly what I do. 

You may already have a firm grasp of all this...sorry if I'm preaching.  But something has gone off the rails for you about maintaining equilibrium.  Maybe it's just the stress of the circumstances you find yourself in, and dealing with the aging process.

[LarryRapp]

Well, there is a lot to answer!

First of all, I changed the mask I use to a ResMed F20.  I think it helped but unfortunately I forgot to put the memory card in the machine last night so I can't use Oscar.  However, I didn't get frowny face so it may have helped.

Second of all. I use 5mg Zaleplon (prescribed by my sleep doc) which sometimes works and mostly doesn't.  I can try Melatonin - I tried it years ago and it didn't work then, maybe it will now.

Exercise - I just got back from a colonoscopy and an endoscopy.  Unfortunately I have bleeding ulcers and they hurt.  I was doing exercises but I've stopped because of the pain.  They also found a "mass" in my stomach - we're waiting to find out what it is.  Frankly, I'm more than a bit worried about it.

Most of your suggestions are good and I do them when I can.  Another of my problems is that I have severe arethritis in both shoulders so sometimes I can't lie on my side

Oh well...

[mesenteria]

Thanks for all that, Larry.  I understand a lot better now, and we can agree that your circumstances are quite a ways from ideal.  The mass, all by itself, is going to weigh on you rather heavily.  It is affecting your sleep at least some. If you can't find a comfortable sleeping position,...that's a head-shaker.  I also find, these days, after many years of long distance running, that my hips are getting sore lying on my side.  And, that's my preferred position now that stomach sleeping is ruled out.

I think our minds and systems 'habituate' to changes and stressors, and that includes many medications or supplements.  I have read that one should not rely on any one sleep aid, certainly not for several nights running.  So, I try to use melatonin only maybe once every two weeks.  Between those occasions, I average about 6 hours even, some nights less, some closer to 7 hours.  It's not ideal, but I seem to be able to exist with that low dose of sleep.

If you are a generally poor sleeper, the goal should be to experience the best sleep for as long as possible.  So, comfort is big, not being aroused by ill-fitting gear, or not being mistreated by incorrect pressures...we need to stave off every arousal possible so that we can remain in the 'lower' stages of sleep, especially REM sleep.

I hope you get more tips here from others interested in the resolution of your problems.  They may come.

[LarryRapp]

Mesenteria,

Thanks for all that.  Thing is, I used to be a very good sleeper.  There is another possibility - lewybodies.  That is a horrible mental degenerative disease.  I am hoping against hope that that disease is not my problem.  

I'm also going to try another mask - ResMed F30.  Who knows?  As I said earlier I think an F20 helped - I should probably know tomorrow.  I have a full beard whick I think makes things more difficult.  I think I should probably ask Bonjour what he is using because as I recall he has a beard and uses a full face mask.

[Gideon]

Larry, my backup mask is the Amara View, My primary is the P10 Pillows and the tongue trick.
The activa nasal was my main mask for a lot of years. It allows you to move around a lot.

[sheepless]

I have a full beard. none of the half dozen or so full and nasal masks they tried on me the night of my titration sealed until we tried the resmed airfit p10 nasal pillow mask. it's the only mask I've used in 3 years. there's a lot to like about it but I am prone to lip leaks (chipmunk cheeks, leading to either aerophagia or air escaping barely parted lips). I can't seem to keep closed whatever shunts exhale to the nose and away from the mouth. I still try but can't manage the tongue suck trick, I assume there's just not enough room in my mouth to pull it off.

so I wear a soft cervical collar which seems to help keep exhale directed to my nose as well as helping to keep my lips closed. I'm still above the leak red line a bit most nights but almost always below 5% of the time and that's much better than without the collar. my leaks aren't so much pressure related as a function of deeper more physically relaxed sleep.

I hope you find a mask that works with your beard. I'd like to have an alternative too.

[LarryRapp]

Bonjour,

Thank you!  I recall your recommending the Amara View several months ago.  I think I should probably  also try a P10 although as I recall, I had problems getting a good seal.  I don't recall the mouth trick but I think I tried it and couldn't get it to work.

Sheepless,

Thanks for the recs - looks like I should check out a P10 but as I recall I had trouble with the pillows.


Thanks, both of you for the excellent recommendations!

[Gideon]

Another thing you can do is to intentionally cause a "mouth leak", likly you will need to stop and restart the machine to clear it but that is ok. That will help you to understand the mechanics of it. Other "exercises" would include talking while under pressure and even sipping on a drink.