6 months in, not feeling major benefits. Any advice? :(

[vegasboy]

Hello!

First-time poster with admiration for the knowledge and experience of this forum's users.

I've been using the Airsense 11 for 6 months with a little trial and error, no help from my DME who was next-to-useless.

I use a Philips Dreamwear Nasal mask, which appears to have a high leak rate even though the fit seems fine to me and it's in good condition. I sleep with a mouthgard, but no taping (happy to consider this if it looks like I need it).

My AHI is rarely under 5 unfortunately. This chart from last night is typical for me. Any and all feedback happily received - thank you! 

[OpalRose]

Did you have an overnight sleep study?  Did it show Central Sleep Apnea?  If you have a copy of that study, post it here.

The most noticeable thing is your high leak rate.  If you're sure that the mask fits properly, then you may be mouth breathing even while using the mouth guard.  This will need corrected, because if you are constantly over the high leak threshold, the machines algorithm may not be able to detect apneas correctly.

Many folk here use tape, so that is an option.

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

[vegasboy]

Thank you OpalRose!

I have just bought mouth tape and I'll try it out and see if it makes a difference.

Please see below my in-lab study results. I don't see any line item for Central / Clear Airway, but I may be misreading it.

My at-home tests don't seem to have a line item for that either.
Very much appreciate your input.

[OpalRose]

I didn't see any mention of CA's on your study either. Since you've been on therapy for 6 months, have the CA's stayed about the same, more or less?

It did say you were titrated to a pressure of 10 with control of apneas.

Have you used the same pressure for the last 6 months?

[vegasboy]

Yes, the CAs have stayed more or less the same.

The 10 was causing aerophagia (I suspected it was the pressure) - so went a couple of months with 8min - 20max, but have reverted to 10 recently to see if that does make a difference.

Here are my pressure statistics summary in case that’s helpful.

Would you suggest trying a higher pressure if my 95% pressure has been ~12 for the past 6 months, should my min pressure be that high?

Thanks ?

[OpalRose]

If you're still experiencing Aerophagia, try using Cpap mode at 8cm with EPR 1 for a couple days to see how that feels. If no Aerophagia, then move pressure up to 8.4cm for a few days.

Keep inching up pressure until you find where you aren't having Aerophagia.
Keep notes.

[vegasboy]

Thank you OpalRose!

I tried the CPAP mode at 8cm with EPR 1, but wasn't able to fall asleep, it didn't feel like enough.
I changed it to 10 with EPR 1 and my result was pretty good (charts attached). It's interesting, because anytime I had tried EPR previously I had ended up with a huge AHI (30+).


I wore a chinstrap, cervical collar and mouth tape (throwing everything at the wall) and my leak redline is only 1.7% which I guess means I was leaking through my mouth.

No aerophagia.

I'm curious, why has CPAP worked here where APAP wasn't? Is it because the machine is changing pressure too frequently and it's triggering apneas in me? Or the leaks were throwing off the APAP? Thank you so much for your help. 

[OpalRose]

Some folk are just sensitive to pressure swings, so you may be one that does better using Cpap mode.

Keep notes as to what works best for you.

[vegasboy]

Thanks so much for your help, really appreciated.
I will keep notes.