Adapting to sleep with cpup

[ivashamagnus]

Hello!
I create this topic for comments on the course of my adaptation to CPUP.

I have difficulty sleeping when I have a mask for breathing under pressure. I usually sleep 1-2-3 hours in a mask for 2 weeks. Recently, I slept once 5 and 8 hours in a mask! But difficulties remain.

Task: will learn to sleep with the CPUP apparatus and feel a resting day. Now this cannot be done well.



About me.
I am a man, 34 years old. I live in the R.F. Weight 271 pounds. Growth 6.1 foot.
Now I am taking a course of antidepressants (fluoxetine) and from 12/23/2023 My doctor prescribed me a drug to improve sleep (GydrOXYzin).



Cardiorespirator monitoring
The total sleep time is 05:10:10. Suitable for breathing analysis 04:21:20.
Apneo/hypopnoe: time = 01: 08: 44. Number = 153. Index 35/hour.
     Apnea: Time = 00: 46: 56. Number = 117. Index 27/hour.
         Obstructive: time = 00: 23: 57. Number33. The index is 100%.
         Central: 0. 0%.
     Hypopnoe: time 00:21:48. Number = 36. Index 8/hour.
Hypopnoe = 8/hour. Quantity = 36. Maximum duration = 00:02:31. General = 01: 08: 44.
Apnoe = 27/hour. Number 117. Maximum duration = 00:02:00. General = 00: 46: 56
Obstructive = 100%. Central = 0%. Duration General = 00: 23: 57

Susperation index 36/hour. Average Desecration = 5.2%. The average desalation level is 92.6%. Saturation <90% 00:14:02. Saturation <89% 00:03:43.
sleep (an example of apnea):
   




Equipment.
Car CPUP Reset Ibreeze 20a Pro
Mask is full front bmc-Fm1a



Nose.
My nose was broken 5 years ago, the nasal partition remained a curve and usually one nostril breathes.
A cyst is detected on the mucous gland in the nasal passage.
The curvature of the nasal septum and the bone growth on it were revealed.
They can operate on me for 2 years, but I am looking for ways faster. Operation in a private clinic costs more than $ 1000, it is expensive for me.
Computed tomography of the nose (picture):
   



Throat.
The tonsils are enlarged, long -term treatment is required so far.
At the base of the throat, a significant size of the snot or discharge from the nose that interferes with breathing can accumulate (perhaps this is due to inflammation of the sinuses).



Pillow.
I have been sleeping for many years on folded towels together.
Such a pillow remains the most convenient for me. The use of classic, large feathers or cheap orthopedic pillows was not convenient for me. But I am in search of a more favorable position for the throat that will give the throat to be in open state.




This is how my dream looks in the Oscar:
**********



This is what my sleep time looks like recently:
**************



I hope that this topic will help someone in the future learn to sleep with CPUP, support a person in his not simple undertakings.
I read the forum and realized that many people novice CPUP therapy reveal problems related to sleeping in a mask under pressure. But thanks to the support of people from this forum, these difficulties on the way to high -quality sleep, well -being to clear creating during the day, overcame these difficulties. This inspires and gives hope for success in adaptation to CPUP as I gave me after reading the topics on the forum. Thank you!

[ivashamagnus]

Equipment.
Car CPUP Reset Ibreeze 20a Pro
Mask is full front bmc-Fm1a
   


Pillow
3,33 inch
   

[ivashamagnus]

Oscar schedule of two days of sleep:
           

---

Schedule of another day:
   

[ivashamagnus]

What kind of pressure should I aim for? Am I experiencing flow restrictions and is the shape of the breathing schedule correct? What can you recommend in general?
           

setting cpup:
ramp 5
ipr 1
pMax ~13-14
pMin 7
humidifier 5

[ivashamagnus]

Sleep duration and sleep retirement time
   

[Sleeprider]

Your CPAP results strongly point to a possible "positional apnea" issue https://www.apneaboard.com/wiki/index.ph...onal_Apnea We can identify this by the fact your flow limits and obstructive apnea events are clustered from time to time, where we see the CPAP pressure rise, and the FL and OA limits are close together. Be sure to evaluate your sleeping position and eliminate excess or firm pillows, inclined sleeping position, and consider the possible use of a soft cervical collar to prevent chin-tucking. You appear to have a ramp time set with lower pressure. Your breathing volume is very high, and your ramp pressure is not providing your needs. Consider turning ramp off or increasing the minimum pressure. The use of expiration pressure relief can help reduce flow limits because pressure increases during inspiration which supports respiratory effort with increasing pressure. You should consider using EPR and increasing minimum pressure to compensate for the loss of pressure during expiration. Oscar does not reliably report pressure on the iBreeze, so let me know your actual settings and I can make more specific suggestions.

[ivashamagnus]

P Max 14.0
P Min 7.0
iPR 1
P RAMP 5.0

Thank you for the background information!

For now, I'm going to videotape me sleeping and compare my body position to the graph in OSCAR.

Had trouble sleeping and I made the most comfortable settings possible, only for me to start falling asleep with the mask on my face. In particular P RAMP 5.0 was installed because it seemed to me that with it there is less air in the stomach. 

Now I can gradually change the settings to a therapeutic level.

I'm still in search of the right neck collar. I realized the importance of this thing thanks to this forum and now I will not wait and will buy some collar and try it thanks to your advice.

[PeaceLoveAndPizza]

Regarding the soft cervical collar, be sure to measure to get the correct size.

[attachment=57606]

[ivashamagnus]

The image shows data from the last four nights of sleep.
Any tips on how to change the CPUP settings please?
Settings last night pMin 7, pMax 14,5, iPR 1, ramp 6. iPR all night. Ramp for 25 minutes if not shut off earlier automatically when I fall asleep.

24. Normal sleep with the mask, without additional devices. Normal feeling.

25. Sleeping with an additional roll under the pillow in the area of the curve of the back of the head. (experiment to improve airway patency). Deteriorated well-being.

26. Sleeping with a soft cervical collar. Poor feeling after sleeping. The collar was pressing from behind in the area of the back of the head.

27. Normal sleep without additional devices. Good feeling, normal.

I videotaped myself sleeping. The comments above about positional opnoea were confirmed by the fact that:
When I sleep on my back, flow restrictions appear on the graph and breathing gets worse.
When I sleep on my side, my breathing improves and flow restrictions are minimized.
I spend most of my sleep on my back.

I've noticed that I sleep a little better when I can secure my chin with a winter hat that has long ears that can be tied under my chin, I can buy a special elastic strap to support my chin.
But my mouth closes, the lips of my mouth close and I can only breathe through one nostril of my nose (I can't breathe fully through my nose, half of it doesn't breathe).
Does anyone use special means to open the mouth (lips of the mouth) to keep mouth breathing when the chin is pressed (fixed) from falling down? Are there such mouth expanders and what are they called?
Thanks!

   

[Sleeprider]

You can request a clinical setup manual from Apnea Board by sending an email to: apneaboard@gmail.com and put "Setup Manual" (without the quotes) in the subject line. Then, let us know in the body of your email the manual you need, Resvent iBreeze 20A Pro APAP