[CPAP] New to CPAP and figuring out how to begin while waiting for consult/tests

[Pawther]

Check out what happens to your leak rate at the moment of that event.  I think you may find the source of your problem.  At some point between the CA event and 00:00 your leak rate went right to the edge of a large leak.  I'm looking at 4 minutes of large leak before your arousal and gasping.

Ahh gotcha, so basically it may have just fallen off my nose or face a bit and not pushed air in to me. I do like how minimal the nasal pillows are, but sometimes I think the full nose/mouth cover might be the move for me because I seem to have to adjust it a lot since I'm a stomach sleeper and my face ends up pushing it a bit off center here and there, so maybe that's what happened.

[Gideon]

Since you are having a good amount of movement, try the ResMed Mirage Activa Nasal Mask. It is old school big but has bellows that allow for a lot of movement. I slept on my side with 19cmw fixed a lot with this mask. Keep the mask over the edge of the pillow for best results. I do use the P10 pillow as my daily mask.

[Pawther]

Hey just wanted to share these OSCAR captures since I have a question.

A couple times in the last few nights, if I either woke up with a gasp or jolt into the air or some uncomfortable sensation, I would wait just a little and restart the machine to see it in the data quickly by looking in front of the stop point.

What I noticed is a commonality of the pressure going upward each time this happened, perhaps based on the flow limitation, especially in the first two photos?

What could these flow limitations mean as far as my breathing or reason for awakening? I'm happy I had a score of 0 one of these three nights in this data, but I am definitely still waking up in weird ways and it seems this data could point to something as I try to eliminate that.

[Gideon]

Flow Limits are driving your pressure up. Boost your PS to 4

[Pawther]

Hey there, good news that I have not had a wake-up-gasping episode since I raised my PS to 4, it's only been a few days but I will continue to see how it goes.

I wanted to attach a new OSCAR example and ask a question since I am curious what the data means. 

What is happening on a technical level between 2:20 and 2:40 in this graph? I know the flow limits can drive the pressure up, but I am wondering what the flow limits mean is happening with my breathing during that time?

I am also curious if my leak rates are considered normal. I do notice the leak rates to be constantly jumping up throughout my daily overviews. I don't notice it leaking out of my nose that much, I do feel some air if I put my hand next to the mask when I am wearing it.

[SarcasticDave94]

I could be wrong, but it looks like the area around 2:30 had some larger leaks than compared to the time before and after. This caused pressure to go up to make up for the loss.

It does sound like a change to PS of 4 was a good move for you.

As for the mask leaking as you describe, there are vents on the front to allow you to exhale and for the excess air from the machine that you don't breathe in to vent out as well. The air has to escape somewhere. Otherwise, you'd breathe through the mask and your nose and exhale out your mouth, which may be happening at times anyway.

[jaswilliams]

Pawther, your pressure went up due to the flow limitations a flow limitation is a pre cursor for an apnea Resmed treat these with more pressure so the pressure was raised. Then over time the pressure turned to its original levels

[Pawther]

Hey all. The experts here have been helpful to me and I wanted to share an update and ask for insight.

To summarize or refresh - I have gasping episodes at night and doctor told me to try a CPAP for a while (that I had passed down to me) to see if the data shows any issues or if it helps me sleep, (before investing in an overnight sleep lab which he feared would be expensive and unproductive based on my general health and a past sleep test years ago, and I don't necessarily disagree.)

Here is what I can say after over a month.

- I do sleep better with a CPAP and my sleep schedule has improved
- I still have gasping episodes but they seem less often
- When I do wake up gasping, it seems to usually happen in the first hour of sleep
- Some days I do see a big pressure swing or two in my sleep or some events, but consistent normal/great AHI from what I have read

What I want to ask is specifically about last night - I had a bad gasping/catch-my-breath episode where I basically jumped up in my sleep having trouble breathing and then took my mask off (hence the flat line/leak rate that follows the spikes) probably the worst physically feeling event since I started the CPAP. It made me sad because I was hoping the CPAP would prevent this.

I turned off the machine and then checked the data (attached close up). Whenever I wake up gasping, I often see a graph that looks close to this with the more abrupt or inconsistent flow rate spikes for between 5-15 seconds before the point that I wake up.

Perhaps this looks overall normal to some of you, I don't know, but I really am trying to eliminate them from my life. If anyone can let me know what might be happening with my breathing during these changes in flow limitation that would be helpful, or if I should be changing any settings to keep trying to dial it in.

SO yeah, maybe all of this is not apnea related, I am not sure... but the data at least tells me something is happening in breathing to correlate with when I am waking up.

[Sleeprider]

There is no doubt that something happens, but it's impossible to tell what it is. You seem to go from restful sleep with normal breathing, to a breath that abruptly ends and is followed by another, then a huge inhale. Whether it is a throat spasm or some other event, we probably won't learn from the CPAP data. I'm glad to hear things are working better for you.