ASV with Oxygen Drops, leaks and aerophagia

[redking2436]

First of all thanks again for the help from Jay51 and Sleeprider helping to adjust my machine settings so I could sleep with the darn thing, 

However things still arn't improving symptoms wise, I've had maybe a few good day's in the 7 months since properly focusing on getting the sleep apnea treated, unfortunately in the 10 months I've had the machine i haven't once had an opportunity to speak to a professional with only 3 monthly check-ins with a nurse who seems to just want the phone call over and not do anything such as try different masks etc.

So far I've bought the large version of the F20 mask as after using the guide realised when my mouth opens when asleep it caused the mask to leak, wasn't too expensive as I only bought the mask part.
I tried a chin strap but can only breathe through one nostril reliably, so losing mouth breathing hasn't gone well.

I wake up some days feeling like a balloon, and it can be quite painful, I've dropped my settings to Epap 5-7.2 and PS 3-8 and have been constantly trying new settings and then trying for a week to see if things improve.

I purchased a wellue sleep ring as it seems very highly recommended on this forum and i wanted to see if oxygen was having any impact, my o2 stats


A good day when I felt amazing was Thursday the 18th yet have felt fatigued and beset by mind fog on the days since, it in some ways made it worse as it let me remember what normal was like.

O2 stats seem to sit around 96 which i believe is fine, but there are multiple drops going down to the high 80's which i don't think is right. I have a bad habit where I will feel like I'm suffocating upon waking up and take the mask off only to then fall asleep, which is why there are gaps where the ring is still reading but no CPAP data.

Attached are the last 3 days inc o2 data,

Any advice on whether the o2 drops are red herrings and whether I can do anything about the aerophagia would be much appreciated.

[Jay51]

You are welcome, redking2436.  I think the place where the SPO2 drops so low is when you take off the mask and breathe room air.  

A few things on your charts.  Good idea reducing pressure some to at least be able to get to sleep and stay asleep.  As you get acclimated to this, you may be able to increase your pressures some in the future also.  

"I have a bad habit where I will feel like I'm suffocating upon waking up and take the mask off only to then fall asleep, which is why there are gaps where the ring is still reading but no CPAP data."   Many members here have described this same feeling, and it usually occurs when pressure is too low.  You are kind of in a catch 22 though, in that you still need the lower pressures to get and stay asleep, but they seem to wake you up at times with feelings of suffocating.  

Your heart rate charts shows a lot of spikes during the night, too.  Normal is usually more flat, straight across with very little, or small spikes every once in awhile.  Just something to keep an eye on.  

Kind of another catch 22 with the aerophagia.  Pressure needs to be high enough to be therapeutic and keep you from feeling like you are suffocating, but not too high as to cause a lot of aerophagia.  

I guess the only thing that I can think of is trying both increasing pressures slightly and then decreasing pressures slightly and taking note of what that does to you.   Not bad therapy right now, even with some aerophagia and a few instances of taking off the mask.  Probably a lot better than nothing.  But I applaud you for trying to optimize it more for both better therapy and comfort.  

If anyone else has any suggestions, please post also. 

[SarcasticDave94]

If you feel you didn't have enough air as your base, as in upon exhaling, try increasing EPAP slightly. You're seemingly at 5-7.2. Maybe just push the EPAP Min to 6, leaving EPAP Max as is. Try it and report back.

EPAP Max might need to go up as well, but consider EPAP Min first.

Next, on PS range, your 3-8 could go up or down as you see fit. Lowest allowed PS range will be 0-5. Your choice on mixing or matching this. Not sure how it'll affect therapy though.

Worst case if it goes bad after the edit, change it back ASAP.