[CPAP] Self treating: Advice for tuning after first night OSCAR data?

[citrus1]

Bit of a setback today. AHI 3.98, and I don't feel as "fresh" waking up today. Slight headache when waking up. 

Pressure 6.4 - 9. No EPR, no ramp.

Had a good initial stretch, then was woken up by my dog. Fell back asleep OK after that, but kept waking up throughout the night. Not sure why.

In the chart, it looks like I could use more pressure, but I don't think I can tolerate it. Maybe raising the min pressure over time would be a better strategy?

I believe the clusters of leaks are from me moving around (back sleeper to side sleeper). 

Finally got my titration study booked for next month!

[SarcasticDave94]

You can try adding pressure in whichever way you can tolerate. Hypopnea present indicates more is needed. It may well make mask leaks worse though.

[citrus1]

You were right about leaks! Moved pressure min to 7.4 (kept max at 9), and sprang lots of large leaks. 

I’m going to experiment with different pillows and see if that helps, as the leaks seem to spring up when I move from back to side. 

This experience reminds me a bit of the Whack a Mole game

[citrus1]

Have not been able to improve the large leaks, and still getting a good number of CA and hypopneas. 

I am going to try switching to a full face mask (Phillips Dreamwear) because I believe a lot of my leaks are mouth leaks (they wake me up), even with taping. That should also help my issues with dry mouth.

Will take a short break from CPAP until the new mask comes. I think I can get by with a collar and mouth taping alone for a few days.

[citrus1]

Latest update: it’s not going well. I switched to a dreamwear full face mask to resolve the mouth pressure leaks and dry mouth from nasal pillows. Absolutely LOVE the dream wear mask, the cushion fits my face shape wonderfully and it fixes my dry mouth problems, BUT I spring so many leaks because of jaw drop while sleeping.

I have tried wearing my cervical collar and mouth taping to address the jaw drop, but neither fully fixes the issue. I ordered a smaller size frame (the dreamwear fit kit came with just the standard medium frame) to see if that would help. I also ordered cover roll mouth tape to replace my 3M paper tape.

I just feel like whenever I address one issue, another one comes up. I may need to wait until the dang titration study next month to really figure this out. Very frustrating but I have learned a lot!

[Phaleronic]

Hi citrus1,

At this point in your therapy I'd suggest trying constant pressure mode, set min/max to 11cm and EPR on 1 fulltime tonight for 30 to 40 minutes please and see how it feels, it may cause less leakage because you're not having pressure swings.

[citrus1]

Thank you very much for your advice! 

I will try constant 11 and EPR 1, and see how it goes.

[Phaleronic]

You're welcome, I usually suggest also trying it for 30 to 40 minutes before bed to see how the new pressure settings feel

[citrus1]

Thanks again - the constant pressure did help to reduce leaks. However, when I drifted off to sleep, my jaw still dropped enough to spring leaks on either side of the muscle at the front of my chin (this is with cervical collar and mouth taping). 

I think my facial anatomy makes it really hard to avoid leaks. I am shopping around for more restrictive collars (looking at the trtl Pillow Plus travel pillow, as it seems to immobilize the head/neck). I’m also considering trying K-tape vertically from lips to just under the chin to emulate a light chin strap. 

I will report back with my findings.

[Bkflg]

Hey, thanks for sharing your journey. 

My experience has been similar - tried perhaps 10 masks, multiple types of taping, chin strap, etc. and I still can’t control mouth leaks.

I’m currently using the Bleep Eclipse and it’s the best mask solution so far, but I can’t fully keep my mouth shut, causing leaks and severe dry mouth.

I’m also looking at the Knightsbridge chin strap, but multiple chin straps already haven’t worked, so was thinking of testing a cervical collar again first. I was also looking at the TRTL travel pillow as a I couldn’t find a standard cervical collar that was comfortable enough to sleep in.

Did you end up trying the TRTL?