OSCAR data suggestions

[thistle]

Am I doing something wrong or did I upset someone? I don't seem to be getting any input any longer.

I've been trying to get used to the P30i but my right nostril is really raw and I think I'll have to take a break for a few days to toughen it up. I keep hearing the air come out the top of the head vent and wonder if it's getting constricted somewhere else and causing it to push more out there. My AHI has been a bit higher lately but I'm going to wait until I can get comfortable with the pillows to make any judgement.

[PurpleOx]

Hi thistle,

I'm in a similar boat. People don't reply to my thread and I'm not sure if it's something I said, or if my treatment is deemed "good"...

Anyway. For your nose, try using Lansinoh. The lanolin is safe for silicone. I use it during the day because it tends to cause leaks if even a little is used with a mask.

Are you looking for feedback because using the machine is still uncomfortable, you're still feeling symptoms, or you want to maximize your CPAP therapy?

In any case:

• CPAP Machine: AirSense 11, APAP mode. Have you considered "APAP for Her" mode? It adjusts for flow limits earlier and has a slower pressure decay rate.
  
• CPAP Mask: Can you summarize your masks (and tape usage, tape position too) and how they affected leaks? (Or at least summarize the good combos.)
  

If you're still tired after CPAP therapy... (Note that I also started CPAP therapy around the same time as you, right at the end of Feb)

• Take a hard look at your sleep hygiene. No electronics before bed, stop caffeine early in the day, reduce stress, we all know the spiel even if we don't follow it all. Be really honestly with yourself on how you can improve your sleep hygiene.
  
• Lost-cost light therapy: I use a daylight lamp on a timer to help me wake up in the morning. (I already had the lamp, the timer was $5.)
  
• Some people take months to feel better from CPAP. I might be one of those cases too. I had to talk to my doctor to treat my EDS separately. Since I have awesome CPAP compliance and I started off on the severe side of OSA, I got prescribed a medication to help stay awake.
  
• Have you talked with your sleep doc about the residual fatigue? There are other sleep disorders that can only be diagnosed or ruled out after OSA is treated.
  
• If you have other health issues, talk with your primary care doctor or specialists about them too.
  

[thistle]

Thanks for the reply.  I know no one here owes me anything.  Like you, if my numbers are considered 'good enough' and I just shouldn't worry about it I would like to hear that.  I just want to maximize my benefit.  I set a target of getting under 1 AHI and also feeling more rested.  I've been under 1 a few times so I know it's possible.  There are also days where I just don't feel more rested, but others I certainly do.  I don't feel like I'm able to read my OSCAR data well enough yet to make my own adjustments and that's mainly what I'm looking for feedback on.

For tape I'm using 3M transpore with a strip horizontally across my mouth.  I'm waking up with it fully sealed and it's not uncomfortable at all.  It has certainly helped.  

My first mask in an N20.  My concern with it is that I wake up to adjust it during the night when it starts leaking around the sides, usually when I'm sleeping on my side.  My OAs seem pretty good with it, but I get woken up quite frequently by the leaks, both noise and feeling the air.  I tried a hanger, tightening the mask, loosening it, and didn't really have much progress.  I tried it again last night with my nostrils needing a break from the pillows and it was good again but same issues waking up.

My new mask is a P30i.  They fitted me for the medium pillows but I think I need the large and I used large the last night I used it.  But I got some pretty good sores on my nostrils and I'm letting them heal before I try it again.  Hopefully a two day break will be enough.  I wake up concerned with the pillows because I can hear the air coming out of the vent on the top of my head quite loudly.  I can reset the pillows and get it to quiet down most of the time but it's still a concern.  I was wondering if the pillows were getting pinched and not working effectively or something.  It feels like they are rocked up too far when the issue starts, if that makes sense.  

I have a wake up light that's tied to the alarm on my phone and I've used it for a couple years.  I like it.  My sleep hygiene is pretty poor and I need to work on it, primarily a regular sleep schedule, no stimulants like caffeine in the evening, more regular cardio, etc.

[SevereApnea]

Hi there thistle!

As a group here we are a pretty robust and hardy bunch: it will be difficult to offend anyone!

Generally if I don't think I can help or add anything I choose not to "clutter the airways" as it were.

Some folk are more chatty which is also good!

Mask selection and preferences are personal, hence the plethora of designs on the market.


My experience with the P30i: this is the best one for me. Less leaks than the others I have tried. More comfortable. Lower pressures needed. It's just trial and error really.

The Medium works for me but could be a bit larger.
The Large works well too, but maybe I am kind of in-between.  I can also get the Small to work.

I tend to rotate/swap them around if I feel any pressure building in the nostrils.

Elsewhere in the forum suggestions have been made to rotate between P30i and other style masks if you need time to recover or adjust.

My P30i top vent blows air towards to the top of the bed or headboard: the whooshing noise can irritate me (I have a low threshold for that sort of stuff!) I just shuffle down the bed a bit so it does not blow straight on the headboard. Or place a Memory foam roll or smaller pillow between the headboard and my main pillow. Totally silent after that. Sometimes the main pillow bunches up too, and the vent blows into the pillow, just need to reposition and carry on.

Even with full horizontal mouth taping, I notice there can still be moderate leaks. Assumption: side sleeping and some dislodgement of the P30i. As long as my leaks are around 6 - 12 or 15'ish I am happy, knowing it does not materially effect treatment. Excessive leaks = dry mouth. That needs to be addressed.

[thistle]

I tend to rotate/swap them around if I feel any pressure building in the nostrils.

Thanks a lot!  Is pressure in the nostrils a sign that you need to go larger or smaller on the pillows?  Sometimes they feel like they're being inflated, if that makes sense, and it creates pressure.  Obviously you're putting presssure into them but it does seem a bit uncomfortable, at least being new.