Abdulfakih - Therapy Thread

[Abdulfakih]

Abdulfakih, here are the best tips from our wiki on decreasing mask leaks: 

 Mask Primer

• Mask leak solutions                                                                                                                                                                                                                                                                                                                                                Hopefully you find something in these articles that works.  I have about 5 different masks.  There are ApneaBoard members who have tried more than even 5 to get the correct one for them.   Just saying hopefully you can optimize this mask to work for you, but if not, there are many, many, many more masks on the market with different styles.  
  

Hi Jay, thanks for the link.

I dont have leaks normally because i tighten the mask a lot, i get mostly leaks when i dont tighten it a lot, but then it becomes a bit unconfortable to use

[Abdulfakih]

Hey guys,

I haven’t used Cpap the last days cause I got kinda sick on the stomach but I’ll return to it today. However something happened a few days ago that scared me.

Basically, I was about to fall asleep, doing the inhale and exhale as usual, however for a second idk why but my breathing got out of synch, so I unconsciously was inhaling, but the machine was exhaling. For a few seconds I felt like I was suffocating. I was gasping for air and got scared. Anyways just wanted to say that, I’ll post some results tomorrow

[Abdulfakih]

Good morning guys.

A week has passed and I am still with the same cold. I havent used CPAP, and honestly so far i am doing ok, I even think i might be sleeping better some nights. Some days are okay and some others are not so good, specially with acid reflux and the fact that i move a lot (and might be putting myself in a position where sleep apneas are a thing). It might be worth to mention that according to my doctors my apnea is positional, however I am sure sleep rider has more knowledge about this since he saw my DISE.

However last night I had a dream that I was in a pool and I was drowning and that made me wakeup instantly with my heart racing. It was 2am, and I just couldnt go back to sleep. I am unsure as to if I should go back to using cpap or staying like this. Please bare in mind that with and without cpap my apple watch records oxigen of 89-100 most nights (dont know how accurate that is)

[Sleeprider]

In spite of your difficulties, you breath better with the positive pressure than without, and your flow limits and respiration are quantitatively better with pressure support. I have pointed out the positional apnea issues and suggested some means to address that. I'm sure the positional apnea wiki has already been linked a half-dozen times so I won't do it again. When you're ready, I'd like to resume increasing pressure support towards 4.0. I never suspend my PAP therapy for a cold, covid or other illness. It is always better with the therapy.

[Abdulfakih]

In spite of your difficulties, you breath better with the positive pressure than without, and your flow limits and respiration are quantitatively better with pressure support. I have pointed out the positional apnea issues and suggested some means to address that.  I'm sure the positional apnea wiki has already been linked a half-dozen times so I won't do it again.  When you're ready, I'd like to resume increasing pressure support towards 4.0.  I never suspend my PAP therapy for a cold, covid or other illness. It is always better with the therapy.

Thank you sleep rider, I will resume my theraphy. I thought maybe the fact that I have my nose blocked was going to make it more difficult, hence why I stopped.

Also is there any setting that I can change to address this;
Last time I used my Cpap, my breathing got out of sync with the Cpap, and when I was inhaling I felt like the Cpap was choking me, I got scared and woke up super fast.

[Sleeprider]

The Resmed Aircurve and Airsense devices all work on spontaneous breathing to trigger IPAP or cycle to EPAP. They are controlled by and follow your own breathing initiatives. What you describe is impossible and the answer to what actually happened can likely be visualized by looking closely at the flow rate (respiration) and mask pressure (device pressure) charts and seeing what happened. Most cases of what you describe have resulted from anxiety resulting from a positional apnea, and can be resolved by calmly realizing you can breathe and reset yourself and the device with a purposeful breath. This will result in an arousal, but the feeling of being choked is due to an adrenaline rush or a panic reaction. Keep in mind that 10 cm-H2O is only 0.14 psi. That cannot stop your breathing or choke you. For perspective, the atmospheric pressure at sea level is 14.696 psi (760 mm Hg).

[Abdulfakih]

The Resmed Aircurve and Airsense devices all work on spontaneous breathing to trigger IPAP or cycle to EPAP. They are controlled by and follow your own breathing initiatives. What you describe is impossible and the answer to what actually happened can likely be visualized by looking closely at the flow rate (respiration) and mask pressure (device pressure) charts and seeing what happened. Most cases of what you describe have resulted from anxiety resulting from a positional apnea, and can be resolved by calmly realizing you can breathe and reset  yourself and the device with a purposeful breath.  This will result in an arousal, but the feeling of being choked is due to an adrenaline rush or a panic reaction.  Keep in mind that 10 cm-H2O is only 0.14 psi. That cannot stop your breathing or choke you.  For perspective, the atmospheric pressure at sea level is  14.696 psi (760 mm Hg).

I understand. It was weird because I wasnt fully asleep and I was kinda in the process of falling asleep.

Regarding last night results: https://imgur.com/a/72g1ZmW in paper all looks well. However, something that I have noticed is that whenever I use my CPAP, my apple watch sleep stages score (Deep sleep) is kinda low. The score was 39minutes of deep sleep. I have noticed this is higher when i dont use the CPAP most of the time.

Anyways I do feel tired today but it might be because I slept late last night, but I sent the data for my breathing pattern so we can investigate.

[Abdulfakih]

Good morning guys, this was my data for last night: https://imgur.com/a/muy45zk

Here is how I feel: I think the current settings are helping me with my respiratory events. However, I think there is a correlation between the correction of the events and the quality / my deep sleep. What I mean by this is that my deep sleep has become so poor, that I am always half awake...

I have been using my apple watch for nearly a year and although I know most people dont like them because they are not super accurate, i have seen a correlation between what the watch says and how I feel in the morning. The last couple of days that I have started using the CPAP again have been the worst in terms of deep sleep, averaging 20minutes total each night.

As you can expect I feel like crap. Yesterday the headache I had all day was so unberable that I just couldnt handle it and had to take a pill for it. Today I wokeup even more tired and hopeless .

[Jay51]

Good morning Abdulfakih.  Your OSCAR chart looks pretty good IMO.  The one little tiny cluster there could possibly have been a positional thing (and even the CA's related to that).  

It may just take more time getting low AHI and low flow limitations (0.03 95th percentile flow limitations) for things to improve for you.  It will take more total time sleeping as well.  

Lowering pillow height, side sleeping vs. back sleeping, and using a soft cervical collar might prevent the few OA's still left on your OSCAR charts (and maybe even the very few CA's if they are related to this).  

It might be worthwhile looking into other health concerns that may be causing your fatigue and low mood.  Pap therapy can help with sleeping, etc. but it can't cure everything.  

I am not sure what to suggest about your lack of deep sleep.  Maybe other members with suggestions as to how to increase deep sleep may want to post some ideas for you to try as well.

[Abdulfakih]

Good morning Abdulfakih.  Your OSCAR chart looks pretty good IMO.  The one little tiny cluster there could possibly have been a positional thing (and even the CA's related to that).  

It may just take more time getting low AHI and low flow limitations (0.03 95th percentile flow limitations) for things to improve for you.  It will take more total time sleeping as well.  

Lowering pillow height, side sleeping vs. back sleeping, and using a soft cervical collar might prevent the few OA's still left on your OSCAR charts (and maybe even the very few CA's if they are related to this).  

It might be worthwhile looking into other health concerns that may be causing your fatigue and low mood.  Pap therapy can help with sleeping, etc. but it can't cure everything.  

I am not sure what to suggest about your lack of deep sleep.  Maybe other members with suggestions as to how to increase deep sleep may want to post some ideas for you to try as well.

Hi Jay, 

Hope you are doing okay. Thanks for the response.

Yes the data does look good, however for some reason my sleep quality is now worse than it was before.

I changed my pillow to accomodate a lower one and I am trying to sleep on my side (however I do end up turning around when I am asleep). My main concern is that it seems to me that I am sleeping better without the cpap than with the cpap. I have to say today and yesterday I feel so awful that I cannot go to the gym and I am falling asleep at work .